Hepatitis C
What Is It?
Chronic viral infection (HCV) transmitted via blood contact. The most common cause of cirrhosis and liver transplant in the US. Now curable in more than 95% of patients with direct-acting antivirals (DAAs).
How Is It Diagnosed?
HCV antibody screening. If positive: HCV RNA confirmatory test and viral load. HCV genotype for treatment selection. Liver fibrosis assessment (FIB-4, FibroScan).
How Is It Treated?
Direct-acting antivirals (sofosbuvir/velpatasvir - Epclusa; glecaprevir/pibrentasvir - Mavyret) - 8-12 week courses, >95% cure rate. No longer need to know genotype for most regimens. Post-cure HCC surveillance if cirrhosis.
Tests and Imaging Typically Needed
HCV antibody, HCV RNA, genotype, LFTs, CBC, BMP, HIV, HBV, AFP, liver ultrasound/FibroScan.
Approximate Self-Pay Costs
Office visit: $95-$150. HCV RNA: $50-$100. DAA therapy: $25,000+ (manufacturer patient assistance programs available - many patients pay $0).