Significance of Hepatitis C. The Evolving Burden of Hepatitis C. The Bad News... The Good News... Chronic Hepatitis C Can be Cured
|
|
- Randolph Hicks
- 6 years ago
- Views:
Transcription
1 Journée scientifique de l'arl Yverdon, 24 mars 2011 Darius Moradpour Service de Gastroentérologie et d'hépatologie Centre Hospitalier Universitaire Vaudois Université de Lausanne Significance of Hepatitis C million chronically infected individuals worldwide 1% of the population in Northern Europe Most common cause of chronic, liver cirrhosis and HCC in the West Most common indication to liver transplantation Evolving treatment options Peak of disease burden expected ~2020 The Bad News... Chronic C is frequent, and the peak of disease burden is yet to be reached The Good News... Chronic C can be cured, even without IFN-α The Evolving Burden of Hepatitis C Prevalence Infections per 100, % 1.5% 1.0% 0.5% Incidence Overall prevalence 0.0% Infected > 20 years Adapted from Armstrong GL et al. Hepatology 2000;31: Chronic Hepatitis C Can be Cured n = 344 patients with SVR 1 median f/u 3.3 years SVR durable in 100% n = 1343 patients with SVR 2 mean f/u 3.9 years SVR durable in > 99% Davis GL et al. Gastroenterology 2010;138: Maylin S et al. Gastroenterology 2008;135: Swain MG et al. Gastroenterology 2010;139:
2 Natural History of Hepatitis C Acute Chronic Cirrhosis HCC EASL ILC. Berlin, March 30-April 3, 2011 Gut 2011, in press % 2-20% 1-6% / yr Based on NIH Consensus Statement. Hepatology 2002;36 (Suppl 1):S2-S20, AASLD Practice Guideline. Hepatology 2009;49: , and EASL Clinical Practice Guideline. J Hepatol 2011, in press. Cofactors of Disease Progression Acute Chronic Co-infections Alcohol Cirrhosis NAFLD HCC Smoking Gender Immunosuppression Age 50-80% 2-20% 1-6% / yr Chronic Hepatitis C Role of Liver Biopsy Grading Staging Recognition or exclusion of cofactors Molecular profiling Reviewed in Missiha SB et al. Gastroenterology 2008;134: Bihl F et al. Rev Med Suisse 2010;6: Chronic Hepatitis C Current Standard Therapy Chronic Hepatitis C Response-Guided Therapy Genotype 1 PEG-IFN-α 1 + RBV mg/d for 48 wks Early virological response (EVR): 2 log drop of viremia at week 12 Genotypes 2 and 3 PEG-IFN-α 1 + RBV mg/d for 24 wks 1 PEG-IFN-α2a 180 µg/wk PEG-IFN-α2b 1.5 µg/kg/wk mg/d in combination with PEG-IFN-α2b Marcellin P et al. J Hepatol 2007;47:
3 Monitoring of Antiviral Therapy in CHC Rapid virological response (RVR) HCV RNA negative at wk 4 Early virological response (EVR) HCV RNA negative at wk 12 Delayed virological response (DVR) > 2 log drop at wk 12 and negative at wk 24 Null response (NR) < 2 log drop at wk 12 Partial response (PR) > 2 log drop at wk 12 but detectable at wk 24 Breakthrough (BT) Reapparance of HCV RNA after virol. response EASL Clinical Practice Guideline. J Hepatol 2011, in press. Monitoring of Antiviral Therapy in CHC Based on EASL Clinical Practice Guideline. J Hepatol 2011, in press. wk 4 HCV Genotype 1 Response-Guided Therapy neg pos wk 12 baseline < 6 x 10 5 IU/ml baseline 6 x 10 5 IU/ml < 2 log drop stop neg 48 wks > 2 log drop wk 24 pos neg 24 wks 48 wks stop 72 wks IL28B EASL Clinical Practice Guideline. J Hepatol 2011, in press. Genetic Polymorphisms Near IL28B Determine Response to PEG-IFN-α and RBV Ge D et al. Nature 2009;461: Suppiah V et al. Nat Genet 2009;41: Tanaka Y et al. Nat Genet 2009;41: Rauch A et al. Gastroenterology 2010;138: Ge D et al. Nature 2009;461:
