This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
Sustained Response to antiviral therapy (IFN + Ribavarin) in hepatitis C is indicated by 
Select and explain. 
A. High HCV-RNA, B. Cirrhosis, C. Age > 40 years, D. Female sex
D: Female sex
Answer: D: Female sex 
Explanation: Answer is D (Female sex): Female sex is a ourable feature, associated with sustained responsiveness to antiviral therapy Male sex is associated with reduced responsiveness. Reduced Responsiveness Genotype 1 High levels of HCV RNA Adranced fibrosis (ciorrhosis, bridging fibrosis) Long duration disease Age > 40 years I mmunosupression African American Obesity Hepatic steatosis Reduced adherence Male sex (Handbook of Gastroenterology) Sustained Responsiveness Genotype 2 and 3 Low levels of HCV RNA Minimal fibrosis Sho duration disease Age < 40 years Immunocompetance Others Absence of obesity Absence of Hepatic steatosis Increased Adherence Female sex (Handbook of Gastroenterology)