Leukopenia and thrombocytopenia are common, so complete blood cell counts should be taken often during therapy. Many patients have persistently normal transferase levels despite the presence of HCV infection. These patients are often asymptomatic, and their HCV-positive state is detected incidentally. Liver biopsy may reveal evidence of chronic hepatitis. Summary and conclusions Hepatitis C is the most common liver disease currently seen in clinical practice.
Many patients remain asymptomatic until decompensation occurs.
Lack of symptoms and minor liver enzyme elevations are typical of HCV infection and cannot be taken as evidence of lack of progression. HCV RNA testing confirms the diagnosis. Once this information is obtained, a rational program for treatment and monitoring can be planned. Patients with newly discovered hepatitis C infection require thorough education about the disease's natural history, transmission, interaction with alcohol, and treatment. In many cases, referral to a gastroenterologist or hepatologist may be the appropriate way to ensure necessary instruction and availability of the latest treatment options.