100. We

suggest for patients with non-cirrhotic disease there is the option to defer treatment until newer therapies or a suitable trial become available. 101. We recommend those deferring treatment are monitored by non-invasive tests at least annually and if they have confirmed progression of fibrosis are reconsidered for initiation of therapy. 8.8.3 Auditable outcomes see Section 8.9.2 8.9 Antiviral treatment: other genotypes 8.9.1 Good practice points 102. We suggest for patients with genotype 4 infection without cirrhosis, there is the option to defer treatment until newer therapies or a suitable clinical trial become available. 103. We recommend if treatment is given now, this should be with pegylated interferon and ribavirin. The duration of therapy Selleck BIBW2992 should be 48 weeks if RVR is achieved. If the RNA is still detectable at 12 weeks, consideration should be given to discontinuing treatment. 104. For those with previous

treatment failure, we U0126 recommend waiting for the availability of interferon-sparing regimens with active DAAs. 105. We recommend individuals coinfected with non-genotype 1–4 should be seen at a tertiary referral centre to determine treatment suitability, nature and duration and a treatment plan made in consultation with the referring hospital. 8.9.2 Auditable outcomes Proportion of patients treated outside of clinical trials for non-genotype 1 who receive therapy with pegylated interferon and ribavirin Proportion of patients treated for non-genotype 1 with a Metavir score of F4 who are offered treatment with pegylated interferon and ribavirin unless contraindicated Proportion of patients with non-genotype 1-4 referred

to a tertiary centre Proportion of patients not receiving therapy undergoing repeat non-invasive staging of their liver disease within 1 year 8.10 Acute hepatitis C 8.10.1 Recommendations 106. We recommend patients without a decrease of 2 log10 in HCV RNA at week 4 post diagnosis of acute infection (1D) or with a positive HCV RNA week 12 post diagnosis of acute infection (1C) are offered therapy. 107. We recommend therapy be commenced prior to an estimated duration of infection of 24 weeks (1D). Patients who have not commenced treatment by this time should Cepharanthine be managed as for chronic hepatitis C. 108. We recommend all patients be offered combination therapy with pegylated interferon and weight-based ribavirin (1C). We recommend against treatment with PEG-IFN monotherapy (1C). 109. We recommend treatment is discontinued if patients do not achieve an EVR (1C). 110. We recommend patients with re-emergent virus after spontaneous or therapeutic clearance are assessed for relapse or reinfection (1C). 111. We recommend patients with AHC who relapse are managed as for chronic hepatitis C (1D). 112. We recommend patients who have been re-infected are managed as for AHC (1D). 8.10.