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src="//cdn.hepatitisc.uw.edu/scripts/min/vendors-min.js?v=bmhjdmMtbWFzdGVyLWM4ODQzNjczLTIwMjQtMTEtMTMtMjA1NjI0Cg"></script> <script type="text/javascript" src="//cdn.hepatitisc.uw.edu/scripts/min/scripts-min.js?v=bmhjdmMtbWFzdGVyLWM4ODQzNjczLTIwMjQtMTEtMTMtMjA1NjI0Cg"></script> <link rel="apple-touch-icon" sizes="180x180" href="//cdn.hepatitisc.uw.edu/css/images/ios/logo.png" /><meta name="theme-color" content="rgb(190,54,39)"> </head> <body class="site-nhcvc logged-out action-go not-mobile use-questions"> <section id="header-components"><div id="header"><div class="inner"><a href="/process.php?action=home" id="logo">Hepatitis C Online</a></div></div><div class="nav-outer"><div class="level1-navigation"><div class="inner"><ul class="main-menu"><span class="name">Module</span><li class="section section-menu visible-mobile"><div class="link"><span class="menu-open glyphicon glyphicon-th" aria-hidden="true"></span><span class="menu-close glyphicon glyphicon-remove" aria-hidden="true"></span> <span class="hidden">Site Navigation</span></div></li><li class="section home-section"><a href="/" title="Hepatitis C Online" class=" link"></a></li><li class="section biology"><a href="/page/hcv/biology" class="link ">HCV <br />Biology</a></li><li class="section treatments nhcvc-medications has-submenu"><a href="/page/treatment/drugs" class=" link ">HCV <br />Medications<span class="submenu-trigger"></span></a><div class="submenu medications"><div class="description description-default">Listed in <strong>alphabetical</strong> order.</div><ul><li class="treatment treatment-7"><a href="/page/treatment/drugs/elbasvir-grazoprevir"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/7.png" alt="Elbasvir-Grazoprevir (Zepatier) Pill Preview" />Elbasvir-Grazoprevir <em>Zepatier</em></a></li><li class="treatment treatment-22"><a href="/page/treatment/drugs/glecaprevir-pibrentasvir"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/22.png" alt="Glecaprevir-Pibrentasvir (Mavyret) Pill Preview" />Glecaprevir-Pibrentasvir <em>Mavyret</em></a></li><li class="treatment treatment-11"><a href="/page/treatment/drugs/ledipasvir-sofosbuvir"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/11.png" alt="Ledipasvir-Sofosbuvir (Harvoni) Pill Preview" />Ledipasvir-Sofosbuvir <em>Harvoni</em></a></li><li class="treatment treatment-3"><a href="/page/treatment/drugs/ribavirin-drug"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/3.png" alt="Ribavirin (Copegus, Rebetol, Ribasphere) Pill Preview" />Ribavirin <em>Copegus, Rebetol, Ribasphere</em></a></li><li class="treatment treatment-1"><a href="/page/treatment/drugs/sofosbuvir-drug"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/1.png" alt="Sofosbuvir (Sovaldi) Pill Preview" />Sofosbuvir <em>Sovaldi</em></a></li><li class="treatment treatment-20"><a href="/page/treatment/drugs/epclusa"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/20.png" alt="Sofosbuvir-Velpatasvir (Epclusa) Pill Preview" />Sofosbuvir-Velpatasvir <em>Epclusa</em></a></li><li class="treatment treatment-21"><a href="/page/treatment/drugs/sofosbuvir-velpatasvir-voxilaprevir"><img class="drug-preview" src="//cdn.hepatitisc.uw.edu/css/images/drugs/21.png" alt="Sofosbuvir-Velpatasvir-Voxilaprevir (Vosevi) Pill Preview" />Sofosbuvir-Velpatasvir-Voxilaprevir <em>Vosevi</em></a></li></ul></div></li><li class="section modules active-trail has-submenu"><a href="/alternate" class="link active-trail">Course <br /> Modules<span class="submenu-trigger"></span></a><div class="submenu modules"><ul><li class="level1 level1-all "><a href="/alternate"><span class="caption">View all Course Modules</span></a></li><li class="level1 level1-31 has-subsubmenu"><a href="/go/screening-diagnosis"><span class="num">1</span><span class="caption">Screening and Diagnosis of Hepatitis C Infection</span><span class="submenu-trigger"></span></a><div class="subsubmenu custom"><a class="description" href="/custom/screening-diagnosis"><h3>Self-Study Module<span class="edition-tag edition-tag-4">4th Edition</span><span class="cme-tag cme-tag-available">CNE/CME Available</span></h3> Track your progress and receive CE credit</a><ul><li><a href="/custom/screening-diagnosis">Screening and Diagnosis: Self-Study <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-108"><a href="/custom/screening-diagnosis/epidemiology-us"><span class="caption">HCV Epidemiology in the United States</span></a></li><li class="level2 level2-109"><a href="/custom/screening-diagnosis/recommendations-screening"><span class="caption">Recommendations for Hepatitis C Screening</span></a></li><li class="level2 level2-110"><a href="/custom/screening-diagnosis/diagnostic-testing"><span class="caption">Hepatitis C Diagnostic Testing</span></a></li><li class="level2 level2-111"><a href="/custom/screening-diagnosis/counseling-prevention"><span class="caption">Counseling for Prevention of HCV Transmission</span></a></li><li class="level2 level2-112"><a href="/custom/screening-diagnosis/acute-diagnosis"><span