Treatment monitoring and follow-up
For patients who have started treatment with the newer drugs, monitoring is essential and must be tailored to the individual, depending on response, side effects and co-morbidities.
Some routine monitoring requirements are listed in the table below, adapted from consensus statement August 2017consensus statement 2017 on managing HCV infection. Refer to the consensus statement for more details or to download summary chart of clinical guidelines for hepatitis C treatment, click here.
On treatment monitoring
- Identify potential barriers to adherence
- Regular follow-up to ensure adherence, adopting a patient-centred approach (adherence guidelines developed by Australian Hepatology Association is available here.)
- Test for HCV RNA to check for sustained virologic response (SVR) 12 weeks after the end of treatment
- At 12 weeks, also check liver function (LFT) (check at 8 weeks if on elbasvir+grazoprevir)
Monitoring after SVR
- If SVR, no cirrhosis and normal LFT - no further follow-up is required
- If SVR and abnormal LFT – assess further for other liver disease and refer to gastroenterology review
- SVR and cirrhosis – refer to gastroenterologist for long-term monitoring and screen for hepatocellular carcinoma, oesophageal varices and osteoporosis
- If no SVR – refer to a specialist for further management
- If SVR + ongoing risk of reinfection – check HCV RNA every 6-12 months