Slide Presentation. Management of HCV Coinfection Susanna Naggie, MD, MHS
|
|
- Osborne Fleming
- 5 years ago
- Views:
Transcription
1 Slide Presentation Management of HCV Coinfection Assistant Professor of Medicine Duke University School of Medicine & Durham VA Medical Center Director of Infectious Diseases Duke Clinical Research Institute Disclosure Research support: AbbVie, Anadys, Bristol-Myers Squibb, Gilead, Medtronic, Scynexis, Achillion, and Vertex Scientific adviser/consultant: Abbott, AbbVie, Boehringer Ingelheim, Gilead, Janssen, Achillion, and Vertex (Updated 3/13/14) **Off-label use of FDA approved medications Treatment of Hepatitis C Virus Infection in the HIV-Infected Patient: Everybody s Doing It
2 Natural History HIV and HCV HIV 4 million Hepatitis C 18 million 1 million people worldwide 3% of US patients with HIV have HCV Epidemic in HIV+ MSM 14.5% of deaths liver related Staples CT. Clin Infect Dis 1999 DAD Study Group, Arch Intern Med 26 HAART Era: Cirrhosis Risk Overall RR 2.11 Pre-HAART era RR 2.49 HAART era RR year, 3-year rates 25%, 54% HCV monoinfection HIV/HCV coinfection Thein et al. AIDS 28; 22:1979
3 Accelerated Liver Disease in HIV Kirk et al. Ann Intern Med 213; 158: Clinical Management HCV Screening in HIV+ Patients CDC STD Treatment Guidelines, Dec 21: To detect acute HCV among HIV-infected MSM with high-risk sexual behaviors or concomitant ulcerative STDs, routine HCV testing should be considered. Q6 mo GI panel, Q12 mo anti-hcv GI panel and anti-hcv 3 months after dx with new STD Liver enzyme elevation = HCV RNA MMWR, Dec 21, 59(RR-12) NEAT Consensus Conference AIDS 211; 25: last accessed 3/21/14
4 Education and Prevention Launay et al. JAMA 211; 35: Fonseca et al. Vaccine 25: 23:292-8 CDC Pink Book Carrieri et al. J Hepatol 214; 6:46-53 Staging of Liver Disease Sensitivity Assessing Fibrosis: AUROC SROC Curve: APRI for Cirrhosis Symmetric SROC AUC =.8265 SE(AUC)=.13 Q*=.7594 SE(Q*)= specificity The size of the dots for 1-specificity and sensitivity of the single studies in the ROC space is derived from the respective sample size. Lin et al. Hepatology 211;53; Sheheen et al. Am J Gastroenterol 27;12; Sheheen et al. HIV Clin Trials 28;9; Chou et al. Ann Intern Med 213;158. APRI (.3, 2.) (F2-4) (cirrhosis, F4) HIV (F4) Fibrotest (.2,.8): (F2-4) (cirrhosis, F4) HIV.86 (F4) SHASTA:.88 Forns :
5 Assessing Fibrosis: Elastography Sensitivity De Ledinghen et al. JAIDS 26;41: Vergara et al. Clin Infect Dis 27;45: F,1 versus F2,3,4 F,1,2 versus F3,4 F,1,2,3 versus F specificity Assessing Fibrosis: Elastography Probability of decompensation De Ledinghen et al. JAIDS 26;41: Vergara et al. Clin Infect Dis 27;45: LSM 9.4 KPa and <14.6 KPa LSM 14.6 KPa P< Number at risk Time (years) Fs cutoff = Fs cutoff = HCV Treatment
6 New Kids on the Block Simeprevir (TMC-435) Multigenotypic NS3/4A PI QD dosing Second-wave PI Low barrier to resistance + DDI with ARVs Rash, photosensitivity HIV not a special pop Sofosbuvir (GS-7977) Pangenotypic NS5B QD dosing Nucleotide analogue Exceptional barrier to resistance No significant DDI No AE Approved for HIV/HCV as special population Drug Interactions: Simeprevir ARV BOC TPV SMV SOF* DCV FDV ATV/r CAUTION STAND CONTRA STAND DCV FDV DRV/r CONTRA CONTRA CONTRA STAND N/A FDV EFV CONTRA TPV CONTRA STAND DCV FDV RPV STAND CAUTION STAND STAND STAND N/A ETV CAUTION CAUTION CONTRA STAND N/A N/A RGV STAND STAND STAND STAND STAND STAND DGV N/A N/A CAUTION STAND N/A N/A Phase III Study: Rilpivirine (15%), Raltegravir (87%), Maraviroc, Enfuvirtide, NRTIs MVC MVC MVC STAND STAND STAND STAND *Tipranavir CONTRA with SOF Ouwerkerk-Mahadevan et al. IDSA 212 Abstract 49; Hulskotte et al. Clin Infect Dis 213; de Kanter et al. CROI 212; Bifano et al. CROI 212; Kirby et al. AASLD 212 Simeprevir QD + P/R: C212 Study Phase III, open-label (TMC435-C212 study) Treatment naïve and experienced (N=16) RGT = <LLOQ week 4 and <LLOD week 12 HCV treatmentnaïve/relapse Partial/null cirrhotic RGT* Week Dieterich et al. CROI 214 Abstract 24 SMV 15mg/PR SMV 15mg/PR SMV 15mg/PR PR Follow-up PR PR Follow-up Follow-up
7 SVR12: Treatment History HCV RNA Undetectable (%) /16 42/53 13/15 7/1 16/28 Overall Naïve Relapse Partial Null Dieterich et al. CROI 214 Abstract 24 C212: Subpopulations HCV RNA Undetectable (%) Overall 1b 1a - Q8K SVR /16 16/18 2/3 36/45 14/22 7/93 8/ F-2 F3/4 on ART off ART Dieterich et al. CROI 214 Abstract Weeks: Simeprevir QD + P/R Co-infection Monoinfection 6/67 (89%) met RGT criteria and ended treatment at Week 24 (noncirrhotic) SVR4 or SVR12 (%) Dieterich et al. CROI 214 Abstract 24
