A 44-year-old man has newly detected hepatitis C antibody positivity. He has mild fatigue, ALT 86 U/L, normal bilirubin, platelet count 210000/mm3,

Question

A 44-year-old man has newly detected hepatitis C antibody positivity. He has mild fatigue, ALT 86 U/L, normal bilirubin, platelet count 210000/mm3, and no prior treatment. HCV RNA is positive. Fibrosis assessment shows no cirrhosis. Which of the following is the most appropriate management?

Accepted Answer

Direct-acting antiviral treatment after baseline staging and drug-interaction review

Answer

Pegylated interferon plus ribavirin for 48 weeks

Answer

Liver biopsy before any antiviral therapy

Answer

Defer therapy until transaminases exceed 5 times normal

Answer

Treat genotype 1 infection with an older genotype-specific regimen

Chronic hepatitis C infection — ABIM Board MCQ

A 44-year-old man has newly detected hepatitis C antibody positivity. He has mild fatigue, ALT 86 U/L, normal bilirubin, platelet count 210000/mm3, and no prior treatment. HCV RNA is positive. Fibrosis assessment shows no cirrhosis. Which of the following is the most appropriate management?