class="caption">Diagnosis of Acute HCV Infection</span></a></li></ol><ul><li><a href="/custom/screening-diagnosis/certificate">Certificate Requirements <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul></div><div class="subsubmenu level2s"><a class="description" href="/go/screening-diagnosis"><h3>Quick Reference<span class="edition-tag edition-tag-4">4th Edition</span></h3> Rapidly access information in this module</a><ul><li><a href="/go/screening-diagnosis">Screening and Diagnosis of Hepatitis C Infection: Overview</a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-153"><a href="/go/screening-diagnosis/epidemiology-us/core-concept/all"><span class="caption">HCV Epidemiology in the United States</span></a></li><li class="level2 level2-157"><a href="/go/screening-diagnosis/recommendations-screening/core-concept/all"><span class="caption">Recommendations for Hepatitis C Screening</span></a></li><li class="level2 level2-154"><a href="/go/screening-diagnosis/diagnostic-testing/core-concept/all"><span class="caption">Hepatitis C Diagnostic Testing</span></a></li><li class="level2 level2-155"><a href="/go/screening-diagnosis/counseling-prevention/core-concept/all"><span class="caption">Counseling for Prevention of HCV Transmission</span></a></li><li class="level2 level2-156"><a href="/go/screening-diagnosis/acute-diagnosis/core-concept/all"><span class="caption">Diagnosis of Acute HCV Infection</span></a></li></ol></div></li><li class="level1 level1-34 has-subsubmenu"><a href="/go/evaluation-staging-monitoring"><span class="num">2</span><span class="caption">Evaluation, Staging, and Monitoring of Chronic Hepatitis C</span><span class="submenu-trigger"></span></a><div class="subsubmenu custom"><a class="description" href="/custom/evaluation-staging-monitoring"><h3>Self-Study Module<span class="edition-tag edition-tag-4">4th Edition</span><span class="cme-tag cme-tag-available">CNE/CME Available</span></h3> Track your progress and receive CE credit</a><ul><li><a href="/custom/evaluation-staging-monitoring">Evaluation, Staging, and Monitoring: Self-Study <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-124"><a href="/custom/evaluation-staging-monitoring/initial-evaluation-chronic"><span class="caption">Initial Evaluation of Persons with Chronic HCV</span></a></li><li class="level2 level2-125"><a href="/custom/evaluation-staging-monitoring/natural-history"><span class="caption">Natural History of HCV Infection</span></a></li><li class="level2 level2-126"><a href="/custom/evaluation-staging-monitoring/counseling-liver-health"><span class="caption">Counseling Persons with Chronic HCV Infection</span></a></li><li class="level2 level2-127"><a href="/custom/evaluation-staging-monitoring/evaluation-staging"><span class="caption">Evaluation and Staging of Liver Fibrosis</span></a></li><li class="level2 level2-128"><a href="/custom/evaluation-staging-monitoring/evaluation-prognosis-cirrhosis"><span class="caption">Evaluation and Prognosis of Persons with Cirrhosis</span></a></li><li class="level2 level2-129"><a href="/custom/evaluation-staging-monitoring/surveillance-hepatocellular-carcinoma"><span class="caption">Surveillance for Hepatocellular Carcinoma</span></a></li><li class="level2 level2-130"><a href="/custom/evaluation-staging-monitoring/extrahepatic-conditions"><span class="caption">Extrahepatic Conditions Related to HCV Infection</span></a></li></ol><ul><li><a href="/custom/evaluation-staging-monitoring/certificate">Certificate Requirements <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul></div><div class="subsubmenu level2s"><a class="description" href="/go/evaluation-staging-monitoring"><h3>Quick Reference<span class="edition-tag edition-tag-4">4th Edition</span></h3> Rapidly access information in this module</a><ul><li><a href="/go/evaluation-staging-monitoring">Evaluation, Staging, and Monitoring of Chronic Hepatitis C: Overview</a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-169"><a href="/go/evaluation-staging-monitoring/initial-evaluation-chronic/core-concept/all"><span class="caption">Initial Evaluation of Persons with Chronic HCV</span></a></li><li class="level2 level2-170"><a href="/go/evaluation-staging-monitoring/natural-history/core-concept/all"><span class="caption">Natural History of HCV Infection</span></a></li><li class="level2 level2-171"><a href="/go/evaluation-staging-monitoring/counseling-liver-health/core-concept/all"><span class="caption">Counseling Persons with Chronic HCV Infection</span></a></li><li class="level2 level2-172"><a href="/go/evaluation-staging-monitoring/evaluation-staging/core-concept/all"><span class="caption">Evaluation and Staging of Liver Fibrosis</span></a></li><li class="level2 level2-175"><a href="/go/evaluation-staging-monitoring/evaluation-prognosis-cirrhosis/core-concept/all"><span class="caption">Evaluation and Prognosis of Persons with Cirrhosis</span></a></li><li class="level2 level2-173"><a href="/go/evaluation-staging-monitoring/surveillance-hepatocellular-carcinoma/core-concept/all"><span class="caption">Surveillance