Saturday, March 12, 2016

MKSAP: 55-year-old man with hepatitis C virus (HCV)

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 55-year-old man is evaluated in follow-up after a recent routine screening for antibody to hepatitis C virus (HCV) was positive. His medical history is unremarkable; he has not used illicit drugs or had any history of blood transfusions. He currently feels well and takes no medications.

Vital signs and physical examination are normal.

Laboratory studies reveal a positive HCV antibody test, but HCV RNA testing is negative. The serum alanine aminotransferase level is normal.

Which of the following is the most appropriate diagnostic test to perform next?

A: Perform liver ultrasound
B: Perform serial alanine aminotransferase monitoring
C: Repeat HCV antibody testing
D: Repeat HCV RNA testing
E: No further testing

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