8 Safety Summary SMV + P/R (N=16) Patients, % First 12 weeks Entire treatment AEs in >25% of patients Fatigue Headache Nausea AEs of special interest 11 9 Pruritis 2 2 Rash Sunburn/Photosensitivity 3/2 4/2 Grade 3-4 AEs Serious AEs 6 1 Treatment D/C due to AEs 4 4 Dieterich et al. CROI 214 Abstract 24 New Kids on the Block Simeprevir (TMC-435) Multigenotypic NS3/4A PI QD dosing Second-wave PI Low barrier to resistance + DDI with ARVs Rash, photosensitivity HIV not a special pop Sofosbuvir (GS-7977) Pangenotypic NS5B QD dosing Nucleotide analogue Exceptional barrier to resistance No significant DDI No AE Approved for HIV/HCV as special population Drug Interactions: Sofosbuvir ARV BOC TPV SMV SOF* DCV FDV ATV/r CAUTION STAND CONTRA STAND DCV FDV DRV/r CONTRA CONTRA CONTRA STAND N/A FDV EFV CONTRA TPV CONTRA STAND DCV FDV RPV STAND CAUTION STAND STAND STAND N/A ETV CAUTION CAUTION CONTRA STAND N/A N/A RGV STAND STAND STAND STAND STAND STAND Phase III Study: Rilpivirine (15%), Raltegravir (87%), Maraviroc, Enfuvirtide, NRTIs DGV N/A N/A CAUTION STAND N/A N/A MVC MVC MVC STAND STAND STAND STAND *Tipranavir CONTRA with SOF Ouwerkerk-Mahadevan et al. IDSA 212 Abstract 49; Hulskotte et al. Clin Infect Dis 213; de Kanter et al. CROI 212; Bifano et al. CROI 212; Kirby et al. AASLD 212
9 The NEUTRINO Regimen in HIV/HCV HCV RNA <LLOQ (25 IU/mL) SVR /19 13/15 4/4 1 1a 1b Rodriguez-Torres et al. IDW 213 Abstract 714 PHOTON-1: Study Design GT 1 TN Wk Wk 12 Wk 24 Wk 36 SOF + RBV, n=114 Wk 48 GT 2/3 TN SOF + RBV, n=68 SVR 12 SVR 24 GT 2/3 TE SOF + RBV, n=41 Broad inclusion criteria Cirrhosis permitted with no platelet cutoff Hemoglobin: 12 mg/dl (males), 11 mg/dl (females) Wide range of ART regimens allowed Undetectable HIV RNA for >8 weeks on stable ART regimen Baseline CD4 count ART treated: CD4 count > 2 cells/mm 3 and HIV RNA < 5 c/ml ART untreated: CD4 count > 5 cells/mm 3 Naggie et al. CROI 214 Abstract 26 Virologic Response: Genotype 1 Patients with HCV RNA <LLOQ (%) * 11/114 13/13 87/114 86/114 Week 4 EOT SVR12 SVR24 Naggie et al. CROI 214 Abstract 26
10 SVR12 by GT 1 Patient Subgroups Overall HCV GT 1a 1b SVR12 Rate, % (95% CI) HCV RNA level <6 log 1 IU/mL 6 log 1 IU/mL IL28B Cirrhosis CC Non-CC No Yes Nonblack Race Black Female Gender Male <5 Age 5 Naggie et al. CROI 214 Abstract Virologic Response: Genotype 2 Patients with HCV RNA <LLOQ (%) 25/26 25/26 23/26 23/26 24/24 23/23 22/24 22/24 Week 4 EOT SVR12 SVR24 Week 4 EOT SVR12 SVR24 Treatment Naïve 12 Weeks SOF + RBV Treatment Experienced 24 Weeks SOF + RBV Naggie et al. CROI 214 Abstract 26 Virologic Response: Genotype 3 Patients with HCV RNA <LLOQ (%) 41/41 39/4 28/42 28/42 17/17 17/17 16/17 15/17 Week 4 EOT SVR12 SVR24 Week 4 EOT SVR12 SVR24 Treatment Naïve 12 Weeks SOF + RBV Treatment Experienced 24 Weeks SOF + RBV Naggie et al. CROI 214 Abstract 26
11 Safety Summary SOF + RBV Patients, % 24 Weeks (n=155) 12 Weeks (n=68) AEs AEs in 1% of patients Fatigue Insomnia Headache Nausea Diarrhea 11 9 Irritability 1 1 URI Grade 3-4 AEs 12 1 Serious AEs 6 7 Treatment D/C due to AEs* 3 4 Death 1 * Weight loss, insomnia/agitation, pneumonia, suicide attempt, foreign body sensation in throat, increased anxiety, dyspnea. Suicide 9 days after completing study treatment; patient had history of depression and was being treated for ADHD and insomnia before entering study. Naggie et al. CROI 214 Abstract 26 Laboratory Abnormalities SOF + RBV n (%) 24 Weeks (n=155) 12 Weeks (n=68) Any Grade 3 33 (21) 8 (12) Grade 3 hyperbilirubinemia (indirect) 28 (18) 4 (6) Taking atazanavir* 26 (17) 4 (6) Not taking atazanavir 2 (1) Grade 3 elevated lipase 3 (2) Hemoglobin <1 mg/dl 27 (17) 7 (1) <8.5 mg/dl 2 (1) 1 (1) *4 patients changed ARV regimens from atazanavir to darunavir due to hyperbilirubinemia; 43 (19%) required ribavirin dose reduction during study; epoetin alfa was not permitted. Naggie et al. CROI 214 Abstract 26 Recommended for HIV/HCV Treatment Naïve/Relapse 76% SVR12 >9% SVR12 89% SVR12
12 Recommended for HIV/HCV Treatment Experienced >9% SVR12 ~72% SVR12 Recommended for HIV/HCV Genotype 2 and 3 88% SVR % SVR12 *Consider addition of PEG to SOF/RBV for 12 weeks for treatment-experienced cirrhotics (LONESTAR-2) What s Next? Patients with SVR12 (%) Naïve Experienced Gane et al. AASLD 213 Abstract 73; Lawitz et al. AASLD 213 Abstract 215/1844; Sulkowski et al. NEJM 214; 37:211-21; abbvie.mediaroom.com/press_release SOF/LDV(P3) ABT QUAD(P3) DCV/SOF(P2)
