SVR rates of approximately 50% are achieved with SMV + Peg-IFN + RBV combination therapy in null responders to previous treatment, and introduction of this regimen is therefore recommended to null responders as well. If problems with tolerability are anticipated, it may be an option to await the advent of newer agents with fewer adverse reactions. When viral therapy is not administered, protective therapies should be administered to patients with abnormal ALT levels. Long-term low dose Peg-IFN (IFN) therapy is another option. As with elderly patients, as a general rule non-elderly patients with advanced fibrosis and associated

high risk of hepatocellular carcinogenesis should be administered SMV + Peg-IFN + RBV combination therapy. Even in patients selleck chemical with mild fibrosis and a lower risk of carcinogenesis, a high SVR rate of approximately 90% is achieved with SMV + Peg-IFN + RBV combination therapy in relapsers and partial responders. Therefore, if treatment is likely to be tolerated, SMV-based triple therapy should be administered to this patient group. On the other hand, for non-elderly null responders with

mild fibrosis, if adverse reactions Selleck Deforolimus are a concern, it may be reasonable to await the advent of newer agents with fewer adverse reactions. When there are no problems with tolerability, SMV + Peg-IFN + RBV combination therapy can be commenced in patients who meet the therapeutic indications for antiviral therapy (ALT > 30 U/L or platelet count < 150 000/μL). TVR + Peg-IFN + RBV triple therapy is an alternative option in cases with mild fibrosis, where safety is relatively guaranteed. Recommendations In general, SMV + Peg-IFN + RBV triple therapy should be administered for retreatment of non-elderly patients with advanced fibrosis, as for elderly patients. this website Even in patients with mild fibrosis, a high SVR rate

of approximately 90% is achieved with SMV + Peg-IFN + RBV combination therapy in relapsers and partial responders. If treatment is likely to be tolerated, SMV-based triple therapy should be therefore administered to this patient group. On the other hand, for non-elderly null responders with mild fibrosis, if adverse reactions are a concern, it may be reasonable to await the advent of newer agents with fewer adverse reactions. When there are no problems with tolerability, SMV + Peg-IFN + RBV combination therapy can be commenced in patients who meet the therapeutic indications for antiviral therapy (ALT > 30 U/L or platelet count < 150 000/μL). In non-responders (partial and null responders), TVR + Peg-IFN + RBV triple therapy is an alternative option in cases with mild fibrosis, if treatment is likely to be tolerated.