Management of cirrhosis due to chronic hepatitis C Gregory T. Everson  Journal of Hepatology  Volume 42, Issue 1, Pages S65-S74 (April 2005) DOI: 10.1016/j.jhep.2005.01.009 Copyright © 2005 European Association for the Study of the Liver Terms and Conditions

Fig. 1 (Panel 1a) Patients with compensated cirrhosis should be treated with a standard antiviral regimen, such as the current treatment standard of peginterferon plus ribavirin. SVR is 40–50%. Patients with SVR may still need long-term monitoring for clinical complications of cirrhosis and development of hepatoma. Patients who experience relapse or fail to respond may be considered for maintenance therapy. (Panel 1b) Patients with decompensated cirrhosis (MELD≤18) but who are not listed may be candidates for LADR. Treatment is most effective for genotypes 2 or 3 with SVR of approximately 50%. SVR is less likely in patients with genotype 1, 10–20%. Patients who relapse may be considered for another course of potentially curative treatment at higher dose or under support of growth factors, particularly if tolerant of side effects of antiviral medication. Otherwise those who relapse or fail to respond might be candidates for maintenance treatment. (Panel 1c) Patients with decompensated cirrhosis (MELD≤18) who are listed for transplantation may be candidates for LADR. Those experiencing SVR should maintain listed status and be monitored for complications, including hepatoma. Patients who relapse should be considered for antiviral therapy up to time of transplantation. Treatment should be withdrawn and not re-instituted in nonresponders. [This figure appears in colour on the web.] Journal of Hepatology 2005 42, S65-S74DOI: (10.1016/j.jhep.2005.01.009) Copyright © 2005 European Association for the Study of the Liver Terms and Conditions