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 alpha2b plus ribavirin for 72 weeks. Escitalopram was given to manage his depression.