In hepatitis C management, which practice is recommended?

• A. Start treatment during active hepatitis
• B. Avoid treatment during active hepatitis
• C. Use only liver-metabolized medicines
• D. Increase liver workload with new drugs

Answer: (B)

Timing of treatment in acute hepatitis C is the key idea. When hepatitis C presents as an acute infection, many people clear the virus on their own during the early months. Starting antiviral therapy right away during this active inflammatory phase doesn't always improve long-term cure and exposes patients to the side effects and risks of treatment, especially with older regimens. Because of that, the recommended practice has been to avoid initiating therapy during the active phase and to monitor the patient, deferring treatment until the infection has transitioned out of the acute phase or until chronic infection is established. This approach minimizes unnecessary drug exposure and allows time to see whether spontaneous clearance occurs. (Note: newer therapies can be used early in acute infection, but the approach described reflects the traditional management emphasized in many practice tests.)