Viral Hepatitis

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Hepatitis C Quicknotes: Pretreatment Assessment

for Health Care Providers

Antiviral Treatment Eligibility

Pretreatment Assessment

  1. Necessary Evaluations
    • Medical history
    • Psychiatric history
    • Screening for depression and alcohol use
    • Biochemical markers of liver injury and synthetic dysfunction
      • Serum ALT
      • Serum albumin
      • Serum bilirubin (particularly direct)
      • Prothrombin time
    • Hemoglobin, hematocrit, total WBC, WBC with differential and platelet count
    • Thyroid function tests
    • Serum creatinine
    • Serum glucose or HgbA1C in diabetic patients
    • Pregnancy test (in women of child-bearing potential)
    • HIV serology
    • Serum HBsAg, anti-HBs, anti-HBc (total) and anti-HAV (total)
    • Quantitative HCV RNA
    • HCV genotype
    • Previous antiviral therapies and response
    • ECG in preexisting cardiac disease
  2. Highly recommended evaluations
    • Liver biopsy to stage severity of disease (especially in patients with genotype 1 infection)
    • Eye examination for retinopathy in patients with diabetes or hypertension
    • Serum ferritin, iron saturation and serum ANA
    • Urine toxicity screen for opiates, cocaine, and amphetamines

Next: Pretreatment Counseling