4.5 Hepatitis C Flashcards
What kind of virus is HCV
single stranded RNA
What increases the risk of chronic HCV?
co infection with Hep B, HIV alcohol, obesity/fatty liver
What are the symptoms os HCV?
tiredness, lathargy, often asymptomatic until cirrhotic or decompensated
fatigue, nausea, arthralgia, depression, anxiety, fever, anxiety, muscle ache, weight loss
What are the HCV specific tests?
Hep C antibody (+ 7-12 weeks)
Hep C RNA PCR (+ 2-3 weeks)
RIBA recombinant immunoblot assay
would does + HCV antibody and + PCR indicate
Acute or chronic infection
What does + HCV antibody and -PCR indicate?
previous/cleared HCV
What does - HCV antibody and + PCR indicate?
Acute HCV or chronic unable to produce antibodies
What are the common HCV genotypes?
1 and 3
What are some lifestyle guidelines for HCV positive patients?
Decrease BMI for reduction in steatosis, abnormal liver enzymes and improvement in fibrosis
Decrease alcohol
Stop smoking
Can HCV be transmitted perinatally? and what increases the risk?
Yes and will have increased risk if co-infected with HIV
What is the current treatment for HCV?
Genotype 1: Peg interferon + ribavirin 48 weeks
(also triple therapy with DAA/sofosbuvir/simeprevir)
Genotype 2 and 3: Peg interferon + ribavirin 24 weeks
What are the contraindications for interferon?
Psychiatric disorder Decompensated cirrhosis Autoimmune disorders blood disorders/cytopenia Organ transplant
What are the contraindications for ribavirin?
Pregnancy
significant cardiorespiratory disease
old age
What are the side effects of anti-virals?
Flu like illness, marrow suppression, haemolysis, skin rash, psychosis, depression Immune phnomena Alopecia thyroid dysfunction drug interactions
