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  #1  
Old 10-28-2011
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Liver Treatment of HCV

A 35-year-old male is found to be positive for anti HCV during a screening 1 year ago. Thereafter, the AST and ALT levels have been within the normal range over 1 year, on 6 occasions. The patient has no complaints and on examination, there is no hepatomegaly, scleral icterus or cirrhotic stigmata. His PCR for HCV RNA is still positive. What would be the most appropriate step in management of this patient?

a. No treatment at this time, and follow up with yearly liver function tests.
b. Assure the patient that he does not have hepatitis C anymore.
c. Start antiviral treatment for hepatitis C.
d. Perform a liver biopsy.
e. Schedule the patient for liver transplantation.
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Old 10-28-2011
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a. No treatment at this time, and follow up with yearly liver function tests.???
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Old 10-28-2011
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I would say perform a liver biopsy coz enzymes can be a distractor n his PCR for HCV RNA is +ve.
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Old 10-28-2011
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Help

What is the answer of this question?????
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Old 10-28-2011
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As patient is asymptomatic so... I think, no need for invasive procedure > a. No treatment at this time, and follow up with yearly liver function tests.
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Old 10-28-2011
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I m btw a and c
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Old 10-28-2011
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A.no tx @ this time.

Akua
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Old 10-28-2011
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A? Have read this one before i think
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Old 10-28-2011
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i think D. Perform a liver biopsy.
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Old 10-28-2011
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C. Start antiviral treatment.

Since PCR for HCV DNA is positive, there is no doubt that he has the virus and it has to be treated promptly because it can progress to cirrhosis...a point of no return! Liver Biopsy can be done but there is no reason to not start treatment right now!
If, on biopsy there is fibrosis,then the treatment becomes more urgent.
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Default answer is A

the answer is A guys. no further treatment. and here's why:

Though this patient is still infected with HCV, he does not need any treatment other than yearly follow-up to look for abnormal liver enzymes. Studies have shown that patients with chronic hepatitis C who show persistently normal liver enzymes on multiple occasions have minimal histological abnormalities and so need not be treated.
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c. Start antiviral treatment for hepatitis C.
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hello the answer is A and the explanation is already posted
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