Overview
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- Diagnosis - cause (if known), when diagnosed
- Manifestations - cirrhosis, lichen planus, cryoglobulinaemia, glomerulonephropathy
- Management - direct acting antivirals, surveillance
Risk Factors for Hepatitis C Infection
- Certain ethnic groups
- Children of hepatitis C positive mothers
- Iatrogenic exposure - surgery, colonoscopy, haemodialysis, blood transfusion prior to 1990
- Healthcare workers
- IV drug use
- Prisoners
- Tattoos
Manifestations
Manifestations of Hepatitis C Infection
Hepatic
- Chronic hepatitis
- Cirrhosis
Extrahepatic
- Dermatologic - lichen planus, porphyria cutanea tarda
- Immune - essential mixed cryoglobulinaemia, Sjogren's syndrome
- Renal - membranoproliferative glomerulonephropathy
- Non-Hodgkin lymphoma
- Type 2 diabetes mellitus
Management
Management of Hepatitis C Infection
Non-Pharmacologic
- Cirrhosis surveillance
- HCC surveillance
Pharmacologic
- NS3/4A inhibitors - grazoprevir, pariteprevir, simepravir
- NS5A inhibitors - daclatasvir, elbasvir, ledipasvir, ombitasvir
- NS5B inhibitors - dasabuvir, sofosbuvir
Overview
Serology may be used to assess for active or past infection with hepatitis C.
Interpretation
- Hepatitis C antibody (Anti-HCV) - indicative of past or current (acute or chronic) infection
- Hepatitis C RNA - indicative of active infection
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