Treatment of Chronic HCV Infection in Adults: Post-Treatment Recs

Clinicians should perform HCV RNA testing 12 weeks after treatment is complete to verify that an SVR has been achieved. (A1)
If SVR is achieved, as established by undetectable HCV RNA at 12 weeks after treatment, clinicians should:
- Inform their patients that the HCV infection has been cured. (A2)
- Explain the risk of HCV reinfection and that HCV antibodies are not protective against reinfection. (A1)
To assess for reinfection in patients with ongoing risk factors, clinicians should perform follow-up screening with HCV RNA testing (not HCV antibody testing) at least annually, even with a history of an SVR. (A1)
- For risk factors, see the NYSDOH AI guideline HCV Screening, Testing, and Diagnosis in Adults.
If HCV RNA is detectable at 12 weeks after treatment, clinicians should:
- Inform patients that treatment has failed. (A1)
- If new to HCV treatment, consult with a liver disease specialist for retreatment evaluation. (B3)
- See the guideline section Recommended DAA Retreatment Regimens.

For patients taking RBV-containing HCV treatment regimens, clinicians should:
- Advise female and male patients to take extreme care to avoid pregnancy for 6 months after completion of therapy. (A2)
- Counsel female and male patients on effective contraceptive use. (A2)
If an individual becomes pregnant within 6 months of completing an RBV-containing HCV treatment regimen, clinicians should discuss the risks of using DAAs and RBV during pregnancy. (A3)

Clinicians should evaluate patients with persistent abnormal transaminase levels after SVR for other causes of liver disease and consult with a liver disease specialist. (A3)
For patients with bridging fibrosis or cirrhosis at the onset of treatment, clinicians should continue screening for HCC with ultrasound and alpha-fetoprotein testing every 6 months indefinitely. (A1)
Clinicians should refer patients with cirrhosis to a liver disease specialist for continued care. (A3)