hepatic and biliary disorders
Hepatitis C, Chronic
Introduction
Hepatitis C is a common cause of chronic hepatitis. It is often asymptomatic until manifestations of chronic liver disease occur. Diagnosis is confirmed by finding positive anti-HCV and positive HCV RNA≥6 months after initial infection. Treatment is with direct-acting antiviral drugs; permanent elimination of detectable viral RNA is possible. (See also Causes of Hepatitis , Hepatitis lasting>6 months is generally defined as chronic hepatitis, although this duration is arbitrary. There are 6 major genotypes of hepatitis C virus (HCV), which vary in their response to treatment. Genotype 1 is more common than genotypes 2, 3, 4, 5, and 6; it accounts for 70 to 80% of cases of chronic hepatitis C in the US. Hepatitis C, Acute becomes chronic in about 75% of patients. The Centers of Disease Control and Prevention (CDC) estimates that, from 2013 to 2016, about 2.4 million people in the US have chronic hepatitis C infection ( Chronic hepatitis C progresses to Cirrhosis in 20 to 30% of patients; cirrhosis often takes decades to appear. Up to 20% of patients with Alcohol-Related Liver Disease harbor HCV. The reasons for this high association are unclear because concomitant alcohol and drug use accounts for only a portion of cases. In these patients, HCV and alcohol act synergistically to worsen liver inflammation and fibrosis. 