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Table 2. Pretreatment Assessments in Patients with Chronic HCV Infection
Medical history, including complications of liver disease, presence of significant extrahepatic disease, and symptoms of chronic HCV that may diminish quality of life
Psychiatric history, including past or ongoing psychiatric and substance use disorders
Screening for depression and alcohol use
Biochemical markers of liver injury and assessment of hepatic function, including ALT, albumin, bilirubin (particularly direct bilirubin), and prothrombin time
White blood cell counts with differential, hemoglobin, hematocrit, and platelets
Thyroid function tests
Serum glucose or glycosylated hemoglobin (HbA1c) in diabetics
Pregnancy test (in women of childbearing age)
Serum HBsAg, anti-HBc, anti-HBs, anti-HAV (total)
Quantitative HCV RNA measurement
Previous antiviral therapies and response
Electrocardiogram in preexisting cardiac disease
Liver biopsy to stage severity of liver disease (especially in HCV genotype 1 infection)
Eye exam for retinopathy in patients with diabetes or hypertension
Serum ferritin, iron saturation and serum ANA
Urine toxicology screen for opiates, cocaine, and amphetamines
ALT = alanine aminotransferase; HBsAg = hepatitis B surface antigen; anti-HBc = antibodies to hepatitis B core antigens; anti-HBs = antibodies to hepatitis B surface antigens; anti-HAV = antibodies to hepatitis A virus; ANA = antinuclear antibodies.