CHRONIC CARE FOCUS
H
epatitis C virus (HCV) infec-
tion is the most common chron-
ic blood-borne infection in the
Unites States.
1
Management of HCV has
been evolving with the introduction of
direct-acting antivirals such as bocepre-
vir (Victrelis) and telaprevir (Incivek)
in 2011, as well as with the approval
of sofosbuvir (Sovaldi) and simeprevir
(Olysio) in 2013.
2,3
Recent changes to
the HCV guidelines with a focus on
treatment-na•ve patients will be reviewed
in this article.
Background
HCV is a positive-stranded RNA virus
in the Flaviviridae family.
4
It is the prin-
cipal cause of death from liver disease
and the leading indication for liver trans-
plantation in the United States.
5
It is
estimated that up to 3.9 million people in
the United States are chronically infected
with HCV.
3
However, 45% to 85% of
infected persons are unaware of their
condition.
3
Transmission and Symptoms
HCV is primarily transmitted through
percutaneous exposure to blood.
2
Individuals at risk of HCV infection are
listed in Table 1.
6
Most patients with chronic HCV infec-
tion are asymptomatic, but when symp-
toms do occur they are generally mild
and can include fever, fatigue, dark urine,
clay-colored stool, abdominal pain, loss
of appetite, nausea, vomiting, and jaun-
dice.
6
Hepatitis C
Jane Giang, PharmD, BCPS, CGP
H6 www.PharmacyTimes.com May 2014
Jane Giang, PharmD, BCPS,
CGP, is a clinic-based
pharmacist at UNC Health
Care in Chapel Hill, North
Carolina.
Treatment Guidelines Have Been Updated to
Include Several New Drugs
HEALTH
SYSTEMS
New Treatment Guidelines
Pg H6 HSchronicHep.indd 6 5/7/14 5:55 PM