Consensus Statement on the Management of Patients with HCV Infection in Romania
Abstract
Background
Consensus Meeting
- (1)
- How do we diagnose patients with HCV infection?
- (2)
- How do we stage liver disease in patients with HCV infection?
- (3)
- How do we monitor patients with HCV infection prior to treatment?
- (4)
- Which patients with HCV infection do we treat?
- (5)
- When do we start treatment for HCV infection?
- (6)
- What regimens do we use for treating HCV infection?
- (7)
- How do we monitor patients with HCV infection during treatment?
- (8)
- What adverse events should we expect during treatment of HCV infection and how do we prevent/manage them?
- (9)
- How do we monitor patients with HCV infection after treatment?
- (10)
- How do we expect the landscape of HCV to change in the following years?
Consensus Statement
Conclusion
Supplementary Materials
Author Contributions
Acknowledgments
Conflicts of Interest
References
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| Fibrosis stage | FibroTest cut-off | Elastography cut-off (kPa) | Description |
| F0 | ≤0.28 | ≤5 | No fibrosis |
| F1 | 0.28–0.48 | 6–7.1 | Mild fibrosis |
| F2 | 0.49–0.58 | 7.2–9.5 | Moderate fibrosis |
| F3 | 0.59–0.74 | 9.6–12.5 | Advanced fibrosis |
| F4.1 | 0.75–0.85 | 12.6–20 | Compensated cirrhosis |
| F4.2 | 0.86–0.95 | 21–50 | Varices |
| F4.3 | ≥0.96 | ≥51 | Decompensated cirrhosis |
| F0–F1–F2 | |
|---|---|
| Time point | Investigations |
| Day 1 Medication | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV RNA, abdominal ultrasound, liver elastography/FibroMax, ECG * |
| Week 1 | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K |
| Week 2 | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K |
| Week 4 Medication | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA, abdominal ultrasound |
| Week 8 Medication | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K |
| Week 12 (end of treatment) | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA, abdominal ultrasound, liver elastography/FibroMax |
| PT Week 12 | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, Na, K, eGFR calculation, AFP, HCV-RNA, abdominal ultrasound, liver elastography/FibroMax |
| PT Week 24 | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, Na, K, eGFR calculation, AFP, HCV-RNA ** abdominal ultrasound, liver elastography/FibroMax |
| Yearly thereafter | Clinical exam, CBC, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, Na, K, eGFR calculation, AFP, abdominal ultrasound, liver elastography/FibroMax |
| F3–F4–F4+ | |
|---|---|
| Time point | Investigations |
| Day 1 Medication | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA, abdominal ultrasound, liver elastography/FibroMax, ECG * |
| Week 1 | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, abdominal ultrasound |
| Week 2 | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, abdominal ultrasound |
| Week 3 | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, abdominal ultrasound |
| Week 4 Medication | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA, abdominal ultrasound |
| Week 8 Medication | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP |
| Week 12 (end of treatment) | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA, abdominal ultrasound, liver elastography/FibroMax |
| PT Week 12 | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA, abdominal ultrasound, liver elastography/FibroMax |
| PT Week 24 | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, eGFR calculation, Na, K, AFP, HCV-RNA **, abdominal ultrasound, liver elastography/FibroMax |
| Every six months thereafter | Clinical exam, CBC, fibrinogen, ALT, AST, albumin, prothrombin time and concentration, direct and indirect bilirubin, fasting serum glucose, creatinine, urea, Na, K, eGFR calculation, AFP, abdominal ultrasound ***, liver elastography/FibroMax |
© GERMS 2017.
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Consensus Statement on HCV Infection in Romania Working Group. Consensus Statement on the Management of Patients with HCV Infection in Romania. GERMS 2017, 7, 32-39. https://doi.org/10.18683/germs.2017.1106
Consensus Statement on HCV Infection in Romania Working Group. Consensus Statement on the Management of Patients with HCV Infection in Romania. GERMS. 2017; 7(1):32-39. https://doi.org/10.18683/germs.2017.1106
Chicago/Turabian StyleConsensus Statement on HCV Infection in Romania Working Group. 2017. "Consensus Statement on the Management of Patients with HCV Infection in Romania" GERMS 7, no. 1: 32-39. https://doi.org/10.18683/germs.2017.1106
APA StyleConsensus Statement on HCV Infection in Romania Working Group. (2017). Consensus Statement on the Management of Patients with HCV Infection in Romania. GERMS, 7(1), 32-39. https://doi.org/10.18683/germs.2017.1106