Initial evaluation of HCV-infected patients with hematologic malignancies
| History and clinical findings . | Laboratory tests . | Virologic tests . | Imaging/staging studies . |
|---|---|---|---|
| History | Routine | HCV | Imaging |
| Alcohol abuse | Complete blood count, AST, ALT, total bilirubin, alkaline phosphatase, albumin, PT/PTT/INR, BUN, creatinine | HCV-RNA quantitation | Abdominal sonography or computed tomography |
| Metabolic risk factors | HCV genotype | ||
| Vaccination status against HAV and HBV | |||
| Physical examination | Others | Coinfections | Noninvasive markers of fibrosis |
| Symptoms/signs of cirrhosis | α-fetoprotein | Anti-HAV | Vibration-controlled transient elastography* |
| GGT | HBsAg | Serum fibrosis panel* | |
| Cryoglobulins | Anti-HBs | ||
| Anti-HBc | |||
| Anti-HIV | |||
| Selected cases | Selected cases | Pathology | |
| Interleukin 28B polymorphism | HCV-resistance testing | Liver biopsy |
| History and clinical findings . | Laboratory tests . | Virologic tests . | Imaging/staging studies . |
|---|---|---|---|
| History | Routine | HCV | Imaging |
| Alcohol abuse | Complete blood count, AST, ALT, total bilirubin, alkaline phosphatase, albumin, PT/PTT/INR, BUN, creatinine | HCV-RNA quantitation | Abdominal sonography or computed tomography |
| Metabolic risk factors | HCV genotype | ||
| Vaccination status against HAV and HBV | |||
| Physical examination | Others | Coinfections | Noninvasive markers of fibrosis |
| Symptoms/signs of cirrhosis | α-fetoprotein | Anti-HAV | Vibration-controlled transient elastography* |
| GGT | HBsAg | Serum fibrosis panel* | |
| Cryoglobulins | Anti-HBs | ||
| Anti-HBc | |||
| Anti-HIV | |||
| Selected cases | Selected cases | Pathology | |
| Interleukin 28B polymorphism | HCV-resistance testing | Liver biopsy |
anti-HAV, antibody to hepatitis A virus; anti-HBc, antibody to hepatitis B core antigen; anti-HBs, antibody to hepatitis B surface antigen; anti-HIV, antibody to HIV; AST, aspartate aminotransferase; BUN, blood urea nitrogen; GGT, γ-glutamyl transpeptidase; HAV, hepatitis A virus; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; INR, international normalized ratio; PT, prothrombin time; PTT, partial thromboplastin time.
Sonography-based vibration-controlled transient elastography (FibroScan VCTE; Echosens, Paris, France) and serologic marker panels for detection of fibrosis have not been studied in HCV-infected patients with hematologic malignancies; thus, results should be interpreted with caution.