• If antibodies present, do nucleic acid testing (NAT) for HCV RNA (more sensitive that core antigen) to confirm active infection (as clearance can occur in 15-45%).

• Asymptomatic, or flu-like illness, tiredness and vague abdominal discomfort. 

• LFTs show raised alanine aminotransferase. 

• Almost 75% will develop a chronic hepatitis. 

• Antiviral medicines can cure more than 95%) e.g. Epclusa (sofosbuvir 400mg/velpatasvir 100mg)

In middle- and high-income countries, most HCV infections occur among people who use unsterile equipment to inject drugs and contaminated drug solutions. In low-income countries, infection with HCV is most commonly associated with unsafe injection practices and procedures such as renal dialysis and unscreened blood transfusions

Resources

• Hepatitis C (CKS)

• Hepatitis C (NHS Choices)

• Hepatitis C (WHO factsheet)

• FIB-4 calculator to estimate liver scarring (Hepatitis C Online)