Last reviewed: October 2017
Last updated: November  2017

Important updates

New drug therapies recommended for the treatment of hepatitis C

The American Association for the Study of Liver Diseases (AASLD)/Infectious Diseases Society of America (IDSA) have updated their hepatitis C guidelines to reflect several important developments, including the approval of glecaprevir/pibrentasvir and sofosbuvir/velpatasvir/voxilaprevir for the treatment of all genotypes of hepatitis C virus.

See Management: approach

Original source of update

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors

Other diagnostic factors

  • constitutional symptoms
  • jaundice
  • ascites
  • signs of hepatic encephalopathy
  • extrahepatic manifestations

Risk factors

  • unsafe medical practices
  • intravenous or intranasal drug use
  • blood transfusion or organ transplant
  • birth between 1945 and 1965
  • heavy alcohol use
  • interleukin (IL)-28B gene polymorphism
  • HIV
  • incarceration/institutionalisation
  • haemodialysis
  • healthcare work
  • tattoos
  • multiple sex partners
  • infected mother (for fetus)
  • male sex

Diagnostic investigations

1st investigations to order

  • enzyme immunoassay or hepatitis C antibodies
  • nucleic acid amplification tests (NAATs)
  • serum aminotransferases
  • viral genotyping
Full details

Investigations to consider

  • non-invasive tests of liver fibrosis or elasticity
  • liver biopsy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Division of Liver Diseases

Mount Sinai Hospital

New York

NY

Disclosures

JA declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Digestive Disease and Liver Transplant

Yale University

CT

Disclosures

AL has participated in an advisory board meeting with Gilead and Janssen, and is a primary investigator for Merck’s C-Surfer trial.

Director of Hepatology and Medical Director of Liver Transplantation

Associate Professor of Medicine

Strong Memorial Hospital

University of Rochester

NY

Disclosures

BM belongs to the paid speaker’s bureau for pharmaceutical companies Gilead (maker of ledipasvir/sofosbuvir), AbbVie (maker of Viekira Pak® - ombitasvir/paritaprevir/ritonavir and dasabuvir), Merck, and Salix.

Consultant Hepatologist

Bradford Teaching Hospitals Foundation Trust

Bradford

UK

Disclosures

SM has received sponsorship and has sat on advisory boards for BMS, Gilead, AbbVie, and Merck.

Consultant Hepatologist

Nottingham University Hospitals NHS Trust

UK

Disclosures

SR is an advisory board (paid) member for AbbVie, Gilead, Janssen, and MSD.

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