Abstract
Despite improvements in antiviral therapy for hepatitis C virus, 50% of patients still fail to clear virus despite optimal therapy with pegylated interferon and ribavirin. No effective treatment has been identified for these nonresponders and consideration should be given to maintenance therapy in patients with advanced fibrotic liver disease. Maintenance therapy is focused on preventing liver failure, hepatocellular cancer, and progression of fibrosis. Multiple agents have been proposed and tried as maintenance therapy, but the leading candidate is low-dose pegylated interferon monotherapy, which is being studied in several large clinical trials. The clinician must individualize choice of maintenance therapy with risk of disease progression, and no definite guidelines exist for maintenance therapy at the present time.
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