for Hepatocellular Carcinoma</span></a></li><li class="level2 level2-174"><a href="/go/evaluation-staging-monitoring/extrahepatic-conditions/core-concept/all"><span class="caption">Extrahepatic Conditions Related to HCV Infection</span></a></li></ol></div></li><li class="level1 level1-33 has-subsubmenu"><a href="/go/management-cirrhosis-related-complications"><span class="num">3</span><span class="caption">Management of Cirrhosis-Related Complications</span><span class="submenu-trigger"></span></a><div class="subsubmenu custom"><a class="description" href="/custom/management-cirrhosis-related-complications"><h3>Self-Study Module<span class="edition-tag edition-tag-4">4th Edition</span><span class="cme-tag cme-tag-available">CNE/CME Available</span></h3> Track your progress and receive CE credit</a><ul><li><a href="/custom/management-cirrhosis-related-complications">Management of Cirrhosis-Related Complications: Self-Study <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-119"><a href="/custom/management-cirrhosis-related-complications/ascites-diagnosis-management"><span class="caption">Diagnosis and Management of Ascites</span></a></li><li class="level2 level2-120"><a href="/custom/management-cirrhosis-related-complications/spontaneous-bacterial-peritonitis-recognition-management"><span class="caption">Recognition and Management of Spontaneous Bacterial Peritonitis</span></a></li><li class="level2 level2-121"><a href="/custom/management-cirrhosis-related-complications/varices-screening-prevention-bleeding"><span class="caption">Screening for Varices and Prevention of Bleeding</span></a></li><li class="level2 level2-122"><a href="/custom/management-cirrhosis-related-complications/hepatic-encephalopathy-diagnosis-management"><span class="caption">Diagnosis and Management of Hepatic Encephalopathy</span></a></li><li class="level2 level2-123"><a href="/custom/management-cirrhosis-related-complications/liver-transplantation-referral"><span class="caption">Referral for Liver Transplantation</span></a></li></ol><ul><li><a href="/custom/management-cirrhosis-related-complications/certificate">Certificate Requirements <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul></div><div class="subsubmenu level2s"><a class="description" href="/go/management-cirrhosis-related-complications"><h3>Quick Reference<span class="edition-tag edition-tag-4">4th Edition</span></h3> Rapidly access information in this module</a><ul><li><a href="/go/management-cirrhosis-related-complications">Management of Cirrhosis-Related Complications: Overview</a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-164"><a href="/go/management-cirrhosis-related-complications/ascites-diagnosis-management/core-concept/all"><span class="caption">Diagnosis and Management of Ascites</span></a></li><li class="level2 level2-165"><a href="/go/management-cirrhosis-related-complications/spontaneous-bacterial-peritonitis-recognition-management/core-concept/all"><span class="caption">Recognition and Management of Spontaneous Bacterial Peritonitis</span></a></li><li class="level2 level2-166"><a href="/go/management-cirrhosis-related-complications/varices-screening-prevention-bleeding/core-concept/all"><span class="caption">Screening for Varices and Prevention of Bleeding</span></a></li><li class="level2 level2-167"><a href="/go/management-cirrhosis-related-complications/hepatic-encephalopathy-diagnosis-management/core-concept/all"><span class="caption">Diagnosis and Management of Hepatic Encephalopathy</span></a></li><li class="level2 level2-168"><a href="/go/management-cirrhosis-related-complications/liver-transplantation-referral/core-concept/all"><span class="caption">Referral for Liver Transplantation</span></a></li></ol></div></li><li class="level1 level1-35 has-subsubmenu hovered active-trail"><a href="/go/evaluation-treatment" class="active-trail"><span class="num">4</span><span class="caption">Evaluation and Preparation for Hepatitis C Treatment</span><span class="submenu-trigger"></span></a><div class="subsubmenu custom"><a class="description" href="/custom/evaluation-treatment"><h3>Self-Study Module<span class="edition-tag edition-tag-4">4th Edition</span><span class="cme-tag cme-tag-available">CNE/CME Available</span></h3> Track your progress and receive CE credit</a><ul><li><a href="/custom/evaluation-treatment">Evaluation and Preparation for Treatment: Self-Study <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-131"><a href="/custom/evaluation-treatment/treatment-goals-predicting-response"><span class="caption">Goals and Benefits with HCV Treatment</span></a></li><li class="level2 level2-132"><a href="/custom/evaluation-treatment/treatment-initiation-decision"><span class="caption">Making a Decision on When to Initiate HCV Therapy</span></a></li><li class="level2 level2-133"><a href="/custom/evaluation-treatment/addressing-structural-barriers-to-treatment"><span class="caption">Addressing Structural Barriers to HCV Treatment</span></a></li></ol><ul><li><a href="/custom/evaluation-treatment/certificate">Certificate