Hepatitis C Questions & Answers

Updated: Jan 17, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What is hepatitis C (hep C)?

What are symptoms of hepatitis C (hep C) infection?

Which physical finding are characteristic of decompensated liver disease in hepatitis C (hep C) infection?

What are common extrahepatic manifestations of hepatitis C (hep C) infection?

Which baseline studies are performed in patients with suspected hepatitis C (hep C) infection?

Which lab tests detect hepatitis C virus (HCV) infection?

What is the role of liver biopsy in the workup of hepatitis C (hep C) infection?

How is hepatitis C (hep C) infection treated?

What is the prevalence of hepatitis C (hep C) infection?

What are medical care costs associated with the treatment of hepatitis C (hep C) infection in the US?

What is the role of hepatitis C (hep C) in the etiology of chronic liver disease?

What is the onset and progression of hepatitis C virus (hep C) infection?

What is the pathophysiology of hepatitis C virus (HCV) infection?

What is the role of hepatitis C viral (HCV) proteins in the pathogenesis of infection?

What are the most common hepatitis C virus (HCV) genotypes?

How is hepatitis C virus (HCV) infection transmitted?

What is the prevalence of hepatitis C virus (HCV) infection in the US?

What is the global prevalence of hepatitis C virus (HCV) infection?

What are the racial predilections for hepatitis C virus (HCV) infection?

Which age group has the highest prevalence of hepatitis C virus (HCV) infection?

What is the prognosis of hepatitis C (hep C) infection?

What is included in patient education for hepatitis C (hep C)?

Presentation

How frequently does acute hepatitis C virus (HCV) infection become chronic?

Which symptoms of hepatitis C (hep C) infection are related to synthetic dysfunction and portal hypertension?

What are the common extrahepatic manifestations of hepatitis C (hep C) infection?

What are dermatologic signs and symptoms of hepatitis C (hep C) infection?

What are signs of decompensated liver disease in patients with hepatitis C (hep C) infection?

What are extrahepatic manifestations of hepatitis C (hep C) infection?

Which physical findings are characteristic of hepatitis C (hep C) infection?

DDX

What are the differential diagnoses for Hepatitis C?

Workup

What guidelines have been published for the diagnosis of hepatitis C (hep C) infection?

What are the advantages of point-of-care screening tests (POCTs) for the diagnosis of hepatitis C (hep C) infection?

How should healthcare workers with needle-stick injury involving an HCV-infected patient be evaluated and monitored?

Which baseline studies are performed in the workup of hepatitis C (hep C) infection?

What are the guidelines for hepatitis C (hep C) infection screening?

How is hepatitis C (hep C) infection diagnosed?

Which hepatitis C virus (HCV) RNA assays are approved by the FDA?

What is the role of quantitative hepatitis C virus (HCV) RNA assays in the diagnosis of hepatitis C (hep C) infection?

What is the role of genotyping in the workup of hepatitis C (hep C) infection?

Which hepatitis C genotype tests are available?

What is the role of genetic testing in the management of hepatitis C (hep C) infection?

What are common serologic findings in patients with chronic hepatitis C (hep C) infection?

Which additional lab tests may be indicated in the workup of hepatitis C (hep C) infection?

What is the role of liver biopsy in the workup of hepatitis C (hep C) infection?

Which histologic findings are characteristic of hepatitis C (hep C) infection?

How is hepatitis C (hep C) infection staged?

Treatment

What treatment guidelines are available for hepatitis C (hep C) infection?

What are the treatment options for acute hepatitis C virus (HCV) infection?

What are the treatment guidelines for chronic hepatitis C (hep C) infection?

What are the goals for treatment of chronic hepatitis C (hep C) infection?

What are the criteria for antiviral therapy to treat chronic hepatitis C (hep C) infection?

Which factors affect the risk of liver morbidity in chronic hepatitis C (hep C) infection?

What interferon (IFN) preparations are used in the treatment of hepatitis C (hep C) infection?

What is the efficacy of interferon (IFN) monotherapy for the treatment of acute hepatitis C (hep C) infection?

What is the efficacy of combined interferon (IFN) and ribavirin for the treatment of hepatitis C (hep C) infection?

