Management of Treatment-Naïve Genotypes 2 and 3 HCV Infection
Genotypes 2 and 3 are distinct from the other genotypes of HCV infection, genotype 1 in particular, for their more favorable response to treatment with peginterferon and ribavirin. This case will review the current treatment of genotypes 2 and 3, as well as provide some background on clinical factors that may influence the management of these patients.
Medications Used in Hepatitis C Treatment
Treatment of hepatitis C currently involves a combination of peginterferon and ribavirin with or without one of the HCV protease inhibitors, telaprevir or boceprevir. This case reviews the appropriate use of these medications as well as the mechanism of action and common adverse effects of each agent.
Virologic Responses during Treatment of Hepatitis C
Understanding virologic responses during and after treatment of hepatitis C is an important component of hepatitis C management. This case reviews the array of terms used to describe virologic responses during treatment, at the end of treatment, and post-treatment.
Pre-treatment Considerations for Chronic Hepatitis C Virus Infection
The decision to initiate treatment for hepatitis C virus infection is influenced by the likelihood of success, the need for treatment related to the rate and stage of liver disease progression, and the treatment efficacy and risks for the individual patient. This case features a discussion of baseline viral and host factors that predict treatment response.
Diagnosis of Hepatitis C Virus Infection
The laboratory tests used to diagnose hepatitis C virus (HCV) infection consist of serologic assays that detect human antibodies against HCV and molecular assays that detect viral nucleic acid. This case reviews HCV diagnostic tests and the general algorithm for diagnosing HCV, including different testing strategies related to the pre-test probability of infection.
Initiating Treatment in Patients with Hepatitis B and HIV Coinfection
Individuals coinfected with HBV and HIV are more likely to experience liver-related morbidity and mortality than those infected with HBV alone. This case discusses the goals of treatment and the unique issues surrounding initiating antiviral therapy in HBV-HIV-infected persons.
Serologic and Virologic Markers of Hepatitis B Virus Infection
Knowldege of HBV serologic markers is important in understanding whether a patient is susceptible to infection, immune as a result of resolved infection, immune as a result of vaccination, acutely infected, or chronically infected. This case provides a detailed summary of hepatitis B serologic markers using graphics and animations.
Evaluation of New Onset Ascites in a Patient with Chronic Hepatitis C
Ascites is an important complication that can occur in patients with cirrhosis. All patients with new onset ascites of uncertain cause should undergo paracentesis. This case reviews the causes of new onset ascites, the appropriate technique for performing a diagnostic paracentesis, and the recommended analysis of the ascitic fluid.
Acute Hepatitis C
Most persons infected with hepatitis C virus are not diagnosed during the first 6 months of infection, but this early period offers a unique treatment opportunity as cure rates during this early period are very high. This case reviews the clinical and laboratory features, disease course, immune response, diagnosis of acute infection, and treatment.
Counseling the Patient with Chronic Hepatitis B Infection
Health educators often have a number of questions posed to them by patients with chronic hepatitis B virus infection. Using a question and answer format, the case provides a framework for counseling and educating patients about chronic hepatitis B.