CASE STUDY:
Treatment of a Naïve HCV Patient

CLINICAL INFORMATION

HISTORY OF PRESENT ILLNESS

A 42-year-old nurse was self-referred for a second opinion regarding chronic hepatitis C virus (HCV) infection diagnosed 2 years earlier during routine blood testing. She has remained asymptomatic.

PAST MEDICAL/SURGICAL HISTORY

The patient denied any past medical or surgical history.

SOCIAL HISTORY

The patient has 2 tattoos that were applied at age 17. She denied a history of intravenous drug use or blood transfusions, but she does recall a number of needle stick incidents during her nursing and EMT careers.

FAMILY HISTORY

Her family history is negative for hepatobiliary diseases.

MEDICATIONS/ALLERGIES

The patient takes no medications and has no known drug allergies.

PHYSICAL EXAMINATION

Vital Signs
Temperature	Pulse	Blood Pressure
36.4° C	64 bpm	110/70 mm Hg

On physical examination, the patient was a normally nourished Caucasian female in no apparent distress. She had isolated spider telangiectasias on her chest and palmar erythema. Her abdomen was soft and nontender with active bowel sounds. She had no ascites, and her liver was firm with a 15 cm vertical span, the lower edge of which projected 1 cm below the right costal margin. Her spleen was palpable. She had no evidence of jaundice or lower extremity edema.