4 Type I and Type III IFNs Use a Similar Intracellular Signaling Pathway Chronic Hepatitis C Therapy 2011 Broad distribution Epithelial expression 50% cured by current therapy 50% resistant to current therapy Response-guided therapy New antiviral strategies O'Brien TR. Nat Genet 2009;41: Hepatitis C Virus Life Cycle Description of non-a, non-b Delineation of HCV genome organization and polyprotein processing First infectious clone of HCV constructed Replicon system established Production of recombinant infectious HCV in tissue culture 2009 Identification of HCV First three-dimensional structure of an HCV protein (NS3-4A serine protease) Interferon-α and ribavirin combination therapy Proof-of-concept clinical studies of an HCV protease inhibitor IL28B genetic polymorphisms determine treatment outcome Adapted from Moradpour D et al. Nat Rev Microbiol 2007;5: Moradpour D, Penin F and Rice CM. Nat Rev Microbiol 2007;5: Novel Antiviral Strategies Membrane Association of HCV Proteins Entry inhibitors RNA interference Antisense strategies Antagomirs IRES inhibitors Structural Nonstructural Immunotherapy Antifibrotic therapy Vaccines Protease inhibitors Helicase inhibitors Polymerase inhibitors NS5A inhibitors Assembly module Replication module Assembly inhibitors Host factors Moradpour D et al. In: Zakim and Boyer's HEPATOLOGY. 6 th ed. In press. 4
5 Nonstructural Protein 3-4A: The Swiss Army Knife of Hepatitis C Virus The HCV NS3-4A Complex Morikawa K et al. J Viral Hepat 2011, in press. Yao N et al. Structure 1999;7: Sensing of Viral RNA Membrane Association of the NS3-4A Complex TLR3 NS3 5'-ppp RIG-I TBK1 TRIF IKKε MAVS IRF-3 IFN-β Brass V et al. Proc Natl Acad Sci USA 2008;105: '-ppp IKKε IRF-3 Huh-7.5 Replicon Replicon Hepatitis C FL C RIG-I TBK1 Control TLR3 TRIF MAVS Cleavage in Patients with Hepatitis C Huh-7.5 Disruption of Innate Immune Responses by NS3-4A MAVS = Cardif = VISA = IPS-1 β-act MAVS IFN-β HCV NS3-4A Li K et al. PNAS 2005;102:2992. Meylan E et al. Nature 2005;437:1167. Bellecave P, Sarasin-Filipowicz M et al. Hepatology 2010;51: Pantxika Bellecave 5
6 NS3-4A Protease Inhibitors NS3-4A Protease Inhibitors Median HCV RNA (Log10 IU/mL) Macrocyclic Placebo VX mg q8h VX mg q8h Linear VX mg q12h 7 Mean 4.4 log decline 4/8 HCV RNA <30 IU/ml Study time (in days) Structures courtesy of Steve W. Ludmerer Reesink HW et al. Gastroenterology 2006;131: NS3-4A Protease Inhibitors Sarrazin C et al. Gastroenterology 2007;132: Telaprevir Phase II Trials PROVE-2 PROVE-3 n = 323 tx-naïve n = 453 tx-experienced Hézode C et al. N Engl J Med 2009;360: McHutchison JG et al. N Engl J Med 2010;362: Hézode C et al. N Engl J Med 2009;360: HCV Nonstructural Protein 5A Penin F et al. J Biol Chem 2004:279: Penin F et al. J TL BioletChem 2004:279: Tellinghuisen al. Nature 2005;435: Moradpour D et 2005;42: Tellinghuisen TLal. ethepatology al. Nature 2005;435:
7 HCV Host Factor Interaction Network Cyclophilin A PI4KIIIα DGAT1... Gao M et al. Nature 2010;465: Li Q et al. Proc Natl Acad Sci USA 2009;106: Cyclophilin binding Cyclophilin Inhibitors CsA Alisporivir (Debio 025) Antiviral Effect of Alisporivir HCV RNA (log10 cp/ml) Treatment (n=3) (n=16) Alisporivir Placebo Calcineurin binding Paeshuyse J et al. Hepatology 2006;43: Inoue K et al. Hepatology 2007;45: T i m e ( D a y s ) Flisiak R et al. Hepatology 2008;47: Flisiak R et al. Hepatology 2009;49: Combinations Mericitabine BMS GS9190 Caspase inh. BI GS9256 Danoprevir BMS Albuferon Taribavirin BI HCV Pipeline Preclinical Phase I Phase II Phase III Filed Telaprevir Boceprevir Vaniprevir GS9256 Danoprevir TMC435 NS3-4A Protease Inhibitors MK5172 BI BMS ABT450 ACH1625 BMS Features of HCV DAA Efficacy Genotype independence Barrier to resistance NS3-4A PI NS5A inhibitors Nitazoxanide PEG-IFN-λ Alisporivir BMS NS5B polymerase NI Others Mericitabine BI Filibuvir PSI7977 GS9190 AZ07259 NS5A Inhibitors NS5B polymerase NNI NS5B Polymerase Inhibitors 7
