Figure 3. Managing and Treating Patients with Chronic HCV Infection, Genotype 4
Eligible Patient Anti-HCV Positive
Determine quantitative HCV RNA Determine HCV genotype
If genotype 4
More than portal fibrosis
Liver biopsy suggested
Treat with PegIFN plus RBV, 1000 mg ≤ 75 kg; 1200 mg > 75 kg
Determine quantitative HCV RNA at week 12
Complete EVR (HCV RNA negative) (HCV RNA $> 2 log) Partial EVR
Determine qualitative HCV RNA at week 24
Continue treatment for a total of 48 weeks
HCV RNA negative
Qualitative HCV RNA at week 72 (to establish SVR)
HCV RNA positive
Stop treatment (HCV RNA $< 2 log) No EVR
No fibrosis or portal fibrosis only
Consider no treatment
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