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Feature Article

Eliminating hepatitis C: Part 4. Ongoing care after hepatitis C treatment

KICO CHAN, * MICHELLE GOOEY, * MARGARET HELLARD, BELINDA GREENWOOD-SMITH, RICHARD CHANEY, David Baker, ALISA PEDRANA, JOSEPH DOYLE, Jessica Howell

Figures

© filippobacci/istockphoto.com
© filippobacci/istockphoto.com

Abstract

Most patients who receive direct-acting antiviral treatment for hepatitis C are cured. The need for and nature of ongoing clinical care after treatment depends on whether cure has been achieved, the presence of cirrhosis or persistently abnormal liver function test results and ongoing risk of reinfection with hepatitis C virus.

Key Points

  • Over 95% of patients are cured after a full course of DAA treatment.
  • Patients with persistent liver function test abnormalities after DAA treatment need specialist referral for further investigation.
  • Patients with cirrhosis need specialist referral and lifelong monitoring for complications such as hepatocellular carcinoma.
  • Past infection does not result in immunity to hepatitis C, so patients should be counselled about the risk of reinfection and importance of harm reduction.
  • Harm reduction is an effective approach to reduce hepatitis C risk, including access to clean needles, syringes and other injecting equipment, and opioid substitution therapy.
  • Patients at risk of reinfection should be offered at least annual hepatitis C virus RNA PCR testing in the knowledge that they are eligible for retreatment if reinfected.

Figures

© filippobacci/istockphoto.com
© filippobacci/istockphoto.com