Confronting the New Epidemic in Primary Care: Diagnosis and Management of Hepatitis C

Thesis (M.Nurs.), College of Nursing, Washington State UniversityHepatitis C (HCV) is the most common bloodborne disease worldwide. Most cases of hepatitis C progress to chronic disease, with a significant portion of these ending in cirrhosis, liver failure and hepatocellular carcinoma. In the United States hepatitis C results in 8,000 to 10,000 deaths annually, and this figure is expected to triple in the next 20 years. There is no effective vaccine against hepatitis C, and efforts to develop a vaccine are hampered by the high degree of mutability exhibited by the virus. Current pharmacotherapy for HCV disease is limited to interferon alpha and ribavirin, and these drugs provide long-term remission of the virus in less than 50% of cases treated. Recent advances in HCV research demonstrate improved responses with the use of pegylated interferons, which have a longer serum half-life than interferon alpha. This paper provides an overview of the natural history and clinical findings of hepatitis C infection, as well as diagnostic testing and treatment schemes currently available