EXAM #2: HEPATITIS C Flashcards
What type of virus is HCV?
- Flaviviridae
- ssRNA
Is Hepatitis C enveloped?
Yes
Where is the highest incidence of HCV worldwide?
Egypt
What populations is HCV most prevalent in?
1) IVDA
2) Incarcerated
3) HIV
4) Alcoholics
5) Homeless
Why is snorting cocaine a risk factor for HCV infection?
- Nosebleeds are associated with cocaine use
- Breach in the mucosa
In what age group is there the highest prevalence of HCV?
Baby-boomer (born before 1964)
Are tattoo parlors and blood transfusions still considered risk factors for HCV infection?
No
- HCV education in tattoo parlors has lowered risk
- Screening has lowered risk for transfusion
When is there a high risk of sexual transmission of HCV?
Woman with HCV and HIV
Monogamous HCV alone is considered low risk for sexual transmission
What is unique about HCV and liver enzyme tests?
LTF levels fluctuate
*Patient may have normal ALT and HCV with cirrhosis
What percent of patients with HCV will develop HCC per year?
4%
What is the worst social behavior associated with HCV infection?
Alcoholism–this is “like throwing gasoline on a fire”
What do you need to remember about HCV infection?
This is a SYSTEMIC disease that can have numerous extrahepatic manifestations
Who needs to be screened for HCV?
Anyone born between 1940 and 1964
How is HCV screened for?
1) HCV antibody screening
2) HCV-RNA confirmation
What is the major determinant of HCV therapy/ success with treatment?
Genotype
What genotype is most resistant to treatment?
Genotype 1 i.e. what is most prevalent in the US
What is the primary goal of HCV therapy?
Eradicate HCV
What is the most important secondary goal of HCV therapy?
Reduce HCC incidence
What does “sustained viral respose” refer to?
Successful HCV
- Viral load drops
- This is NOT a cure b/c virus will still be detectable
What is pegylated interferon?
- Interferon linked to a bulky inert molecule
- Decreases metabolism of interferon
What are the adverse effects associated with Interferon?
Interferon is the same cytokine that kills the flu–it is what causes the sx of flu
Thus, the side effects resemble the flu
What DAAs?
Direct anti-viral agents
What is the standard of care of HCV infection now?
Harvoni–Sofosbuvir + Ledipasvir
What is the MOA of Harvoni?
Inhibits HCV at 3 locations:
What is the single most common reason for liver transplant?
HCV
Outline the high points of the HCV timeline.
1985= nothing known 1987= Chiron patents genome 2012= DAAs 2014= Sofosbavir
