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The PEG-IFN-�� dose should be reduced if the absolute neutrophil count falls below 750/mm3, or the platelet count falls below 50,000/mm3, and stopped if the neutrophil count falls below 500/mm3 or the platelet count falls below 25,000/mm3 or if severe unmanageable http://www.selleck.cn/products/s-gsk1349572.html depression develops (C2). If neutrophil or platelet counts go up, treatment can be restarted, but at a reduced PEG-IFN-�� dose (C2). If haemoglobin? http://www.selleckchem.com/products/z-vad-fmk.html level falls below 10?g/dl to avoid RBV dose reduction http://www.selleckchem.com/products/ly2157299.html or discontinuation (C2). There is no evidence that neutropenia during PEG-IFN-��/RBV therapy is associated with more frequent infection episodes (C1), or that the use of granulocyte colony-stimulating factor (G-CSF) reduces the rate of infections and/or improves SVR rates (B1). Patients with a history and/or signs of depression should be seen by a psychiatrist before therapy (C2). Patients who develop depression during therapy should be treated with antidepressants. Preventive antidepressant therapy in selected subjects may reduce the incidence of depression during treatment, without any impact on the SVR (B2). Patients with compensated cirrhosis should be treated, in the absence of contraindications, to prevent short to mid-term complications (A1). Assiduous monitoring and management of side effects, especially those linked to portal hypertension and hypersplenism, is required. Growth factors are particularly useful in this group (C2). Patients with cirrhosis should undergo regular surveillance for HCC, irrespective of SVR (B1). Patients awaiting transplantation, antiviral therapy, when feasible, prevents graft re-infection if an SVR is achieved (B1). Many patients have contraindications to treatment and the results of therapy are generally poor in this group of individuals with very advanced liver disease (B1).