Description

Systemic viral infection involving the liver

Epidemiology

Geriatric Considerations
Patients >60 years may be less responsive to therapy, as they are more likely to have advanced fibrosis or cirrhosis at time of diagnosis (1).

Pregnancy Considerations

• Routine prenatal HCV testing
• For HCV-infected mothers, retest HCV RNA postpartum to evaluate for spontaneous clearance.

Pediatric Considerations

• Test children born to HCV-positive mothers (at 18 months of age).
• HCV-positive children have no restrictions for participation in regular childhood activities.
• Treatment starts ≥3 years of age (1),(2)

Incidence

• Incidence of acute Hepatitis C has more than doubled since 2013.
• IV drug use accounts for ~60–70% of new cases.

Prevalence

• HCV is the most common cause of chronic liver disease and transplantation in the United States.
• There are eight known genotypes (GT). GT 1 is the predominant form (75%) in U.S. GT predicts response to treatment (1).

Etiology and Pathophysiology

Single-stranded RNA virus of Flaviviridae family

Genetics

• No known predisposing genetic factors
• Transmission occurs primarily via parenteral exposure to infected blood.

Risk Factors

Exposure risks

• Chronic hemodialysis
• Blood/blood product transfusion or organ transplantation before July 1992
• Household or health care–related exposure
• Children born to HCV-positive mothers

General Prevention

• Do not share hygiene products.
• Use clean needles and dispose of needles properly. Do not share needles; cover cuts and sores.
• Practice safe sex (condoms).

Commonly Associated Conditions

• Hepatitis B coinfection, HIV coinfection
• Mixed cryoglobulinemia
• HCV-related renal disease—most commonly membranoproliferative glomerulonephritis