Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 364, Issue 25, Pages 2429-2438Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp1006613
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A 45-year-old man undergoing a routine examination for life insurance is noted to have an aspartate aminotransferase level of 80 U per milliliter (normal range, 9 to 40) and an alanine aminotransferase level of 110 U per milliliter (normal range, 7 to 52). He reports a remote history of intravenous drug use. Tests for hepatitis C antibody and hepatitis B surface antibody are positive, and tests for hepatitis A and human immunodeficiency virus (HIV) antibodies are negative. Genotyping of the hepatitis C virus (HCV) reveals genotype 1b; the viral load is 2,460,000 IU per milliliter. The complete blood count is normal; the platelet count is 220x10(9) per liter. An abdominal ultrasonogram is normal. How should this patient's case be managed?
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