Clinical Evaluation of Chronic Hepatitis C and Indications for HCV Treatment

Hepatitis C virus (HCV) is the most common cause of liver cirrhosis in the United States. If untreated, HCV can lead to death from complications of liver failure or hepatocellular carcinoma, making screening imperative in high-risk patients. Established risk factors for HCV infection include injection drug use, receipt of blood transfusion or organ transplantation prior to 1992, and hemodialysis. Recent evidence has demonstrated that those born between 1945-1965 are additionally at high risk for HCV acquisition and should undergo one time screening. Once diagnosed, consideration for treatment should be based on patient motivation, concurrent medical co-morbidities, degree of liver injury, and risk of progression to cirrhosis. Therapy may also be indicated in patients with extra-hepatic manifestations of HCV.