Porphyria Cutanea Tarda — SCE Dermatology MCQ

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ModerateBlistering DiseasesPorphyria Cutanea TardaSCE Dermatology

A 30-year-old woman has porphyria cutanea tarda. She is hepatitis C positive. Modern direct-acting antiviral (DAA) therapy for hepatitis C has what effect on PCT?

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Correct answer: A — Successful HCV eradication with DAAs often leads to biochemical and clinical remission of PCT

Successful eradication of HCV with direct-acting antivirals (DAAs — Sofosbuvir, Ledipasvir, Glecaprevir/Pibrentasvir etc.) frequently leads to remission of PCT, as HCV is a major trigger maintaining the uroporphyrinogen decarboxylase deficiency. This represents a paradigm shift from the interferon era (where IFN therapy could paradoxically worsen PCT). Current guidelines recommend concurrent management: HCV eradication with DAAs alongside standard PCT treatment (venesection or low-dose Hydroxychloroquine). In many patients, HCV cure alone leads to PCT remission without requiring additional PCT-specific therapy.

Reference: BAD 2019 Porphyria Guidelines; NICE HCV