Hepatitis C Infection
(HCV, Hep C)

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Hepatitis C infection (HCV, hep C) facts

  • HCV is one of several viruses that cause hepatitis (inflammation of the liver).
  • Up to 85% of individuals who are initially (acutely) infected with HCV will fail to eliminate the virus and will become chronically infected.
  • HCV is spread most commonly through inadvertent exposure to infected blood. Intravenous drug abuse is the most common mode of transmission. The risk of acquiring HCV through sexual contact is low.
  • Generally, patients do not develop symptoms of chronic infection with HCV until they have extensive scarring of the liver (cirrhosis). Some individuals, however, may have fatigue and other non-specific symptoms in the absence of cirrhosis. A minority of patients with HCV have symptoms from organs outside of the liver.
  • In the U.S., Infection with HCV is the most common cause of chronic hepatitis and the most common reason for liver transplantation.
  • HCV is diagnosed by determining levels in the blood of antibodies to the virus and then confirmed with other tests for viral RNA. The amount of viral RNA in the blood (viral load) does not correlate with the severity of the disease but can be used to track the response to treatment.
  • A liver biopsy may be used to assess the amount of liver damage (liver cell injury and scarring), which can be important in planning treatment.
  • Considerable progress has been made in the treatment of HCV, although response rates remain imperfect, approximately 50%-60% for genotype 1. Combined therapy with pegylated interferon, ribavirin, and one of two new drugs (direct acting anti-viral drugs) telaprevier (Incivek - This drug was discontinued by the manufacturer, but will be available until October 2014) and boceprevir (Victrelis) is the current treatment regimen.
  • Treatment results in reduced inflammation and scarring of the liver in most sustained responders and also occasionally (and to a much lesser extent) in those who relapse or do not respond.
Medically Reviewed by a Doctor on 2/2/2014

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New Hepatitis C Drug Treatments

The types of drugs available for treating chronic hepatitis C virus are undergoing a radical change. The genetic material of hepatitis C virus (its RNA) has been sequenced, and most of the virus' genes are now known. Some genes direct the manufacture of enzymes that are crucial to the production of new hepatitis C virus. Others are crucial for production of new hepatitis C virus, but their exact functions are unknown. Knowing the nature of the hepatitis C virus genetic material and its products, it has been possible to develop drugs that target portions of the genetic material or its products and prevent their actions. These drugs are referred to as direct acting anti-viral drugs.

The first of these new, direct acting antiviral drugs - telaprevir (Incivek) and boceprevir (Victrelis)...