🦠 Hepatitis C (HCV)

Nelson Textbook of Pediatrics 22nd Edition — Hepatitis C virus (HCV) is an RNA virus (Flaviviridae). Chronic infection develops in 70-80% of infected children. Perinatal transmission is the most common route in pediatrics. Direct-acting antivirals (DAAs) cure >95% of children ≥3 years. Screening: all children born to HCV-infected mothers (HCV RNA at 2-6 months, or anti-HCV after 18 months).

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📋 30 Clinical Scenarios — Hepatitis C

📇 High‑Yield Review Cards (Hepatitis C)

🩺 Clinical Presentations: Hepatitis C

Select a presentation for diagnostic clues and management.

📋 Stepwise Evaluation & Management of Hepatitis C

🔑 Key Principles — Hepatitis C (Nelson Ch.406)
• Diagnosis: Anti-HCV (screening) → HCV RNA (confirms active infection).
• Perinatal screening: Test HCV RNA at 2-6 months of age (maternal antibodies persist up to 18 months).
• Natural history: 20-40% spontaneous clearance. Chronic infection → risk of cirrhosis and HCC.
• Treatment — DAAs: All children ≥3 years with chronic HCV should be treated. Cure rates >95%.
• DAAs for children: Ledipasvir/sofosbuvir (genotypes 1,4,5,6, ≥3y), glecaprevir/pibrentasvir (pangenotypic, ≥3y), sofosbuvir/velpatasvir (pangenotypic, ≥3y).

    ⚡ Reflex Prompts — Hepatitis C Clinical Decisions

    📖 Hepatitis C — Core Summary (Nelson Ch.406)