Hepatitis has a broad spectrum of presentations that range from a complete lack of symptoms to severe liver failure. Entecavir (Baraclude) is an orally administered cyclopentyl guanosine analogue that is used for treatment of chronic hepatitis B virus infection in adults with evidence of active viral replication and either evidence of persistent elevation in serum aminotransferases or histologically active disease. Now that more advanced screening tests for hepatitis C are used in blood banks, the risk of transmission to recipients of blood or blood products is considered extremely rare, at <1 case per 2 million units transfused. This book is a collection of chapters offering the distilled knowledge of various worldwide experts in hepatic surgery and hepatic physiology. Patients with chronic active hepatitis had a greater frequency of seropositivity than those with chronic persistent hepatitis (26% vs. 0%, p < 0.05), and patients with symptomatic chronic disease harbored the antibody more commonly than asymptomatic counterparts (14% vs. 2%, p < 0.01) or patients with acute hepatitis (14% vs. 1%, p < 0.02). Ideally, positive antibody tests are “reflexed” to an HCV RNA test automatically from the same blood sample. Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver of unknown etiology identified in the 1940s and formerly called chronic active hepatitis. People with occult infection may reactivate hepatitis B virus infection if they become immunocompromised. In Chronic Viral Hepatitis, Second Edition, a panel of distinguished clinicians and clinical investigators build upon the first edition by comprehensively reviewing all the relevant new information regarding resistance, side effects, and ... No. Chronic hepatitis B is associated with death from cirrhosis and/or hepatocellular carcinoma in up to 25% of cases. How many new HCV infections occur annually in the United States? Background: The significance of mutations of hepatitis B virus (HBV) precore/core antigen in causing persistent infection and subsequent liver diseases is debatable. The aim of this study was to investigate whether there is an … Attenuates hepatic fibrosis in a number of animal models and in humans with chronic active hepatitis. Screening for hepatitis B is recommended in pregnant women at their … Hepatitis B surface antigen (HBsAg): A protein on the surface of hepatitis B virus; it can be detected in high levels in serum during acute or chronic hepatitis B virus If diagnosed early enough, many patients can be successfully treated. Health care, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV‑positive blood, https://www.cdc.gov/hepatitis/HCV/PDFs/hcv_graph.pdf, https://www.cdc.gov/hepatitis/HCV/PDFs/hcv_flow.pdf, the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. Other than needlesticks, do other exposures (like splashes to the eye) place health-care personnel at risk for hepatitis C? Chronic hepatitis C infection is caused by the hepatitis C virus (HCV). This site needs JavaScript to work properly. J Small Anim Pract 33: 389–394. [] Abstract. Prior infection with HCV does not protect against later infection with the same or different genotypes of the virus. Mahajan R, Xing J, Liu SJ, Ly KN, Moorman AC, Rupp L, Xu F, Holmberg SD; Chronic Hepatitis Cohort Study (CHeCs) Investigators. However, these diseases were excluded in this patient who did have chronic persistent hepatitis. Given that hepatitis C treatment has been simplified, many types of providers can effectively manage HCV-infected patients, including internal medicine and family practice physicians, nurse practitioners, physician assistants, and pharmacists (33). Bookshelf Acute-on-chronic liver failure (ACLF) is an important syndrome of liver failure that has a high risk of short-term mortality in patients with chronic liver disease. 2008 Feb;42(2):199-203. doi: 10.1097/01.mcg.0000225681.45088.48. Pyoderma gangrenosum may occur in association with underlying diseases such as leukemia, monoclonal gammopathy, inflammatory bowel disease, arthritis, and chronic active hepatitis. CDC recommends that people who are diagnosed with hepatitis C be provided. How should providers determine hepatitis C prevalence to inform testing within their practices? 1989 Sep 1;101(16):544-7. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. How soon after exposure to HCV can HCV RNA be detected? Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world's hepatocellular carcinoma and more than half of all fatal cirrhosis. Cases of suspected health-care-associated HCV infection should be reported to state and local public health authorities for prompt investigation and response. The review/meta-analysis concludes that people who tolerate opioids may get "modest short-term relief" at best and that there's really no evidence to speak of for long … 8600 Rockville Pike This review summarizes studies on HBV persistence and reactivation with a focus on the definitions and mechanisms. The aim of this study was to … Hepatology. Chronic hepatitis is the result of unresolved acute injury and is associated with ongoing liver damage. Can a patient have a normal liver enzyme (e.g., ALT) level and still have chronic hepatitis C? Since T cells in chronic active hepatitis B are exhausted and a primary cause of this condition is their persistent exposure to high antigen doses, the first goal of therapy should be to restore the antiviral T cell function by inducing a decline of antigenaemia with nucleoside analogues. However, reflex testing is not possible in every laboratory or clinical setting. Therefore, all patients initiating HCV DAA therapy should be tested for HBV with HBsAg, anti-HBs, and anti-HBc. Thus, there was no significant difference in the prevalence of type II among the various stages of chronic liver disease. For more information about management of people diagnosed with acute HCV infection, see http://www.hcvguidelines.orgexternal icon. For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. (2009) down-modulation may explain Vgamma9Vdelta2 T lymphocyte anergy in HIV- Natural killer cell functional dichotomy in chronic hepatitis B and chronic infected patients. Under what circumstances might a false-negative HCV antibody (anti-HCV) test result occur, even when a person has been exposed to HCV? This study was a large, active-control trial of two nucleoside therapies in patients with HBeAg-positive chronic hepatitis. The indications, technic and findings]. This edition incorporates new material and combines the basic aspects of autoimmunity with discussion of specific autoimmune diseases in humans. Globally, there are over 350 million chronic carriers of HBV who are at … Autoimmune Hepatitis, also known as AIH, is a chronic (condition that lasts longer than six months), usually lifelong liver condition. Accessibility With the exception of pregnant women and children under 3 years of age, people with acute hepatitis C (i.e., those with measurable HCV RNA) should be treated for their infection. However, it was unknown whether the HCV-antibody-positive patients had current infection at the time of exposure. analysis of class I and class II HLA antigens and chronic hepatitis B virus 10. This study explores the efficacy, safety and tolerability of tenofovir DF (TDF) 300 mg once daily monotherapy versus the combination of emtricitabine 200 mg plus tenofovir DF 300 mg (FTC/TDF) once daily in subjects currently being treated with adefovir dipivoxil (Hepsera) for chronic hepatitis B who have persistent viral replication (detectable hepatitis B virus … Before 1992 (the year that blood screening became available), blood transfusion was a leading cause of hepatitis C virus transmission (18,19). Is it possible for someone to become infected with HCV and then spontaneously clear the infection? As the virus enters the body, it causes an infection in the liver. Hepatitis B virus (HBV) is transmitted through percutaneous and mucosal exposure to infected blood or body fluids. {{configCtrl2.info.metaDescription}} This site uses cookies. These recommendations are available at http://www.hcvguidelines.orgexternal icon. A person infected with HCV mounts an immune response to the virus, but replication of the virus during infection can result in changes that evade the immune response. 2008 Nov 1;28(9):1102-10. doi: 10.1111/j.1365-2036.2008.03825.x. Wien Klin Wochenschr. Recent data reveal that up to approximately half of people who test anti-HCV positive do not have current chronic infection (1), indicating they may have experienced spontaneous clearance after acute infection. Only those with current infection as evidenced by a positive HCV RNA test need treatment. PMC There is no evidence that breastfeeding spreads hepatitis C. Currently, both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists support breastfeeding in HCV-infected women (40,41). Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. When people are initially infected with HBV, they usually don't have any symptoms. Initial evaluation for presence of disease should include multiple measurements of ALT at regular intervals, because ALT activity fluctuates in persons with chronic hepatitis C. Patients with … Pregnant women with known risk factors should be tested during each pregnancy, regardless of setting prevalence. Individuals with HIV have an increased risk of acquiring HBV through injection drug use and/or condomless sex. Indeed, patients with hepatitis C may have chronic hepatitis for as long as 40 years before progressing to cirrhosis. Content includes initial evaluation, natural history, preventing liver damage, … These are the first WHO guidelines on testing for chronic HBV and HCV infection and complement published guidance by WHO on the prevention, care and treatment of chronic hepatitis C and hepatitis B infection. There is no definite cure for the … A previous acute-phase episode had occurred in 8 patients. ACR Classification Criteria for Determining Progression of Rheumatoid Arthritis This book addresses the need for a definitive, up-to-date text on the pathology of viral hepatitis, and provides a summary of modern understanding of these diseases. When the … This text provides a concise yet comprehensive overview of autoimmune hepatitis (AIH). Overview