Q: One of my friends, 27 years old, has been infected with Hepatitis C Virus - Genotype 6K. The following are his test results: HCV Quantitative RT – PCR 22, 72, 700. Haemoglobin - 14.2, TC -12,750, platelet Count - 1.75, polymorphs – 78, lymphocytes – 20, eosinophils – 01, monocytes – 01, ESR (1/2 hour) – 02, ESR (1 hour) – 05 mm, prothrombin time - 16.3, total bilirubin - 0.6, direct bilirubin - 0.2, indirect bilirubin – 0.4, total protein - 7.1, albumin - 4.0, globulin - 3.1, A/G ratio - 1.2:1. Enzymes: SGOT - 23, SGPT – 42 and SALP - 190. HIV 1 & 2 are negative. How serious is this? Is there any cure? If yes, what are the side effects?

A:I note that your friend is a young male of 27 years infected with hepatitis C virus. Although, the HCV RNA viral load is high, his liver function tests are nearly in the normal range. Is there a history of jaundice anytime? Is there a history of surgery or blood transfusion in the past? It is often difficult to ascertain as to how and when the patient got this infection. It is important to understand that hepatitis C infection leads to chronic hepatitis in up to 80% of cases. However, it damages the liver very slowly and it has been shown that it may take up to 20-25 years for it to cause liver cirrhosis. So it is advised that patients with hepatitis C should be investigated and kept on a regular follow up. They need investigations including monitoring of LFT, ultrasound of liver and sometimes, liver biopsy to know the extent of liver damage. Now we have effective antiviral drugs such as Pegylated interferon and Ribavirin with good results. The patient needs to be treated by a Hepatologist (Liver Specialist) who can advise about the antiviral treatment.