Hepatitis C Management

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Question:

This patient is a 54-year-old female health care worker in a wound/ostomy clinic with genotype 1 HCV, mild fibrosis, and an HCV viral load of 13,000,860. She had two treatments with mild silver protein IV 400 ppm. The last treatment was 5 months ago. The side effects were so bad that she had to stop treatment. She does not know how she contracted HCV; she did not use drugs or have blood transfusions. She has had breast biopsy, neuroma surgery, and arthroplasty. She was lethargic and had laboratory tests that showed an HCV RNA of 12 million IU/mL. After reading about peginterferon/ribavirin treatment, the side effects sound the same as those she had: projectile vomiting, headaches, a feeling of broken bones for days to weeks, nausea, and rigors. Are there any treatments with fewer side effects? Another important question is: Is there a way to accurately pinpoint when one contracted the virus?

Although a number of potentially novel anti-HCV treatment options are being developed, none are available by prescription. Unless there is an exposure time (history of transfusion for example), there are no tests available to pinpoint when the patient acquired HCV.

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