13 Drug Interactions: Faldaprevir and Daclatasvir ARV BOC TPV SMV SOF* DCV FDV ATV/r CAUTION STAND CONTRA STAND DCV FDV DRV/r CONTRA CONTRA CONTRA STAND N/A FDV EFV CONTRA TPV CONTRA STAND DCV FDV RPV STAND CAUTION STAND STAND STAND N/A ETV CAUTION CAUTION CONTRA STAND N/A N/A RGV STAND STAND STAND STAND STAND STAND Phase III Study: Rilpivirine (15%), Raltegravir (87%), DGV N/A N/A CAUTION STAND N/A N/A MVC MVC MVC STAND Maraviroc, Enfuvirtide, NRTIs STAND STAND STAND *Tipranavir CONTRA with SOF Ouwerkerk-Mahadevan et al. IDSA 212 Abstract 49; Hulskotte et al. Clin Infect Dis 213; de Kanter et al. CROI 212; Bifano et al. CROI 212; Kirby et al. AASLD 212 In a nutshell... Response to HCV treatment is no longer different. IFN-free regimens approved in GT 2/3. IFN inclusive still recommended for GT 1 patients who can tolerate IFN. IFN-free for GT 1 is recommended but can be hard to get. FDA-approved all-oral treatments are months away! Baseline Demographics Treatment Naive GT 1 n=114 GT 2/3 n=68 Treatment Experienced GT 2/3 n=41 Mean age, y (range) 48 (25-7) 49 (24-71) 54 (34-68) Male, n (%) 93 (82%) 55 (81%) 37 (9%) Black, n (%) 37 (32%) 8 (12%) 7 (17%) Hispanic, n (%) 25 (22%) 19 (28%) 1 (24%) Mean BMI, kg/m 2 (range) 27 (18-46) 27 (2-43) 27 (19-4) Genotype 1a, n (%) 9 (79) NA NA Genotype 2, n (%) NA 26 (38) 24 (59) Genotype 3, n (%) NA 42 (62) 17 (41) IL28B CC, n (%) 3 (27) 25 (37) 2 (49) Mean HCV RNA, log 1 IU/mL (range) 6.6 ( ) 6.3 (5.-7.4) 6.5 ( ) Cirrhosis, n (%) 5 (4) 7 (1) 1 (24) On ART, n (%) 112 (98) 61 (9) 39 (95) CD4 T-cell count (cells/μl), mean (SD) 636 (251) 585 (246) 658 (333) 4
14 Antiretroviral Regimens Treatment Naive Treatment Experienced Regimen, n (%) GT 1 n=114 GT 2/3 n=68 GT 2/3 n=41 On ART 112 (98) 61 (9) 39 (95) Tenofovir DF/emtricitabine plus Efavirenz 42 (37) 2 (33) 16 (41) Atazanavir/ritonavir 24 (21) 7 (11) 8 (21) Darunavir/ritonavir 15 (13) 17 (28) 2 (5) Raltegravir 21 (18) 8 (13) 7 (18) Rilpivirine 7 (6) 5 (8) 2 (5) Other 3 (3) 4 (7) 4 (1) 41 Patient Disposition Treatment Naive Treatment Experienced Regimen, n (%) GT 1 n=114 GT 2/3 n=68 GT 2/3 n=41 Completed 13 (9) 62 (91) 4 (98) Discontinued 11 (1) 6 (9) 1 (2) Reason for discontinuation AE 3 (3) 3 (4) 1 (2) Withdrew consent 2 (2) 1 (1) Protocol violation* 4 (4) Investigator decision 1 (<1) 1 (1) Efficacy failure 1 (<1) Lost to follow-up 1 (1) *Three GT1 subjects inadvertently discontinued after 12 weeks; one GT 1 subject did not adhere to study visits 42 Virologic Outcome Treatment Naive Treatment Experienced GT 1 GT 2 GT 3 GT 2 GT 3 Outcome, n (%) n=114 n=26 n=42 n=24 n=17 SVR12 87 (76) 23 (88) 28 (67) 22 (92) 16 (94) HCV virologic failure 26 (23) 1 (4) 12 (29) 1 (4) 1 (6) Relapse 25 (22) 12 (29) 1 (4) 1 (6) Completed study drug Did not complete study drug HCV viral breakthrough* 1 (<1) 1 (4) Other 1 (<1) 2 (8) 2 (5) 1 (4) *Both patients with HCV breakthrough were nonadherent to SOF, confirmed by PK analysis. 43
15 Safety of Sofosbuvir Safety Outcome Total (N=775) No Peg (N=331) Yes Peg (N=444) Grade 3 AE, N(%) 88 (11) 17 (5) 71 (16) SAE, N(%) 28 (3.6) 12 (3.6) 16 (3.6) Leading to d/c, N(%) 38 (5) 4 (1.2) 34 (7.6) Grade 3/4 anemia 146 (19) 24 (7) 122 (27.5) Grade 3/4 neutropenia 93 (12) 93 (21) Grade 3/4 lymphopenia 35 (4.5) 7 (2) 28 (6.3) Grade 3/4 thrombocytopenia 4 (1) Grade 3/4 hyperbilirubinemia 8 (1) 5 (1.5) 3 (.6) Kowdley KV et al. EASL 213 Abstract C212: Sub-hoc Analyses HCV RNA <LLOQ (25 IU/mL) on ART SVR12 62 not on ART SVR CD4 5/mm3 CD>5/mm3 Dieterich et al. CROI 214 Abstract 24; NCT
Latest Treatment Updates for GT 2 and GT 3 Patients
Latest Treatment Updates for GT 2 and GT 3 Patients Eric Lawitz, MD, AGAF, CPI Vice President, Scientific and Research Development The Texas Liver Institute Clinical Professor of Medicine University of
More informationICVH 2016 Oral Presentation: 28
Ledipasvir/Sofosbuvir Is Safe and Effective for the Treatment of Patients with Genotype 1 Chronic HCV Infection in Both HCV Mono- and HIV/HCV Coinfected Patients A Luetkemeyer 1, C Cooper 2, P Kwo 3, K
More informationLedipasvir-Sofosbuvir (Harvoni)
HEPATITIS WEB STUDY HEPATITIS C ONLINE Ledipasvir-Sofosbuvir (Harvoni) Robert G. Gish MD Professor, Consultant, Stanford University Medical Center Senior Medical Director, St Josephs Hospital and Medical
More informationHIV/HCV Co-Infection
HIV/HCV Co-Infection 2015 Kentucky Conference on Viral Hepatitis Matt Cave, M.D. Associate Professor Department of Medicine Division of Gastroenterology, Hepatology, & Nutrition Department of Pharmacology
More informationCan we afford to Cure all HIV-HCV Co-infected Patients of HCV?
