Chronic hepatitis C: Update on diagnosis and treatment

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Although the number of new hepatitis C virus (HCV) infections dropped dramatically during the last decade, millions of Americans remain infected and at risk for fatal liver disease. Because chronic hepatitis C is usually asymptomatic, many are unaware that they are infected. Test patients who have documented exposures, such as health care workers with needle-stick injuries and children born to HCV-positive women. Consider testing patients who have ever injected illicit drugs, received dotting factor concentrates before 1987 or blood transfusions or organ transplants before July 1992, undergone long-term hemodialysis, had unexplained increases in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels, or are HIV positive. Liver biopsy remains the best method of assessing disease severity. Combination therapy with interferon alfa and ribavirin produces sustained viral eradication in about 40% of patients; however, therapy carries the risk of serious side effects and must be carefully monitored. The most common adverse reactions are flu-like symptoms, which appear to decrease in severity as treatment continues. Anemia caused by ribavirin usually occurs in the first 2 months of therapy but can occur later.

Original languageEnglish
Pages (from-to)1590-1596
Number of pages7
Issue number9
StatePublished - 2000
Externally publishedYes


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