Chronic Hepatitis C

Question 1

How many weeks of treatment is required to cure hepatitis C?

Answer 1

8-12 weeks

Question 2

Which genotype of hepatits C is most common in Australia?

Answer 2

genotype 3

Question 3

What are some of the extra hepatic clinical manifestations of chronic hepatitis C?

Answer 3

mebranoprolifeative GN
porphyria cutanea tarda
cryoglobulinaemia

Question 4

What test should be done if hepatitis C antibody is positive?

Answer 4

test for HCV RNA

Question 5

What should be done for people with positive HCV antibody and no RNA with ongoing risk?

Answer 5

yearly test for RNA only

Question 6

What other tests need to be done once hepatitis C is identified?

Answer 6

hepatitis C genotype
HIV, Hep A, Hep B
FBE, UEC, LFT, INR
evaluated for cirrhosis

Question 7

What is the APRI score?

Answer 7

AST to platelet ratio index -if <1 very unlikely to have cirrhosis

Question 8

What is the rate of cure for genotype 3 cirrhotics?

Answer 8

85%

Question 9

What is the rate of cure for decompensated cirrhotics?

Answer 9

75-85%

Question 10

What are the four different types of direct acting antivirals for hepatitis C?

Answer 10

NS3/4a protease inhibitors
NS5a inhibitors
Nucleoside polymerase inhibitors
Non-nucleoside polymerase inhibitors

Question 11

What needs to be checked before starting antivirals for hepatitis C?

Answer 11

genotype
presence of cirrhosis
other medications
HBV/HIV status
eGFR
discuss avoidance of pregnancy

Question 12

Why does hepatitis B status need to checked before starting antivirals for hepatitis C?

Answer 12

risk of reactivation of hep B during treatment for hep C

Question 13

What are some of the medications that interact with hepatitis C treatment?

Answer 13

PPIs, statin, amiodarone, anti epileptics

Question 14

What is the most clinically significant resistance associated substitution?

Answer 14

Y93H

Question 15

Why are protease inhibitors relatively contraindicated in cirrhosis?

Answer 15

can precipitate liver failure