Hepatitis C in cirrhosis patients

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Recommendations for Treatment of Persons with Compensated and Decompensated Cirrhosis: AASLD Practice Guidelines 2009

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1.Patients with HCV-related compensated cirrhosis (CTP class A), can be treated with the standard regimen of pegylated interferon and ribavirin but will require close monitoring for adverse events (Class I, Level A). 2. Patients with HCV-related decompensated cirrhosis should be referred for consideration of liver transplantation (Class I, Level B). 3. Interferon-based therapy may be initiated at a lower dose in patients with decompensated cirrhosis (CTP class B and C), as long as treatment is administered by experienced clinicians with vigilant monitoring for adverse events preferably in patients who have already been accepted as candidates for liver transplantation (Class IIb, Level B). 4. Growth factors can be used for treatment-associated anemia and leukopenia to improve quality of life and may limit the need for antiviral dose reductions in patients with decompensated cirrhosis (Class IIb, Level C).

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