Diagnosis and management of hepatitis C

Thad Wilkins, Mariam Akhtar, Eunice Gititu, Christine Jalluri, Jason Ramirez

Research output: Contribution to journalArticle

19 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)835-842
Number of pages8
JournalAmerican family physician
Volume91
Issue number12
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Family Practice

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    Wilkins, T., Akhtar, M., Gititu, E., Jalluri, C., & Ramirez, J. (2015). Diagnosis and management of hepatitis C. American family physician, 91(12), 835-842.