Requirements <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul></div><div class="subsubmenu level2s"><a class="description" href="/go/evaluation-treatment"><h3>Quick Reference<span class="edition-tag edition-tag-4">4th Edition</span></h3> Rapidly access information in this module</a><ul><li><a href="/go/evaluation-treatment">Evaluation and Preparation for Hepatitis C Treatment: Overview</a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-176"><a href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all"><span class="caption">Goals and Benefits with HCV Treatment</span></a></li><li class="level2 level2-177"><a href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all"><span class="caption">Making a Decision on When to Initiate HCV Therapy</span></a></li><li class="level2 level2-178"><a href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all"><span class="caption">Addressing Structural Barriers to HCV Treatment</span></a></li></ol></div></li><li class="level1 level1-30 has-subsubmenu"><a href="/go/treatment-infection"><span class="num">5</span><span class="caption">Treatment of Hepatitis C Infection</span><span class="submenu-trigger"></span></a><div class="subsubmenu custom"><a class="description" href="/custom/treatment"><h3>Self-Study Module<span class="edition-tag edition-tag-4">4th Edition</span><span class="cme-tag cme-tag-available">CNE/CME Available</span></h3> Track your progress and receive CE credit</a><ul><li><a href="/custom/treatment">Treatment of HCV: Self-Study <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-102"><a href="/custom/treatment/multi-genotype-treatment-new-lesson"><span class="caption">Simplified HCV Treatment for All HCV Genotypes</span></a></li><li class="level2 level2-103"><a href="/custom/treatment/retreatment-patients-prior-treatment-experience"><span class="caption">Retreatment of Patients with Prior HCV Treatment Experience</span></a></li><li class="level2 level2-101"><a href="/custom/treatment/monitoring"><span class="caption">Monitoring During and After HCV Treatment</span></a></li><li class="level2 level2-105"><a href="/custom/treatment/treatment-cirrhosis"><span class="caption">Treatment of HCV in Persons with Cirrhosis</span></a></li><li class="level2 level2-104"><a href="/custom/treatment/treatment-acute-infection"><span class="caption">Treatment of Acute HCV Infection</span></a></li></ol><ul><li><a href="/custom/treatment/certificate">Certificate Requirements <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul></div><div class="subsubmenu level2s"><a class="description" href="/go/treatment-infection"><h3>Quick Reference<span class="edition-tag edition-tag-4">4th Edition</span></h3> Rapidly access information in this module</a><ul><li><a href="/go/treatment-infection">Treatment of Hepatitis C Infection: Overview</a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-149"><a href="/go/treatment-infection/multi-genotype-treatment-new-lesson/core-concept/all"><span class="caption">Simplified HCV Treatment for All HCV Genotypes</span></a></li><li class="level2 level2-150"><a href="/go/treatment-infection/retreatment-patients-prior-treatment-experience/core-concept/all"><span class="caption">Retreatment of Patients with Prior HCV Treatment Experience</span></a></li><li class="level2 level2-143"><a href="/go/treatment-infection/monitoring/core-concept/all"><span class="caption">Monitoring During and After HCV Treatment</span></a></li><li class="level2 level2-152"><a href="/go/treatment-infection/treatment-cirrhosis/core-concept/all"><span class="caption">Treatment of HCV in Persons with Cirrhosis</span></a></li><li class="level2 level2-151"><a href="/go/treatment-infection/treatment-acute-infection/core-concept/all"><span class="caption">Treatment of Acute HCV Infection</span></a></li></ol></div></li><li class="level1 level1-32 has-subsubmenu"><a href="/go/key-populations-situations"><span class="num">6</span><span class="caption">Treatment of Key Populations and Unique Situations</span><span class="submenu-trigger"></span></a><div class="subsubmenu custom"><a class="description" href="/custom/key-populations-unique-situations"><h3>Self-Study Module<span class="edition-tag edition-tag-4">4th Edition</span><span class="cme-tag cme-tag-available">CNE/CME Available</span></h3> Track your progress and receive CE credit</a><ul><li><a href="/custom/key-populations-unique-situations">Treatment of Key Populations and Unique Situations: Self-Study <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-113"><a href="/custom/key-populations-unique-situations/treatment-hiv-coinfection"><span class="caption">Treatment of HCV in Persons with HIV Coinfection</span></a></li><li class="level2 level2-114"><a href="/custom/key-populations-unique-situations/treament-renal-impairment"><span class="caption">Treatment of HCV in Persons with Renal Impairment</span></a></li><li class="level2 level2-115"><a href="/custom/key-populations-unique-situations/treatment-substance-use"><span class="caption">Treatment of HCV in Persons with Substance