Care After Cure: Long-term Follow-up in Hepatitis C

To summarize recommendations and common practices for long-term surveillance after hepatitis C cure. Patients with advanced fibrosis and cirrhosis have continued risk of the complications of portal hypertension and hepatocellular carcinoma after hepatitis C cure. While improvement in fibrosis has been noted, the clinical implications are not fully understood. Guidelines recommend no alteration in surveillance strategies based upon fibrosis measurements after hepatitis C cure. Liver wellness approaches and strategies to avoid reinfection are recommended for all patients after hepatitis C cure. Patients with early stage fibrosis after hepatitis C cure can be discharged from specialty care unless a co-existing liver disease is present, including nonalcoholic fatty liver disease. Patients with advanced fibrosis or cirrhosis are recommended to have indefinite surveillance for the complications of portal hypertension and hepatocellular carcinoma. Further investigation is needed to understand fibrosis regression and thresholds when surveillance can be discontinued.