Chronic vs. Acute HCV infection
- liver tests elevated for at least 6 months = chronic HCV
- HCV Ab negative for the first 4-6 weeks of infection, then becomes positive
- HCV RNA typically detectable in the first 2 weeks of infection
Posted 07/20/16 09:18:54 AM by Anna Krigel
Patterns seen on liver biopsy
- Chornic HCV = periportal lymphocytic infiltration
- Autoimmune hepatitis = portal fibrosis with plasma cell infiltrate
- ETOH and NASH = central/perisinusoidal injury
Posted 07/20/16 09:55:53 AM by Anna Krigel
IL28B genotype testing
Posted 07/20/16 10:04:47 AM by Anna Krigel
Acute HCV infection
- majority of patients are asymptomatic
- symptomatic patients may present with jaundice, nausea, dark urine, and RUQ pain
- often present with aminotransferases elevated 10 to 20 times above the upper limit of normal
- recent studies estimate rates of spontaneous clearance of infection at 50% (typically occurs within 12 weeks)
- newer, direct-acting antiviral regimens have not yet been studied for the treatment of acute HCV
- risk of waiting to treat the infection until viremia becomes chronic is now minimal with newer agents
Posted 07/20/16 10:26:58 AM by Anna Krigel
For further reading...
Posted 07/20/16 10:28:21 AM by Anna Krigel
Created by Christopher Kelly
Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
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