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 alpha;2b plus ribavirin for 72 weeks. Escitalopram was given to manage his depression.
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