Use</span></a></li><li class="level2 level2-116"><a href="/custom/key-populations-unique-situations/treatment-corrections"><span class="caption">Treatment of HCV in a Correctional Setting</span></a></li><li class="level2 level2-117"><a href="/custom/key-populations-unique-situations/management-health-care-workers-potentially-exposed-to-hcv"><span class="caption">Management of Health Care Personnel Exposed to HCV</span></a></li><li class="level2 level2-118"><a href="/custom/key-populations-unique-situations/perinatal-hcv-transmission"><span class="caption">Perinatal HCV Transmission</span></a></li></ol><ul><li><a href="/custom/key-populations-unique-situations/certificate">Certificate Requirements <span class="cme-tag cme-tag-available">CNE/CME</span></a></li></ul></div><div class="subsubmenu level2s"><a class="description" href="/go/key-populations-situations"><h3>Quick Reference<span class="edition-tag edition-tag-4">4th Edition</span></h3> Rapidly access information in this module</a><ul><li><a href="/go/key-populations-situations">Treatment of Key Populations and Unique Situations: Overview</a></li></ul><h4>Lessons</h4><ol><li class="level2 level2-158"><a href="/go/key-populations-situations/treatment-hiv-coinfection/core-concept/all"><span class="caption">Treatment of HCV in Persons with HIV Coinfection</span></a></li><li class="level2 level2-159"><a href="/go/key-populations-situations/treament-renal-impairment/core-concept/all"><span class="caption">Treatment of HCV in Persons with Renal Impairment</span></a></li><li class="level2 level2-160"><a href="/go/key-populations-situations/treatment-substance-use/core-concept/all"><span class="caption">Treatment of HCV in Persons with Substance Use</span></a></li><li class="level2 level2-161"><a href="/go/key-populations-situations/treatment-corrections/core-concept/all"><span class="caption">Treatment of HCV in a Correctional Setting</span></a></li><li class="level2 level2-162"><a href="/go/key-populations-situations/management-health-care-workers-potentially-exposed-to-hcv/core-concept/all"><span class="caption">Management of Health Care Personnel Exposed to HCV</span></a></li><li class="level2 level2-163"><a href="/go/key-populations-situations/perinatal-hcv-transmission/core-concept/all"><span class="caption">Perinatal HCV Transmission</span></a></li></ol></div></li></ul></div></li><li class="section tools has-submenu"><a href="/page/clinical-calculators/apri" class="link ">Tools &<br /> Calculators<span class="submenu-trigger"></span></a><div class="submenu tools"><ul><li class="section-page section-page-7 has-subsubmenu"><a href="/page/clinical-calculators/ctp" class=""><span class="caption">Clinical Calculators</span><span class="submenu-trigger"></span></a><div class="subsubmenu sections"><ul><li class="tool"><a href="/page/clinical-calculators/ctp" class="">CTP Calculator <em>Child-Turcotte-Pugh (CTP) Calculator</em></a></li><li class="tool"><a href="/page/clinical-calculators/apri" class="">APRI Calculator <em>AST to Platelet Ratio Index (APRI) Calculator</em></a></li><li class="tool"><a href="/page/clinical-calculators/bmi" class="">BMI Calculator <em>Body Mass Index (BMI) Calculator</em></a></li><li class="tool"><a href="/page/clinical-calculators/crcl" class="">CrCl Calculator <em>Creatinine Clearance (CrCl) Calculator</em></a></li><li class="tool"><a href="/page/clinical-calculators/fib-4" class="">FIB-4 Calculator <em>Fibrosis-4 (FIB-4) Calculator</em></a></li><li class="tool"><a href="/page/clinical-calculators/glasgow-coma" class="">Glasgow Coma Scale <em>Glasgow Coma Scale</em></a></li><li class="tool"><a href="/page/clinical-calculators/mdrd" class="">GFR Calculator <em>Glomerular Filtration Rate (GFR) Estimate by MDRD 4-Variable Equation</em></a></li><li class="tool"><a href="/page/clinical-calculators/meld" class="">MELD Calculator <em>Model for End-Stage Liver Disease (MELD) for ages 12 and older</em></a></li><li class="tool"><a href="/page/clinical-calculators/saag" class="">SAAG Calculator <em>Serum-Ascites Albumin Gradient (SAAG)</em></a></li></ul></div></li><li class="section-page section-page-14 has-subsubmenu"><a href="/page/substance-use/audit-c" class=""><span class="caption">Substance Use Screening Tools</span><span class="submenu-trigger"></span></a><div class="subsubmenu sections"><ul><li class="tool"><a href="/page/substance-use/audit-c" class="">Alcohol: AUDIT-C <em>Alcohol Use Disorders Identification Test (AUDIT-C)</em></a></li><li class="tool"><a href="/page/substance-use/cage" class="">Alcohol: CAGE <em>CAGE Alcohol Questionnaire</em></a></li><li class="tool"><a href="/page/substance-use/opioid" class="">Opioid: Risk Tool <em>Opioid Risk Tool (ORT)</em></a></li></ul></div></li></ul></div></li><li class="section ccn"><a href="/page/site/clinical-consultation" class="link has-tooltip">Clinical <br />Consultation</a></li><li class="section expert-opinions"><a href="/page/challenges/expert-opinions" class=" link "><span class="icon"><span class="glyphicon glyphicon-link"></span></span>Clinical <br />Challenges</a></li><li class="section mini-lectures"><a href="/mini-lectures" class="link">Mini-<br>Lectures</a></li><li class="section glossary"><a href="javascript:void(0)" title="Search for any topic" class="link ">Search</a><div id="search-minimal" class="search-interface"><div class="close"></div><div class="search-controls"><label for="search-q">Search for</label><input type="text" name="search-q" id="search-q" class="search-input" placeholder="Terms, medications, lectures, core concepts, etc..." /></div><div class="search-results-container"></div><div class="search-notice"><strong>Use this Search to quickly find items or navigate the site.