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
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
4 days ago
Among patients with moderate-to-severe psoriasis, the use of biologics appears to lower the risk of being hospitalized for the novel coronavirus disease (COVID-19), a new study has found.