Hepatitis C Management

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Question:

Should a healthy patient with hepatitis C infection and normal liver tests be treated?

Selecting candidates for treatment based on symptoms is not the optimal strategy. Symptoms of HCV are often mild, protean, and correlate poorly with the amount of liver injury. More importantly, symptoms do not identify patients in whom the liver injury is accompanied by hepatic fibrosis, the prelude to cirrhosis. Hepatitis C infection often does not exist in a vacuum. A second “hit” such as obesity or alcohol use may coexist. Patients infected with HCV, even when the liver enzymes are normal, may develop hepatic fibrosis.

For more information, see the laboratory assessment section in the Hepatitis C Management monograph.

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