</strong></div></div></li></ul><div class="user-status"><a class="loggedout" href="https://www.hepatitisC.uw.edu/alternate" title="Sign In for registered users"><span class="glyphicon glyphicon-log-in"></span><span class="label-text"> Sign In</span></a><span class="hidden-xs"> or <a class="loggedout" href="https://www.hepatitisC.uw.edu/page/account/register" title="Create an account">Register</a></span></div></div></div></div></section><div id="wrap" class="content-wrap"> <div id="content"> <div id="notifications"></div><div class="page-titles"><h2 class="main-title level135"><a href="/go/evaluation-treatment"><span class="heading">Evaluation and Preparation for Hepatitis C Treatment</span></a></h2></div><div id="page" class="levels level135 menu-closed-forced menu-closed"><div class="inner"><div id="sidebar" class=""><span class="menu-toggle"><span class="icon_open glyphicon glyphicon-menu-hamburger title-extra" title="Open the navigation menu"></span><span class="icon_closed glyphicon glyphicon-remove" title="Hide the navigation menu"></span><span class="button-description">Section Navigation</span></span><div class="header">Section Navigation</div><div class="inner"><ul class="overview"><li class="page page-overview level1 first active-trail not-started"><span class="active-trail-indicator"></span><a href="/go/evaluation-treatment" class="title-extra level1 active-trail" title="Evaluation and Preparation for Hepatitis C Treatment"><span class="type">Module 4 Overview</span><br /><span class="title">Evaluation and Preparation for Hepatitis C Treatment</span></a></li><li class="level2 not-started"><a href="/go/evaluation-treatment/treatment-goals-predicting-response" title="Goals and Benefits with HCV Treatment" class="title-extra level2"><span class="progress-container level135" title="Progress of this Lessons"><span class="progress-bar progress-bar-0" style="width: 0%"><span class="percent less">0%</span></span></span><span class="type">Lesson 1</span><br /><span class="title">Goals and Benefits with HCV Treatment</span></a><div class="level3s" ><span class="title">Activities</span><ol><li class="level3"><a href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all" class="title-extra " title="Core Concepts"><span class="ui-icon ui-icon-note"></span><span class="num">1A.</span>Core Concepts</a></li></ol><li class="level2 not-started"><a href="/go/evaluation-treatment/treatment-initiation-decision" title="Making a Decision on When to Initiate HCV Therapy" class="title-extra level2"><span class="progress-container level135" title="Progress of this Lessons"><span class="progress-bar progress-bar-0" style="width: 0%"><span class="percent less">0%</span></span></span><span class="type">Lesson 2</span><br /><span class="title">Making a Decision on When to Initiate HCV Therapy</span></a><div class="level3s" ><span class="title">Activities</span><ol><li class="level3"><a href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all" class="title-extra " title="Core Concepts"><span class="ui-icon ui-icon-note"></span><span class="num">2A.</span>Core Concepts</a></li></ol><li class="level2 not-started"><a href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment" title="Addressing Structural Barriers to HCV Treatment" class="title-extra level2"><span class="progress-container level135" title="Progress of this Lessons"><span class="progress-bar progress-bar-0" style="width: 0%"><span class="percent less">0%</span></span></span><span class="type">Lesson 3</span><br /><span class="title">Addressing Structural Barriers to HCV Treatment</span></a><div class="level3s" ><span class="title">Activities</span><ol><li class="level3"><a href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all" class="title-extra " title="Core Concepts"><span class="ui-icon ui-icon-note"></span><span class="num">3A.