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Infectious Diseases
Hepatitis C: Review Questions
George J. Alangaden, MD
Dr. Alangaden is an Associate Professor of Internal Medicine, Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI.
Choose the single best answer for each question.
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1. Which of the following factors is associated with a slower progression of hepatitis C virus (HCV) infection to chronic liver disease?
- Alcohol use
- Female gender
- HCV genotype 2
- Older age at infection
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2. On which of the following criteria should selection of patients for treatment of chronic hepatitis C infection be based?
- HCV genotype
- Liver biopsy results
- Serum HCV RNA levels
- Serum transaminase levels
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3. A 44-year-old man with end-stage renal disease is evaluated for therapy of chronic hepatitis C infection (genotype 2). He has strictly abstained from alcohol for the past 6 months. His serum alanine aminotransferase level is 250 U/L, and his HCV RNA level is detectable. Results of a liver biopsy reveal evidence of fibrosis and severe necrosis and inflammation. Which of the following is the best therapeutic option for this patient?
- Administration of interferon and ribavirin
- Administration of pegylated interferon alfa
- Administration of pegylated interferon and ribavirin
- No therapy
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4. A 52-year-old man with chronic hepatitis C infection (genotype 1) and moderate hepatic fibrosis and inflammation on liver biopsy is treated with pegylated interferon and ribavirin. After 12 weeks of therapy, his HCV RNA level has declined by 1 log. Which of the following is the most appropriate next step in his treatment
- Continue treatment for a total of 24 weeks
- Continue treatment for a total of 48 weeks
- Discontinue treatment
- Repeat liver biopsy and assess the need for further therapy
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