Hepatitis C Management

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Question:

My mother contracted acute hepatitis C following a surgery, but has recovered fully. Twice, her hepatitis C titers were negative. Now, she again shows 6,000, but has a normal AST and ALT and is totally asymptomatic. She is not willing to have a biopsy. Should aggressive treatment be initiated or can we wait considering the very low titers, normal liver function, and absence of any symptoms?

I do not see a problem in waiting and doing nothing, especially in an older patient. The natural history of hepatitis C is that of a very slow progressing disease which may lead to liver cirrhosis or liver failure over a period of 20 to 30 years. In some patients, no significant progression is seen.

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