Hepatitis C



Systemic viral infection involving the liver


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


  • 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


  • 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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