and Statistics. HBV persistence is mediated by an intranuclear, episomal form of … Purpose and Scope. The risk is significantly higher if the mother has a high HCV viral load, or is coinfected with HIV with which the rate of transmission ranges from 8%–15% (39). Entecavir, 0.5 mg daily, will have clinical efficacy (assessed as an undetectable hepatitis B DNA, <300 copies/mL, by Roche Comprehensive Bio-Analytical System Amplicor … This book provides a comprehensive, state-of-the art review of HBV infection and liver disease. Biopsy Interpretation of the Liver, Second Edition offers pathologists clear, practical guidelines for recognizing and diagnosing the full spectrum of liver disorders. This includes. Hepatitis B virus (HBV) infection is an important disease worldwide 1,2.Current therapy for chronic hepatitis B (CHB) relies upon interferon (IFN)-based therapy or … HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood. When symptoms do occur, they can include: In those people who do develop symptoms, the average period from exposure to symptom onset is 2–12 weeks (range: 2–26 weeks) (13, 14). Routine periodic testing is recommended for people with ongoing risk factors, while risk factors persist, including those who currently inject drugs and share needles, syringes, or other drug preparation equipment, along with people who have certain medical conditions (e.g., people who ever received maintenance hemodialysis). Persistent Viral Infections focuses on: * The pathogenesis and immunology of chronic infections * Animal models that provide, or have the potential to provide, major insights This volume will be essential reading for virologists, ... Can hepatitis C be spread within a household? of chronic hepatitis B. For the 9 remaining patients, the gradient was between 0.79 and 0.93 kPa, 3 had persistent hepatitis, and 6 had active hepatitis. Although less frequent, HCV can also be spread through: No nationwide seroprevalence surveys targeting PWID have been conducted in the United States, and estimates based on smaller surveys in regional and metropolitan areas vary considerably. Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment (e.g., gloves, masks, and protective eyewear). Typically, once the symptoms of hepatitis become obvious, chronic liver disease and liver damage are well underway. The virus is transmitted sexually or by blood/body fluid exposure. How likely is HCV infection to become chronic? It is common for patients with chronic hepatitis C to have fluctuating liver enzyme levels, with periodic returns to normal or near normal levels. HBV causes chronic hepatitis B (CHB), a severe liver disease responsible for nearly a million deaths each year. Updated guidelines for management and treatment of hepatitis Cexternal icon are available to provide guidance for health-care personnel who become infected via exposure to contaminated blood at the workplace. These infection control breaches have included reuse of syringes and other failures of aseptic technique, contamination of multidose vials, and inadequate cleaning of equipment. Do hepatitis C outbreaks occur in healthcare settings? This study was a large, active-control trial of two nucleoside therapies in patients with HBeAg-positive chronic hepatitis. To obtain data on the clinical presentation and the course of the disease of biopsy-proven chronic persistent hepatitis (CPH), we coordinated a multicentre retrospective study on 1197 patients … Although sharps injuries have decreased in recent decades due to improved prevention measures, they continue to occur, placing health-care personnel at risk for several bloodborne pathogens like hepatitis C. A recent analysis of several studies revealed an overall 0.2% risk for infection among those exposed to HCV-antibody-positive blood through needlestick or sharps injuries (35). yong.yuan@bms.com Comment in J Manag Care Pharm. These drugs stop the virus from making copies … Of these 14, 3 (21 percent) had chronic persistent hepatitis, 7 (50 percent) had chronic active hepatitis, and 4 (29 percent) had cirrhosis. B18.1 - chronic viral hepatitis B without delta-agent B18.2 - chronic viral hepatitis C B18.8 - other chronic viral hepatitis B18.9 - chronic viral hepatitis, unspecified K73.0 - … The gradient separated clearly chronic active hepatitis with or without cirrhosis. Saving Lives, Protecting People. Untreated chronic active hepatitis is generally thought to progress to cirrhosis. 