I have had HCV for 27 years. A needle biopsy 12 years ago showed fibrosis; a double needle biopsy (during a gall bladder surgery) showed crusting/layering or cirrhosis as did the overall external appearance of the liver (which was still relatively normal in size). A year ago my platlet count was at 75 and has dropped progressively to 45 over that time/with WBC at the 2.6-3.6 range (with an obviously enlarged spleen). I was accepted to the peg-interf w/ribov test group until they found my platlets below 50. Accordingly, I cannot recieve any form of treatment for fear of reducing the platlet count further. I work a full day; work out, and generally live an otherwise healthy life (no smokes, drinking, eat healthy, etc.). Any suggestions for approaching this end stage problem? Thanks much. (ALT @ 205, viral load 1.2 mil @ present).

It sounds like you have well-compensated cirrhosis meaning that your liver is scarred but functioning well. I would go to a nearby University Hospital, one that is used to dealing with advanced liver disease due to HCV, for a complete evaluation. There are a number of things that should be done to fully stage your disease. Sometimes patients with low platelet counts can be treated with very careful monitoring.