Hepatitis C Infection: A Clinical Review

[Guest guest]

Southern Medical Journal: Volume 97(4) April 2004 pp 365-373

Hepatitis C Infection: A Clinical Review

Pearlman, L. MD

From the Center for Hepatitis C, Atlanta Medical Center, Atlanta, GA, and

the Medical College of Georgia, Augusta, GA

Accepted January 15, 2004.

Reprint requests to Pearlman, MD, Center for Hepatitis C, Atlanta

Medical Center, 315 Boulevard NE, Suite 140, Atlanta, Georgia 30312. Email:

brianpearlman@...

Dr. Pearlman is on the speakers' bureau for Schering-Plough, the company

that manufactures one of the two available pegylated interferon products to

treat hepatitis C.

Abstract

Nearly three million persons in the United States are viremic with hepatitis

C (HCV). Despite a decreasing incidence of HCV in this country, the

prevalence of HCV-related chronic liver disease is increasing. Most

infections in the United States are acquired by intravenous drug use. The

chronicity rate of HCV is high, reaching 85% in some populations, and the

risk of progression to advanced liver disease is as high as 20% within

twenty years of infection. Host factors like alcohol use accelerate the rate

of progression. The enzyme immunoassay is the preferred initial test for

diagnosis; the third generation assay has greater than a 99% specificity in

immunocompetent patients. Barring contraindications, the standard of care

for treatment of chronic HCV has become pegylated interferon and ribavirin.

With this therapy, the cure rate for treatment-naïve patients is about 55%,

but rates are higher in certain groups. Common side effects of therapy

include neuropsychiatric symptoms, influenza-like symptoms and hematological

abnormalities.

[Guest guest]

Southern Medical Journal: Volume 97(4) April 2004 pp 365-373

Hepatitis C Infection: A Clinical Review

Pearlman, L. MD

From the Center for Hepatitis C, Atlanta Medical Center, Atlanta, GA, and

the Medical College of Georgia, Augusta, GA

Accepted January 15, 2004.

Reprint requests to Pearlman, MD, Center for Hepatitis C, Atlanta

Medical Center, 315 Boulevard NE, Suite 140, Atlanta, Georgia 30312. Email:

brianpearlman@...

Dr. Pearlman is on the speakers' bureau for Schering-Plough, the company

that manufactures one of the two available pegylated interferon products to

treat hepatitis C.

Abstract

Nearly three million persons in the United States are viremic with hepatitis

C (HCV). Despite a decreasing incidence of HCV in this country, the

prevalence of HCV-related chronic liver disease is increasing. Most

infections in the United States are acquired by intravenous drug use. The

chronicity rate of HCV is high, reaching 85% in some populations, and the

risk of progression to advanced liver disease is as high as 20% within

twenty years of infection. Host factors like alcohol use accelerate the rate

of progression. The enzyme immunoassay is the preferred initial test for

diagnosis; the third generation assay has greater than a 99% specificity in

immunocompetent patients. Barring contraindications, the standard of care

for treatment of chronic HCV has become pegylated interferon and ribavirin.

With this therapy, the cure rate for treatment-naïve patients is about 55%,

but rates are higher in certain groups. Common side effects of therapy

include neuropsychiatric symptoms, influenza-like symptoms and hematological

abnormalities.

[Guest guest]

Southern Medical Journal: Volume 97(4) April 2004 pp 365-373

Hepatitis C Infection: A Clinical Review

Pearlman, L. MD

From the Center for Hepatitis C, Atlanta Medical Center, Atlanta, GA, and

the Medical College of Georgia, Augusta, GA

Accepted January 15, 2004.

Reprint requests to Pearlman, MD, Center for Hepatitis C, Atlanta

Medical Center, 315 Boulevard NE, Suite 140, Atlanta, Georgia 30312. Email:

brianpearlman@...

Dr. Pearlman is on the speakers' bureau for Schering-Plough, the company

that manufactures one of the two available pegylated interferon products to

treat hepatitis C.

Abstract

Nearly three million persons in the United States are viremic with hepatitis

C (HCV). Despite a decreasing incidence of HCV in this country, the

prevalence of HCV-related chronic liver disease is increasing. Most

infections in the United States are acquired by intravenous drug use. The

chronicity rate of HCV is high, reaching 85% in some populations, and the

risk of progression to advanced liver disease is as high as 20% within

twenty years of infection. Host factors like alcohol use accelerate the rate

of progression. The enzyme immunoassay is the preferred initial test for

diagnosis; the third generation assay has greater than a 99% specificity in

immunocompetent patients. Barring contraindications, the standard of care

for treatment of chronic HCV has become pegylated interferon and ribavirin.

With this therapy, the cure rate for treatment-naïve patients is about 55%,

but rates are higher in certain groups. Common side effects of therapy

include neuropsychiatric symptoms, influenza-like symptoms and hematological

abnormalities.

[Guest guest]

Southern Medical Journal: Volume 97(4) April 2004 pp 365-373

Hepatitis C Infection: A Clinical Review

Pearlman, L. MD

From the Center for Hepatitis C, Atlanta Medical Center, Atlanta, GA, and

the Medical College of Georgia, Augusta, GA

Accepted January 15, 2004.

Reprint requests to Pearlman, MD, Center for Hepatitis C, Atlanta

Medical Center, 315 Boulevard NE, Suite 140, Atlanta, Georgia 30312. Email:

brianpearlman@...

Dr. Pearlman is on the speakers' bureau for Schering-Plough, the company

that manufactures one of the two available pegylated interferon products to

treat hepatitis C.

Abstract

Nearly three million persons in the United States are viremic with hepatitis

C (HCV). Despite a decreasing incidence of HCV in this country, the

prevalence of HCV-related chronic liver disease is increasing. Most

infections in the United States are acquired by intravenous drug use. The

chronicity rate of HCV is high, reaching 85% in some populations, and the

risk of progression to advanced liver disease is as high as 20% within

twenty years of infection. Host factors like alcohol use accelerate the rate

of progression. The enzyme immunoassay is the preferred initial test for

diagnosis; the third generation assay has greater than a 99% specificity in

immunocompetent patients. Barring contraindications, the standard of care

for treatment of chronic HCV has become pegylated interferon and ribavirin.

With this therapy, the cure rate for treatment-naïve patients is about 55%,

but rates are higher in certain groups. Common side effects of therapy

include neuropsychiatric symptoms, influenza-like symptoms and hematological

abnormalities.