Can we afford to Cure all HIV-HCV Co-infected Patients of HCV? Michael S. Saag, MD Professor of Medicine University of Alabama at Birmingham Birmingham, Alabama FINAL AU EDITED: 09-17-14 Disclosure Dr
More informationRome, February nd Riunione Annuale AISF th AISF ANNUAL MEETING
Rome, February 20-21 nd 2014 Riunione Annuale AISF 2014 14 th AISF ANNUAL MEETING Present and future treatment strategies for patients with HCV infection: chronic hepatitis and special populations IFN
More informationNew developments in HCV research and their implications for front-line practice
New developments in HCV research and their implications for front-line practice Dr. Curtis Cooper Associate Professor, University of Ottawa Director, Ottawa Hospital Viral Hepatitis Program June 17, 2013
More informationCase 4: A 61-year-old man with HCV genotype 3 with cirrhosis. Ira M. Jacobson, M.D. Weill Cornell Medical College New York, New York USA
Case 4: A 61-year-old man with HCV genotype 3 with cirrhosis Ira M. Jacobson, M.D. Weill Cornell Medical College New York, New York USA 1 Genotype 3 case 61-year-old man with HCV genotype 3 Cirrhosis on
More informationClinical Management: Treatment of HCV Mono-infection
Clinical Management: Treatment of HCV Mono-infection Curtis Cooper, MD, FRCPC Associate Professor-University of Ottawa The Ottawa Hospital- Infections Diseases Viral Hepatitis Program- Director Industry
More informationTough Cases in HIV/HCV Coinfection
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Tough Cases in HIV/HCV Coinfection John Scott, MD, MSc Assistant Professor University of Washington Presentation prepared by: J Scott Last Updated: Jun 5, 2014
More informationHIV Infection with HCV Future Directions
HIV Infection with HCV Future Directions Dr Ranjababu (Babu) Kulasegaram Consultant Physician in HIV/GU Medicine Guy s and St Thomas NHS Foundation Trust London, UK Presenter disclosure information Dr
More informationProgram Disclosure. Provider is approved by the California Board of Registered Nursing, Provider #13664, for 1.5 contact hours.
Program Disclosure This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint-sponsorship
More informationHepatitis C Treatment 2014
Hepatitis C Treatment 214 Brendan M. McGuire, MD UAB Liver Center Outline Epidemiology/National History Terminology for Treatment Treatment Considerations Current Treatment Options Genotype 1 (GT 1) Genotype
More information6/2/2015. Interactive Case-Based Presentations and Audience Discussion
Interactive Case-Based Presentations and Audience Discussion Arthur Y. Kim, MD Assistant Professor of Medicine Harvard Medical School Director, Viral Hepatitis Clinic Massachusetts General Hospital Boston,
More informationHIV-HCV coinfection. Mark Sulkowski, MD Professor of Medicine Johns Hopkins University School of Medicine Baltimore, Maryland
HIV-HCV coinfection Mark Sulkowski, MD Professor of Medicine Johns Hopkins University School of Medicine Baltimore, Maryland Disclosures Principal investigator for research grants Funds paid to Johns Hopkins
More informationCase 2: Coinfection. Patient Case
Case 2: Coinfection Jennifer J. Kiser, PharmD Assistant Professor University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora, Colorado FORMATTED: 04-21-14 Learning Objectives After
More information47 th Annual Meeting AISF
47 th Annual Meeting AISF Rome, 21 February 2014 Present and future treatment strategies for patients with HCV infection: chronic hepatitis and special populations (HCV/HIV coinfection, advanced cirrhosis,
More informationEASL 2013 Interferon Free, All Oral Regimens for Hepatitis C. Maria Buti Hospital Universitario Valle Hebron Barcelona Spain
EASL 2013 Interferon Free, All Oral Regimens for Hepatitis C Maria Buti Hospital Universitario Valle Hebron Barcelona Spain The first Results with Oral therapy: a Protease Inhibitor and NS5A inhibitor
More informationHIV-HCV Co-Infection. George Mason University Falls Church, Virginia. Overview. Prevalence of HCV co-infection Incidence and Recent Trends
HIV-HCV Co-Infection Zobair Younossi MD, MPH, FACG, AGAF, FAASLD Chairman, Department of Medicine, Inova Fairfax Hospital Vice President for Research, Inova Health System Professor of Medicine, VCU-Inova
More informationWhy make this statement?
