Hepatitis C Treatment Protocol

The HCV clinic at St. Vincent’s provides streamlined treatment for hepatitis C virus (HCV) infection. We follow a 3-visit protocol to screen patients, evaluate eligibility, and initiate appropriate antiviral therapy.

Summary of HCV Protocol

Visit 1: Initial Screening

• Confirm patient has no prior HCV treatment and does not have cirrhosis or HIV/hepatitis B co-infection
• Refer all patients to STV, HCV Clinic, Scheduled by front desk for initial visit
• Obtain lab screening:
  • Complete blood count
  • Comprehensive metabolic panel
  • Quantitative HCV viral load
  • HIV, hepatitis B, and pregnancy testing
• Labs must be within 3 months of potential treatment start
• HCV genotyping is NOT required

Visit 2: Physical Exam and Final Eligibility

• Complete physical exam and medication reconciliation
• Draw screening labs if not completed at Visit 1
• Confirm patient eligibility and insurance/assistance options
• Review treatment expectations and side effect management

Visit 3: Initiate Treatment

• Submit paperwork for patient assistance programs
• Provide instructions for pharmaceutical support programs
• Dispense 30-day supply of Epclusa (sofosbuvir/velpatasvir)
• Schedule follow-up visits to monitor virus response
• Emphasize importance of adherence and offer resources as needed

Eligibility Criteria for Simplified Treatment

Adults with chronic hepatitis C (any genotype) who do not have cirrhosis and have not previously received hepatitis C treatment

Patients Not Eligible for Simplified Treatment

• Patients who have any of the following characteristics:
  • Prior hepatitis C treatment
  • Cirrhosis (see simplified treatment for treatment-naive adults w/ compensated cirrhosis)
  • HIV or HBsAG positive
  • Current pregnancy
  • Known or suspected HCC
  • Prior liver transplantation

These patients require further specialty consultation prior to treatment.  Decompensated treatment requires longer duration of therapy.  Escalate these cases to Dr. Farr.

See detailed treatment guidelines at the following site: https://www.hcvguidelines.org/

Patient Education

• Counsel on potential side effects like headache, fatigue, nausea
• Advise checking blood sugar for hypoglycemia if on diabetes medication
• Discuss drug interactions such as warfarin
• Offer harm reduction resources as needed

Our goal is to provide patient-centered, accessible treatment to all patients with chronic HCV infection. Please reach out with any additional questions!