ÎNo recommendation can be made for or against the addition of RBV; the decision will therefore need to be considered on a case-by-case basis (IIa-C).
Persons with Normal Serum Aminotransferase Values
ÎRegardless of the serum alanine aminotransferase level, the decision to initiate therapy with pegylated interferon and RBV should be individualized based on the severity of liver disease by liver biopsy, the potential for serious side effects, the likelihood of response, and the presence of comorbid conditions (I-B).
ÎThe treatment regimen for HCV-infected persons with normal aminotransferase levels should be the same as that used for persons with elevated serum aminotransferase levels (I-B).
HCV-Infected Children
ÎThe diagnosis and testing of children suspected of being infected with HCV should proceed as for adults (I-B).
ÎRoutine testing for anti-HCV at birth of children born to HCV-infected mothers is
recommended because of the high rate of positive
antibody due to passive transfer from the mother. Testing for anti-HCV may be performed at 18 months of age or older (I-B).
ÎTesting for HCV RNA may be considered at 1-2 months of age in infants born to HCV-infected mothers if early diagnosis is desired (II-B).
ÎChildren aged 2-17 years who are infected with HCV should be considered appropriate candidates for treatment using the same criteria as that used for adults (IIa-B).
ÎChildren should be treated with pegylated interferon alfa-2b, 60 mcg/m2
a duration of 48 weeks (I-B). HIV Coinfection
ÎAnti-HCV testing should be performed in all HIV-infected persons (I-B). HCV RNA testing should be performed to confirm HCV infection in HIV-infected persons who are positive for anti-HCV, as well as in those who are negative and have evidence of unexplained liver disease (I-B).
ÎHepatitis C should be treated in the HIV/HCV coinfected patient in whom the likelihood of serious liver disease and a treatment response are judged to outweigh the risk of morbidity from the adverse effects of therapy (I-A).
ÎInitial treatment of hepatitis C in most HIV-infected patients should be PegIFN alfa plus RBV for 48 weeks at doses recommended for HCV mono-infected patients (I-A).
11 weekly in combination with RBV, 15 mg/kg daily for
N
OT
