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Table 4. Monitoring Parameters for Interferon-Based Therapies With or Without Ribavirin

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PARAMETER	INTERVAL	COMMENTS
ALT = alanine aminotransferase; ANC = absolute neutrophil counts; EVR = early virologic response; Hb = hemoglobin; Hct = hematocrit; WBC = white blood cell count.
WBC with differential, Hb, Hct, platelets, serum creatinine	Before treatment, week 1 or 2, week 4, then monthly or bimonthly during therapy or more frequently as indicated.	Prior to therapy, acceptable hematological and biochemical indices: Hb ≥12 g/dL for men and ≥11 g/dL for women; ANC >1.5 k/mm3; platelets >70 k/mm3; serum creatinine <1.5 mg/dL; creatinine clearance >50 mL/min. See Table 8 and Table 9 for dose modifications.
Serum ALT	Before treatment, month 1, then every 1-2 months	Monitor when performing other tests.
Pregnancy test	Before treatment, monthly during therapy and for 6 months after completing therapy	Patients and their partners should use two forms of contraception throughout therapy and for 6 months afterwards; if pregnancy occurs, therapy should be discontinued and the pregnancy monitored closely.
Thyroid-stimulating hormone (TSH)	Before treatment and at least every 12 wk during therapy	If TSH becomes elevated, confirm result and check a free thyroxine (T4) level; consider thyroid replacement therapy if indicated.
Blood glucose	Before treatment and at least every 12 wk during therapy	If blood glucose is elevated, confirm result by checking glycosylated Hb. If elevated, consider starting insulin sensitizer.
HCV RNA by quantitative and/or qualitative assay	Before treatment, 4, 12, and 24 wk during therapy, at end-of-therapy, and 6 months following the completion of therapy	Consider discontinuing treatment at 12 wk if <2 log₁₀ reduction in pretreatment HCV RNA. If EVR is not achieved and treatment is continued, discontinue treatment if HCV RNA is detectable at 24 wk if the goal is viral eradication. An assay with a minimum lower detection limit of HCV RNA <50 IU/mL should be used at 24 wk, end-of-therapy, and 6 months following completion of therapy.
Assess for adverse effects and adherence	At each routine visit	Nonadherence impairs response.
Depression screen	At baseline and each routine visit	For patients screening positive, consider antidepressant therapy and/ or referral to mental health specialist.
Substance use assessment (history of alcohol, cocaine, opiate, heroin, or amphetamine use)	At baseline and each routine visit	If positive, refer to addiction specialist.