Treatment of chronic HCV – Quick reference
A quick reference guide to recommended practices for managing chronic hepatitis C infections.
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Duration of treatment
The duration of treatment should be:
- 12-24 weeks for patients with genotype 2 or 3
- 48 weeks for patients with genotype 1 or 4.
- Patients with genotype 1 infection should be tested for EVR at 12 weeks.
- Patients with genotype 1 infection who fail to achieve an EVR at 12 weeks should be considered for cessation of treatment.
- Patients with genotype 1 infection with an EVR at 12 weeks should continue treatment for 48 weeks. Those who are still HCV RNA positive at 24 weeks should be considered for cessation of treatment.
Patients with genotype 2 or 3 infection should have an HCV RNA test performed 4 weeks after starting antiviral therapy and, if this is negative, the duration of therapy may be reduced to 12 or 16 weeks.
Management of adverse effects
In patients receiving pegylated IFN and ribavirin therapy:
erythropoietin should be considered in CHC patients who develop anaemia
G-CSF should be considered on a case-by-case basis for patients who develop significant neutropenia
all patients should be monitored for signs of depression before, during and immediately post-treatment
patients who report dyspnoea that is not related to anaemia should be urgently assessed for cardiopulmonary problems
thyroid function should be monitored at baseline before IFN therapy, at week 12 of treatment and at any time where there is a suspicion of thyroid dysfunction.
Good practice points
Pegylated IFN and ribavirin must not be prescribed to women who are pregnant.
Couples where one partner is receiving treatment, should use two forms of contraception until 6 months post-therapy.
