MEDizzy - A 27-year-old female is found to have a positive hepatitis C

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Gastroenterology 2

A 27-year-old female is found to have a positive hepatitis C antibody at the time of plasma donation. Physical examination is normal. Liver enzymes reveal ALT of 62 U/L (normal < 40), AST 65 U/L (normal < 40), bilirubin 1.2 mg/dL (normal), and alkaline phosphatase normal. Hepatitis C viral RNA is 100,000 copies/mL. Hepatitis B surface antigen and HIV anti- body are negative. Which of the following statements is true?

ExplanationThis patient has chronic hepatitis C. A positive test for hepatitis C viral RNA confirms the diagnosis. Liver biopsy is not necessary for confirmation, but may be useful in predicting candidacy for treatment. Chronic hepatitis C rarely resolves spontaneously. Untreated, about 15% of patients with hepatitis C will eventually develop cirrhosis. The levels of ALT and viral RNA correlate poorly with histologic disease and eventual prognosis. Treatment with pegylated interferon and ribavirin is aimed at preventing cirrhosis. Females, patients under age 40, patients with minimal or no cirrhosis, and those infected with genotypes 2 and 3 are more likely to respond to treatment. All patients with chronic hepatitis C should receive vaccination against hepatitis A and B, which can cause fulminate hepatic failure in patients with preexisting hepatitis C.