HCV Treatment
Forms, decision trees and prescribing informationWe want to keep you informed of recent drugs, screenings, treatments, and other news pertaining to Hepatitis and other liver diseases. As news becomes available we will post content here. Check back often to stay informed!
Simplified Treatment — 3 Easy Steps
Who Is Eligible? |
Who Is NOT Eligible? |
---|---|
Adults with hepatitis C (any genotype) who do NOT have cirrhosis or have compensated cirrhosis (CTP score < 6) and persons who have not previously received HCV treatment
Persons with cirrhosis should be referred to Liver Clinic for cirrhosis evaluation and follow up. Those with compensated cirrhosis, i.e. CTP < 6 [see Step 1 below for CTP calculation] can still receive Simplified Treatment; consult Liver Clinic for treatment recommendations. |
Patients who have any of the following:
– Prior HCV treatment – Current or prior episode of decompensated cirrhosis, defined as Child-Turcotte-Pugh (CTP) score > 6 or presence of ascites, hepatic encephalopathy, total bilirubin > 2.0mg/dL, albumin < 3.5g/dL, or INR > 1.7 – HIV positive – HBsAg positive – Current pregnancy – End-stage renal disease (i.e. eGFR <30mL/min/m2) – Known or suspected hepatocellular carcinoma – Prior liver transplantation |
Step 1: Determine FIB-4 Score
FIB-4 CalculatorYou will need age, ALT and AST, and platelet count
FIB-4 < 1.45 |
FIB-4 (1.45-3.25) |
FIB-4 > 3.25 |
---|---|---|
No Cirrhosis | Indeterminate Fibrosis Fibrosis Interpretation |
Cirrhosis Calculate CTP Score |
Step 2: Obtain Pre-Treatment Labs
Lab | How Recent? |
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If FIB-4 is indeterminate (1.45 – 3.25), Serum Fibrosis Test (FibroSure/Labcorp or FibroTest/Quest) or obtain FibroScan if test available (i.e. ANMC) | Complete prior to choosing HCV medication – Fibrosis Interpretation |
Pregnancy Test | Immediately prior to treatment start and counsel about pregnancy risk with HCV medication |
HCV RNA | Acceptable within past 6 months |
Hepatic function panel and eGFR | Acceptable within past 6 months |
AFP | Acceptable within past 6 months |
CBC (without diff) | Acceptable within 3 months if cirrhosis, 6 months if no cirrhosis |
PT/INR (only needed in cirrhosis) | Acceptable within 3 months |
HCV genotype | Not needed if treating with pangenotypic treatment; recommended if patient has cirrhosis, past treatment failure, or concern for reinfection; anytime prior |
HIV antigen/antibody | Anytime prior |
Hepatitis B surface antigen | Anytime prior |
Step 3: Write Prescription
State of Alaska Medicaid Prior Authorization
Hep Drug Interactions
Prescription Assistance Programs
Simplified Tx Prescribing Information
Glecaprevir/Pibrentasvir (Mavyret™)
Sofosbuvir/Velpatasvir (Epclusa®)
HCV Tx Documents
Simplified Treatment Checklist
Patient Readiness Attestation
Hepatitis C Information
Alcohol Use Disorders Identification Test (Audit-C)
Patient Health Questionnaire (PHQ-9)
Health Summary
Pre-Treatment Letter
Letter: End of Treatment
Letter: SVR 12
Letter: SVR 12 Cured
Medication Information Packet
Treatment Medications and Dosing
Patient Assistance Programs
Treatment Experienced Patients
Consult Liver Disease Specialist
Prescribing Information for Other Medications
Elbasvir/Grazoprevir (Zepatier™)
Ledipasvir/Sofosbuvir (Harvoni®)
Sofosbuvir/Velpatasvir/Voxelaprevir (Vosevi®)
Links for Clinical Care
AASLD Recommendations for Testing, Managing, and Treating Hep C
FDA Approved Drug Search
Adult Hepatitis Clinic
Internal Medicine Clinic
Healthy Communities Building
3rd Floor
Phone: (907) 729-1500
Pediatric Clinic
Anchorage Native Primary Care Center
First Floor
Phone: (907) 729-1000
Liver Disease & Hepatitis Program
Phone: (907) 729-1560
1-800-655-4837