Hepatitis C, diagnosis and treatment in various situations

• This portion of the course describes the hepatitis C infection? How this infection is transmitted and what are the chances of this becoming chronic. What are its symptoms in uncomplicated infection? What are the complications and what are the symptoms in those complications especially the clinical presentation in brief. The diagnostic outline is discussed in detail. What investigations are required for the diagnosis of infection and what are the tests required to plan treatment? The complications can be diagnosed clinically. Some cases may require investigations like blood tests, ultrasound, and CAT scanning of the abdomen or endoscopy to pick up the complications. The outline of treatment available is given. Mention is made of different classes of directly acting antiviral (all oral) available for treatment. These four classes include 3/4 A protease inhibitors, NS5A polymerase inhibitors, and NS5B polymerase inhibitors. The NS5B drugs may be divided into nucleotide or non-nucleotide classes. Of these later dasabuvir is currently not used in general treatment algorithms. The treatment of non-cirrhotic treatment-naive patients is discussed. This treatment uses a combination of two drugs used for a period of eight to twelve weeks. The treatment of complicated clinical situations is also discussed in other sections of the course.

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