hepatitis%20c
HEPATITIS C

Hepatitis C can be transmitted through blood transfusions, organ transplants, percutaneous (especially IV drug use), sexual or perinatal route.

It has an incubation period of 14-180 days.

Goal of treatment is to prevent progression to chronic hepatitis C through antiviral treatment of acute hepatitis C. Also, it aims to prevent occurrence of liver-related complications through antiviral treatment of chronic hepatitis C.

Hepatitis%20c Management

General Care

  • Supportive care
    • Consider hospitalization if there is vomiting, dehydration, signs of hepatic decompensation
  • Evaluate for advanced fibrosis or other conditions that may hasten liver fibrosis (eg HBV and HIV infections, genotype 3, nonalcoholic fatty liver disease) to help guide treatment
    • Monitor for HCC with alpha-fetoprotein and liver ultrasound every 6 months
  • Screen for other sexually-transmitted diseases in cases of sexually acquired hepatitis or if otherwise appropriate
  • Identify extrahepatic manifestations and treat comorbidities appropriately 
    • Test for HIV infection, past or current HBV infection and for hepatitis A virus immunity to search for other causes of liver comorbidities

Prevention

Primary Prevention

  • At present, there is no available vaccine for HCV
  • The prevention of HCV would depend on the reduction of the risk of exposure especially in patients in healthcare setting and those who are in a high-risk population (eg IV drug use and through sexual contact)
    • HCV RNA should be assessed at 6 or 12 months after SVR to monitor for HCV reinfection in the high-risk population
  • Recommended primary intervention:
    • Hand hygiene should include proper surgical hand preparation, hand washing and use of gloves
    • Appropriate and safe use of healthcare injection
    • Proper handling and disposal of sharp needles and other objects and waste
    • Comprehensive harm-reduction services should be provided to PWID including the use of sterile injecting equipments and treatment of dependence
    • Sterilization of equipments
    • All healthcare personnel should be trained
    • Donated blood should be tested for HBV, HCV, HIV and syphilis
    • Proper and consistent use of condoms should be promoted

Secondary and Tertiary Prevention

  • Recommendations for people who are infected with HCV:
    • Conduct an education and counseling program for patient care and treatment, including risk of reinfection and prevention of HCV transmission
    • Immunization with hepatitis A and B vaccines are recommended to prevent coinfection and provide protection to the liver
    • Early and appropriate medical management including use of antiviral therapy
    • Regular monitoring is the key to early diagnosis of chronic liver disease
      • Continue hepatocellular carcinoma surveillance every 6 months in patients with advanced fibrosis and cirrhosis as an SVR will only reduce but not remove the risk of hepatocellular carcinoma
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Audrey Abella, 2 days ago
Reductions in liver fat and adipose tissue volumes were sustained in patients with type 2 diabetes (T2D) with the addition of the SGLT-2* inhibitor dapagliflozin (DAPA) and the DPP-4** inhibitor saxagliptin (SAXA) to metformin (MET), compared with a regimen comprising glimepiride (GLIM)+MET, according to the extension period results of a phase IIIb trial.