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Management of chronic hepatitis C

V Lo Re1, J R Kostman

  • 1Division of Infectious Diseases, Center for Clinical Epidemiology and Biostatistics, 502 Johnson Pavilion, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. vincent.lore@uphs.upenn.edu

Postgraduate Medical Journal
|June 7, 2005
PubMed

Insights

Hepatitis C virus (HCV) screening involves antibody detection, with positive results requiring viraemia assessment to confirm chronic infection. HCV genotype and liver biopsy inform treatment decisions for this significant cause of liver disease.

Area of Science:

  • Hepatology
  • Virology
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) infection is a primary cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma.
  • Transmission predominantly occurs via percutaneous exposure, often linked to injection drug use.
  • Chronic HCV develops in a significant majority of infected individuals.

Purpose of the Study:

  • To outline the diagnostic and prognostic significance of HCV antibody screening, viraemia assessment, and genotyping.
  • To detail the role of liver biopsy in evaluating hepatic fibrosis and guiding treatment selection.
  • To describe the standard of care for antiviral therapy in chronic HCV.

Main Methods:

  • Initial screening using HCV antibody detection in at-risk populations.
  • Confirmation of chronic infection through assessment of HCV viraemia.
  • HCV genotyping to predict treatment response.
  • Liver biopsy for fibrosis staging and assessment of concurrent liver conditions.
  • Clinical decision-making for antiviral therapy based on disease severity, patient factors, and genotype.

Main Results:

  • HCV antibody testing identifies individuals requiring further evaluation.
  • HCV viraemia confirms the presence of active infection.
  • HCV genotype is a key predictor of treatment efficacy.
  • Liver biopsy provides crucial information for patient management and treatment selection.

Conclusions:

  • A multi-step diagnostic approach including antibody testing, viraemia assessment, and genotyping is essential for managing HCV.
  • Liver biopsy plays a vital role in disease staging and treatment planning.
  • Combination therapy with pegylated interferon and ribavirin remains the standard of care for chronic HCV.

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