I have had hep c for probably many years., Low level cirrhosis was found from biopsy done prior to treatment. I completed interferon/ribivarin course for hepatitis c (1) with undetectable viral load at end of 24 and 48 weeks. The virus is again detectable. What courses of treatment available for relapsers today?

My personal choice would be to put you on maintenance therapy pending results of large trials of this approach.

Since you have cirrhosis, but responded to therapy, there is an excellent chance of viral load suppression on low dose pegylated interferon alone. I would treat you with standard pegylated interferon alfa 2a and ribavirin until you attain a non-detectable viral load. Then I would switch you to low dose peg at 90 micrograms per week. This is well tolerated.

It is important to note that this is NOT a proven approach. The major treatment trials will hopefully tell us whether this approach can decrease the incidence of decompensated cirrhosis and liver related cancer.

Whether your physician will consider this will also depend on your other medical issues and on whether your insurance will allow this unproven approach.

Dr. M.