Infectious Disease Compendium

Hepatitis C

Microbiology

Virus.

Epidemiologic Risks

Blood exposure for the most part, some sexual contact, esp in men who have sex with men (PubMed). And amateur tattoos (PubMed). Avoid amateur tats, but those who get their friends to do the tats probably are not particularly fastidious in the first place (PubMed).

The sex, drugs and rock 'n' roll have caught up with boomers (born between 1945 and 1965; wait, that includes me). The CDC suggests all boomers be tested for Hepatitis C.

The incidence of HCV transmission among couples was 3.6 per 10,000 person-years with an estimated risk per sexual encounter of 1 per 380,000 (PubMed).

Syndromes

Hepatitis, often chronic (Review). Interesting immunologic complications like cryoglobulinemia and hepatic carcinoma.

Hepatitis C patients also have a higher risk of MI (PubMed).

Treatment

The bias of this particular guide. It covers diseases and processes that are mostly in patient oriented, diseases I treat or I find interesting. Hepatitis C is none of the above. So look elsewhere for current treatments of what is now a curable disease. I have no doubt I will miss these questions on my recert.

Pegylated interferon plus ribavirin plus boceprevir (for genotype 1)(PubMed). That's old school. Me? I refer them to GI.

"Telaprevir-based regimen significantly improved sustained virologic response rates in patients with genotype 1 HCV (PubMed, PubMed)".

Notes