Management of cirrhosis
A damaged liver can still function, but cirrhosis increases the risk for liver failure and other serious and life-threatening complications.
DAAs work, but are less effective (80% cure with cirrhosis rather than over 95%, without), and side effects can be worse.
Sometimes ribavirin is also needed, and/or treatment is longer (for 24 weeks).
A liver specialist should be consulted about HCV treatment.
Child-Pugh score
The Child-Pugh score is used to grade the severity of cirrhosis and end stage liver disease (ESLD). Some DAAs cannot be used in people with more advanced (Child-Pugh Class B or C) cirrhosis.
The Child-Pugh score is calculated based on results from several tests including bilirubin, albumin and PT and the presence of ascites and encephalopathy.
Class A and B categorise compensated cirrhosis with Class C indicating decompensated disease, see Table 4.
Table 4: Child-Pugh scores
| Grade | Score
(points) |
Cirrhosis |
| Class A | 5-6 | Compensated |
| Class B | 7-9 | Compensated |
| Class C | 10-15 | Decompensated |
Last updated: 17 August 2017.