Hepatitis C
BASICS
DESCRIPTION
Systemic viral infection involving the liver
EPIDEMIOLOGY
Geriatric Considerations
- Patients aged >60 years may be less responsive to therapy (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 (ideally at 2 to 6 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 continuously increased from 2010–2021, and declined for the first time in 2022. Incidence of acute hepatitis C has doubled since 2013.
- IV drug use accounts for ~60–70% of new cases.
Prevalence
- Most common blood-borne infection in the U.S.
ETIOLOGY AND PATHOPHYSIOLOGY
- Enveloped, single-stranded RNA virus
- Seven known genotypes (GT) with 86 subtypes.
- GT 1 is the predominant form in United States (75%) and worldwide (46%) (1).
Genetics
- No known predisposing genetic factors.
- Transmission occurs primarily via parenteral exposure to infected blood.
RISK FACTORS
Exposure risks
- IV drug use, HIV infection, 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, 34th ed., Wolters Kluwer, 2026. 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; 2026. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116267/all/Hepatitis_C. Accessed July 16, 2025.
Hepatitis C. (2026). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (34th 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; 2026. [cited 2025 July 16]. 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
TY - ELEC
T1 - Hepatitis C
ID - 116267
ED - Domino,Frank J,
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
ET - 34
DB - Medicine Central
DP - Unbound Medicine
ER -