8 Combination Therapy Telaprevir Phase III Trials ADVANCE REALIZE Ribavirin PEG-IFN-α PI N(N)I or NS5A-I n = 1088 tx-naïve (21% F3/F4) n = 662 tx-experienced Inspired by Stefan Zeuzem Jacobson IM et al. AASLD Hepatology 2010;52 Suppl:427A. Zeuzem S et al. EASL J Hepatol 2011;54 Suppl, in press. Boceprevir Phase II and III Trials SPRINT-1 n = 520 tx-naïve Cohort 1 (non-black) SPRINT-2 Cohort 2 (black) n = tx-naïve (10% F3/F4) Kwo P et al. Lancet 2010;376: Poordad F et al. AASLD Hepatology 2010;52 Suppl:107A. Key Points Consider the natural history of C Correct treatment indication crucial ("Treat the disease, not the infection!") Triple therapy will become standard for patients with genotype 1 in 2011/2012 TVR and BOC increase SVR rates to 75% with shortened treatment duration in ~½ Advances will come at the expense of new adverse effects and increased cost Key Points Antiviral therapy will become much more complex (patient selection, adherence, treatment milestones, adverse effect management, resistance issues,...) Acute Management of Hepatitis C Chronic Cirrhosis HCC IL28B genotyping and subtyping for genotype 1 likely to become clinical practice No data in patients with high unmet need (coinfections, decompensated cirrhosis, post-olt recurrence,...) Prevention Antiviral therapy LT HCC surveillance Cofactors 8
Outline. Outline. Natural History of Hepatitis C. Significance of Hepatitis C. Hepatitis C at a crossroads
79 ème Assemblée Annuelle de la SSMI Lausanne, 11-13 mai 2011 Outline Darius Moradpour Service de Gastroentérologie et d'hépatologie Centre Hospitalier Universitaire Vaudois Université de Lausanne Outline
More informationAntiviral agents in HCV
Antiviral agents in HCV : Upcoming Therapeutic Options Su Jong Yu, M.D., Ph.D. Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine Estimated 170 Million
More informationThe HCV pipeline: Will IFN-free treatment be possible? Heiner Wedemeyer. Hannover Medical School Germany
: Will IFN-free treatment be possible? Heiner Wedemeyer Hannover Medical School Germany Interferon-free regimens to treat hepatitis C What should be the goal of interferon-free treatment regimens: Sustained
More informationProtease inhibitor based triple therapy in treatment experienced patients
Protease inhibitor based triple therapy in treatment experienced patients Universitätsklinikum Leipzig Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber
More informationHow to optimize current therapy for GT1 patients Shortened therapy with IFNa-based therapy
How to optimize current therapy for GT1 patients Shortened therapy with IFNa-based therapy Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber- und Studienzentrum
More informationDirect acting anti-virals: the near future
Direct acting anti-virals: the near future Heiner Wedemeyer Hannover Medical School Germany Will IFN-free treatment be possible in the near future? Interferon-free regimens to treat hepatitis C What should
More informationNew Therapies on the Horizon in Hepatitis C Patients Paul Y. Kwo, MD
