treatment for hep c post transplant

I am post tx 2008 with reccurrent hep-c. now at grade 3 fibrosis. Ive been given the following choices on how to proceed. 1) go on trial with teplavir,interferon, riboviron.@ ny presby.48 weeks 2) take just interferon and ribovirin for 52 weeks(mayo clinic jacksonville) ( previously tried this and went viral negative but couldnt complete course do to anemia and side effects then virus came back) 3) Do nothing and wait for new meds with less side effects and hope fibrosis dont worsen. My bloods are good normal ast,alt alp,alb,but low wbc 1.7and platlets 70k. immunosuppressed 50mg neoral 2x daily and500mg cellcept 2x daily (no rejection).What is your advice on how I should proceed. Please give me your valued opinion

[Thomas D Schiano, MD]

i definitely would not just take PEG and ribavirin.  if you are going to take one of the protease inhibitors it should be part of a clinical trial.  The newer meds in the pipeline are better than the current protease inhibitors but i am unsure as to when clinical trials will be present in the post-liver transplant setting.  interferon can cause problems for people who have advanced fibrosis post-transplantation so you will not escape those potential significant side effects with the current trial.