Perform a virological evaluation

Confirm the diagnosis of chronic HCV infection

In an individual who is repeatedly HCV antibody-positive, current HCV infection should be confirmed by a PCR assay for HCV RNA. Quantitative PCR is recommended as part of the pre-treatment assessment because HCV RNA level can identify people who are eligible for a short treatment duration with certain regimens. 

Identify the genotype of HCV infection

We continue to recommend HCV genotyping as a routine part of the pre-treatment assessment. Many of the approved treatment regimens for HCV are genotype-specific, and the HCV genotype must be documented in the patient’s history to meet PBS criteria for the new HCV medicines. In particular, short treatment duration (8 weeks) is possible for treatment-naive people with Gt 1 HCV, no cirrhosis and an HCV RNA level < 6 x 106 IU/mL. HCV genotype is also important for differentiating relapse from reinfection. HCV genotyping is now a routine laboratory test. 

Document the HCV treatment history

It is important to document any prior treatment for HCV infection. Key information includes treatment regimen, duration, adherence and response. These may influence the choice of treatment regimen and/or treatment duration (see Section on treatment for chronic HCV). 

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