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Prediabetes follow-up — USMLE Step 3 MCQ

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HardPreventive Medicine, Epidemiology, BiostatisticsPrediabetes follow-upUSMLE Step 3

A clinician who spontaneously cleared hepatitis C years ago sustains a needlestick from a source whose HCV RNA is positive. Baseline testing within 48 hours shows reactive HCV antibody and undetectable HCV RNA. Which follow-up schedule is recommended?

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Correct answer: E — Test HCV RNA at 3–6 weeks and, if negative, again at 4–6 months

The best answer is “Test HCV RNA at 3–6 weeks and, if negative, again at 4–6 months”. Because the source is HCV RNA positive, CDC recommends nucleic-acid testing 3–6 weeks after exposure. If that result is negative, testing is repeated at 4–6 months; because this clinician remains antibody positive after prior clearance, the later test should also be HCV RNA rather than antibody seroconversion. Baseline undetectable RNA excludes pre-existing viremia but does not end follow-up after this documented exposure.

Reference: CDC Guidelines for Health Care Personnel Exposed to Hepatitis C Virus: https://www.cdc.gov/hepatitis-c/hcp/infection-control/index.html