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What are the symptoms of most acute HCV infections?
Asymptomatic
What can delays in HCV diagnosis lead to?
Significant disease progression
What is the most common bloodborne pathogen?
HCV
Why has the number of HCV cases increased since 2010?
Improved surveillance and increase in incidence
Who is recommended to undergo universal HCV screening?
All persons aged 18 and older
How is HCV transmitted?
Percutaneous exposure
What is the major source of HCV infection?
Injection drug use
What are some less common modes of HCV transmission?
Tattoos received in unregulated settings, sexual contact, vertical transfer (mother to infant)
What are the risk factors for HCV infection?
People who inject drugs, anal sex, multiple sex partners, coinfection with STIs
Who should undergo routine periodic testing for HCV?
Persons who inject drugs, share needles, syringes, or other drug preparation equipment; persons
undergoing hemodialysis; sexually active MSM with HIV; MSM at initiation of HIV PrEP
Pregnant people during each pregnancy
What is the initial test for HCV infection?
Anti-HCV antibody or antibody test
What is the confirmatory test for HCV infection?
HCV RNA test
, What does a positive antibody test and negative RNA test indicate?
No active HCV infection
Does the presence of HCV antibody infer immunity?
No, individuals are still at risk of HCV infection if re-exposed
What type of virus is HCV?
Single-stranded RNA virus
Why is vaccine development for HCV challenging?
Frequent viral mutations due to lack of proofreading polymerase
Where does HCV replicate?
Inside hepatocytes
Is HCV directly cytopathic?
No, it does not change host cell structure or function directly
Why is it difficult for the immune system to eliminate HCV?
HCV replicates copiously
How many major genotypes is HCV differentiated into?
7
How are genotypes further classified?
Subtypes (a, b, c, etc.)
Which genotypes are most common in the United States?
GT1a and GT1b
What are the potential outcomes of chronic HCV infection?
Cirrhosis, end-stage liver disease (ESLD), or hepatocellular carcinoma (HCC)
What are pan-genotypic therapies?
Therapies which treat all genotypes of HCV
What happens in most cases of acute HCV infection?
It leads to chronic infection (~85% of cases)
Why is the immune response to acute HCV insufficient to eradicate the virus?
Due to the copious replication of the virus
How does the immune system sometimes eliminate HCV on its own?
By robust T-cell response with highly-active CD8 and CD4 response
What is the role of CD8 cells in the immune response to HCV?