Contraindications to pegylated interferon alfa include the following: Decompensated liver disease Autoimmune hepatitis Renal failure Immunosuppression Solid organ transplantation Cytopenia The following tests should be used to monitor patients treated with pegylated interferon alfa: Complete blood count (monthly to every 3 months) Thyroid-stimulating hormone (every 3 months) Clinical monitoring for autoimmune, ischemic, neuropsychiatric, and infectious complications Lactic acid levels if there is clinical concern Test for HIV before initiating treatment Nonpreferred antiviral therapies (adefovir, lamivudine, telbivudine, interferon alfa) may be considered if the above drugs are unavailable.