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Hepatitis C

Jennifer L. Bauer, MD and Christopher Lin-Brande, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

Hepatitis C virus (HCV) is a systemic viral infection (acute and chronic) primarily involving liver. 

EPIDEMIOLOGY

  • Highest incidence between ages 20 and 39 years; highest prevalence be...

DIAGNOSIS

HISTORY

  • Determine exposure risk: detailed social history, including alcohol and IV drug use, psychiatric and medical comorbidities, and coinfections.

  • Chronic HCV: Most cases are mildly symptom...

TREATMENT

GENERAL MEASURES

  • Report acute HCV to health department.

  • Treat patients with virologic evidence of HCV (except patients with a short life expectancy whose prognosis would not be changed by trea...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Treat early to prevent fibrosis. If cirrhosis is present, treatment may not prevent decompensation.

  • Monitor serial viral load only if on antiviral therapy.

  • Some exp...

REFERENCES

1
Denniston MM, Jiles RB, Drobeniuc J, et al. Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med.  2...

ADDITIONAL READING

Leoni MC, Ustianowski A, Farooq H, et al. HIV, HCV and HBV: a review of parallels and differences [published online ahead of print September 4, 2018]. Infect Dis Ther. doi:10.1007/s...

CODES

ICD10

  • B19.20 Unspecified viral hepatitis C without hepatic coma

  • B17.10 Acute hepatitis C without hepatic coma

  • B18.2 Chronic viral hepatitis C

ICD9

  • 070.70 Unspecified viral hepatitis C without hepatic...

CLINICAL PEARLS

  • 1 of every 10 patients with hepatitis C has no identifiable risk factors.

  • 15–25% of HCV-infected persons spontaneously resolve the infection without specific treatment.

  • Assess for coinfe...

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