European Association for the Study of the Liver (Easl) Recommendations on Diagnostic and Treatment of Hepatitis C 2015

Hepatitis C virus infection is one of the main causes of chronic liver disease worldwide which could induce a highly variable impact, ranging from minimal histological changes to fibrosis and cir­rhosis or hepatocellular carcinoma. The diagnosis of chronic hepatitis C is based on the detection of hepatitis C antibodies. It is important to make a screenfng for chronic hepatitis C in order to identify in­fected persons and engage them in care and treatment. It is recommended to use rapid diagnostic tests instead of enzyme immunoassay to screen for hepatitis C antibodies. The goal of therapy is to cure hepatitis C virus infection in order to prevent the complications. The endpoint of therapy is to achieve the sustained virological response. The causal relation­ship between hepatitis C virus infection and liver disease should be established, liver disease severity must be assessed, and base line virological parameters should be determined. It is recommended to use non-invasive methods instead of liver biopsy to assess liver disease sever­ity prior to therapy. Treatment priority should be based on fibrosis stage, risk of progression, presence of extra-hepatic manifestations and risk of hepatitis C vi­rus transmission. For each virus geno­type there are different treatment regi i mens in clud ing pegylated in terferon, ribavirin and first generation direct-act­ing antivirals. Treatment options are di­vided into interferon-containing and in­terferon-free. A real-time polymerase chain reaction assay with a lower limit of detection of <15 IU/ml should be used to monitor hepatitis C virus ribonucleic acid levels during and after therapy.