Hepatitis C

• most are asymptomatic

There are 6 major genotypes

• Type 1 is the most difficult to treat and the most common.  Biopsy is usually performed to assess stage at diagnosis, establish baseline.
• Type 2 has a high therapeutic success rate (85%). Biopsy may not be necessary if patients are willing to treat anyway.
• Type 3 in general also has a high therapeutic success rate unless there is a high viral titer, in which case it is difficult.
• All other types are difficult to treat.

Advice to avoid transmission:

• avoid sharing toothbrushes, dental, shaving equipment
• cover any bleeding wound in order to keep blood away from others
• the risk of sexual transmission is low and that the infection itself is not a reason to change sexual practices (ie, those in long-term relationships need not start using barrier precautions and others should always practice "safer" sex)
• do not donate blood, body organs, other tissues, or semen

Plan:

• If HCV positive
• Obtain genotype and viral level
• Refer to hepatology for biopsy