How are patients with hepatitis C monitored and followed up?

  I. Follow-up monitoring of patients receiving antiviral therapy.  1. Monitoring items before treatment: liver and kidney function, blood routine, thyroid function, blood glucose and urine routine should be tested before treatment. Blood tests should be performed once a week for the first month after starting treatment, then once a month for 6 months, and then once every 3 months.  2. Biochemical testing: ALT should be checked every month during the treatment period and every two months for 6 months after the end of treatment. ALT should be rechecked regularly even if the patient fails to clear HCV. 3.Virology test: HCV RNA should be measured at 3 months of treatment; HCV RNA should also be tested at the end of treatment and 6 months after the end of treatment. 4.Monitoring of adverse reactions: All patients should have their thyroid function tested every 6 months during treatment and every 3-6 months after the end of treatment, and if abnormal thyroid function exists before treatment. then thyroid function should be checked monthly. In elderly patients, electrocardiogram and cardiac function should be determined before treatment. Mental status should be evaluated regularly, especially for patients with significant depression and suicidal tendencies, and should be discontinued and closely guarded.  II. Follow-up of patients without indications for treatment or with contraindications and unwillingness to receive antiviral therapy.  1.Liver biopsy: those who show no or only slight damage, the possibility of liver disease progression is small, but still should have a physical examination and test ALT every 24 weeks. 2.Biochemical examination: for those with persistently normal ALT and no liver biopsy, have a physical examination and test ALT every 24 weeks. 3.Follow-up of patients with cirrhosis: if cirrhosis has developed, they should be tested every 3 to 6 months For patients at high risk of HCC (>50 years old, male, alcoholic, hepatic insufficiency or with increased AFP), follow-up should be strengthened. In addition, patients with cirrhosis should also undergo upper gastrointestinal endoscopy or esophageal radiography every 1 to 2 years to observe the presence of esophagogastric fundic varices.