1976 Feb;29(2):89-93. doi: 10.1136/jcp.29.2.89. Intended for clinicians involved in long-term management of persons with chronic hepatitis C infection. See CDC’s hepatitis C testing guidelines for detailed information on calculating prevalence in a health-care setting. Ray MB, Desmet VJ, Fevery J, De Groote J, Bradburne AF, Desmyter J. J Clin Pathol. People with recently acquired acute infection typically have detectable HCV RNA levels as early as 1–2 weeks after exposure to the virus (26). Should a woman with hepatitis C be advised against breastfeeding? Gastroenterology … What is the prevalence of hepatitis C among people who inject drugs (PWID)? Written by well-respected experts from the UK and USA, Equine Internal Medicine: Self-Assessment Color Review Second Edition presents more than 200 interesting and challenging cases encountered in equine practice, complete with photographs, ... Said Y, Salem M, Mouelhi L, et al. The anti-HCV test only provides information about past exposure to HCV. Baseline testing of the source patient and the health-care personnel should be done as soon as possible (preferably within 48 hours) after the exposure. Hepatitis has a broad spectrum of presentations that range from a complete lack of symptoms to severe liver failure. Human herpesvirus 6 (HHV-6) is the common collective name for human betaherpesvirus 6A (HHV-6A) and human betaherpesvirus 6B (HHV-6B). With the advent of hepatitis C therapies that are effective against many genotypes, genotyping is no longer required prior to treatment initiation. If a person tests positive for HCV antibodies, hepatitis C testing is not considered complete unless the initial positive anti-HCV test is followed by a test for HCV RNA as per CDC guidelines. Yes. When should children born to HCV-infected mothers be tested to see if they were infected at birth? 1994 Sep 16;119(37):1245-7. doi: 10.1055/s-2008-1058829. The symptoms of hepatitis can be confounding, ranging from mild, short-lived flu-like symptoms (e.g., fever and fatigue) to more classic ones, such as jaundice—or even no symptoms at all. What are the case definitions for reportable HCV infections? This book pragmatically overviews the intricate interplay between viral and host factors during hepatitis C virus infection progression, as well as other hepatitis C-associated clinical implications. Mechanisms: hepatoprotectant, anti-inflammatory, immunomodulatory (glucocorticoid … Liaw YF, Sheen IS, Chen TJ, Chu CM, Pao CC. This 2-volume set presents cutting-edge discussions of scientific principles, pathogenesis, pathophys-iology, diagnosis, treatment, and prevention for the full range of tropical infectious diseases. Most people with chronic HCV infection are asymptomatic or have non-specific symptoms such as chronic fatigue and depression. People who have been very recently infected with HCV might not yet have developed antibody levels high enough to be detected by the anti-HCV test. Not enough information is available regarding the risks of transmission through breastfeeding by infected mothers with cracked or bleeding nipples. Clipboard, Search History, and several other advanced features are temporarily unavailable. It is possible to show the appearances of a chronic persistent hepatitis in one part and in another a chronic active one. How soon after exposure to HCV can HCV antibodies be detected? Introduction. Incidence, determinants and significance of delayed clearance of serum HBsAg in chronic hepatitis B virus infection: a prospective study. We conclude that severe chronic active hepatitis that has been treated with prednisone and converted to chronic persistent hepatitis will often and … This site needs JavaScript to work properly. Persons with chronic infection (e.g., those with persistent hepatitis B surface antigen [HBsAg] in the serum for at least 6 months following acute infection) serve as the main reservoir for HBV transmission (4). Yes; however, transmission between household members does not occur very often. Yes. Autoimmune hepatitis is a chronic hepatitis characterized by immunologic and autoimmune features, generally including the presence of circulating autoantibodies and a high serum gamma … Specific guidance for providers that perform certain types of surgery that may pose a risk of bloodborne virus transmission based on HCV RNA level is available from the Society for Health care Epidemiology of Americapdf iconexternal icon (SHEA) (37). Exclusion criteria: patients with apparent cirrhosis, and patients who did not receive immunosuppressive or antiviral therapy within six months before the study. Immune-Active Chronic HBV or Reactivation of Chronic HBV. Chronic liver disease and liver cancer caused by chronic HCV infection are a common reason for liver transplants in the United States (13,14). We also do our own R&D. Dig Liver Dis. Yuan Y(1), Iloeje UH, Hay J, Saab S. Author information: (1)Bristol-Myers Squibb Company, Princeton, NJ 08543-4000, USA. The book discusses many Western diseases including diabetes, gynecological disorders, stroke, tumors, myocardial infarction, and the interaction of these with other pathological factors. Oliviero B, Varchetta S, Paudice E, Michelone G, Zaramella M, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. PRACTICEGUIDELINE AASLD Guidelines for Treatment of Chronic Hepatitis B Norah A. Terrault,1 Natalie H. Bzowej,2 Kyong-Mi Chang,3 Jessica P. Hwang,4 Maureen M. Jonas,5 and M. Hassan … Hepatitis; Increased insulin resistance; Metoprolol can aggravate breathing difficulties in patients with asthma, chronic bronchitis, or emphysema. For chronic hepatitis C, doctors most often use medications called direct acting antivirals, or DAAs. To determine the baseline prevalence, providers and program directors are encouraged to consult CDC or their state and local