Consensus recommendations

Consensus recommendations

Grade

Assessment of comorbid conditions and liver disease cofactors, including HBV and HIV infection, should occur before commencing DAA therapy, and these conditions should be addressed before or concurrent with DAA therapy.

A1

Assessment of HCV genotype should be considered before making decisions regarding HCV therapy.

A1

Past HCV treatment experience should be documented, including regimen and response.

A1

Detecting cirrhosis is essential to identify people requiring long-term management of chronic liver disease, and also determines treatment duration for a number of DAA regimens.

A1

A non-invasive assessment of liver fibrosis is suitable for the majority of people.

A1

People with cirrhosis should be screened for complications including:

  • HCC (liver ultrasound)
  • oesophageal varices (gastroscopy)
  • osteoporosis (bone densitometry)

A1

All people with cirrhosis should be referred to, and managed in consultation with, a specialist familiar with the management of this condition.

A1

Vaccination against HAV and HBV is recommended for all susceptible individuals with HCV infection.

A1

All concomitant medications must be assessed for potential drug–drug interactions.

A1

Women of childbearing potential should be cautioned to avoid pregnancy while receiving DAA treatment and for 4 weeks afterwards.

B1

Men and women of childbearing potential should be cautioned to avoid pregnancy while receiving ribavirin-containing antiviral regimens, and for up to 6 months after stopping.

A1

Breastfeeding women should not be treated with DAAs.

B1