Hepatitis C: follow-up after treatment
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
12 weeks after the end of treatment (SVR12)
12 weeks after the last dose
Do not order
- HCV serology (antibodies) after treatment: it remains positive after cure; only RNA indicates cure or reinfection [3,4]
- HCV RNA or liver function tests during treatment in the simplified pathway: no monitoring is necessary [1]
- Blood fibrosis markers or elastometry to follow a cured non-cirrhotic patient: not recommended [1]
After cure: cirrhosis or advanced fibrosis before treatment
Every 6 months
- Liver Doppler ultrasound (not a laboratory test).
- Alpha-fetoproteinif neededPatient eligible for HCC screening (cirrhosis, or elastometry ≥ 10 kPa before treatment): the AFEF 2025 “probably” combines AFP with six-monthly ultrasound (weak recommendation) [1,9].
Once a year (cirrhosis without oesophageal varices)
- FBC (platelet count)if needednon-French guidelineCirrhosis without varices at endoscopy before treatment: annual platelets and elastometry; no endoscopy as long as platelets remain > 150 000/mm³ and elastometry < 20 kPa [2].
Also consider
- Cirrhosis before treatment? The rest of the follow-up is decided with the hepatologist: see also the page “Uncomplicated cirrhosis”.
After cure: behaviour at risk of reinfection
Every 6 to 12 months
- HCV RNA (viral load)
Sources (10)
- Association française pour l'étude du foie (AFEF). Recommandations pour le diagnostic et le suivi non-invasif des maladies chroniques du foie. Juillet 2020. Chapitre 3 : infection chronique par le VHC (A. Tran).
- European Association for the Study of the Liver (EASL). EASL recommendations on treatment of hepatitis C: Final update of the series. J Hepatol. 2020;73(5):1170-1218.
- Haute Autorité de santé. Hépatite C : prise en charge simplifiée chez l'adulte. Fiche mémo, validée le 18 septembre 2019.
- Association française pour l'étude du foie (AFEF), avec la SPILF. Recommandations AFEF pour l'élimination de l'infection par le virus de l'hépatite C en France. Mars 2018 (PDF mis en ligne en juin 2023).
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 4124 (détection-quantification de l'ARN du VHC).
- Garvey L, Bhagani S, Kulasegaram R, et al. British Association for Sexual Health and HIV (BASHH) guidelines on the management of viral hepatitis 2026. Int J STD AIDS. 2026 (publication en ligne).
- AASLD-IDSA. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. Section « Monitoring Patients Who Are Starting HCV Treatment, Are on Treatment, or Have Completed Therapy », consultée le 29 octobre 2026.
- Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). Australian STI Management Guidelines for Use in Primary Care : Hepatitis C. Page mise à jour le 30 juin 2026, consultée le 29 octobre 2026.
- Association française pour l'étude du foie (AFEF). Prise en charge du carcinome hépatocellulaire et outils pour la pratique. Recommandations (coord. E. Assenat, J.-F. Blanc, C. Costentin), mars 2025.
- AASLD-IDSA. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. Section « Identification and Management of HCV in People Who Inject Drugs », consultée le 11 octobre 2026.