Viral Targets for HCV New Therapies on the Horizon in Hepatitis C Patients Paul Y. Kwo, MD Sites for development of inhibitors Metalloproteinase Serine protease (trans) Core E E2 NS2 NS3 NS4a/NS4b NS5a/NS5b
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 informationNew Therapeutic Strategies: Polymerase Inhibitors
New Therapeutic Strategies: Polymerase Inhibitors 6th Paris Hepatitis Conference 14 th - 15 th January, 2013 Stefan Zeuzem Goethe University Hospital Frankfurt, Germany Direct antiviral targets C E1 E2
More informationHepatitis C Therapy Falk Symposium September 20, 2008
Hepatitis C Therapy Falk Symposium September 20, 2008 Ira M. Jacobson, MD Vincent Astor Professor of Clinical Medicine Chief, Division of Gastroenterology and Hepatology Medical Director, Center for the
More informationPrise en charge actuelle de l'hépatite C et nouvelles approches thérapeutiques
Prise en charge actuelle de l'hépatite C et nouvelles approches thérapeutiques Future Complications of Darius Moradpour Service de Gastro-entérologie et d'hépatologie Centre Hospitalier Universitaire Vaudois
More informationChanging Direction Towards More Effective HCV Treatment
Changing Direction Towards More Effective HCV Treatment By: Prof.Dr.Abdel fattah Hanno Professor of Tropical Medicine Alexandria Faculty of Medicine The most common disease in the world HCV infects almost
More informationABCs of Hepatitis C: What s New. The Long-Awaited New Era: Protease Inhibitors for HCV Genotype 1
ABCs of Hepatitis C: What s New ACG Postgraduate Course Washington, DC October 30, 2011 Ira M. Jacobson, M.D. Vincent Astor Professor of Medicine Chief, Division of Gastronterology and Hepatology Medical
More informationOral combination therapy: future hepatitis C virus treatment? "Lancet Oct 30;376(9751): Oral combination therapy with a nucleoside
Author manuscript, published in "Journal of Hepatology 2011;55(4):933-5" DOI : 10.1016/j.jhep.2011.04.018 Oral combination therapy: future hepatitis C virus treatment? Commentary article on the following
More informationThe role of triple therapy with protease inhibitors in hepatitis C virus genotype 1na «ve patients
The role of triple therapy with protease inhibitors in hepatitis C virus genotype 1na «ve patients David R. Nelson Clinical and Translational Science Institute, University of Florida, FL, USA Liver International
More informationLes Inhibiteurs de Protéase du VHC
Les Inhibiteurs de Protéase du VHC Pr Jean-Michel Pawlotsky National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital University of Paris-Est
More informationHCV MEDICATIONS & Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati
HCV MEDICATIONS & THERAPEUTIC TRIALS Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati DISCLOSURES Active or Within 12 Months Research
More informationHepatitis C Resistance Associated Variants (RAVs)
Hepatitis C Resistance Associated Variants (RAVs) Atif Zaman, MD MPH Oregon Health & Science University Professor of Medicine Division of Gastroenterology and Hepatology Nothing to disclose Disclosure
More informationThe Changing World of Hepatitis C
The Changing World of Hepatitis C Alnoor Ramji Gastroenterology & Hepatology Clinical Associate Professor Division of Gastroenterology University Of British Columbia St. Paul s Hospital Site Disclosures
More informationClinical Cases Hepatitis C Naïve Patients. Rafael Esteban Liver Unit. Hospital General Universitari Vall Hebron. Barcelona.
