What is the role of antiviral therapy in the treatment of hepatitis C?

Updated: May 10, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Answer

The initiation of treatment is a complex decision involving knowledge of the patient's HCV genotype, compliance and social support, comorbid psychiatric conditions (depression can be worsened significantly by treatment), and progression of liver disease. Children younger than 3 years should not be treated due to a lack of approved medications and the possibility of spontaneous clearance of infection without therapy.

Identify suitable candidates for antiviral therapy, although all patients with chronic infection are potential candidates. Treatment is recommended for patients with chronic infection who have a persistently elevated serum ALT level, portal or bridging fibrosis, and at least moderate inflammation and necrosis at liver biopsy.

Consider treatment for other patients on an individual basis. Do not use antiviral therapy to treat patients with decompensated cirrhosis.


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