Incidence	- incidence in people with haemophilia and IVDUs is extremely high - role of sexual transmission is limited - low infection rate in male homosexuals, protitutes, attendees at STD clinics
Age
Sex
Geography	- prevalence of infection in healthy blood donors in 1988 was 0.02% in northern europe, 6% in Afriva, 19% in Egypt
Aetiology	- single-stranded RNA virus family Flaviviridae - vertical transmission can occur
Presentation	History - most are asymptomatic and present years later with chronic disease - 10% have a mild 'flu-like illness with jaundice - extrahepatic manifestations include arthritis, agranulocytosis, aplastic anaemia, diffuse neurological problems
Investigations	LFTs - mild rise in aminotransferases in the symptomatic 10%
Macro
Micro
Staging
Serum markers
Management	- interferon has been used successfully in some cases
Prognosis	- at least 50% go on to chronic liver disease - 20-30% develop cirrhosis within 5-30 years; of these 15% will develop hepatocellular carcinoma - course is adversely affected by alcohol consumption - more severe in male patients and those over 40 years on acquiring infection
Complications

Hepatobiliary medicine

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