Hepatitis C Difficult to Treat: A Case Report in Jos, Nigeria
Duguru Mary John
Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.
McHenry Stephen
Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.
Nyam Paul David *
Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.
Davwar Mark Pantong
Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.
Okeke Edith Nonyelum
Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
We report a case of a 60-year-old male Nigerian businessman who first presented to the gastroenterology unit of the Jos University Teaching Hospital (JUTH) with systemic hypertension and Chronic HCV which was diagnosed in 2019. Treatment failure can occur in many situations. Some genotypes are harder to treat and hence prone to more failures. This is more with genotype 3 which is associated more with insulin resistance and alteration in lipid metabolism leading to steatosis. The presence of significant fibrosis, male gender, high viral load and deranged LFTs are usually associated with difficulty in achieving SVR12. Our patient in this report had many of these features. The first Fibroscan score was 10KPa and a repeat of 33.0KPa which was in keeping with severe fibrosis. Since our patient’s condition has worsened over the years, a liver transplant could also prove invaluable in this case at present as the patient has decompensated over time due to inability to have SVR and non-availability of the suitable DAAs and financial constraints on part of the patient.
Keywords: Chronic HCV, Fibroscan, pan-genotypic, sustained virologic response