What are the benefits of combination ribavirin and propylene glycol (PEG)-interferon (IFN) therapy for the treatment of hepatitis C (hep C) infection?

What is the efficacy of combination ribavirin and propylene glycol (PEG)-interferon (IFN) therapy for hepatitis C (hep C) infection?

How is response to combination ribavirin and propylene glycol (PEG)-interferon (IFN) therapy for hepatitis C (hep C) infection determined?

What are the adverse effects of interferon (IFN) for the treatment of hepatitis C (hep C) infection?

What are the adverse effects of ribavirin in the treatment of hepatitis C (hep C) infection?

What is the role of growth factors in the treatment of hepatitis C (hep C) infection?

What is FDA approved for the treatment of thrombocytopenia in chronic hepatitis C (hep C) infection?

How is depression managed in patients with hepatitis C (hep C) infection?

What is the role of (PEG)-interferon (IFN) in hepatitis C treatment in resource-limited settings?

What is the efficacy of elbasvir/grazoprevir (Zepatier) for the treatment of hepatitis C (Hep C) infection?

What is the efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak) for the treatment of hepatitis C (Hep C) infection?

What is the treatment regimen for ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak) in treatment naïve patients with hepatitis C virus (HCV) infection genotype 1a infection?

What is the efficacy of ombitasvir/paritaprevir/ritonavir (Technivie) for the treatment of hepatitis C (Hep C) infection?

What is the efficacy of sofosbuvir/velpatasvir (Epclusa) for the treatment of hepatitis C (Hep C) infection?

What is the role of direct-acting antiviral agents (DAAs) in the treatment of hepatitis C (hep C) infection?

Which direct-acting antiviral agents (DAAs) are currently available for the treatment of hepatitis C (hep C) infection?

What is the role of NS3/4 serine protease inhibitors in the treatment of hepatitis C (hep C) infection?

What is the role of simeprevir (Olysio) in the treatment of hepatitis C (hep C) infection?

What is the role of NS5B targeting polymerase inhibitors in the treatment of hepatitis C (hep C)?

What is the efficacy of sofosbuvir in the treatment of hepatitis C (hep C) infection?

What is the efficacy of combined NS5B targeting polymerase inhibitors for the treatment of hepatitis C (hep C) infection?

Which NS5A targeting agents are available for the treatment of hepatitis C (hep C) infection?

What is the efficacy of ledipasvir/sofosbuvir (Harvoni) in the treatment of hepatitis C (hep C) infection?

What is the efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak) for hepatitis C virus (HCV) infection genotype 1a infection?

What is the efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak) for hepatitis C virus (HCV) infection genotype 1b infection?

How is hepatitis C virus (HCV) infection managed in patients with HIV infection?

What are considerations for antiretroviral medications used in the treatment of patients coinfected with HIV and hepatitis C virus (HCV)?

Which antiretroviral combinations should be avoided by patients coinfected with HIV and hepatitis C virus (HCV)?

Why is interferon (IFN) contraindicated following liver transplantation in patients with hepatitis C (hep C) infection?

What are the treatment guidelines for hepatitis C genotype 1, 4, 5, or 6 without cirrhosis following liver transplantation?

What are the treatment guidelines for hepatitis C genotype 1, 4, 5, or 6 with compensated cirrhosis following liver transplantation?

What are posttransplantation alternative treatment regimens for hepatitis C genotype 1, 4, 5, or 6, with or without compensated cirrhosis?

What are the treatment guidelines for hepatitis C genotype 1, 4, 5, or 6 with decompensated cirrhosis following liver transplantation?

What are the treatment guidelines for hepatitis C genotype 2 or 3 without cirrhosis following liver transplantation?

What are the treatment guidelines for hepatitis C genotype 2 or 3 with compensated cirrhosis following liver transplantation?

What are the treatment guidelines for hepatitis C genotype 2 or 3 with decompensated cirrhosis following liver transplantation?

What are the treatment guidelines for hepatitis C (Hep C) in patients using alcohol or injection drugs?

How can hepatitis C virus (HCV) infection be prevented?

Which specialist consultations are required for the management of hepatitis C (hep C) infection?

What is the role of RNA testing in the management of hepatitis C (hep C) infection?

