HCV


Indication for Hospitalization:

Facts:

Work-up:

HCV Testing

HCV Testing


Elisa anti-HCV Ab
(-)  but suspicious (AST,ALT) (+)

HCV RNA PCR
false (+) Cleared Persistent
(-) (+)        
- HCV RNA PCR
- Viral Genotype

NO infection

Acute Infection

HCV Exposure

  1. Baseline testing for anti-HCV and ALT activity
  2. Follow-up testing at 4-6 months for anti-HCV and ALT activity OR HCV RNA at 4-6 weeks
  3. Exposed individuals should not donate blood, plasma, organs, tissue, or semen
  4. Exposed person does not need to modify sexual practices or refrain from pregnancy or discontinue breast feeding
  5. When HCV infection is confirmed early, the person should be referred for medical management to a specialist in this area
  6. IG and anti-viral agents are not recommended


HCV in pregnancy

  • HCV Viral load
  • Viral Genotype
  • Expectant management like any other pregnancy.
  • Normal Vaginal delivery OK
  • AVOID scalp monitor.
    • Infant:
      • Bath immidiatly
      • Screen at age 1 yr old.
  • Breastfeeding OK (Per CDC)

Cryoglobulinemia

  • Nephritic syndrome, IV drug user, Low Complement level.
  • Tx:
    • (+) renal dysfunction = Only INF-Alpha,
    • (-) renal dysfunction= INF-Alpha + Ribavirin.

Lichen planus

  • Lichen planus is an idiopathic inflammatory disease affecting the skin and oral mucosa.
  • The characteristic violaceous, polygonal papules may be intensely itchy.
  • There is a significant association between lichen planus and hepatitis C virus infection
ITE 2014 Q81.
A 53-year-old white female with chronic hepatitis C is concerned about ulcers in her mouth. She is not currently receiving therapy. Your examination reveals several ulcers involving the buccal mucosa. The patient also points out a number of pruritic, reddish-purple plaques on her wrists, ankles, and back. Laboratory studies are within normal limits except for mildly elevated transaminases. Which one of the following is the most likely diagnosis?

A) Behçet’s syndrome
B) Lichen planus
C) Aphthous stomatitis
D) Herpetic stomatitis
E) HIV infection

ANSWER: B

  • Lichen planus is an idiopathic inflammatory disease affecting the skin and oral mucosa. The characteristic violaceous, polygonal papules may be intensely itchy. There is a significant association between lichen planus and hepatitis C virus infection.

    Ref: Le Cleach L, Chosidow O: Lichen planus. N Engl J Med 2012;366(8):723-732.