HCV Council 2014 10 clinical practice statements were evaluated by the Council A review of the available literature was conducted The level of support and level of evidence for the statements were discussed
More informationHIV and Hepatitis C: Advances in Treatment
NORTHWEST AIDS EDUCATION AND TRAINING CENTER HIV and Hepatitis C: Advances in Treatment John Scott, MD, MSc Asst Professor University of Washington Presentation prepared & presented by: John Scott, MD,
More informationCURRENT TREATMENTS. Mitchell L Shiffman, MD Director Liver Institute of Virginia. Richmond and Newport News, VA, USA
CURRENT TREATMENTS FOR HCV Mitchell L Shiffman, MD Director Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, VA, USA Liver Institute of Virginia Education, Research and
More informationTreatments of Genotype 2, 3,and 4: Now and in the future
Treatments of Genotype 2, 3,and 4: Now and in the future THERAPY FOR THE TREATMENT OF GENOTYPE 2 1 GT 2 and GT 3 Treatment-Naïve: SOF+RBV vs PEG-IFN+RBV FISSION Study Design HCV GT 2 and GT 3 Treatment-naïve
More informationEmerging Therapies for HCV: Highlights from AASLD 2012 (Part 2)
Emerging Therapies for HCV: Highlights from AASLD 2012 (Part 2) Goals for Hepatitis C Therapy Compared to PegIFN α/rbv, new treatment regimens for chronic hepatitis C should offer: Improved efficacy Efficacy
More informationEvolution of Therapy in HCV
Hepatitis C: Update on New Therapies and AASLD 13 David Bernstein, MD, FACP, AGAF, FACP Professor of Medicine Hofstra North Shore-LIJ School of Medicine Evolution of Therapy in HCV 199 1999 1 13 (%) SVR
More information5/12/2016. Learning Objectives. Management of Hepatitis C Virus Genotype 2 or 3 Infected Treatment-Naive or Experienced Patients
5/12/216 Management of Hepatitis C Virus Genotype 2 or 3 Infected Treatment-Naive or Experienced Patients Alexander Monto, MD Professor of Clinical Medicine University of California San Francisco San Francisco,
More informationCurrent State of Treatment for HCV. Nancy Reau, MD Associate Professor of Medicine University of Chicago
Activity Code FA376 Current State of Treatment for HCV Nancy Reau, MD Associate Professor of Medicine University of Chicago Learning Objectives Upon completion of this presentation, learners should be
More informationDr Janice Main Imperial College Healthcare NHS Trust, London
BHIVA AUTUMN CONFERENCE 2014 Including CHIA Parallel Sessions Dr Janice Main Imperial College Healthcare NHS Trust, London 9-10 October 2014, Queen Elizabeth II Conference Centre, London BHIVA AUTUMN CONFERENCE
More informationHIV/HCV Coinfection: Why It Matters and What To Do About It. Cody A. Chastain, MD 10/26/16
HIV/HCV Coinfection: Why It Matters and What To Do About It Cody A. Chastain, MD 10/26/16 Disclosures I have no relevant financial disclosures. Objectives At the end of this lecture, the learner will be
More informationSHOULD EVERYONE WITH HCV/HIV COINFECTION BE TREATED NOW?
SHOULD EVERYONE WITH HCV/HIV COINFECTION BE TREATED NOW? Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati College of Medicine Disclosures
More informationWill difficult-to-treat patients remain difficultto-treat. generation of treatments?
Will difficult-to-treat patients remain difficultto-treat with the new generation of treatments? Jordan J Feld MD MPH Toronto Centre for Liver Disease Sandra Rotman Centre for Global Health University
More informationTreatement Experienced patients without cirrhosis. Rafael Esteban Hospital Universitario Valle Hebron Barcelona
Treatement Experienced patients without cirrhosis Rafael Esteban Hospital Universitario Valle Hebron Barcelona Agenda With IFN PegIFN+ Ribavirin + Simeprevir PegIFN+ Ribavirin+ Sofosbuvir Without IFN Sofosbuvir
More informationInitial Treatment of HCV G Hugo E. Vargas, MD Professor of Medicine Medical, Director Office of Clinical Research Mayo Clinic Arizona
Initial Treatment of HCV G1 2016 Hugo E. Vargas, MD Professor of Medicine Medical, Director Office of Clinical Research Mayo Clinic Arizona Disclosure Information Disclosure Information Dr. Vargas receives
More informationHepatitis C Emerging Treatment Paradigms
Hepatitis C Emerging Treatment Paradigms David R Nelson MD Assistant Vice President for Research Professor of Medicine Director, Clinical and Translational Science Institute University of Florida Gainesville,
More informationThe HCV Pipeline Ira M. Jacobson, MD, FACP, FACG, AGAF. Slide Presentation. IFN-free DAA combinations (G1)
Slide Presentation The HCV Pipeline Vincent Astor Distinguished Professor of Medicine Chief, Division of Gastroenterology and Hepatology Medical Director, Center for the Study of Hepatitis C Weill Cornell
More informationIntroduction. The ELECTRON Trial
63rd AASLD November 9-13, 12 Boston, Massachusetts Faculty Douglas T. Dieterich, MD Professor of Medicine and Director of CME Department of Medicine Director of Outpatient Hepatology Division of Liver
More informationFuture strategies with new DAAs
Future strategies with new DAAs Ola Weiland professor New direct antiviral drugs Case no 1 male with genotype 2b Male with gt 2b chronic HCV Male with gt 2b relapse afer peg-ifn + RBV during 24 weeks
More informationEmerging Therapies for HCV: Highlights from AASLD 2012 (Part 2)
Emerging Therapies for HCV: Highlights from AASLD 2012 (Part 2) PegIFN and RBV remain vital components of HCV therapy-- selected presentations from: Program Disclosure This activity has been planned and
More informationLearning Objective. After completing this educational activity, participants should be able to:
Learning Objective After completing this educational activity, participants should be able to: Use patient characteristics and preferences to select HCV treatment strategies that maximize the potential
More informationAddressing Unmet Medical Needs in HCV Genotype 3
Addressing Unmet Medical Needs in HCV Genotype 3 Karen Doucette, MD, MSc (Epi), FRCPC Associate Professor, Division of Infectious Diseases, Department of Medicine University of Alberta Objectives Identify
More informationHow to optimize treatment in G3 patients? Jérôme GOURNAY, MD Hépatologie Centre Hospitalier Universitaire de Nantes France
How to optimize treatment in G3 patients? Jérôme GOURNAY, MD Hépatologie Centre Hospitalier Universitaire de Nantes France Paris Hepatitis Conference, January 12, 2016 Disclosures I have received funding
More informationEmerging Therapies for HCV: Highlights from AASLD 2012 (Part 1)
Emerging Therapies for HCV: Highlights from AASLD 2012 (Part 1) Goals for Hepatitis C Therapy Compared to PegIFN/RBV, new products should offer: Improved efficacy Efficacy in all patient types including
More information10/21/2016. Susanna Naggie, MD, MHS Associate Professor of Medicine Duke University Durham, North Carolina. Learning Objectives
A Crash Course on the AASLD/IDSA Hepatitis C Virus Infection Treatment Guidelines: What s New Susanna Naggie, MD, MHS Associate Professor of Medicine Duke University Durham, North Carolina FORMATTED: 1/3/16
More informationVII CURSO AVANCES EN INFECCIÓN VIH Y HEPATITIS VIRALES
VII CURSO AVANCES EN INFECCIÓN VIH Y HEPATITIS VIRALES REGIMENES TERAPÊUTICOS DE LA HEPATITIS C, INTERFERÓN FREE A Coruña 2 Febrero 2013 Rui Sarmento e Castro Centro Hospitalar do Porto HJU ECS Universidade
More informationUpdate on chronic hepatitis C treatment: current trends, new challenges, what next?
