Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EBAC - Infectious Disease > Hepatitis C Virus > Flashcards

Hepatitis C Virus Flashcards

1
Q

What is the family of the Hepatitis C virus (HCV)?

A

Flaviviridae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many genotypes and subtypes are known for HCV?

A

Seven genotypes and 84 subtypes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which HCV genotypes are the most common worldwide?

A

Genotypes 1 and 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What was the estimated global prevalence of chronic HCV infection in 2019?

A

58 million (0.8% of the general population)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What percentage of adults in the United States were estimated to be HCV antibody positive from 2013 to 2016?

A

1.7% of all adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the estimated prevalence of HCV RNA positive individuals in the United States from 2013 to 2016?

A

1% of all adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What factors contributed to the decline in HCV prevalence estimates from 2015 to 2019?

A
  • Increased cures with new treatment options
  • Increasing death rates due to aging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the estimated prevalence of HCV coinfection among people with HIV?

A

6.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the increased risk of HCV infection in people with HIV compared to those without?

A

Six times higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the primary transmission routes for HCV?

A
  • Percutaneous exposure to blood
  • Sexual intercourse
  • Perinatal transmission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or False: HCV is less infectious than HIV through percutaneous blood exposures.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common mode of HCV acquisition in the United States?

A

Injection drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What percentage of infants born to HCV-positive mothers without HIV are affected by perinatal transmission?

A

Approximately 7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What percentage of infants born to HCV-positive mothers with HIV are affected by perinatal transmission?

A

Approximately 12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are common symptoms of acute HCV infection?

A
  • Low-grade fever
  • Mild right-upper-quadrant pain
  • Nausea
  • Vomiting
  • Anorexia
  • Dark urine
  • Jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the risk of developing cirrhosis in patients with chronic HCV infection?

A

20 to 40% within 20 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What factors increase the risk for significant liver disease in HCV patients?

A
  • Older age at the time of infection
  • Male sex
  • Obesity
  • Concomitant alcohol use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the role of HCV screening in HIV care?

A

All patients should undergo routine HCV screening on entry into HIV care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of testing is recommended for HCV in at-risk individuals?

A

HCV antibody testing annually or as indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should be done for individuals who test positive for HCV antibody?

A

Additional diagnostic testing using a sensitive quantitative assay for HCV RNA level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the primary method for preventing HCV transmission among people who inject drugs?

A

Harm-reduction strategies including syringe services programs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the recommended action for those with acute HCV infection?

A

Immediate treatment with regimens recommended for chronic HCV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the association between HBV and HCV coinfection?

A

Coinfection with HBV is associated with increased morbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should patients with HCV infection avoid to prevent liver damage?

A
  • Alcohol consumption
  • Potentially hepatotoxic medications
  • Iron supplementation in the absence of deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What treatment regimens are preferred for HCV infection?

A

Direct-acting antiviral (DAA) regimens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the goals of therapy for patients with HIV/HCV coinfection?

A

Similar to those recommended for HCV mono-infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How has the approach to HCV treatment changed for non-specialist providers?

A

Simplified approaches have emerged to facilitate treatment

28
Q

What is the main purpose of simplified approaches to HCV treatment?

A

To facilitate treatment by non-specialist providers and increase treatment uptake for the majority of persons with HCV infection.

29
Q

Who can generally qualify for simplified HCV treatment?

A

Treatment-naive persons without cirrhosis.

30
Q

What are the key components of simplified HCV treatment?

A
  • Minimal baseline testing (omission of genotype)
  • Standardized treatment approaches using pangenotypic regimens
  • No on-treatment testing or in-person follow-up
  • Limited follow-up to confirm sustained virologic response (SVR)
31
Q

What has eliminated clinically significant drug interactions in HCV treatment for people with HIV?

A

The emergence of unboosted integrase strand transfer inhibitor (INSTI)-based ARV regimens.

32
Q

What is the significance of the AIDS Clinical Trial Groups (ACTG) A5360 study?

A

It evaluated a simplified approach consisting of limited baseline testing and supply of the entire sofosbuvir/velpatasvir treatment regimen, showing a 95% SVR in participants with HIV.

33
Q

What was the SVR after 12 weeks post-treatment in the ACTG A5360 study?

A

95% overall and 95% in the subset of people with HIV.

34
Q

What did the SMART-C study compare?

A

A standard 8-week treatment with glecaprevir/pibrentasvir versus a simplified approach that omitted on-treatment visits.

35
Q

What was the SVR12 for the simplified approach in the SMART-C study?

36
Q

What is the recommended assessment for patient readiness before HCV treatment?

A

A pre-HCV treatment assessment indicating that reasonable adherence can be expected.

37
Q

Is treatment for HCV recommended if a patient has untreated HIV infection?

A

Yes, treatment should not be withheld solely due to perceived lack of adherence with HIV therapy.

38
Q

What is the recommended assessment for fibrosis stage in people with HIV?

A

Additional fibrosis stage assessment may be indicated if FIB-4 score is indeterminate.

39
Q

What is the preferred method for liver fibrosis staging?

A

Non-invasive ultrasound-based or imaging-based modalities.

40
Q

What should not be withheld if access to additional staging modalities is not available?

