Hepatitis C (Texas Mandatory)

Evaluation of Individual Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.


Learning Objectives

Upon completing the course, you will able to:

  1. Discuss the epidemiology of HCV and demographic characteristics of HCV infection.
  2. Discuss various prevention and control recommendations for HCV infection.
  3. List elements of a comprehensive strategy to prevent and control hepatitis C virus infection.
  4. Provide specific advice to persons with high-risk drug or sexual practices as part of HCV prevention strategy.
  5. Identify persons who should be tested routinely for hepatitis C virus infection.
  6. Identify persons with chronic hepatitis C who are recommended for treatment and those that are not.
  7. Provide HCV-specific information and prevention messages to infected persons and individuals at risk.

Table of Contents

Introduction

Figure 1. Reported cases of acute hepatitis C by selected risk factors– United States, 1983–1996

Background

Epidemiology

  • Demographics Characteristics
    • Figure 2. Prevalence of hepatitis C virus (HCV) infection by age and race/ethnicity– United States, 1988–1994
  • Transmission Modes

Screening and Diagnostic Tests

  • Serologic Assays

Clinical Features and Natural History

  • Acute HCV Infection
  • Chronic HCV Infection
  • Clinical Management and Treatment

Prevention and Control Recommendations

Rationale

Primary Prevention Recommendations

  • Blood, Plasma Derivatives, Organs, Tissues, and Semen
  • High-Risk Drug and Sexual Practices
  • Percutaneous Exposures to Blood in Health-Care and Other Settings
    • Health-Care Settings
    • Other Settings

Secondary Prevention Recommendations

Persons for Whom Routine HCV Testing Is Recommended

  • Persons Who Have Ever Injected Illegal Drugs
  • Persons With Selected Medical Conditions
  • Prior Recipients of Blood Transfusions or Organ Transplants
  • Health-Care, Emergency Medical, and Public Safety Workers After Needle Sticks, Sharps, or Mucosal Exposures to HCV-Positive Blood
  • Children Born to HCV-Positive Women

Persons for Whom Routine HCV Testing Is Not Recommended

  • Health-Care, Emergency Medical, and Public-Safety Workers
  • Pregnant Women
  • Household (Nonsexual) Contacts of HCV-Positive Persons

Persons for Whom Routine HCV Testing Is of Uncertain Need

  • Recipients of Transplanted Tissue
  • Intranasal Cocaine and Other Noninjecting Illegal Drug Users
  • Persons with a History of Tattooing or Body Piercing
  • Persons with a History of Multiple Sex Partners or STDs

Testing for HCV Infection

  • Figure 3. Hepatitis C virus (HCV)-infection–testing algorithm for asymptomatic persons

Prevention Messages and Medical Evaluation

  • Persons with High-Risk Drug and Sexual Practices
  • Negative Test Results
  • Indeterminate Test Results
  • Positive Test Results

NIH Consensus Statement Regarding Management of Hepatitis C (Excerpted)

  • Persons Recommended for Treatment
  • Persons for Whom Treatment Is Unclear
  • Persons for Whom Treatment Is Not Recommended

Public Health Maintenance

  • Surveillance for Acute Hepatitis C
  • Laboratory Reports of Anti-HCV-Positive Tests
  • Serologic Surveys
  • Surveillance for Chronic Liver Disease

Future Directions

References