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


Class A 5-6 Compensated
Class B 7-9 Compensated
Class C 10-15 Decompensated

Last updated: 17 August 2017.