A

HCV treatment.

41
Q

What exclusions are noted for simplified HCV treatment in people with HIV?

A
  • Prior HCV treatment
  • Decompensated cirrhosis
  • TDF-containing regimen with eGFR <60 mL/min
  • On efavirenz, etravirine, nevirapine, or boosted HIV-1 protease inhibitors
  • Untreated chronic HBV infection
  • Pregnancy
42
Q

What is required for pre-treatment assessment under the simplified approach?

A
  • Creatinine, liver function tests, and complete blood count
  • HCV RNA
  • Hepatitis B surface antigen
  • Initial fibrosis staging with FIB-4
  • Medication and drug interaction review
43
Q

What is a significant drug interaction concern when using efavirenz with HCV DAAs?

A

Efavirenz coadministration results in a significant decrease in glecaprevir, pibrentasvir, and velpatasvir exposures.

44
Q

What is the recommended DAA regimen for HCV treatment-naive persons without cirrhosis?

A
  • Glecaprevir/pibrentasvir FDC for 8 weeks
  • Sofosbuvir/velpatasvir FDC for 12 weeks
45
Q

What was the SVR12 in the ASTRAL-5 study for sofosbuvir/velpatasvir?

46
Q

What is recommended if compensated cirrhosis is present and sofosbuvir/velpatasvir is planned?

A

Pre-treatment HCV genotyping is recommended.

47
Q

What is the significance of the EXPEDITION-2 study regarding glecaprevir/pibrentasvir?

A

It showed an SVR12 of 98% in participants with HIV, including those with cirrhosis.

48
Q

What is the recommendation for HCV treatment in acute HCV infection for people with HIV?

A

HCV treatment should be started as soon as possible.

49
Q

What should patients who achieve viral clearance be counseled about?

A

The potential for reinfection.

50
Q

What is the recommended timing for starting HCV treatment in people with HIV?

A

As soon as possible to reduce onward transmission and benefit the individual

This is classified as AIII recommendation.

51
Q

What are simplified treatment regimens recommended for?

A

Acute HCV infection

This is classified as AII recommendation.

52
Q

What should patients who achieve viral clearance be counseled about?

A

The potential for reinfection

53
Q

Why were persons with HIV excluded from certain DAA treatment trials?

A

They were not included in registrational trials for sofosbuvir/velpatasvir/voxilaprevir and initial trials for glecaprevir/pibrentasvir.

54
Q

How should treatment approaches for DAA failures in people with HIV compare?

A

They should be the same as those for persons with HCV mono-infection

This is based on AIII recommendation.

55
Q

Is laboratory monitoring required for patients on simplified treatment?

A

No, it is not required.

56
Q

What documentation may be required by payors during treatment?

A

Documentation of HCV RNA levels at week 4 of therapy.

57
Q

What is the recommended follow-up after completing HCV therapy?

A

Document SVR (HCV RNA less than lower limits of quantification) at least 12 weeks after completion of therapy

This is classified as AI recommendation.

58
Q

How often should HCV reinfection assessments be conducted?

A

At least yearly for those with ongoing risk behaviors.

59
Q

What is the screening recommendation for hepatocellular carcinoma in patients with cirrhosis?

A

Liver ultrasound every 6 months indefinitely

This is classified as BII recommendation.

60
Q

What is the rate of perinatal transmission of HCV for infants born to mothers with HIV?

A

Approximately 12%.

61
Q

What is the current standard of care for treating HCV infection?

A

DAA combination therapy.

62
Q

What did a pilot study of ledipasvir/sofosbuvir find regarding pregnant women?

A

It was safe and resulted in cure in nine women.

63
Q

What should not be used during pregnancy due to teratogenicity concerns?

A

Ribavirin

Ribavirin is an FDA category X drug.

64
Q

What is the recommended treatment for treatment-naive patients without cirrhosis?

A
  • Three (glecaprevir 100 mg/pibrentasvir 40 mg per tablet) tablets daily for 8 weeks (AI)
  • One (sofosbuvir 400 mg/velpatasvir 100 mg per tablet) tablet daily for 12 weeks (AI)
65
Q

What is the preferred therapy for treatment-naive patients with compensated cirrhosis for genotypes 1, 2, 4–6?

A
  • Three (glecaprevir 100 mg/pibrentasvir 40 mg per tablet) tablets daily for 8 weeks (AIII)
  • One (sofosbuvir 400 mg/velpatasvir 100 mg per tablet) tablet daily for 12 weeks (AI)
66
Q

What is the alternative therapy for genotype 3 patients?

A
  • Three (glecaprevir 100 mg/pibrentasvir 40 mg per tablet) tablets daily for 12 weeks (CI)
  • One (sofosbuvir 400 mg/velpatasvir 100 mg per tablet) tablet daily, with or without ribavirin for 12 weeks pending results of NS5A RAS testing (CI)
67
Q

What is the recommended treatment for acute HCV infection?

A
  • Three (glecaprevir 100 mg/pibrentasvir 40 mg per tablet) tablets daily for 8 weeks (AII)
  • One (sofosbuvir 400 mg/velpatasvir 100 mg per tablet) tablet daily for 12 weeks (AII)

EBAC - Infectious Disease (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions