Treatment of Chronic Hepatitis C with Decompensated Liver Cirrhosis (Child-Pugh B or C) in Treatment-Naive Adults

This protocol addresses treatment-naive adults with confirmed chronic hepatitis C infection who have decompensated cirrhosis of the liver, defined as a Child-Pugh score of 7 or above (Child-Pugh class B or C).

A Child-Pugh score ≥7 indicates decompensated cirrhosis. This degree of hepatic impairment places these patients outside the scope of simplified first-line approaches used in compensated disease — a dedicated, tailored regimen is required.

Treatment involves an antiviral regimen, with ribavirin eligibility and the severity of cirrhosis both influencing the choice and duration of therapy. The clinical goal is sustained virologic response at 12 weeks after completing treatment (SVR12), confirmed by undetectable HCV RNA. The complete regimen — including all options and the criteria that determine them — is available in the full protocol.