Treatment of chronic hepatitis C in a slow responder: a case for extended therapy.

BACKGROUND: A 49-year-old white man presented to his primary-care clinic with fatigue and poor concentration. He had an enlarged liver with a minimally tender edge and was subsequently referred to our liver clinic. INVESTIGATIONS: Physical examination, laboratory investigations (including tests for HCV-RNA, antibodies to hepatitis B surface and core antigens, and HBV-DNA), and liver biopsy. DIAGNOSIS: The patient had chronic hepatitis C infection and was a slow responder to treatment. MANAGEMENT: Administration of pegylated interferon alpha2b plus ribavirin for 72 weeks. Escitalopram was given to manage his depression.