Acute HCV Questions

A 29-year-old male with well-controlled HIV for 2 years when initiated on antiretroviral therapy (Abacavir/lamivudine/dolutegravir) upon HIV diagnosis (CD4 = 462 cells/ml³, HIV RNA <20 copies/ml), baseline viral hepatitis panel was negative for all hepatitis A, B, and C serology markers, followed every 6 months in clinic, and normal liver function studies during his last scheduled visit, presents 4 months later to clinic with fatigue for 5 weeks. Labs are notable for an ALT 72, AST 45, normal bilirubin, platelets, albumin, hemoglobin, and INR. A viral hepatitis panel shows a reactive hepatitis C antibody, and a reflex HCV RNA is 1,630,000 copies/ml. Physical exam is unremarkable. Patient states he’s had 3 new male sexual partners since his last visit, and had unprotected sex with 2 male partners at a party approximately 3 months ago in which he was using methamphetamine.

Which of the following is not true?

A 55-year-old female coinfected with HIV and hepatitis C, genotype 1b, F3 baseline transient elastography staging, was treated for hepatitis C with 12 weeks of elbsavir/grazoprevir, and now comes into clinic to receive her SVR12 results. Her HCV RNA PCR is reported as not detected. A repeat Fibroscan at this visit has a score of 8.5 kPa (F2). Counseling at this visit should include all of the following, except: