What are the guidelines for the medical management and monitoring of acute hepatitis C (hep C) infection?

Updated: Oct 07, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD  more...
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Answer

Recommendations [9]

  • Regularly monitor with laboratory studies in the setting of acute HCV infection. In addition, monitor HCV RNA (eg, every 4-8 weeks) for 6 to 12 months to determine spontaneous clearance versus persistence of HCV infection.

  • Counsel patients with acute HCV infection to avoid hepatotoxic insults, including hepatotoxic drugs (eg, acetaminophen) and alcohol consumption, and to reduce the risk of HCV transmission to others.

  • Refer to an addiction medicine specialist for patients with acute HCV infection related to substance use.

  • If a decision to delay initiation of treatment is acceptable to the clinician and patient, monitor for spontaneous clearance for at least 6 months. If, after 6 months, a decision is made to initiate therapy, treat as previously discussed under the section Treatment-Naive Patients with Chronic Hepatitis C Infection.

  • If a decision to initiate treatment is made during the acute infection period, before starting therapy, monitor HCV RNA levels for at least 12-16 weeks for possible spontaneous clearance.

  • The same treatment regimens recommended for chronic HCV infection are recommended for acute HCV infection.


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