Patients with thalessemia can be offered therapy with the understanding that during treatment there is likely to be a 40 to 90% increase in their transfusion requirements. It may be possible to reduce the ribavirin dose. Data on the need to aggressively reduce hepatic iron by chelation to optimize response to treatment is controversial. Alternatively these patients may be better off waiting for the long acting interferons to become available.

Patients with hemophilia can be offered therapy (78,79).Pre-treatment assessment should include a liver biopsy that may be performed by the transjugular or by plugged percutaneous route with clotting factor coverage.

Patients on methadone maintenance should not be excluded from treatment.

Therapy for incarcerated patients should be individualized based on their expected compliance and risk of re-infection.

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