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Hepatitis C (HCV)

Chronic HCV Infection — Universal Screening and Direct-Acting Antivirals

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Hepatitis C (HCV)?

Hepatitis C virus is a single-stranded RNA Flaviviridae transmitted primarily through blood-to-blood contact (injection drug use, unsafe healthcare, transfusion before screening).

Acute infection spontaneously resolves in about 25%; chronic infection develops in the remainder, progressing to cirrhosis in 20% over 20–30 years.

Diagnosis with HCV antibody followed by HCV RNA PCR to confirm active infection; genotype largely obviated by pangenotypic DAAs.

Extrahepatic manifestations include mixed cryoglobulinemia, membranoproliferative glomerulonephritis, lichen planus, and porphyria cutanea tarda.

Symptoms

Most patients are asymptomatic for decades
Fatigue, malaise, and arthralgia
Right upper quadrant discomfort and mildly elevated ALT
Signs of cirrhosis in advanced disease: jaundice, ascites, encephalopathy
Extrahepatic: palpable purpura, neuropathy, renal dysfunction from cryoglobulinemia
Acute infection often subclinical; jaundice rare

Risk Factors

Injection drug use and intranasal cocaine
Blood transfusion before 1992 or unscreened products
Needlestick injury and unsafe tattoo or piercing
HIV coinfection and men who have sex with men
Hemodialysis and recipients of organ transplants
Vertical transmission from HCV-positive mother (3–5%)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Universal screening recommended for all adults at least once
  • Risk factors: injection drug use, HIV, hemodialysis, incarceration history
  • Pregnancy (screen each pregnancy) and persistently elevated liver enzymes

Treatment Methods

01
Pangenotypic DAA regimens: sofosbuvir/velpatasvir 12 weeks or glecaprevir/pibrentasvir 8 weeks for treatment-naive without cirrhosis
02
Decompensated cirrhosis: sofosbuvir/velpatasvir plus ribavirin for 12 weeks; avoid protease inhibitors
03
Confirm cure with sustained virologic response 12 weeks post-treatment (SVR12)
04
Continue HCC surveillance every 6 months in cirrhosis even after SVR
05
Harm reduction: opioid substitution, needle exchange, safer-injection education
06
Vaccinate against hepatitis A and B; avoid alcohol; treat comorbidities

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.