The bulk of evidence shows that with standard interferon monotherapy, sustained virological response in patients with cirrhosis is approximately half as likely as in patients without cirrhosis. Emerging evidence suggests that more intensive treatment regimens may improve response rates. Adverse events associated with therapy and the cost-effectiveness of therapy are issues that cannot be ignored when discussing treatment regimens for a group of patients in whom the benefits are questionable, and perhaps unproven. Interferon therapy is expensive. Cost-effectiveness is inversely correlated with the patient s age.
Cirrhotic patients tend to be older than non-cirrhotic patients.
Emerging evidence makes discussion and debate regarding the optimal endpoints, treatment and overall benefit of treating this group of patients both timely and necessary.