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Hep C genotype 4
Dec 4, 2009

I'm 56 years old and I've been recently diagnosed with Hep C (genotype 4) and have no idea were I contracted it. I've been told that my viral load is 40 000 IU. Should this be treated?

Response from Dr. McGovern

I would follow this HCV RNA again to be certain that it remains detectable in case you recently acquired HCV infection - since you don't know how you got it...

Low level viremia (<100,000) is uncommon in chronic infection (McGovern 2009 Clin Infect Dis)...

If it remains low, you have an outstanding chance of responding to treatment so I would skip the biopsy and get treated. If you attain a rapid virologic response (RVR) with an undetectable viral load at week 4, you will have a great chance of viral eradication.

The duration of treatment in this case would be hard to say. If you were having significant side effects and had achieved a RVR, I would consider only six months due to your low viral load. I am also assuming that your doctor has not found anything in your laboratories or your exam to suggest advanced liver disease.

My condition now
ALT/AST high again after 2nd try with Truvada

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