Hepatitis C

Background

  • Bloodborne transmission
  • NO acute phase
  • >75% progress to chronic hepatitis C infection
  • Disease course depends on comorbidities (e.g. alcohol use, HIV status, etc.)
  • May progress to cirrhosis, +/- hepatocellular carcinoma

Clinical Features

Differential Diagnosis

Acute hepatitis

Evaluation

Acute Hepatitis Panel

Anti-hepatitis A, IgM Hepatitis B surface antigen Anti-hepatitis B core, IgM Anti-hepatitis C Interpretation
Positive Negative Negative Negative Acute hepatitis A
Negative Positive Positive Negative Acute hepatitis B
Negative Positive Negative Negative Chronic hepatitis B infection
Negative Negative Positive Negative Acute hepatitis B; quantity of hepatitis B surface antigen is too low to detect
Negative Negative Negative Positive Acute or chronic hepatitis C; additional tests are required to make the determination

Management

Complications of cirrhosis

Outpatient HCV treatment may include:

  • Interferon-α or pegylated interferons
  • Ribavirin
  • Direct-acting antiviral agents (boceprevir, telaprevir, simeprevir, sofosbuvir, Harvoni, etc.)

Disposition

  • Often complex and should be based on presence/absence of acute complications
  • If no complications present, discussion with patient's primary care provider or gastroenterologist recommended

See Also

External Links

References