Clinical Cases Hepatitis C Naïve Patients Rafael Esteban Liver Unit. Hospital General Universitari Vall Hebron. Barcelona. Case study 1 27 year old woman, Diagnosed with Chronic Hepatitis C 3 years ago
More informationASSAYS UTILZIED TO MONITOR HCV AND ITS TREATMENT
ASSAYS UTILZIED TO MONITOR HCV AND ITS TREATMENT Mitchell L Shiffman, MD Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, VA Liver Institute of Virginia Education, Research
More informationBest of AASLD 2010 For IAGH. April 2011 Reza Malekzadeh M.D. AGAF Professor of Medicne DDRC/TUMS
Best of AASLD 2010 For IAGH April 2011 Reza Malekzadeh M.D. AGAF Professor of Medicne DDRC/TUMS DAAs Direct-Acting Antivirals Understanding of HCV life cycle Identification of potential targets of antivirals
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 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 informationTratamiento de la Hepatitis C Rafael Esteban Hospital General Universitario Valle de Hebrón Barcelona
Tratamiento de la Hepatitis C Rafael Esteban Hospital General Universitario Valle de Hebrón Barcelona rrent HCV Therapy 8% % sustained response 6% 4% 2% % 54-61% 41% 34% 25% 16% 6% IFN 24w IFN 48w Peg
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 informationHepatitis C: Aplicaciones Clínicas de la Resistencia. Eva Poveda Division of Clinical Virology INIBIC-Complexo Hospitalario Universitario de A Coruña
Hepatitis C: Aplicaciones Clínicas de la Resistencia Eva Poveda Division of Clinical Virology INIBIC-Complexo Hospitalario Universitario de A Coruña DAA agents approved or in more advanced stages of clinical
More informationInfection with hepatitis C virus (HCV) is a global health concern,
Advances in the Treatment of Hepatitis C Virus Infection Arun B. Jesudian, MD, Maya Gambarin-Gelwan, MD, and Ira M. Jacobson, MD Dr. Jesudian is a Clinical Fellow, Dr. Gambarin-Gelwan is an Assistant Professor
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 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 informationHepatitis C Virus Treatments: Present and Future
Hepatitis C Virus Treatments: Present and Future Charles D. Howell, M.D., A.G.A.F Professor of Medicine University of Maryland School of Medicine Baltimore, MD Charles Howell Disclosures Boehringer Ingelheim,
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 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 informationTreating HCV Genotype 2 & 3
Treating HCV Genotype 2 & 3 3rd Workshop on HCV Therapy Advances, Rome 14.12.2013 Christoph Sarrazin Klinikum der J. W. Goethe-Universität Frankfurt am Main, Germany HCV Genotypes 2 & 3 Laurel and Hardy
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 informationROLE OF IL28B AND ITPA POLYMORPHISMS IN DIFFERENT GENOTYPES OF HCV
ROLE OF IL28B AND ITPA POLYMORPHISMS IN DIFFERENT GENOTYPES OF HCV (Especially HCV-6) WK Seto Clinical Assistant Professor Department of Medicine Queen Mary Hospital The University of Hong Kong HCV GENOTYPES:
More informationPersonalizzazione della Cura in Epatologia. Epatite Cronica C: Pazienti con Genotipo 2
Monotematica AISF 213 Personalizzazione della Cura in Epatologia Pisa, 17-19 Ottobre 213 Epatite Cronica C: Pazienti con Genotipo 2 Maria Grazia Rumi U.O. Epatologia, Ospedale San Giuseppe Università degli
More informationHCV eradication with direct acting antivirals (DAAs)?
