Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

Viral Hepatitis

Quick Links

Veterans Crisis Line Badge
My healthevet badge

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