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AASLD Hepatitis C

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Key Points ÎHepatitis C virus (HCV) infection is the principal cause of death from liver disease and the leading indication for liver transplantation in the US. ÎIn the US the CDC estimates approximately 3.2 million persons have chronic HCV infection. An estimated 170-200 million people are infected worldwide. ÎPersons newly infected with HCV are usually asymptomatic, so acute Hepatitis C is rarely identified or reported. ÎRecently, two major advances have changed the optimal treatment regimen of genotype 1 chronic HCV infection: > The development of direct acting antiviral agents has led to a substantial improvement in sustained virologic response (SVR) rates and the option of abbreviated therapy in many patients with genotype 1 chronic HCV infection. > Several single nucleotide polymorphisms have been associated with spontaneous and treatment-induced clearance of HCV infection. Screening and Testing Comment: All persons should be screened for behaviors that place them at high risk for HCV infection (I-B). Persons for whom HCV screening is recommended: ÎPersons who have injected illicit drugs in the recent and remote past, including those who injected only once and do not consider themselves to be drug users. ÎPersons with conditions associated with a high prevalence of HCV infection including: > Persons with human immunodeficiency virus (HIV) infection > Persons with hemophilia who received clotting factor concentrates prior to 1987 > Persons who have ever been on hemodialysis > Persons with unexplained abnormal aminotransferase levels ÎPrior recipients of transfusions or organ transplants prior to July 1992 including: > Persons who were notified that they had received blood from a donor who later tested positive for HCV infection > Persons who received a transfusion of blood or blood products > Persons who received an organ transplant ÎChildren born to HCV-infected mothers. ÎHealth care, emergency medical and public safety workers after a needle stick injury or mucosal exposure to HCV-positive blood.

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