Abstract
Introduction: We present a clinical case of an unusual laboratory abnormality, mixed pattern Hepatitis C genotype. The incidence of “mixed genotype HCV infections has been assessed across numerous geographical regions with estimates between 1.2% and 25.3% reported” (McNaughton et al, 2017, p. 524). This case highlights the importance of accurate identification of HCV genotype, subtype,and resistance-associated substitutions. Case Description/Methods: A 30-year-old male presented with a chief complaint of postprandial nausea/vomiting occurring daily for 3 weeks as well as episodes of heartburn and unintentional weight loss. He had a past history of substance abuse: intranasal and IV drug use of both heroin and cocaine. He tested positive for hepatitis C. There was remote use of alcohol (Cessation of use > 1 year),as well as a history of bipolar/depression, suicidal ideations, and self-mutilation. On physical examination BMI was 30.6. There were multiple body piercings. The liver was not palpable. Laboratory: Hepatitis C genotype-1B/3(method used: RT-PCR and reverse hybridization of the 5' UTR and core region of the HCV genome performed by Quest Diagnostics).Viral load-199,000 , Alk. Phos-86, AST-75, ALT-186, Tbil-0.5, PLT-238,000. Negative for HIV. Urine toxicology-positive for benzodiazepine& cocaine. Ultrasound elastography revealed F1 fibrosis. He was lost to care due to incarceration. Discussion: This case report highlights the unusual existence of mixed HCV genotype and the importance of accurate determination of viral genotypes and subtypes for determination of treatment with DAA. In this situation there tends to be a major and a minor genotype presumably because one is more replicatively fit. This may make selection of the appropriate DAA difficult and may explain some treatment failures.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.