How is hepatitis C treated?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Answer

For acute hepatitis C virus (HCV) infection, supportive care is the mainstay of treatment. Early initiation of antiviral therapy is not defined.

In chronic HCV infection, the goal is to identify complications and suitable candidates for antiviral therapy. The purpose of antiviral therapy is to ameliorate symptoms and reduce the risk of progressive liver disease. Consultation with a gastroenterologist may be indicated.

Long-term monitoring is essential because the risk of liver cancer is still high, even in sustained virologic responders. [8] In children, a well-defined interval for monitoring is not known, but every 6-12 months is probably reasonable to assess alanine aminotransferase (ALT) levels and clinical status.

Serum ALT levels have no consistent relationship to liver histologic findings. Longitudinal assessment of hepatitis C virus RNA provides a strong correlation with liver histologic results but is a weaker predictor of rate of progression.

Consider liver transplantation in patients with advanced liver disease. Surgical intervention may also be necessary for complications such as portal hypertension and hepatocellular carcinoma (HCC).

See also Pediatric Hepatitis A and Pediatric Hepatitis B.


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