CHC and acute viral hepatitis — DFSRH MCQ

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HardUKMECCHC and acute viral hepatitisDFSRH

A 26-year-old woman with jaundice from acute viral hepatitis asks to restart CHC. ALT is markedly raised and she is under hepatology follow-up. What is the UKMEC category for CHC?

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Correct answer: A — UKMEC 3

For combined hormonal contraception (CHC), acute viral hepatitis or an acute flare is classified by UKMEC as category 3 for initiation and category 2 for continuation. This patient is asking to restart CHC, so this is initiation, not continuation. Her jaundice, markedly raised ALT and hepatology follow-up indicate active acute viral hepatitis rather than stable carrier/chronic disease. Therefore CHC is not usually recommended because the theoretical or proven risks usually outweigh the benefits; an alternative non-oestrogen method should be used until recovery/reassessment. The correct UKMEC category is 3.

Reference: Faculty of Sexual & Reproductive Healthcare (FSRH). UK Medical Eligibility Criteria for Contraceptive Use (UKMEC), full book, amended September 2019: viral hepatitis—acute or flare: CHC initiation category 3, continuation category 2. https://www.fsrh.org/Common/Uploaded%20files/Standards-and-Guidance/fsrh-ukmec-full-book-2019.pdf