Hepatitis C

Learning Objectives

Upon completing the course, you will able to:

  1. Discuss the epidemiology of HCV and demographic characteristics of HCV infection.
  2. Discuss various prevention and control recommendations for HCV infection.
  3. List elements of a comprehensive strategy to prevent and control hepatitis C virus infection.
  4. Provide specific advice to persons with high-risk drug or sexual practices as part of HCV prevention strategy.
  5. Identify persons who should be tested routinely for hepatitis C virus infection.
  6. Identify persons with chronic hepatitis C who are recommended for treatment and those that are not.
  7. Provide HCV-specific information and prevention messages to infected persons and individuals at risk.

Evaluation of Individual Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.


Table of Contents

Introduction

Figure 1. Reported cases of acute hepatitis C by selected risk factors– United States, 1983–1996

Background

Epidemiology
  • Demographics Characteristics
    • Figure 2. Prevalence of hepatitis C virus (HCV) infection by age and race/ethnicity– United States, 1988–1994
  • Transmission Modes

Screening and Diagnostic Tests

  • Serologic Assays

Clinical Features and Natural History

  • Acute HCV Infection
  • Chronic HCV Infection
  • Clinical Management and Treatment

Prevention and Control Recommendations

Rationale
 
Primary Prevention Recommendations
  • Blood, Plasma Derivatives, Organs, Tissues, and Semen
  • High-Risk Drug and Sexual Practices
  • Percutaneous Exposures to Blood in Health-Care and Other Settings
    • Health-Care Settings
    • Other Settings

Secondary Prevention Recommendations

Persons for Whom Routine HCV Testing Is Recommended
  • Persons Who Have Ever Injected Illegal Drugs
  • Persons With Selected Medical Conditions
  • Prior Recipients of Blood Transfusions or Organ Transplants
  • Health-Care, Emergency Medical, and Public Safety Workers After Needle Sticks, Sharps, or Mucosal Exposures to HCV-Positive Blood
  • Children Born to HCV-Positive Women

Persons for Whom Routine HCV Testing Is Not Recommended

  • Health-Care, Emergency Medical, and Public-Safety Workers
  • Pregnant Women
  • Household (Nonsexual) Contacts of HCV-Positive Persons

Persons for Whom Routine HCV Testing Is of Uncertain Need

  • Recipients of Transplanted Tissue
  • Intranasal Cocaine and Other Noninjecting Illegal Drug Users
  • Persons with a History of Tattooing or Body Piercing
  • Persons with a History of Multiple Sex Partners or STDs

Testing for HCV Infection

  • Figure 3. Hepatitis C virus (HCV)-infection–testing algorithm for asymptomatic persons

Prevention Messages and Medical Evaluation

  • Persons with High-Risk Drug and Sexual Practices
  • Negative Test Results
  • Indeterminate Test Results
  • Positive Test Results

NIH Consensus Statement Regarding Management of Hepatitis C (Excerpted)

  • Persons Recommended for Treatment
  • Persons for Whom Treatment Is Unclear
  • Persons for Whom Treatment Is Not Recommended

Public Health Maintenance

  • Surveillance for Acute Hepatitis C
  • Laboratory Reports of Anti-HCV-Positive Tests
  • Serologic Surveys
  • Surveillance for Chronic Liver Disease

Future Directions

References