Case description: Patient Wang Moumou, male, 81 years old, came to our hospital in 2012 after a physical examination revealed a liver occupancy. Further examination revealed positive hepatitis C antibody, HCV RNA 10^6 copies/ml, genotype 1b. The diagnosis was hepatocellular carcinoma (stage 1a); hepatitis cirrhosis, type C, compensated stage; hypersplenism, hypoplastic plateletemia; type 2 diabetes mellitus; primary hypertension. Treatment history: Stage 1: hepatocellular carcinoma treatment The patient was in good general health and had basically normal liver function despite her age. Considering that liver cancer is the main factor determining the patient’s survival, radiofrequency ablation combined with successive cellular immunotherapy was first performed for liver cancer in order to completely treat liver cancer and prevent recurrence and metastasis. After the operation, the patient was successfully discharged from the hospital and has been rechecked every 3 months since then, no recurrence of liver cancer and no metastasis to other organs have occurred. Stage 2: Antiviral treatment The successful treatment of liver cancer has boosted the patient’s confidence in overcoming the disease and raised higher expectations for a cure for hepatitis C. The patient had already developed liver cancer and had relative contraindications to interferon such as diabetes mellitus (on insulin therapy) and hypoplastic plateletemia (50×109/L)). After careful evaluation, it was decided to give glyburide starting from 100ug subcutaneously for one year. HCVRNA was negative, and there was still no recurrence at six months follow-up, achieving clinical cure of hepatitis C. Regression: no recurrence and metastasis of hepatocellular carcinoma for 3 years; clinical cure of hepatitis C. Physician’s comments: 1. Do chronic hepatitis C patients who have developed hepatocellular carcinoma still need antiviral therapy? A large number of literature reports show that antiviral therapy for patients with hepatitis C cirrhosis can significantly slow down the progression of cirrhosis. Therefore, antiviral treatment for this patient can achieve long-term stability of liver function and create prerequisites for subsequent treatment of hepatocellular carcinoma. The progression of hepatocellular carcinoma includes recurrence and metastasis of the primary lesion, as well as new onset of hepatocellular carcinoma in some patients. Anti-viral therapy clears hepatitis C virus and reduces the risk of new hepatocellular carcinoma. Therefore, it is very beneficial to improve the long-term prognosis of patients. 2. How to give antiviral therapy when there are contraindications to interferon therapy such as diabetes, cirrhosis and low platelet count? Many patients with hepatitis C have the above problems, but these are only relative contraindications. After careful evaluation and close monitoring by an experienced physician, many patients can still achieve clinical cure by starting interferon in small doses. In particular, patients who already have early cirrhosis must start treatment as soon as possible. Otherwise, cirrhosis may progress to the decompensated stage and become irreversible before the new drug is clinically applied in China. 3. Is advanced age a contraindication to hepatitis C interferon therapy? With the progress of society, the average life expectancy of our people has reached 76 years, and the residents’ demand for health is getting higher and higher. More and more elderly people not only want to live a long life, but also want to have a good quality of life. Our department has treated more than 10 elderly patients with hepatitis C over 70 years of age cumulatively, and no significant adverse reactions have been found, and the overall response rate is similar to that of adults. Therefore, after a comprehensive assessment and adequate communication, advanced age is not a contraindication to interferon therapy.