resumen de hepatits c

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), characterized by a slow and progressive course that can lead to both acute and chronic infection states. Acute infection occurs within 6 months of exposure and may be asymptomatic or present with nonspecific symptoms, while chronic infection is defined by persistence of HCV RNA beyond 6 months, occurring in 55–85% of infected individuals NICE CKS.

HCV is primarily transmitted through contact with infected blood. The main routes include sharing needles or injecting paraphernalia, exposure during blood transfusions prior to the 1990s, inadequate sterilization of medical equipment, needlestick injuries, and other blood exposures. Less commonly, sexual and vertical (mother to child) transmission occur NICE CKS.

Many people with hepatitis C remain asymptomatic for years; symptoms, when present, may include fatigue, arthralgia, and jaundice, though these are not universal NICE CKS NHS Hepatitis C. Untreated chronic infection can result in serious complications such as cirrhosis, liver failure, and hepatocellular carcinoma, making timely diagnosis and management critical NICE CKS Panduro & Roman 2025.

Diagnosis begins with serological testing for HCV antibodies to detect prior exposure, followed by HCV RNA testing to confirm active infection and determine viral genotype. In immunocompromised patients, HCV RNA testing is essential even if antibody results are negative NICE CKS. Active infection requires both positive antibodies and detectable viral RNA NICE CKS.

Referral to specialist care is recommended upon diagnosis: immediate specialist referral for suspected acute hepatitis C, and urgent referral for chronic infection to initiate monitoring and treatment NICE CKS. Notification of acute cases to health protection authorities is essential for public health surveillance NICE CKS.

Treatment consists of direct-acting antiviral (DAA) agents administered orally daily for 8 to 12 weeks. DAAs are highly effective, achieving cure (sustained virologic response) in over 95% of patients, with fewer side effects compared to previous interferon-based therapies. Monitoring of treatment response includes regular blood tests during and after therapy NHS Hepatitis C Panduro & Roman 2025. Adherence to therapy is critical to treatment success NHS Hepatitis C.

Primary care roles include ensuring patient engagement with specialist services, providing education and support, advising on reducing disease progression risk (such as alcohol cessation and smoking cessation), and counseling on preventing HCV transmission—emphasizing not sharing razors, toothbrushes, or other items contaminated with blood, and addressing sexual transmission risks particularly in high-risk groups NICE CKS.

Among people living with HIV (PWH), hepatitis C co-infection is common, particularly in people who inject drugs and men who have sex with men, with a more rapid progression of liver disease and increased risk of hepatocellular carcinoma Lin et al. 2026. The availability of DAAs has revolutionized treatment in this population, enabling similarly high cure rates. However, reinfection remains a significant challenge in high-risk populations and requires ongoing surveillance and harm-reduction strategies Lin et al. 2026.

Global efforts aim to eliminate hepatitis C as a public health threat by 2030, supported by the World Health Organization's targets. Achieving this requires improving access to testing, linkage to care, treatment availability, and addressing social determinants and stigma that limit engagement with healthcare services Panduro & Roman 2025.