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In the Clinic |

Hepatitis C

Janice H. Jou, MD; and Andrew J. Muir, MD
Ann Intern Med. 2012;157(11):ITC6-1. doi:10.7326/0003-4819-157-11-201212040-01006
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The approach to hepatitis C virus (HCV) infection has undergone tremendous change in the past 2 years. The first-generation protease inhibitors have been approved for treatment of genotype 1 infection, leading to sustained virologic response (SVR) rates of 68%–75% for treatment-naïve patients (1, 2). Other direct-acting antiviral agents are being developed, and it is expected that treatments for all genotypes will have better response rates and side effect profiles in coming years. In this context, the Centers for Disease Control and Prevention (CDC) recently updated its HCV screening guidelines and now recommends screening for all Americans born between 1945 and 1965 (3) because the baby-boomer generation has the highest prevalence of HCV infection (4). Risks for cirrhosis and hepatocellular carcinoma continue to rise due to progression of HCV infection, and HCV remains the most common indication for liver transplantation. Effective treatment can reduce the risk for these life-threatening complications, and here we discuss HCV prevention, screening, diagnosis, and management (5).

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Figure 1.

Regimens for treatment-naïve hepatitis C genotype 1.

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Figure 2.

Regimens for treatment-experienced hepatitis C genotype 1.

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