Management of chronic hepatitis C.
Hepatitis C virus (HCV) infection is transmitted primarily through percutaneous exposure to blood, and most infections are associated with injection drug use. Progression to chronic HCV occurs in 55% to 86% of infected people, and persistent infection is a major cause of cirrhosis, end stage liver disease, and hepatocellular carcinoma. The detection of HCV antibodies should be performed initially to screen at risk populations. In those who are seropositive, HCV viraemia should be assessed to determine if chronic HCV is present. The HCV genotype should also be determined, as this is the strongest predictor of response to available treatment. A liver biopsy is very often helpful because it can estimate degree of hepatic fibrosis, identify concurrent diseases that might contribute to hepatic injury, and aid in selection of patients for treatment. The decision to start antiviral therapy should take into account potential contraindications to therapy, patient motivation, severity of disease, age, and HCV genotype. Combination therapy with weekly subcutaneous pegylated interferon and daily oral ribavirin is the standard of care for treating patients with chronic HCV.
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Division of Infectious Diseases, Center for Clinical Epidemiology and Biostatistics, 502 Johnson Pavilion, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. vincent.lore@uphs.upenn.edu
Kostman
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D000998:Antiviral Agents / Q000627:therapeutic use*; D019411:Clinical Laboratory Techniques; D000075202:Contraindications; D004338:Drug Combinations; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology; D008487:Medical History Taking; D010353:Patient Education as Topic; D010808:Physical Examination; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012944:Social Support
D000998:Antiviral Agents; D004338:Drug Combinations