Update on chronic hepatitis C treatment: current trends, new challenges, what next? Matti Maimets 12.06.2015 MMaimets15 Disclosure this presentation is sponsored by Gilead Sciences MMaimets15 MMaimets15
More informationHCV Case Study. Treat Now or Wait for New Therapies
HCV Case Study Treat Now or Wait for New Therapies This program is supported by educational grants from Kadmon and Merck Pharmaceuticals. Program Disclosure This activity has been planned and implemented
More informationPreliminary Results of an Evaluation of Ledipasvir/Sofosbuvir in Patients with Chronic HCV or HCV/HIV Co-Infection
Preliminary Results of an Evaluation of Ledipasvir/Sofosbuvir in Patients with Chronic HCV or HCV/HIV Co-Infection Konstantin Zhdanov 1, Viacheslav Morozov 2, Elena A Orlova-Morozova 3, Riina Salupere
More informationExperience with pre-transplant antiviral treatment: PEG/RBV and DAA. Xavier Forns, MD Liver Unit Hospital Clínic IDIBAPS and CIBREHD Barcelona
Experience with pre-transplant antiviral treatment: PEG/RBV and DAA Xavier Forns, MD Liver Unit Hospital Clínic IDIBAPS and CIBREHD Barcelona Interferon-free regimens G1b nulls Asunaprevir (PI) + Daclatasvir
More informationTreatment of Hepatitis C in HIV-Coinfected Patients. Vincent Soriano Department of Infectious Diseases Hospital Carlos III Madrid, Spain
Treatment of Hepatitis C in HIV-Coinfected Patients Vincent Soriano Department of Infectious Diseases Hospital Carlos III Madrid, Spain Estimated no. of persons infected with HIV and hepatitis viruses
More informationAntiviral treatment in Unique Populations
Antiviral treatment in Unique Populations Atif Zaman, MD MPH Oregon Health & Science University Professor of Medicine Division of Gastroenterology and Hepatology Unique HCV Populations HIV/HCV co-infected
More informationTreatment of chronic hepatitis C in HIV co-infected patients
Treatment of chronic hepatitis C in HIV co-infected patients Vicente Soriano Department of Infectious Diseases Hospital Carlos III, Madrid, Spain The most prevalent chronic viral infections in humans HBV
More informationSimeprevir + PEG + RBV in Treatment-Naïve Genotype 1 QUEST-1 Trial
Phase 3 Treatment Naïve Simeprevir + in Treatment-Naïve Genotype 1 QUEST-1 Trial Jacobson IM, et al. Lancet. 2014;384:403-13. Simeprevir + PEG + Ribavirin for Treatment-Naïve HCV GT1 QUEST-1 Trial QUEST-1
More informationPivotal New England Journal of Medicine papers 2014 Phase 3 Trial data
4 th HCV Therapy Advances Meeting Paris, December 12-13, 14 Pivotal New England Journal of Medicine papers 14 Phase 3 Trial data Stefan Zeuzem, MD University of Frankfurt Germany Disclosures Consultancies:
More informationTREATMENT OF GENOTYPE 2
Treatment of Genotype 2, 3,and 4 David E. Bernstein, MD, FACG Advisory Committee/Board Member: AbbVie Pharmaceuticals, Gilead, Merck, Janssen Consultant: AbbVie Pharmaceuticals, Bristol-Myers Squibb, Gilead,
More informationCase #1. Case #1. Case #1: Audience vote VS. The Great Debate: When to Treat HCV in our HIV coinfected patients
Case #1 The Great Debate: When to Treat HCV in our HIV coinfected patients Medical Management of AIDS December, 2012 Moderated by George Beatty,MD 35 year old African American man, CD4 + 450, HIV RNA
More informationTreatment of HCV in 2016
5/1/16 Treatment of HCV in 16 Graham R Foster Professor of Hepatology QMUL Conflicts of Interest Speaker and consultancy fees received from AbbVie, BI, BMS, Gilead, Janssen, Roche, Merck, Novartis, Springbank,
More informationGlobal Prevalence of HBV, HCV, HIV
Treatment of Patients with HCV and HIV Paul Y. Kwo, MD, FACG Professor of Medicine Stanford University email: pkwo@stanford.edu Global Prevalence of HBV, HCV, HIV 24 m Journal of Clinical Virology Page
More informationAssociate Professor of Medicine University of Chicago
Nancy Reau, MD Associate Professor of Medicine University of Chicago Management of Hepatitis C: New Drugs and New Paradigms HCV is More Lethal than HIV Infection HCV superseded HIV as a cause of death
More informationUpdate on Real-World Experience With HARVONI
Update on Real-World Experience With A RESOURCE FOR PAYERS This information is intended for payers only. The HCV-TARGET and TRIO studies were supported by Gilead Sciences, Inc. Real-world experience data
More informationSYNOPSIS Final Clinical Study Report for Study AI444031
Name of Sponsor/Company: Bristol-Myers Squibb Name of Finished Product: Name of Active Ingredient: () Individual Study Table Referring to the Dossier (For National Authority Use Only) SYNOPSIS for Study
More information3/28/2016. The Top 5 Things to Remember about Treating HCV
The Top 5 Things to Remember about Treating HCV Susanna Naggie, MD, MHS Associate Professor of Medicine Duke University School of Medicine Durham, North Carolina FORMATTED: MM/DD/YY New York, New York:
More informationHighlights of AASLD 2012 CCO Official Conference Coverage of the 2012 Annual Meeting of the American Association for the Study of Liver Diseases
Highlights of AASLD 12 CCO Official Conference Coverage of the 12 Annual Meeting of the American Association for the Study of Liver Diseases November 9-13, 12 Boston, Massachusetts In partnership with
More informationGenotype 1 HCV in 2016: Clinical Decision Making in a Time of Plenty
Genotype 1 HCV in 216: Clinical Decision Making in a Time of Plenty Ira M. Jacobson, MD Chair, Department of Medicine Mount Sinai Beth Israel Senior Faculty and Vice-Chair, Department of Medicine Icahn
More informationHCV In 2015: Maximizing SVR