Which tests may be used to monitor drug toxicity due to hepatitis C (hep C) treatment?

What is the role of alanine aminotransferase (ALT) monitoring in the management of hepatitis C (hep C) infection?

What screening should patients with hepatitis C (hep C) infection and cirrhosis receive?

What is the most economical treatment strategy for chronic hepatitis C (hep C) infection?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 1a patients without cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 1a patients with compensated cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 1b patients without cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 1b patients with compensated cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 2 patients without cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 2 patients with compensated cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 3 patients without cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 3 patients with compensated cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 4 patients without cirrhosis?

What are the treatment guidelines for chronic HCV infection in treatment-naïve genotype 4 patients with compensated cirrhosis?

What are the treatment guidelines for chronic hepatitis C (hep C) infection in patients with genotype 5 or 6?

What are the guidelines for treatment of chronic HCV infection in PEG-IFN/ribavirin treatment-experienced genotype 1a patients without cirrhosis?

What are the guidelines for treatment of chronic HCV infection in PEG-IFN/ribavirin treatment-experienced genotype 1a patients with compensated cirrhosis?

What are the guidelines for treatment of chronic HCV infection in PEG-IFN/ribavirin treatment-experienced genotype 1b patients without cirrhosis?

What are the guidelines for treatment of chronic HCV infection in PEG-IFN/ribavirin treatment-experienced genotype 1b patients with compensated cirrhosis?

What are the guidelines for treatment of chronic HCV infection in NS3 PI + PEG-IFN/ribavirin treatment-experienced genotype 1 patients without cirrhosis?

What are the guidelines for treatment of chronic HCV infection in NS3 PI + PEG-IFN/ribavirin treatment-experienced genotype 1 patients with compensated cirrhosis?

What are the guidelines for treatment of chronic HCV infection in non-NS5A inhibitor, sofosbuvir-containing regimen, treatment-experienced genotype 1 patients without cirrhosis?

What are the guidelines for treatment of chronic HCV infection in non-NS5A inhibitor, sofosbuvir-containing regimen, treatment-experienced genotype 1 patients with compensated cirrhosis?

What are the guidelines for treatment of chronic HCV infection in NS5A inhibitor DAA-experienced genotype 1 patients with/without compensated cirrhosis ?

What are the treatment guidelines for chronic HCV infection in genotype 2 patients without cirrhosis previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in genotype 2 patients with compensated cirrhosis previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in patients with genotype 2 previously treated with either sofosbuvir plus ribavirin or sofosbuvir plus NS5A?

What are the treatment guidelines for chronic HCV infection in genotype 3 patients without cirrhosis previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in genotype 3 patients with compensated cirrhosis previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in genotype 3 patients previously treated with a DDA?

What are the treatment guidelines for chronic HCV infection in genotype 4 patients without cirrhosis previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in genotype 4 patients with compensated cirrhosis previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in genotype 4 patients previously treated with a DDA?

What are the treatment guidelines for chronic HCV infection in genotype 5 or 6 patients previously treated with PEG-IFN/ribavirin?

What are the treatment guidelines for chronic HCV infection in genotype 5 or 6 patients previously treated with a DAA?

How is coinfection of hepatitis B virus (HBV) and hepatitis C virus (HCV) managed?

What are the treatment options for acute hepatitis C (hep C) infection?

What are the guidelines for the medical management and monitoring of acute hepatitis C (hep C) infection?

Medications

How has the treatment of chronic hepatitis C (hep C) infection evolved?

Which direct-acting antiviral agents (DAAs) are used in the treatment of hepatitis C (Hep C) infection?

What is the most economically efficient treatment strategy for hepatitis C (Hep C) infection?

Which medications in the drug class HCV Protease Inhibitors are used in the treatment of Hepatitis C?

Which medications in the drug class HCV Polymerase Inhibitors are used in the treatment of Hepatitis C?

Which medications in the drug class HCV NS5A Inhibitors are used in the treatment of Hepatitis C?

Which medications in the drug class Combination Products are used in the treatment of Hepatitis C?

Which medications in the drug class Interferons and ribavirin are used in the treatment of Hepatitis C?

Which medications in the drug class Thrombopoietin-Receptor Agonists are used in the treatment of Hepatitis C?