Medical History and Physical Examination
- Clinicians should assess all patients with a confirmed diagnosis of chronic HCV infection, defined as a positive HCV surface antibody test result and detectable HCV RNA, for treatment. (A1)
- Clinicians should refer patients with chronic HCV and decompensated liver disease and patients who are pre- or post-liver transplant to a liver disease specialist. (A3)
- Clinicians new to treating chronic HCV infection should consult with a liver disease specialist when treating chronic HCV in patients with any of the following conditions (A3):
- Compensated cirrhosis; concurrent hepatobiliary conditions
- Extrahepatic manifestations of HCV, including renal, dermatologic, and rheumatologic manifestations
- Significant renal impairment (CrCl <30 mL/min) or who are undergoing hemodialysis
- Active HBV infection, defined as a positive HBsAg test result and detectable HBV DNA
- Ongoing HCV infection after failure of treatment with DAAs
- Treatment after organ transplantation