</span>Core Concepts</a></li></ol></div></li></ul><ul class="progress-tracker"><li class="progress-tracker last"><a href="javascript:void(0)" onclick="progressTracker()" class="progress-tracker title-extra" title="Progress Tracker"><i class="glyph-tasks"></i> Progress Tracker</a></li></ul></div></div><div id="page-content"><h1 class="title" style="color: rgb(190,54,39);">Evaluation and Preparation for Hepatitis C Treatment Overview<span class="edition-tag edition-tag-4">4th Edition</span></h1><div id="page-navigation-top" class="page-navigation "><div class="content"><span class="left"> </span><span class="right next"><a class="button button-next" tabindex="1" style="display: inline-block;" href="" title="" onclick="return pageNavigationNext()">Next</a></span><span class="prev right"><a class="button button-prev" tabindex="2" href="https://www.hepatitisC.uw.edu/go/evaluation-treatment"><span class="glyphicon glyphicon-chevron-left"></span> Back</a></span></div></div><div class="inner"><br /><div class="level1s-intro"><div class="row"><div class="col-xs-12 col-sm-5"><div class="content"><div class="section-objectives"><h4 id="objectives" class="title">Module Core Competency</h4><div class="content"><p class="lead">Provide Evidence-Based Evaluation and Preparation for Treatment of Persons with Hepatitis C Infection</p></div></div></div></div><div class="col-xs-12 col-sm-3"><div class="section-objectives"><h4 id="description" class="title">Target Audience</h4><div class="content">For clinicians evaluating persons with chronic HCV infection for hepatitis C treatment, including clinicians who will independently assess treatment candidacy and clinicians who will provide treatment candidacy with assistance from a hepatitis C expert.</div></div></div><div class="col-xs-12 col-sm-2"><div class="content"><div class=" section-speaker-info speaker-info-level1 contributor-blurbs"><h4 class="title">Editors</h4><div class="content"><div class="contributor-blurb"><a href="javascript:void(0)">John D. Scott, MD</a><div class="data-content"><strong>John D. Scott, MD</strong><br /> Assistant Director Hepatitis and Liver Clinic<br /> Harborview Medical Center<br /> Professor of Medicine<br /> Division of Allergy & Infectious Diseases<br /> University of Washington<div class="disclosures"><em>Disclosures</em>: Consulting: Gilead Sciences</div></div></div>, <div class="contributor-blurb"><a href="javascript:void(0)">David H. Spach, MD</a><div class="data-content"><strong>David H. Spach, MD</strong><br /> Professor of Medicine<br /> Division of Allergy & Infectious Diseases<br /> University of Washington<div class="disclosures"><em>Disclosures</em>: None</div></div></div></div></div></div></div><div class="section-self-study section-theme-34 col-xs-12 col-sm-2"><h4 id="self-study" class="title">Free <span class="cme-tag cme-tag-available">CNE/CME</span></h4><div class="content">Available in the<p><a href="/custom/evaluation-treatment" style="color: rgb(190,54,39);"><strong>Evaluation and Preparation for Hepatitis C Treatment Self-Study Module <span class="glyphicon glyphicon-chevron-right"></span></strong></a></div></div></div></div><div class="row"><div class="major-section major-section-level2-plan col-xs-12"><h2 class="title" id="lesson-plan">Module Lessons</h2><div class="content"><div class="section section-level2-plan not-started"><h3 class="title"><a href="/go/evaluation-treatment/treatment-goals-predicting-response"><span class="level2-icon">1</span><span class="kind">Lesson 1</span> <strong class="title">Goals and Benefits with HCV Treatment</strong></a></h3><div class="content level2"><ul class="row"><li class="level3 objective not-started col-xs-12 col-sm-6"><strong>Learning Objectives</strong><ul> <li>Cite the goals and rationale for HCV therapy in persons with chronic HCV</li> <li>Discuss durability of sustained virologic response when achieved with direct-acting antiviral therapy</li> <li>List several long-term benefits of HCV treatment on clinical outcomes in persons with chronic HCV</li> <li>Describe the impact of HCV treatment on survival</li> <li>Summarize the population-level benefit of HCV treatment</li> </ul></li><li class="level3 level3-type-note not-started col-xs-12 col-sm-6"><a href="https://www.hepatitisC.uw.edu/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all"><span class="ui-icon ui-icon-note ui-icon-large"></span><span class="kind">Quick Reference</span><strong class="title">Goals and Benefits with HCV Treatment Core Concepts</strong></a><ul class="level4s"><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#background">Background</a></li><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#virologic-cure-sustained-virologic-response">Virologic Cure and Sustained Virologic Response</a></li><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#impact-hcv-treatment-on-clinical-outcomes">Impact of HCV Treatment on Clinical Outcomes</a></li><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#impact-hcv-treatment-on-quality-life">Impact of HCV Treatment on Quality of Life</a></li><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#impact-hcv-treatment-on-survival">Impact of HCV Treatment on Survival</a></li><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#population-level-benefits-hcv-elimination">Population-Level Benefits of HCV Elimination</a></li><li class="level4"><a class="level2s-176" href="/go/evaluation-treatment/treatment-goals-predicting-response/core-concept/all#summary-points">Summary Points</a></li></ul></li></ul></div></div><div class="section section-level2-plan not-started"><h3 class="title"><a