 10. Fulminant hepatitis; current cirrhosis or clinical manifestations of end-stage liver disease for example, ascites or hepatic encephalopathy; acute hepatic failure or acute decompensation of chronic hepatic failure; or aspartate aminotransferase AST or alanine aminotransferase ALT level greater than 5-fold the upper limit of normal or total bilirubin greater than 3-fold the upper limit of normal using local or regional laboratory reference values. 