HCV eradication with direct acting antivirals (DAAs)? Emilie Estrabaud Service d Hépatologie et INSERM UMR1149, AP-HP Hôpital Beaujon, Paris, France. emilie.estrabaud@inserm.fr HCV eradication with direct
More informationMany promising small molecule inhibitors directed
GASTROENTEROLOGY 2012;142:1351 1355 Will Interferon-Free Regimens Prevail? Christoph Welsch Stefan Zeuzem Department of Internal Medicine I, J. W. Goethe University Hospital, Frankfurt/Main, Germany Many
More informationResistencias & Epidemiología. Eva Poveda Division of Clinical Virology INIBIC-Complexo Hospitalario Universitario de A Coruña
Resistencias & Epidemiología Eva Poveda Division of Clinical Virology INIBIC-Complexo Hospitalario Universitario de A Coruña Rapid Evolution of HCV Regimens: Easier to take/tolerate, Short Duration, Pangenotypic,
More informationTreatment Targets HCV Genotype 1 & PIs Treating HCV G2&3 Future Therapies. Advances in treatment of HCV Dr John F Dillon
Treatment Targets HCV Genotype 1 & PIs Treating HCV G2&3 Future Therapies Advances in treatment of HCV Dr John F Dillon Disclosure slide I have received consulting fees and Honoraria from MSD, Abbott,
More informationNew Antiviral Therapy for HCV: Progress Toward Cure
New Antiviral Therapy for HCV: Progress Toward Cure Raymond T. Chung, MD Director of Hepatology Vice Chief, GI Unit MGH Worldwide Prevalence of HCV HCV Genomic Organization 5 UTR region 9.6 kb RNA 3 UTR
More informationVirological Tools and Monitoring in the DAA Era
Virological Tools and Monitoring in the DAA Era Prof. Jean-Michel Pawlotsky, MD, PhD National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital
More informationCurrent Standard of Care for Naïve HCV Patients (SVR)
Hepatitis C: Non-responders Nikunj Shah, MD Associate Professor of medicine University of Illinois Medical center 1 Current Standard of Care for Naïve HCV Patients (SVR) 1 8 8 6 53 45 4 6 52 46 4 2 2 Peg
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 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 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 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 informationHepatitis C: Management of Previous Non-responders with First Line Protease Inhibitors
Hepatitis C: Management of Previous Non-responders with First Line Protease Inhibitors Fred Poordad, MD The Texas Liver Institute Clinical Professor of Medicine University of Texas Health Science Center
More informationManagement of CHC G1 patients who are relapsers or non-responders to Peg IFN and RBV therapy: Wait or Triple Therapy?
Management of CHC G1 patients who are relapsers or non-responders to Peg IFN and RBV therapy: Wait or Triple Therapy? Prof. Teerha Piratvisuth NKC Institute of Gastroenterology and Hepatology Prince of
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: Racial Disparities. Charles D. Howell, M.D., A.G.A.F Professor of Medicine University of Maryland School of Medicine Baltimore, MD
HCV: Racial Disparities Charles D. Howell, M.D., A.G.A.F Professor of Medicine University of Maryland School of Medicine Baltimore, MD Charles Howell Disclosures Research Grants Boehringer Ingelheim, Inc.
More informationOptimal Treatment with Boceprevir. Michael Manns
Optimal Treatment with Boceprevir Michael Manns 6th Paris Hepatitis Conference, 14th January 2013 Acknowledgements Benjamin Maasoumy Optimal Patient Selection Defining the Ideal Candidate Treatment Urgency
More informationTriple therapy with telaprevir or boceprevir: management of side effects
Triple therapy with telaprevir or boceprevir: management of side effects Universitätsklinikum Leipzig Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber
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 informationTreatment Options in HCV Relapsers and Nonresponders. Raymond T. Chung, M.D.
