Some important points to remember: Patients receiving antiviral therapy require careful pretreatment assessment for comborbidities that may influence treatment response. All patients should have careful monitoring during treatment, particularly for anemia if ribavirin is included in the regimen. Some regimens should be considered only in those patients who require immediate treatment, as it is anticipated that safer and more effective IFN-free regimens will become available by 2015.

1. Regimens are classified as either

• “Recommended” when it is favored for most patients or
• “Alternative” when optimal in a particular subset of patients in that category, or
• “Not Recommended” when a treatment is clearly inferior or is deemed harmful. Such regimens should not be administered to patients with HCV infection.

2. Interferon ineligible is defined as one or more:

• Intolerance to IFN
• Autoimmune hepatitis and other autoimmune disorders
• Hypersensitivity to PEG or any of its components
• Decompensated hepatic disease
• History of depression, or clinical features consistent with depression
• A baseline neutrophil count below 1500/μL, a baseline platelet count below 90,000/μL or baseline hemoglobin below 10 g/dL
• A history of preexisting cardiac disease

3. Specific considerations are addressed in other sections of the document:

• HIV/HCV coinfection
• Compensated and decompensated cirrhosis (moderate or severe hepatic impairment)
• Post-liver transplant HCV
• Patients with severe renal impairment or ESRD

The paper/website addresses: 

A) INITIAL TREATMENT OF HCV INFECTION IN PATIENTS STARTING TREATMENT for 

This section provides guidance on the recommended initial treatments for persons with chronic HCV infection who are naive to HCV treatment or who have achieved an undetectable level of virus during a prior treatment course of PEG/RBV and relapsed (relapsers) according to genotype.