What follow-up protocols should I implement for patients treated for Hepatitis C to monitor for reinfection or treatment failure?

Follow-up protocols for patients treated for hepatitis C to monitor for reinfection or treatment failure include:

• Monitoring for sustained virological response (SVR) by testing for undetectable HCV RNA 12 weeks after completion of antiviral treatment, as SVR is considered equivalent to a cure.
• Ongoing specialist assessment and monitoring by a hepatologist or specialist gastroenterologist to detect any treatment failure or reinfection.
• Regular viral load testing to assess response to treatment and detect any viral recurrence.
• Screening for hepatocellular carcinoma (HCC) with liver ultrasound in patients with advanced fibrosis or cirrhosis, as these patients remain at risk despite viral clearance.
• Providing ongoing lifestyle advice to reduce disease progression risk, including smoking cessation and avoiding blood-borne virus transmission risks.
• Offering immunisation against hepatitis A and B to those at continued risk of blood-borne infections.
• Ensuring integrated multidisciplinary care, including specialist nurse input, to maximise retention in care and support ongoing monitoring.
• Monitoring for adverse effects of treatment, including glucose levels in diabetic patients and INR in those on anticoagulants, during and shortly after treatment.
• Advising patients about the risk of reinfection, especially if they continue to engage in behaviours that expose them to HCV, and encouraging regular testing if at risk.

These protocols ensure early detection of treatment failure or reinfection and facilitate timely specialist intervention to prevent disease progression and transmission.

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