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Consensus recommendations |
Grade |
|
Indications for assessment by a liver transplant centre include a Child–Pugh score ≥ B7, MELD score ≥ 13 or one of the following clinical events: refractory ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent or chronic hepatic encephalopathy, small HCC or severe malnutrition. |
A1 |
|
People with decompensated HCV cirrhosis, Child–Pugh score B and MELD score < 15 should be assessed by an expert hepatologist for consideration of treatment as soon as possible, as they are at risk of further decompensation and liver-related complications and death, which may be prevented by eradicating HCV. |
B2 |
|
People with decompensated HCV cirrhosis, Child–Pugh score B or C and MELD score > 15 (who are NOT liver transplant candidates) should be assessed by an expert hepatologist for consideration of treatment where there is an anticipated benefit from such treatment. |
B1 |
|
People with decompensated HCV cirrhosis, Child–Pugh score B or C and MELD score > 15 (who ARE liver transplant candidates) should be assessed by a liver transplant physician to consider the individual benefit and risks of treatment before transplantation. |
B2 |
|
When making treatment decisions, decompensated liver disease should be defined by a Child–Pugh score ≥ B7. |
A1 |
|
The first-line treatment regimen for chronic Gt 1-6 HCV infection and decompensated liver disease is (see Table 5): |
|
|
A1 |
|
The following treatments should NOT BE USED in people with decompensated liver disease:
|
A1 |