HCV In 2015: Maximizing SVR Alnoor Ramji Gastroenterology & Hepatology Clinical Associate Professor Division of Gastroenterology University Of British Columbia ramji_a@hotmail.com Disclosures (within Last
More informationUpdates on the AASLD/IDSA HCV Guidance
Updates on the AASLD/IDSA HCV Guidance Susanna Naggie, MD, MHS Associate Professor of Medicine Duke University School of Medicine Durham, North Carolina Learning Objectives After attending this presentation,
More informationHCV Treatment Failure: What Next? Dr Ashley Brown, Imperial College Healthcare NHS Trust, London
HCV Treatment Failure: What Next? Dr Ashley Brown, Imperial College Healthcare NHS Trust, London European HIV Hepatitis Co-infection Conference QEII Conference Centre 10 th December 2015 Dr Ashley Brown
More informationMeet the Professor: HIV/HCV Coinfection
Meet the Professor: HIV/HCV Coinfection Vincent Lo Re, MD, MSCE Assistant Professor of Medicine and Epidemiology Division of Infectious Diseases Center for Clinical Epidemiology and Biostatistics University
More information4/30/2015. Interactive Case-Based Presentations and Audience Discussion. Debika Bhattacharya, MD, MSc. Learning Objectives
4/3/215 Interactive Case-Based Presentations and Audience Discussion Debika Bhattacharya, MD, MSc Assistant Clinical Professor University of California Los Angeles Los Angeles, California Formatted:4-27-215
More informationIFN-free therapy in naïve HCV GT1 patients
IFN-free therapy in naïve HCV GT1 patients Paris Hepatitis Conference Paris, 12th January, 2015 Pr Tarik Asselah MD, PhD; Service d Hépatologie & INSERM U773 University Paris Diderot, Hôpital Beaujon,
More informationHCV-G3: Sofosbuvir with ledipasvir or daclatasvir?
HCV-G3: Sofosbuvir with ledipasvir or daclatasvir? Ioannis Goulis, MD Aristotelian University of Thessaloniki XXIII International Hepatitis B & C Meeting of Athens Hadziyannis HCV genotype 3 therapy Chronic
More informationMy HCV patient is co-infected with HIV: how to manage?
EASL «White Nights of Hepatology 2016» My HCV patient is co-infected with HIV: how to manage? A.V. Кravchenko MD, Professor Russia AIDS Federal Center Central Research Institute of Epidemiology St.-Petersburg,
More informationDuncan Webster, BSc, BA, MA, MD, FRCPC
Moderator Duncan Webster, BSc, BA, MA, MD, FRCPC Internist, Infectious Disease Physician, Department of Medicine Medical Microbiologist, Department of Laboratory Medicine, Saint John Regional Hospital
More informationEASL and The Future of HCV Treatment
EASL and The Future of HCV Treatment Douglas T. Dieterich, M.D Professor of Medicine Division of Liver Diseases, Gastroenterology and Infectious Diseases Department of Medicine Mount Sinai School of Medicine
More informationUpdate on Real-World Experience With HARVONI
Update on Real-World Experience With A RESOURCE FOR PAYERS MAY 217 This information is intended for payers only. The HCV-TARGET study was supported by Gilead Sciences, Inc. Real-world experience data were
More informationPatients with Cirrhosis: Managing the HCV Peri-Transplant Patient
Patients with Cirrhosis: Managing the HCV Peri-Transplant Patient Fred Poordad, MD Professor of Medicine University of Texas Health Science Center VP, Academic and Clinical Affairs The Texas Liver Institute
More informationPhase 3. Treatment Experienced. Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2. Afdhal N, et al. N Engl J Med. 2014;370:
Phase 3 Treatment Experienced Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2 Afdhal N, et al. N Engl J Med. 2014;370:1483-93. Ledipasvir-Sofosbuvir +/- Ribavirin in Treatment-Experienced HCV
More informationUpdate in the Management of Hepatitis C: What Does the Future Hold
Update in the Management of Hepatitis C: What Does the Future Hold Paul Y Kwo, MD, FACG Professor of Medicine Mdi Medical ldirector, Liver Transplantation tti Gastroenterology/Hepatology Division Indiana
More informationHCV Treatment: Why to Wait
HCV Treatment: Why to Wait Prof. Jean-Michel Pawlotsky, MD, PhD National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital University of Paris-Est
More information8/5/2014. A new era of HCV clinical management. Direct-Acting Antivirals for Hepatitis C. Goal of HCV treatment is viral cure HIV HBV HCV
NS5B NS5B 8/5/214 A new era of HCV clinical management Mark Sulkowski, MD Professor of Medicine Medical Director, Viral Hepatitis Center Divisions of Infectious Disease and Gastroenterology/Hepatology
More informationSVR Updates from the 2013 EASL
Updates from the 2013 EASL By Tracy Swan, Treatment Action Group Streamlining HCV Treatment Treatment for hepatitis C virus (HCV) is becoming simpler, shorter, and more effective. All-oral combinations
More informationIFN-free for Genotype 1 HCV: the current landscape. Prof. Graham R Foster
IFN-free for Genotype 1 HCV: the current landscape Prof. Graham R Foster Wonderful new drugs are coming Poordad F, et al. New Engl J Med 2014; online DOI: 10.1056/NEJMoa1402869. 2 The New Drugs Two treatment
More informationPEARL-I. Ombitasvir + Paritaprevir + Ritonavir +/- Ribavirin in HCV GT4. Treatment Naïve and Treatment Experienced
Phase 2b Treatment Naïve and Treatment Experienced Ombitasvir + Paritaprevir + Ritonavir +/- Ribavirin in HCV GT4 PEARL-I Hézode C, et al. Lancet. 2015 March 30. [Epub ahead of print] PEARL-I: Study Design
More informationUpdate on the Treatment of HCV
Update on the Treatment of HCV K. Rajender Reddy, MD Professor of Medicine Director of Hepatology Director, Viral Hepatitis Center University of Pennsylvania Philadelphia, USA 1 K. Rajender Reddy, MD Disclosure
More informationHIV and Hepatitis C Have we finally slayed the beast?
