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Viral Hepatitis

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Hepatitis C Quicknotes: Contraindications

for Health Care Providers

Antiviral Treatment Eligibility

Contraindications

  1. Interferon (if contraindicated, patient should not receive any therapy since ribavirin alone is not useful)
    • Platelet count ≤70,000 cells/µL
    • ANC ≤1,500 cells/µL
    • Life-determining extrahepatic disease (malignancy, unstable angina, severe COPD)
    • Clinically decompensated liver disease
    • Uncontrolled autoimmune disorders
    • Pregnancy or planned pregnancy in patient or partner, or unwillingness to use birth control
    • Documented nonadherence to prior therapy, or failure to complete pretreatment evaluation appointments or procedures
    • Inability to self-administer or to arrange administration of parenteral medication
    • Severe uncontrolled psychiatric disease, particularly depression with current suicidal risk
    • Ongoing injection drug use
    • Ongoing alcohol abuse
  2. Ribavirin (if contraindicated, interferon monotherapy can be considered)
    • Serum creatinine ≥1.5 g/dL or creatinine clearance ≤50 ml/min
    • Hemoglobin <12 g/dL in men or <11 g/dL in women
    • Thalassemia or other hemoglobinopathy
    • Significant cardiac disease (arrhythmias, angina, CABG, MI) in past 12 months
    • Pregnancy or planned pregnancy in patient or partner, or unwillingness to use birth control

Next: Pretreatment Assessment