Hepatitis C
Basics
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
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Citation
Domino, Frank J., et al., editors. "Hepatitis C." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116267/all/Hepatitis_C.
Hepatitis C. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116267/all/Hepatitis_C. Accessed December 10, 2023.
Hepatitis C. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116267/all/Hepatitis_C
Hepatitis C [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 December 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116267/all/Hepatitis_C.
* Article titles in AMA citation format should be in sentence-case
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T1 - Hepatitis C
ID - 116267
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ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116267/all/Hepatitis_C
PB - Wolters Kluwer
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DB - Medicine Central
DP - Unbound Medicine
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