HIV and Hepatitis C Have we finally slayed the beast? Mark W. Sonderup Division of Hepatology Department of Medicine University of Cape Town & Groote Schuur Hospital Accelerated Fibrosis in HIV-HCV co-infected
More informationOverview on latest data on IFN-sparing and IFN-free regimens in HCV/HIV patients 10th HIV and hepatitis coinfection workshop June 2014 Paris, France
Overview on latest data on IFN-sparing and IFN-free regimens in HCV/HIV patients 10th HIV and hepatitis coinfection workshop June 2014 Paris, France Patrick Ingiliz, Berlin Conflicts of Interest Boards,
More informationTreating HCV After Liver Transplantation: What are the Treatment Options?
4 th OPTIMIZE WORKSHOP USING DAAs IN PATIENTS WITH CIRRHOSIS AND LIVER RECIPIENTS Treating HCV After Liver Transplantation: What are the Treatment Options? Maria Carlota Londoño, MD Liver Unit, Hospital
More informationHEPATITIS WEB STUDY. Treatment of Hepatitis C following Liver Transplantation
HEPATITIS WEB STUDY Treatment of Hepatitis C following Liver Transplantation Terry D. Box, MD Associate Professor of Medicine Division of Gastroenterology/Hepatology University of Utah Health Sciences
More informationCase 2: A 71-year-old man with cirrhosis
Case 2: A 71-year-old man with cirrhosis 1 JM, 71 year old African American male with known cirrhosis Asymptomatic apart from fatigue No prior history of decompensation Past history: Diabetes for 11 years
More informationPotential Issues in Treating HIV/HCV co-infection with new HCV antivirals
State of the Art in Hepatitis C Virus Infection in HIV/HCV-Coinfected Patients FORMATTED: 11/17/15 David L. Wyles, MD Associate Professor of Medicine University of California San Diego San Diego, California
More informationInterferon-based and interferon-free new treatment options
Interferon-based and interferon-free new treatment options White Nights of Hepatology St. Petersburg, 7. June 2013 Christoph Sarrazin Klinikum der J. W. Goethe-Universität Medizinische Klinik I Frankfurt
More informationWhat is the Optimized Treatment Duration? To Overtreat versus Undertreat. Nancy Reau, MD Associate Professor of Medicine University of Chicago
What is the Optimized Treatment Duration? To Overtreat versus Undertreat Nancy Reau, MD Associate Professor of Medicine University of Chicago Learning Objectives: 1. Discuss patient populations appropriate
More informationHCV therapy : Clinical case
HCV therapy : Clinical case PHC 2018 Paris January 14th, 2018 Tarik Asselah (MD, PhD) Professor of Medicine Hepatology, Chief INSERM UMR 1149, Hôpital Beaujon, Clichy, France. Disclosures Professor Asselah
More informationAzienda ULSS12 Veneziana
Azienda ULSS12 Veneziana Risultati del trattamento dei monoinfetti con Sofosbuvir, Simeprevir nella coorte veneziana. Confronto di esito con la coorte del trattamento con Boceprevir e Telaprevir Dr.ssa
More informationHCV/HIV Coinfection ANTON AND MARGARET FUISZ CHAIR IN MEDICINE. HIV and HCV Share Risk Factors PREVALENCE OF CO-INFECTION BY RISK FACTOR 60%
HCV/HIV Coinfection BRUCE A. LUXON, MD, PHD, FACG ANTON AND MARGARET FUISZ CHAIR IN MEDICINE PROFESSOR AND CHAIRMAN DEPARTMENT OF MEDICINE GEORGETOWN UNIVERSITY HIV and HCV Share Risk Factors PREVALENCE
More informationProgram Disclosure. Provider is approved by the California Board of Registered Nursing, Provider #13664, for 1.5 contact hours.
Program Disclosure This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint-sponsorship
More informationSelecting HCV Treatment
Selecting HCV Treatment Caveats Focus on treatment selection for genotypes 1, 2, and 3. Majority of US population infected with GT 1, 2, or 3 GT 4 treatment closely reflects GT 1 treatment GT 5 and 6 are
More informationTreatment of genotype 4 patient. with cirrhosis. Vincent LEROY Clinique Universitaire d Hépato-Gastroentérologie INSERM U823 CHU de Grenoble
Treatment of genotype 4 patient with cirrhosis Vincent LEROY Clinique Universitaire d Hépato-Gastroentérologie INSERM U823 CHU de Grenoble Clinical case 52 year-old patient Intra-venous drug user 1987-1989
More informationWorkshop I Planning Committee
Workshop I Planning Committee Nancy Reau, MD Associate Professor of Medicine University of Chicago School of Medicine Chicago, IL Stuart C. Gordon, MD Professor of Medicine Wayne State University School
More informationSAVINO BRUNO, MD Director Internal Medicine and Hepatology Unit AO Fatebenefratelli e Oftalmico, Milano
SAVINO BRUNO, MD Director Internal Medicine and Hepatology Unit AO Fatebenefratelli e Oftalmico, Milano Market wheretelaprevir has not yet launched Victrelis is still launching January 29 th 214 Developed
More informationClinical Applications of Resistance Stuart C. Ray, MD
Clinical Applications of Resistance Stuart C. Ray, MD Professor of Medicine and Oncology Director, Infectious Diseases Fellowship Training Program Johns Hopkins University School of Medicine Disclosures
More information