title: Diagnosis and Management of Hepatitis C.
abstract: Hepatitis C virus (HCV) infection, a major cause of chronic liver disease and cirrhosis, is predominantly transmitted by exposure to blood or body fluids. The infection progresses to a chronic state in 80% of patients, whereas the virus clears completely after the acute infection in 20% of patients. Screening for HCV with an anti-HCV antibody test is recommended for all adults at high risk of infection, and one-time screening is recommended in adults born between 1945 and 1965. If the anti-HCV antibody test result is positive, current infection should be confirmed with a qualitative HCV RNA test. In patients with confirmed HCV infection, quantitative HCV RNA testing and testing for HCV genotype is recommended. An assessment of the degree of liver fibrosis with liver biopsy or noninvasive testing is necessary to determine the urgency of treatment. Treatment of patients with chronic HCV infection should be considered based on genotype, extent of fibrosis or cirrhosis, prior treatment, comorbidities, and potential adverse effects. The goal of therapy is to reduce all-cause mortality and liver-associated complications. Although interferon-based regimens have been the mainstay of treatment for HCV infection, the U.S. Food and Drug Administration recently approved two combination-pill interferon-free treatments (ledipasvir plus sofosbuvir, and ombitasvir/paritaprevir/ritonavir plus dasabuvir) for chronic HCV genotype 1.
authors.affiliation: Georgia Regents University, Augusta, GA, USA.
authors.forename: Thad
authors.initials: T
authors.lastname: Wilkins
authors.affiliation: Georgia Regents University, Augusta, GA, USA.
authors.forename: Mariam
authors.initials: M
authors.lastname: Akhtar
authors.affiliation: Georgia Regents University, Augusta, GA, USA.
authors.forename: Eunice
authors.initials: E
authors.lastname: Gititu
authors.affiliation: University of Maryland, Baltimore, MD, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Jalluri
authors.affiliation: University of Maryland, Baltimore, MD, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Ramirez
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D018450:Disease Progression; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006508:Hepatitis Antibodies; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D006801:Humans; D016898:Interferon-alpha; D008107:Liver Diseases / Q000145:classification / Q000821:virology; D008403:Mass Screening; D011092:Polyethylene Glycols; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin; D012307:Risk Factors; D012720:Severity of Illness Index; D019562:Viral Load; D017361:Viral Nonstructural Proteins / Q000037:antagonists & inhibitors
chemical_list: D000998:Antiviral Agents; D006508:Hepatitis Antibodies; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D017361:Viral Nonstructural Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a