I think all patients with compensated chronic liver disease due to HCV should be consider for therapy. It is also advised for patients with moderate and advanced fibrosis. In patients with mild fibrosis indication for treatment will be individual. Genotype and viral load are very important for duration of treatment.All patients with genotype 1 who didn,t respond to primary treatment , should treat with approval currently available protease inhibitors in combination with IFN and ribavirin according to new guidelines.

My answer is that all the eligible patients should be treated with the standard treatment option that is pegyalated INTERFERONE and ribavirin.all the newer agents are under trails and based on genotype 1 and these all treatment options are so costly so they are always secondary option ......

It is critical for us to predict the responsibility to drugs before start and considering the risk of progression in any therapy.

Yes you are right .but in are setup genotype 3 is common and these agent are used in gt 1 and are majority patients belonging to rural area they can't afford these newer agents hardly in 20-30 one can afford that is the main problem in our setup

Even in genotype 1 patients, as you know, there are sustained responders to interferon and ribavirin without adding other drugs. One of the key for predicting a potential response is the detection of IL28 polymorphism. In my retrospective experiene C/C polymorphism carriers have an history of sustained response to dual classic therapy. The new anti-protease drug often add further side effects to that already relevant of interferon and ribavirin. What are your opinion and experience about?