J Clin Outcomes Manage
Hepatitis C: update on management of chronic infection
Reddy SI, Ukomau C
Program Audience Primary care physicians. Educational Needs Addressed Patients with chronic hepatitis C virus (HCV) infection are at risk for progressive liver disease, including fibrosis, cirrhosis, and hepatocellular carcinoma. Recent advances in treatment for HCV have led to better outcomes in patients with chronic infection but have also created controversy around some management issues, including which patients should be treated and which patients should undergo liver biopsy prior to treatment. For example, it has been suggested that because approximately 80% of patients infected with HCV genotypes 2 and 3 can expect to achieve long-term viral eradication, liver biopsy may not be required in these patients. This article reviews key points in the management of patients with chronic HCV infection, including laboratory testing to confirm the presence of chronic infection and assess for liver disease, treatment decision making, and monitoring patient response to therapy. Educational Objectives 1. Know the routes of transmission of hepatitis C virus (HCV) infection 2. Know the natural history of HCV infection 3. Use appropriate testing to diagnose chronic HCV infection, assess for liver disease, and determine HCV genotype 4. Determine which patients should be treated and which should undergo liver biopsy 5. Initiate therapy with pegylated interferon and ribavirin and monitor patient response
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