Who should receive antiviral therapy for hepatitis C virus?
Patients at risk for cirrhosis should be considered for treatment of HCV. According to a consensus statement from the National Institutes of Health (NIH) these include persons with: • HCV infection and persistent elevation of ALT (alanine aminotransferase, a liver enzyme in the blood) • High levels of HCV RNA in the blood • HCV infection and evidence of fibrosis (scarring) on liver biopsy • HCV infection and evidence of at least moderate inflammation and liver cell injury (necrosis) on liver biopsy These are general guidelines. Patients and providers may decide that treatment is needed for other reasons. For example, patients with HIV have a more rapid course of liver injury and may need treatment at an earlier stage. Newer therapies may be offered to selected patients in research settings. Individuals who should not be treated with antiviral therapy include those who are unable to comply with the treatment schedule, should not take the specific medications (for example, allergy), and