True statement regarding hepatitis C infection:
Ans: (b) Highly likely to cause chronic ongoing infectionRef: Harrison's Principles of Internal Medicine, 19th edition, Page 2040; Sleisenger and Fordtran's Gastrointestinal and Liver Disease, Page 1332Acute hepatitis C is rarely seen in clinical practice, because nearly all cases are asymptomatic.Chronic hepatitis C follows acute hepatitis C in 50-70% of cases20-25% of patients with chronic hepatitis C progress to cirrhosisProgression of liver disease depends on:AgeLonger duration of infection - most important factorConcomitant other liver diseaseObesityHIV infectionLong-term prognosis for chronic hepatitis C in a majority of patients is relatively benign o The best prognostic indicator in chronic hepatitis C is liver histologyAminotransferase levels tend to fluctuate more (the characteristic episodic pattern of aminotransferase activity)Interesting and occasionally confusing finding in patients with chronic hepatitis C is the presence of autoantibodies Anti LKMDrugs used in the treatment of hepatitis C infection: PEG IFN-a plus ribavirinAgentGenotype(s)DoseCommentProtease InhibitorsBoceprevir1800 mg three times dailyUsed in combination with pegylated interferon and ribavirin; no longer recommendedTelaprevir11125 mg twice dailyUsed in combination with pegylated interferon and ribavirin; no longer recommendedSimeprevir1 and 4150 mg once dailyUsed in combination with pegylated interferon and ribavirin or with sofosbuvirParitaprevir1 and 4150 mg once dailyUsed in combination with ombitasvir and dasabuvir; ritonavir boostedAsunaprevir1 and 4200 mg twice dailyUsed in combination with daclatasvir or with daclatasvir and BMS-791324Grazoprevir1,2, 4-6100 mg once dailyUsed in combination with eibasvirNon-nucleos(t)ide Polymerase InhibitorsDasabuvir1 and 4250 mg twice dailyUsed in combination with paritaprevir and ombitasvirBMS-791325175 mg twice dailyUsed in combination with daclatasvir and asunaprevirNucleos(t)ide Polymerase InhibitorSofosbuvir1-6400 mg once dailyUsed in combination with pegylated interferon and ribavirin (all genotypes) or with ribavirin alone (genotypes 2 and 3) or with simeprevir (genotypes 1 and 4) or with declatasvir (all genotypes) or with ledipasvir (genotypes 1,3 and 4) or with GS-5861 (under study)NS5A InhibitorsDaclatasvir1-660 mg once dailyUsed in combination with sofosbuvir (genotypes 1-6) or with pegylated interferon and ribavirin (genotype 4) or with asunaprevir (with or without BMS-791325; under study)Ledipasvir1,3 and 490 mg once dailyUsed in combination with sofosbuvirOmbitasvir1 and 425 mg once dailyUsed in combination with paritaprevir and dasabuvirEibasvir1-650 mg once dailyUsed in combination with grazoprevirGS-58161-6100 mg once dailyUsed in combination with sofosbuvir
Most patients have severe symptoms when infected for first time
Highly likely to cause chronic ongoing infection
Transmitted by eating raw oysters
It is DNA virus
Infection