health departments to determine a reasonable estimate in their setting or a methodology for determining how many people they need to screen before confidently being able to establish that the prevalence is below 0.1%. HCV RNA testing should then be repeated at a subsequent visit, independent of the initial HCV RNA test result (42). A 2016 systematic review and meta-analysis found that most people taking narcotic pain relievers (also known as opioids)for back pain did not get "clinically important pain relief" in the dosage range evaluated. Chronic hepatitis B virus infection is associated with most of the serious complications. Lemoine M, Katsahian S, Ziol M, Nahon P, Ganne-Carrie N, Kazemi F, Grando-Lemaire V, Trinchet JC, Beaugrand M. Aliment Pharmacol Ther. Specialists (e.g., infectious-disease physicians, gastroenterologists, pediatricians, and hepatologists) may be more appropriate when managing children with hepatitis C and patients who have certain HCV-related sequelae or advanced disease, including those requiring a liver transplant. Chronic Hepatitis B. Learn more about APCs and our commitment to OA.. Over time, the … In the absence of hepatitis C prevalence data in a particular practice or patient catchment area, providers and program directors should immediately begin screening all adults and all pregnant women during each pregnancy for HCV infection. Most infants infected with HCV at birth have no symptoms. Primary-care and other types of providers wishing to manage treatment for patients with hepatitis C can learn from the Project ECHOexternal icon model of hepatitis C treatment delivery. Immunotherapeutic interventions to revive host immunity in chronic hepatitis B virus infection. 2012 Apr 14;18(14):1616-21. doi: 10.3748/wjg.v18.i14.1616. Recently, the role of the gut microbiome has increasingly emerged in … Such conditions can include: CDC now recommends universal hepatitis C screening for all U.S. adults and all pregnant women during every pregnancy, except in settings where the prevalence of HCV infection is <0.1% (see How should providers determine hepatitis C prevalence?). Who should be tested for HCV on a routine basis? The terminology for assessment of chronic viral hepatitis in liver biopsy specimens has become confusing with the proliferation of grading and staging schemes that have paralleled … 2008 Jan-Feb;14(1):61-4. is diabetes a chronic diseases Hypoglycemia is difficult to define in neonates, but is generally considered a serum glucose concentration < … In the United States, health-care-associated transmission of hepatitis C has been associated with inadequate infection prevention practices during inpatient care, outpatient care, and hemodialysis. Hepatology. INTRODUCTION At least 250 million people worldwide are chronic-ally infected with HBV1 and at a greatly increased risk to develop liver fibrosis, cirrhosis and hepato … Hepatitis B with delta agent The entire field has been divided into 15 sections consisting of 529 fully structured essays and 2147 short definitions. All entries will be arranged in alphabetical order with extensive cross-referencing between them. Should HCV-infected health-care personnel be restricted in their work? Often, health-care-associated outbreaks are first detected by astute clinicians who find new infections in people without risk factors and then report cases to public health authorities. Pyoderma gangrenosum may occur in association with underlying diseases such as leukemia, monoclonal gammopathy, inflammatory bowel disease, arthritis, and chronic active hepatitis. Unable to load your collection due to an error, Unable to load your delegates due to an error. For the 9 remaining patients, the gradient was between 0.79 and 0.93 kPa, 3 had persistent hepatitis, and 6 had active hepatitis. As long as Standard Precautions and other infection-control practices are consistently implemented, medical and dental procedures performed in the United States generally do not pose a risk for the spread of hepatitis C. However, hepatitis C can be spread in health-care settings when injection equipment, such as syringes, is shared between patients or when injectable medications or intravenous solutions are mishandled and become contaminated with blood. Inclusion criteria: histopathological evidence of chronic active hepatitis, seropositive for anti‐HCV and HCV‐RNA, and ALT levels above 50 IU/L for more than six months. 