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Hepatitis C

Last reviewed: 16 Aug 2025
Last updated: 10 Mar 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • unsafe medical practices
  • intravenous or intranasal drug use
  • history of transfusion or organ transplantation
Detalhes completos

Outros fatores diagnósticos

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

Fatores de risco

  • unsafe medical practices
  • intravenous or intranasal drug use
  • blood transfusion or organ transplant
  • heavy alcohol use
  • interleukin (IL)-28B gene polymorphism
  • HIV
  • incarceration/institutionalization
  • dialysis
  • healthcare work
  • tattoos/body piercing
  • acupuncture
  • multiple sex partners
  • infected mother (for fetus)
  • male sex
  • vitamin D deficiency
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • hepatitis C virus (HCV)-antibody enzyme immunoassay (EIA)
  • hepatitis C virus (HCV) RNA polymerase chain reaction (PCR)
  • serum aminotransferases
Detalhes completos

Investigações a serem consideradas

  • viral genotyping
  • hepatitis C virus (HCV) core antigen assay
  • noninvasive tests of liver fibrosis or elasticity
  • aspartate aminotransferase-to-platelet ratio index (APRI)
  • liver biopsy
  • testing for co-infection
Detalhes completos

Algoritmo de tratamento

Inicial

recent infection

AGUDA

chronic infection suitable for simplified treatment: any genotype

chronic infection not suitable for simplified treatment and treatment-naive: genotype 1a

chronic infection not suitable for simplified treatment and treatment-naive: genotype 1b

chronic infection not suitable for simplified treatment and treatment-naive: genotype 2

chronic infection not suitable for simplified treatment and treatment-naive: genotype 3

chronic infection not suitable for simplified treatment and treatment-naive: genotype 4

chronic infection not suitable for simplified treatment and treatment-naive: genotype 5 or 6

chronic infection not suitable for simplified treatment and treatment-experienced: all genotypes

CONTÍNUA

decompensated cirrhosis

Colaboradores

Autores

Jawad Ahmad, MD, FRCP, FAASLD

Professor of Medicine

Division of Liver Diseases

Mount Sinai Hospital

New York

NY

Declarações

JA declares that he has no competing interests.

Agradecimentos

Dr Jawad Ahmad would like to gratefully acknowledge Dr Brian L. Pearlman, the previous contributor to this topic.

Declarações

BLP is on the speakers' bureaus and serves as an advisor to Merck, Gilead, J&J, and AbbVie, and does contracted research with Boehringer Ingelheim, Tibotec/Janssen, Bristol-Myers Squibb, Gilead, and Merck. BLP is also an author of a number of references cited in this topic. BLP wishes to acknowledge Chaithanya Mallikarjun, MD, for her help in writing the original version of the manuscript.

Revisores

AnnMarie Liapakis, MD

Assistant Professor

Digestive Disease and Liver Transplant

Yale University

CT

Declarações

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

Benedict Maliakkal, MRCP

Director of Hepatology and Medical Director of Liver Transplantation

Associate Professor of Medicine

Strong Memorial Hospital

University of Rochester

NY

Declarações

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.

Sulleman Moreea, FRCS (Glasg), FRCP

Consultant Hepatologist

Bradford Teaching Hospitals Foundation Trust

Bradford

UK

Declarações

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

Steve Ryder, DM, FRCP

Consultant Hepatologist

Nottingham University Hospitals NHS Trust

UK

Declarações

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

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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  • Diretrizes

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    • Guidelines for health care personnel exposed to hepatitis C virus
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  • Folhetos informativos para os pacientes

    Hepatitis C: what is it?

    Hepatitis C: what are the treatment options?

    Mais Folhetos informativos para os pacientes
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