Session IV Treatment Options in HCV Relapsers and Nonresponders Raymond T. Chung, M.D. Director of Hepatology, Massachusetts General Hospital, Associate Professor of Medicine, Harvard Medical School, Boston,
More informationAdvances in Hepatitis C Virus Therapeutics HBV HIV HCV. Advances in HCV Therapeutics. Greg Dore. Viral Hepatitis Clinical Research Program
Advances in Hepatitis C Virus Therapeutics Greg Dore Viral Hepatitis Clinical Research Program National Centre in HIV Epidemiology and Clinical Research Hepatitis C notifications: 199-23 Estimates of BBV
More informationVicente Soriano Department of Infectious Diseases
Predictors of Response to Hepatitis C Therapy Vicente Soriano Department of Infectious Diseases Hospital Carlos III, Madrid, Spain Diagnosis Therapy IL28B alleles Non-invasive liver fibrosis methods Viral
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 informationTransformation of Chronic Hepatitis C Treatment
Transformation of Chronic Hepatitis C Treatment UVHS, Adana, 22 May 2015 Christoph Sarrazin Goethe-University Hospital Frankfurt am Main Germany Epidemiology of HCV Infection Global Global HCV Prevalence
More informationPharmacological management of viruses in obese patients
Cubist Pharmaceuticals The Shape of Cures to Come Pharmacological management of viruses in obese patients Dr. Dimitar Tonev, Medical Director UKINORD 1 Disclosures } The author is a pharmaceutical physician
More informationPredictors of Response to Hepatitis C Therapy in the DAA Era. Pablo Barreiro Servicio de Enfermedades Infecciosas Hospital Carlos III, Madrid
Predictors of Response to Hepatitis C Therapy in the DAA Era Pablo Barreiro Servicio de Enfermedades Infecciosas Hospital Carlos III, Madrid Why Predicting HCV Response? Select candidates for therapy Prioritizing
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 informationHep C U Later. GP CME Rotorua Ed Gane NZ Liver Transplant Unit
Hep C U Later GP CME Rotorua 2012 Ed Gane NZ Liver Transplant Unit GP CME Rotorua 2012 Hepatitis C Facts 200 million HCV+ worldwide»>50,000 HCV+ New Zealanders >90% from recreational injecting drug use»peak
More informationTreatment of chronic hepatitis C genotype 1 with triple therapy comprising telaprevir or boceprevir
Published 24 February 2012, doi:10.4414/smw.2012.13516 Cite this as: Treatment of chronic hepatitis C genotype 1 with triple therapy comprising telaprevir or boceprevir Swiss Association for the Study
More informationViral dynamics and Resistance Implications for HCV drug development
Viral dynamics and Resistance Implications for HCV drug development Robert T. Schooley, M.D. University of California, San Diego June 23, 2011 SVR Rate Priorities in HCV Therapeutics 100 90 80 70 60 50
More informationNovember 2013 AASLD Investor Event 4 November
November 2013 AASLD Investor Event 4 November Maris Hartmanis, President and CEO Charlotte Edenius, EVP Development Bertil Samuelsson, CSA Rein Piir, EVP Corporate Affairs & IR Corporate presentation,
More informationCurrent Treatment Options for HCV Patients. Michael Manns Dept. of Gastroenterology, Hepatology and Endocrinology Hannover Germany
Current Treatment Options for HCV Patients Michael Manns Dept. of Gastroenterology, Hepatology and Endocrinology Hannover Germany 7th International Congress of Internal Medicine of Central Greece, Larissa,
More informationHCV Resistance Associated variants: impact on chronic hepatitis C treatment
HCV Resistance Associated variants: impact on chronic hepatitis C treatment Dr. Stéphane Chevaliez Associate Professor of Medicine at the University of Paris-Est. History of Resistance in HCV Concern Only
