Hepatitis C Infection
(HCV, Hep C)
Mary D. Nettleman, MD, MS, MACP
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
- Hepatitis C infection (HCV, hep C) facts
- What is hepatitis C infection?
- What is the nature (biology) of the hepatitis C virus?
- How does liver damage occur in hepatitis C infection?
- How is hepatitis C virus spread, is it contagious, and how can transmission be prevented?
- What are the symptoms of hepatitis C infection?
- What conditions outside the liver are associated with hepatitis C infection?
- What is the usual progression of chronic hepatitis C infection?
- Who is at high risk and should be tested for hepatitis C infection?
- What are the diagnostic tests for hepatitis C virus and how are they used to diagnose hepatitis C infection?
- What is the role of a liver biopsy in the management of chronic hepatitis C?
- What is the treatment for hepatitis C infection?
- Who should receive antiviral therapy for hepatitis C virus infection?
- What are the different patterns of response to antiviral treatment?
- What are the goals of therapy for hepatitis C infection?
- What are the therapy options for previously untreated patients with chronic hepatitis C infection?
- How are relapses and nonresponders treated?
- Should individuals with acute hepatitis C infection be treated?
- What are the side effects of treatment for hepatitis C infection?
- What about liver transplantation for hepatitis C infection?
- What is the current research and what is in the future for hepatitis C?
- Hepatitis C FAQs
- Find a local Gastroenterologist in your town
Hepatitis C infection (HCV, hep C) facts
- HCV is one of several viruses that cause hepatitis (inflammation of the liver).
- Up to 85% of individuals who are initially (acutely) infected with HCV will fail to eliminate the virus and will become chronically infected.
- HCV is spread most commonly through inadvertent exposure to infected blood. Intravenous drug abuse is the most common mode of transmission. The risk of acquiring HCV through sexual contact is low.
- Generally, patients do not develop symptoms of chronic infection with HCV until they have extensive scarring of the liver (cirrhosis). Some individuals, however, may have fatigue and other non-specific symptoms in the absence of cirrhosis. A minority of patients with HCV have symptoms from organs outside of the liver.
- In the U.S., Infection with HCV is the most common cause of chronic hepatitis and the most common reason for liver transplantation.
- HCV is diagnosed by determining levels in the blood of antibodies to the virus and then confirmed with other tests for viral RNA. The amount of viral RNA in the blood (viral load) does not correlate with the severity of the disease but can be used to track the response to treatment.
- A liver biopsy may be used to assess the amount of liver damage (liver cell injury and scarring), which can be important in planning treatment.
- Considerable progress has been made in the treatment of HCV, although response rates remain imperfect, approximately 50%-60% for genotype 1. Combined therapy with pegylated interferon, ribavirin, and one of two new drugs (direct acting anti-viral drugs) telaprevier (Incivek - This drug was discontinued by the manufacturer, but will be available until October 2014) and boceprevir (Victrelis) is the current treatment regimen.
- Treatment results in reduced inflammation and scarring of the liver in most sustained responders and also occasionally (and to a much lesser extent) in those who relapse or do not respond.
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