A 48-year-old man presents for an evaluation of abnormal findings on liver tests detected during an insurance examination. He had a blood transfusion 25 years previously but denies drug or alcohol use.
He denies a history of ascites, encephalopathy, or gastrointestinal bleeding. Laboratory findings Complete blood cell count normal Aspartate aminotransferase 115 U/L Alanine aminotransferase 137 U/L Albumin normal Bilirubin normal Hepatitis C virus antibody positive Hepatitis C RNA 200,000 IU/L Hepatitis A virus antibody IgG and IgM negative Hepatitis B surface antigen negative Hepatitis B surface antibody negative Human immunodeficiency virus negative Ultrasonography of the liver normal Liver…