What are the most important labs to monitor before, during, and after HCV treatment? Essentials in this brief slide show.
Before HCV treatment is initiated,
stage for hepatic fibrosis, document HCV genotype, subtype, viral load; assess for HBV co-infection.
Three months before HCV treatment is started,
obtain a CBC, liver function panel, GFR, INR; if PEG-IFN will be used, obtain baseline TSH.
Monitoring required during HCV treatment,
includes a CBC, Cr, GFR at 4 wks; viral load at 4 and 12 wks; if PEG-IFN, test TSH every 12 wks.
Post-HCV treatment monitoring:
test viral load at completion and 24 wks; based on SVR and cirrhosis/fibrosis, hepatocellular carcinoma screening, GI referral; CBC, LFT, INR every 6-12 months if no cirrhosis.
The treatment of HCV has evolved dramatically in the past few years. The drugs known as direct-acting antiviral (DAA) agents are generally well tolerated and highly effective. Before DAAs are prescribed, however it is important to assess for potential drug interactions. For example, DAAs have been shown to have interactions with antifungal and antiretroviral medications, antibiotics, and acid-reducing and lipid-lowering agents. Prior to initiation of DAA therapy, it is helpful to tap the expertise of a pharmacist to discuss a patient’s current medication regimen.This brief slide show is an at-a-glance primer on the laboratory studies that need to be ordered and monitored prior to, during, and after treatment of HCV. The goal of HCV treatment is to achieve an undetectable HCV viral load with a sustained virologic response and the HCV quantitative RNA (viral load) should be obtained prior to, during, and after treatment. Â The most up-to-date guidelines on HCV treatment can be found at http://www.hcvguidelines.org/full-report/monitoring-patients-who-are-starting-hepatitis-c-treatment-are-treatment-or-have