Case 5
A 47 years
old male ,known to be HCV infected was quiet well and with a good
general condition when I saw him one year ago (with negative physical
examination findings) .He only had a mild ↑ in ALT and AST enzymes and I advised him
for follow-up. Since that time he did not show back till few days ago.
During that year he sought medical
advice in a hepatology centre and was prescribed Interferon and
Ribavirin after proper investigations which revealed no other causes of
hepatitis or contraindications for the treatment.
His course
of treatment at the hepatology centre was as follows:
-At the12th week his
HCV PCR was negative and at the same time his ALT elevated
4 times and this increase persisted throughout the course of treatment up
to his second visit to me few days ago at the 40th week of
the course of treatment (the first visit was 1
year ago) when there is still no viraemia and his positive findings were as
follows :
-Liver cirrhotic changes.
-splenomegaly.
-↓platelets count markedly.
-Significant ↑in ALT and AST levels.
What is the problem?
What is the decision to take?
