Summary Hepatitis C Virus (HCV) Infection: Virology, Epidemiology, and Management

This seminar presentation by Dr. Desta E. provides a comprehensive overview of Hepatitis C Virus (HCV) infection, a major cause of chronic liver disease affecting over 71 million people worldwide, detailing its virology as a single-stranded RNA virus in the Flaviviridae family with six major genotypes, emphasizing global distribution shifts due to migration and transmission modes like percutaneous exposure (e.g., injection drug use, blood transfusions) and non-percutaneous routes (sexual, perinatal), while noting sporadic cases. It explores pathogenesis involving innate and adaptive immune evasion, pathology with lobular mononuclear infiltration and fibrosis progression influenced by factors like age, alcohol, and coinfections, clinical manifestations ranging from acute asymptomatic phases to chronic cirrhosis, extrahepatic issues (e.g., cryoglobulinemia, glomerulonephritis), and natural history with 15-45% spontaneous clearance. Diagnosis relies on anti-HCV antibodies and RNA quantification, with universal screening recommended for adults; management focuses on direct-acting antivirals (DAAs) like sofosbuvir-velpatasvir or glecaprevir-pibrentasvir achieving >90% sustained virologic response (SVR), tailored for special populations including decompensated cirrhosis, HIV/HBV coinfection, pregnancy, CKD, post-transplant recurrence, and acute infection, with monitoring for adherence, side effects, and post-treatment follow-up to prevent reinfection and HCC, supported by images, tables, and references from Harrison's, UpToDate, AASLD/IDSA, and WHO guidelines.