Peginterferon and ribavirin for chronic hepatitis C

A 44-year-old woman with chronic hepatitis C has intermittent fatigue and persistent elevations in serum alanine aminotransferase levels. She has had hepatitis C for 10 years. The diagnosis was made after she attempted to donate blood and was found to have antibodies against the hepatitis C virus (HCV). On questioning, she reports having used illicit injection drugs in her early 20s. The physical examination is normal except for obesity. The results of laboratory tests show an alanine aminotransferase level of 86 U per liter (normal value, <42); the alkaline phosphatase level, direct and total bilirubin levels, albumin level, prothrombin time, and complete blood count are normal. The serum HCV RNA level is 3.5 million IU per milliliter (genotype 1), and a liver biopsy specimen shows bridging fibrosis. The patient is evaluated by a hepatologist, who recommends treatment with pegylated interferon and ribavirin. Copyright © 2006 Massachusetts Medical Society.