1987 Oct;82(10):1057-61. Accessibility People with newly acquired HCV infection usually are asymptomatic or have mild symptoms that are unlikely to prompt a visit to a health-care professional. Among 42 studies comparing antiviral therapy versus control in 62,731 patients, 16 studies8-23 com-pared IFN versus no treatment, … Centers for Disease Control and Prevention. When a person is first infected with the hepatitis B virus, it is called an "acute infection" (or a new infection).Most healthy adults that are infected do not have any symptoms and are able to get rid of the virus without any problems. Possible exposures include. What resources are available to providers who wish to manage treatment for patients with hepatitis C. Is routine HCV genotyping required when managing a person with hepatitis C? This percentage was higher (80%) in patients under 20. Background/aims Oxidative stress and hepatocellular pathological changes are common associations with chronic hepatitis C virus (CHC) disease. Prevention and treatment information (HHS), To obtain data on the clinical presentation and the course of the disease of biopsy-proven chronic persistent hepatitis (CPH), we coordinated a multicentre retrospective study on 1197 patients observed in 16 liver units throughout Italy from 1975 to 1985. Individuals ever infected with HBV are at risk of viral reactivation under certain circumstances. What are the extrahepatic manifestations of chronic HCV infection? However, pre-treatment genotyping continues to be recommended for patients with evidence of cirrhosis and/or past unsuccessful hepatitis C treatment, because this knowledge can help tailor treatment regimens and improve patient outcomes. Any pregnant women testing positive for anti-HCV should receive a PCR test for HCV RNA to determine current infection status. guidance for the management of patients with hepatitis C. recommendations for prevention and control of HCV infection, https://www.aasld.org/publications/practice-guidelines-0, Hepatitis B Reactivation During Immunosuppressive Drug Therapy, National Institute for Occupational Safety and Health, guidelines for management and treatment of hepatitis C, Society for Health care Epidemiology of America, Instead, the source patient in question should be tested for HCV RNA or hepatitis C antibodies, https://doi.org/10.1016/j.cgh.2019.04.035, https://doi.org/10.1097/MLR.0b013e31825517d4, https://www.niddk.nih.gov/health-information/liver-disease/liver-transplant/definition-facts, https://optn.transplant.hrsa.gov/data/view-data-reports/build-advanced, https://www.nhlbi.nih.gov/health/health-topics/topics/bt/risks, https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/hepatitis-c, https://www.cdc.gov/injectionsafety/drugdiversion/index.html, https://shea-online.org/images/guidelines/BBPathogen_GL.pdf, https://www.hcvguidelines.org/unique-populations/pregnancy, Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus — CDC Guidance, United States, 2020, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Recommendations for Prevention and Control of HCV Infection and HCV-Related Chronic Disease, Viral Hepatitis Surveillance â United States, Health Care Related Outbreaks Reported to CDC, Interpretation of Results of Tests for Hepatitis C Virus (HCV) Infection and Further Actions, Vital Signs: Dramatic increases in hepatitis C, U.S. Department of Health & Human Services, Current or former people who use injection drugs (PWID), including those who injected only once many years ago, People with selected medical conditions, including those who ever received maintenance hemodialysis (, Prior recipients of transfusions or organ transplants, including people who received clotting factor concentrates produced before 1987, people who received a transfusion of blood or blood components before July 1992, people who received an organ transplant before July 1992, and people who were notified that they received blood from a donor who later tested positive for HCV infection, Health care, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV-positive blood, Children born to mothers with HCV infection, Having nonalcoholic fatty liver disease, hepatitis B, or HIV coinfection, Injection-drug use (currently the most common mode of HCV transmission in the United States) (, Sex with an HCV-infected person (an inefficient means of transmission, although HIV-infected men who have sex with men [MSM] have increased risk of sexual transmission), Sharing personal items contaminated with infectious blood, such as razors or toothbrushes, Other health-care procedures that involve invasive procedures, such as injections (usually recognized in the context of outbreaks), Receipt of donated blood, blood products, and organs (rare in the United States since blood screening became available in 1992), Needlestick injuries in health-care settings, People who ever injected drugs and shared needles, syringes, or other drug preparation equipment, including those who injected once or a few times many years ago, People who have ever received maintenance hemodialysis, People with persistently abnormal ALT levels, People who received clotting factor concentrates produced before 1987, People who received a transfusion of blood or blood components before July 1992, People who received an organ transplant before July 1992, People who were notified that they received blood from a donor who later tested positive for HCV infection, Any person who requests hepatitis C testing, Screening tests for antibody to HCV (anti-HCV), enhanced chemiluminescence immunoassay (CLIA), Chemiluminescence microparticle immunoassay (CMIA), Electrochemiluminescence immunoassay (ECLIA), Qualitative nucleic acid tests to detect presence HCV RNA, Quantitative nucleic acid tests to detect levels of HCV RNA.
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