Hepatitis C
| causes the most morbidity in IVDUs | |
|---|---|
| Etiology | RNA flavivirus. |
| Epidemiology | Transmission: exposure to infected blood, sexual contact. At-risk: IVDU, HIV+ (↑ risk of disease progression), people who received blood products before 1990, sexual partners, Needlestick injuries. |
| Clinical features | Incubation: 4-20 weeks 60-80% asymptomatic 15-45% people clear infection spontaneously; treatment given in acute phase = more likely to clear |
| Diagnosis and investigations | Immunoassay |
| Management | - Direct-acting antivirals - cure rate >90% - HCV cure is defined as negative HCV RNA in the blood 12 weeks after treatment completion - Risk of treatment-related reactivation of Hep B virus |
| Complications | HCC, cirrhosis; 80% of patients have persistent infection |
chronic hep c infection
- presence of HCV >6/12 after acquiring infection
- complication - cirrhosis
- direct-acting antivirals first line