FACT FILE: Hepatitis C and treatment centers

Hepatitis C (HCV) is an infection caused by a virus. It can be acute (short duration) or chronic (long-lasting). Approximately 15% to 25% of acute cases clear the virus from their bodies without treatment. HCV can lead to liver disease, and in 1% to 5% of cases, it can lead to death as a result of liver disease. HCV is contagious through blood-to-blood contact, often through items that might have infected blood on them, such as needles or razors.

Incidence and Prevalence:

• Acute cases = 2,138 (reported in 2013)
• Chronic cases = 5 million to 7 million

Approximately one-third of young (ages 18 to 30) injection-drug users are HCV-infected. Older and former injection-drug users typically have a higher prevalence (approximately 70% to 90%) of HCV infection.

Risk Factors:

Current or former injection-drug users, including those who injected only once many years ago, are at high risk of infection. Co-infection is also an issue. In fact, 50% to 90% of human immunodeficiency virus (HIV)-infected persons who use injection drugs are also infected with HCV. 

Prognosis:

Of every 100 persons infected with HCV, approximately:

• 75 to 85 will go on to develop chronic infection
• 60 to 70 will go on to develop chronic liver disease
• 5 to 20 will go on to develop cirrhosis over a period of 20 to 30 years
• 1 to 5 will die from the consequences of chronic infection (liver cancer or cirrhosis)

Treatment:

Until recently, the mainstay of treatment for chronic HCV infection has been prescription drugs, which were given for 24 to 48 weeks. Treatment often created side effects such as flulike symptoms, insomnia, depression and anxiety.

In late 2013, The Food and Drug Administration approved new types of antiviral drugs to treat chronic HCV infection, and more have been approved since.  The medications generally clear the virus in  80% to 95% of patients after 12 to 24 weeks of treatment, with milder side effects. They are considered a cure for HCV.

Approved hepatitis C drugs:

• Copegus, Moderiba, Rebetol, Ribasphere (ribavirin)
• Harvoni (ledipasvir + sofosbuvir)
• Olysio (simeprevir)
• Pegasys and PegIntron (peginterferon)
• Sovaldi (sofosbuvir)
• Victrelis (boceprevir)
• Viekira Pak (ombitasvir, paritaprevir, ritonavir + dasabuvir)

What clinicians and patients should know:

• HCV is not spread by sneezing, hugging, holding hands, coughing, sharing eating utensils or drinking glasses, or through food or water.
• Sharing items that might have blood on them can pose a risk to others.
• Patients should be informed about the low but present risk for transmission with sex partners.
• Cuts and sores on the skin should be covered to keep from spreading infectious blood or secretions.
• Donating blood, organs, tissue, or semen can spread HCV to others.

Guidelines:

https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm

CDC Informational Video:

Source: Centers for Disease Control and Prevention; Food and Drug Administration; Substance Abuse and Mental Health Services Administration