Fast Five Quiz: Are You Prepared to Confront Hepatitis C?

Vinod K. Dhawan, MD


June 04, 2021

To improve access to curative HCV treatment, the "Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection" now includes a simplified HCV treatment algorithm that can be provided by a range of healthcare professionals, including specialists, primary care physicians, nurse practitioners, clinical pharmacy specialists, physician assistants, and registered nurses, without compromising treatment efficacy or safety. Treatment-naive patients 18 years and older with any genotype and who have no evidence of cirrhosis as defined by the parameters specified in the guidance are eligible for simplified treatment.

A FIB-4 score > 3.25 is evidence of cirrhosis, which disqualifies patients from eligibility for simplified HCV treatment. Other evidence of cirrhosis includes any of the following findings from a previously performed test:

  • Transient elastography indicating cirrhosis

  • Noninvasive serologic tests that exceed proprietary cutoffs

  • Clinical evidence of cirrhosis (eg, liver nodularity and/or splenomegaly on imaging, platelet count < 150,000/mm3, etc.)

  • Prior liver biopsy showing cirrhosis

Patients with cirrhosis are not eligible for simplified treatment because they require more nuanced care. This also applies to previously treated patients, regardless of the presence or absence of cirrhosis; patients with HIV/HBV co-infection; patients who have undergone prior liver transplantation; patients with HCC and/or end-stage renal disease; and patients who are pregnant at the time of treatment.

Learn more about medication for HCV infection.


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