African Americans
ÎAfrican Americans infected with HCV who are appropriate treatment candidates should be treated with the current optimal regimen (I-A).
ÎAfrican Americans with baseline neutropenia (ANC ≤ 1500 mm3
should not be excluded from HCV treatment (IIa-B). Compensated and Decompensated Cirrhosis
ÎPatients with HCV-related compensated cirrhosis (CTP Class A) can be treated with the standard regimen but will require close monitoring for adverse events (I-A).
ÎPatients with HCV-related decompensated cirrhosis should be referred for consideration of liver transplantation (I-B).
ÎInterferon-based therapy may be initiated at a lower dose in patients with decompensated cirrhosis (CTP Class B and C), as long as treatment is administered by experienced clinicians with vigilant monitoring for adverse events preferably in patients who have already been accepted as candidates for liver transplantation (IIb-B).
ÎGrowth factors can be used for treatment-associated anemia and leukopenia to improve quality of life and may limit the need for antiviral dose reductions in patients with decompensated cirrhosis (IIb-C).
Patients After Solid Organ Transplantation
ÎTreatment of HCV-related disease following liver transplantation should be initiated in appropriate candidates after demonstration of recurrent histologic disease but should be undertaken with caution and under the supervision of a physician experienced in transplantation (IIa-A).
ÎPegIFN alfa either with or without RBV should be the preferred regimen when treating patients with HCV after liver transplantation (IIa-B).
ÎInterferon-based therapy should be used in recipients of heart,
lung and kidney grafts, except for patients who develop fibrosing cholestatic hepatitis (III-C).
)
13
N
OT
