Chronic hepatitis C: guidelines for screening and treatment
Hepatitis C Virus Hepatitis C virus (HCV) is a small (55–65 nm in size), enveloped, positive-sense singlestranded RNA virus of the family Flaviviridae. ď ˝ Hepatitis C virus is the cause of hepatitis C and some cancers such as liver cancer and lymphomas in humans. ď ˝
HCV Distribution
Taxonomy The hepatitis C virus belongs to the genus Hepacivirus, a member of the family Flaviviridae. However a member of this genus has been discovered in dogs: canine hepacivirus. There is also at least one virus in this genus that infects horses Several additional viruses in the genus have been described in bats and rodents
Structure
CHC(Chronic Hep C)Epidemiology Transmission Percutaneous exposure to blood Vertical (mother-to-infant) • Risk Factor CHC History of illicit drug use other than marijuana Male gender Black race Incarceration (30% are HCV Ab +) ď ˝
Birth Cohort Screening
NHANES data from 1988-1994, 1999-2002:
People born between 1945-1965 have a disproportionately high prevalence of HCV infection
NHANES data from 1999-2008:
◦ ◦
3.25% of people born from 1945-1965 are HCV antibody positive. Accounts for 76.5% of the anti-HCV prevalence in the United States. Correlates with the high exposure incidence in the 1970-1980s.
Goal Of Treatment ď ˝
SVR12: negative (<12 IU/mL) HCV VL at 12 weeks after completion of therapy Reduce liver inflammation Reduce fibrosis and improve portal hypertension Reduce mortality
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