Hepatitis C Clinic

As many as 4 million Americans have hepatitis C, a liver disease caused by a blood-borne virus, and most of them are unaware of their diagnosis.

To this end, the Centers for Disease Control (CDC) has recently recommended a one-time hepatitis C virus (HCV) antibody test for anyone born between 1945 and 1965. Identification of cases is now more important than ever because dramatically improved treatments are now available for HCV infection with cure rates approaching 100%. These new medications are much more tolerable than prior therapies such as interferon which is limited by many side effects. Cure of HCV has now been definitively shown to reduce mortality related to liver disease. The Hepatitis C Clinic at Massachusetts General Hospital offers comprehensive evaluation, diagnosis and treatment for patients with all phases of hepatitis C infection.

What to Expect

During your first visit to the Hepatitis C Clinic, you will undergo:

• Evaluation of your medical history
• Physical examination

After a complete evaluation you will work with your doctor to determine if further tests are needed to indicate how you should be treated. These tests can include:

• Blood tests, including tests for viral load and genotype strain, to assess likelihood of response to therapy. Viral load measures the amount of hepatitis C virus circulating in the blood. The genotype tells us which of the six types of hepatitis C you have
• Liver biopsy to assess whether you have early or advanced disease, which will have an impact on the timing of antiviral therapy
• Noninvasive alternatives to liver biopsy such as:
  • Transient elastography (Fibroscan), an ultrasound-like test which can safely and accurately stage patients with hepatitis C and many other liver conditions
  • Blood tests that can help distinguish more advanced from less advanced disease
  • Imaging tests that can provide information about the quantity of scar tissue across the whole liver
  • Radiographic studies such as ultrasound or MRI
• Radiographic studies such as ultrasound or MRI

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Personalized, Multidisciplinary Treatment

Treatment for all hepatitis C genotypes now involves combinations of oral direct acting antiviral agents, without need for interferon. These are well tolerated and highly effective, with cure rates consistently exceeding 90%. The length of treatment can be as short as eight weeks or extend to 24 weeks, depending on your prior treatment experience and the extent of liver disease.

You may also be referred for a clinical trial of novel direct antiviral agents against hepatitis C.

The Hepatitis C Clinic team works closely with our colleagues in transplant and hepatobiliary surgery, radiology, pathology, psychiatry and social work. We will provide you with easy access to any other Mass General specialists you may need to ensure you receive the best care possible.

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Clinical Trials

The Mass General Liver Center is currently conducting a large number of clinical trials using antiviral agents. In most cases, these medications have been associated with high rates of sustained response of virus infection. They have also allowed patients freedom from the drug interferon, the major cause of side effects in patients undergoing therapy for hepatitis C. Most of these trials involve all oral medications, usually of limited duration (12 to 24 weeks). Screening and study visits take place at predetermined intervals with study staff, including Liver Center doctors and coordinators.

Learn more about clinical trials

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Referring a Patient

Hepatitis C is the leading reason for liver transplantation, and a condition at high risk for progression to cirrhosis and liver cancer. If your patient has chronic hepatitis C, the Mass General Hepatitis C Clinic can help risk stratify your patient to determine if further testing, including liver biopsy, is needed and to determine what long-term interventions, including medications, are warranted. To refer a patient, please call the Hepatitis C Clinic at 617-724-6006. If you are a physician with questions about hepatitis C, including its diagnosis and management, please email the director of the clinic, Raymond Chung, MD.

Email Raymond Chung, MD

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