Chronic Hepatitis C Virus Infection

HIV HCV Curriculum Logo

This lesson focuses on defining, screening for, and diagnosing chronic HCV infection through history, physical examination, and laboratory (and other) testing. The lesson also covers identification of clinical manifestations of chronic HCV infection and its pathophysiology. 

Revised May 2018

Download Slides

References

  1. AASLD-IDSA. HCV testing and linkage to care. Recommendations for testing, managing, and treating hepatitis C. Available at: https://www.hcvguidelines.org/full-report/hcv-testing-and-linkage-care. Accessed May 15, 2017.
  2. Spach DH. Recommendations for hepatitis C screening. Hepatitis C Online. Available at: https://www.hepatitisc.uw.edu/go/screening-diagnosis/recommendations-screening/core-concept/all. Updated August 30, 2016. Accessed May 15, 2017.
  3. Spach DH. Hepatitis C diagnostic testing. Hepatitis C Online. Available at:  https://www.hepatitisc.uw.edu/go/screening-diagnosis/diagnostic-testing/core-concept/all. Updated October 21, 2015. Accessed May 15, 2017.
  4. Bräu N. Evaluation of the hepatitis C virus-infected patient: the initial encounter. Clin Infect Dis. 2013 Mar;56(6):853-60.
  5. Thornton K. Natural history of hepatitis C infection. Hepatitis C Online. Available at: https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/natural-history/core-concept/all. Updated September 21, 2015. Accessed May 15, 2017.
  6. Di Martino V, Rufat P, Boyer N, et al. The influence of human immunodeficiency virus coinfection on chronic hepatitis C in injection drug users: a long-term retrospective cohort study. Hepatology. 2001 Dec;34(6):1193-9.
  7. Graham CS, Baden LR, Yu E, et al. Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis. Clin Infect Dis. 2001 Aug 15;33(4):562-9.
  8. De Lédinghen V, Barreiro P, Foucher J, et al. Liver fibrosis on account of chronic hepatitis C is more severe in HIV-positive than HIV-negative patients despite antiretroviral therapy. J Viral Hepat. 2008 Jun;15(6):427-33.
  9. Kirk GD, Mehta SH, Astemborski J, et al. HIV, age, and the severity of hepatitis C virus-related liver disease: a cohort study. Ann Intern Med. 2013 May 7;158(9):658-66.
  10. Fierer DS, Dieterich DT, Fiel MI, et al. Rapid progression to decompensated cirrhosis, liver transplant, and death in HIV-infected men after primary hepatitis C virus infection. Clin Infect Dis. 2013 Apr;56(7):1038-43.
  11. Cacoub P, Comarmoud C, Domont F, Savey L, Desbois AC, Saadoun D. Extrahepatic manifestations of chronic hepatitis C virus infection. Ther Adv Infect Dis. 2016 Feb;3(1):3-14.
  12. Fox RK. Extrahepatic conditions related to hepatitis C. Hepatitis C Online. Available at: https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/extrahepatic-conditions/core-concept/all. Updated July 1, 2015. Accessed May 15, 2017.
  13. AASLD-IDSA. When and in whom to initiate HCV therapy. Recommendations for testing, managing, and treating hepatitis C. Available at: http://hcvguidelines.org/full-report/when-and-whom-initiate-hcv-therapy. Accessed May 15, 2017.
  14. Ramers CB. Initial evaluation of persons with chronic hepatitis C. Hepatitis C Online. Available at: https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/initial-evaluation-chronic/core-concept/all. Updated March 27, 2014. Accessed May 15, 2017.
  15. Cox-North PP, Shuhart MC. Evaluation and staging of liver fibrosis. Hepatitis C Online. Available at: https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-staging/core-concept/all. Updated October 21, 2015. Accessed May 15, 2017.
  16. Sanford NL, Walsh P, Matis C, Baddeley H, Powell LW. Is ultrasonography useful in the assessment of diffuse parenchymal liver disease? Gastroenterology. 1985 Jul;89(1):186-91.
  17. Celle G, Savarino V, Picciotto A, Magnolia MR, Scalabrini P, Dodero M. Is hepatic ultrasonography a valid alternative tool to liver biopsy? Report on 507 cases studied with both techniques. Dig Dis Sci. 1988 Apr;33(4):467-71.
  18. Kudo M, Zheng RQ, Kim SR, et al. Diagnostic accuracy of imaging for liver cirrhosis compared to histologically proven liver cirrhosis. A multicenter collaborative study. Intervirology. 2008;51 Suppl 1:17-26.
  19. Scott JD, Woolston SL. Making a decision on when to initiate HCV therapy. Hepatitis C Online. Available at: http://www.hepatitisc.uw.edu/go/evaluation-treatment/treatment-initiation-decision/core-concept/all. Updated March 7, 2017. Accessed May 15, 2017.
  20. Thornton K. Evaluation and prognosis of patients with cirrhosis. Hepatitis C Online. Available at: http://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-prognosis-cirrhosis/core-concept/all  Updated July 14, 2016. Accessed May 15, 2017.
  21. AASLD-IDSA. Monitoring patients who are starting hepatitis C treatment, are on treatment, or have completed therapy. Recommendations for testing, managing, and treating hepatitis C.
  22. Fox RK. Surveillance for hepatocellular carcinoma. Hepatitis C Online. https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/surveillance-hepatocellular-carcinoma/core-concept/all. Updated October 21, 2015. Accessed May 15, 2017.

Resources