href="/go/evaluation-treatment/treatment-initiation-decision"><span class="level2-icon">2</span><span class="kind">Lesson 2</span> <strong class="title">Making a Decision on When to Initiate HCV Therapy</strong></a></h3><div class="content level2"><ul class="row"><li class="level3 objective not-started col-xs-12 col-sm-6"><strong>Learning Objectives</strong><ul> <li>Summarize current recommendations for HCV treatment indications in persons with chronic HCV</li> <li>List absolute contraindications for HCV treatment with direct-acting antiviral therapy</li> <li>Discuss relative contraindications for HCV treatment with direct-acting antiviral therapy</li> <li>Describe key patient readiness factors to assess prior to initiating treatment</li> <li>Outline general monitoring recommendations when HCV treatment is deferred</li> </ul></li><li class="level3 level3-type-note not-started col-xs-12 col-sm-6"><a href="https://www.hepatitisC.uw.edu/go/evaluation-treatment/treatment-initiation-decision/core-concept/all"><span class="ui-icon ui-icon-note ui-icon-large"></span><span class="kind">Quick Reference</span><strong class="title">Making a Decision on When to Initiate HCV Therapy Core Concepts</strong></a><ul class="level4s"><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#background">Background</a></li><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#indications-hcv-treatment">Indications for HCV Treatment</a></li><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#contraindications-treatment">Contraindications for Treatment</a></li><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#treatment-readiness">Treatment Readiness</a></li><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#timing-initiation-treatment">Timing of Initiation of Treatment</a></li><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#monitoring-follow-up-if-not-treated">Monitoring and Follow-Up if Not Treated</a></li><li class="level4"><a class="level2s-177" href="/go/evaluation-treatment/treatment-initiation-decision/core-concept/all#summary-points">Summary Points</a></li></ul></li></ul></div></div><div class="section section-level2-plan not-started"><h3 class="title"><a href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment"><span class="level2-icon">3</span><span class="kind">Lesson 3</span> <strong class="title">Addressing Structural Barriers to HCV Treatment</strong></a></h3><div class="content level2"><ul class="row"><li class="level3 objective not-started col-xs-12 col-sm-6"><strong>Learning Objectives</strong><ul> <li>State the key steps in HCV care continuum</li> <li>List major barriers to hepatitis C testing</li> <li>Describe approaches for improving linkage to hepatitis C care services</li> <li>Explain potential insurance and Medicaid restrictions that can limit access to HCV treatment</li> <li>Discuss strategies for expanding hepatitis C medical provider capacity</li> </ul></li><li class="level3 level3-type-note not-started col-xs-12 col-sm-6"><a href="https://www.hepatitisC.uw.edu/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all"><span class="ui-icon ui-icon-note ui-icon-large"></span><span class="kind">Quick Reference</span><strong class="title">Addressing Structural Barriers to HCV Treatment Core Concepts</strong></a><ul class="level4s"><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#background">Background</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#the-path-to-hcv-cure-hcv-care-continuum">The Path to HCV Cure: HCV Care Continuum</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#hcv-testing-access-efficiency-reimbursement">HCV Testing: Access, Efficiency, and Reimbursement</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#improving-services-linkage-to-care">Improving Services for Linkage-to-Care</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#expanding-medical-provider-capacity">Expanding Medical Provider Capacity</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#expanding-settings-hcv-clinical-care-treatment">Expanding Settings for HCV Clinical Care and Treatment</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#insurance-medicaid-restrictions-to-hcv-treatment-access">Insurance and Medicaid Restrictions to HCV Treatment Access</a></li><li class="level4"><a class="level2s-178" href="/go/evaluation-treatment/addressing-structural-barriers-to-treatment/core-concept/all#summary-points">Summary Points</a></li></ul></li></ul></div></div></div></div></div></div><div id="page-navigation" class="page-navigation "><div class="content"><span class="left"> </span><span class="right next"><a class="button button-next" style="display: inline-block;" href="" title="" onclick="return pageNavigationNext()">Next</a></span><span class="prev right"><a class="button button-prev" href="https://www.hepatitisC.uw.edu/go/evaluation-treatment"><span class="glyphicon glyphicon-chevron-left"></span> Back</a></span></div></div></div></div><div id="share-form" title="Share this page"> <div id="share-boxes"> <div id="shareme" 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