More informationDisclosures 29/09/2014. Genetic determinants of. HCV treatment outcome. IDEAL: IL28B-type is the strongest pre-treatment predictor of SVR
29/9/214 Genetic determinants of ᴧ HCV treatment outcome Disclosures Advisory board member - Gilead, Abbvie, Bristol-Myers Squibb (BMS), Janssen, Merck, and oche Speaker - Gilead, Janssen, Merck, BMS,
More informationSpecifically Targeted Antiviral Therapy (STAT-C) for Patients With Chronic Hepatitis C
Specifically Targeted Antiviral Therapy (STAT-C) for Patients With Chronic Hepatitis C Zobair M. Younossi, MD, MPH, FACP, FACG Medscape Gastroenterology. 2007; 2007 Medscape Posted 06/01/2007 Introduction
More informationHepatitis C Management and Treatment
Hepatitis C Management and Treatment Kaya Süer Near East University Faculty of Medicine Infectious Diseases and Clinical Microbiology 1 Discovery of Hepatitis C Key facts Hepatitis C: the virus can cause
More informationAntiviral treatment in HCV cirrhotic patients on waiting list
Antiviral treatment in HCV cirrhotic patients on waiting list Krzysztof Tomasiewicz Department of Hepatology and Infectious Diseases Medical University of Lublin, Poland Disclosures Consultancy/Advisory
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 informationClinical Pharmacology of DAA s for HCV: What s New and What s in the Pipeline
Clinical Pharmacology of DAA s for HCV: What s New and What s in the Pipeline Anita Mathias, PhD Clinical Pharmacology, Gilead Sciences 14 th Int. Workshop on Clinical Pharmacology of HIV Therapy April
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 informationNew Treatments for Chronic Hepatitis C. Rafael Esteban Hospital Valle Hebron. Barcelona Spain
New Treatments for Chronic Hepatitis C Rafael Esteban Hospital Valle Hebron. Barcelona Spain The present: a complex treatment with a better SVR Genotype 1 Genotypes 2 and 3 Triple therapy Boceprevir (BOC)
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 informationThe Egyptian Plan to Cure HCV
The Egyptian Plan to Cure HCV Gamal Esmat Professor of Endemic Medicine & Hepatology Vice President of Cairo University for Graduate Studies and Research Disclosure Advisory Committee Board Member : MSD,
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 informationInterferon Side Effects and The Future of Interferon Sparing Regimens. Todd Wills, MD ETAC Infectious Disease Specialist
Interferon Side Effects and The Future of Interferon Sparing Regimens Todd Wills, MD ETAC Infectious Disease Specialist HEPATITIS C TREATMENT EXPANSION INITIATIVE MULTISITE CONFERENCE CALL FEBRUARY 15,
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 informationةي : لآا ةرقبلا ةروس
سورة البقرة: اآلية HCV RELAPSERS AND NONRESPONDERS: How to deal with them? BY Prof. Mohamed Sharaf-Eldin Prof. of Hepatology and Gastroenterology Tanta University Achieving SVR The ability to achieve a
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 informationOptimal ltherapy in non 1 genotypes:
Optimal ltherapy in non 1 genotypes: genotype 2 and 3 patients Antonio Craxì GI & Liver Unit, Di.Bi.M.I.S. University of Palermo, Italy craxanto@unipa.it Peg IFN alpha plus ribavirin : SVR rate of >80%
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 informationShould Elderly CHC Patients (>70 years old) be Treated?
Should Elderly CHC Patients (>70 years old) be Treated? Deepak Amarapurkar Consultant Gastroenterologist & Hepatologist Bombay Hospital & Medical Research Center, Mumbai & Jagjivanram Western Railway Hospital,
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 informationHow to optimize treatment for HCV Genotype 4
How to optimize treatment for HCV Genotype 4 Paris Hepatitis Conference Pr Tarik Asselah 14 janvier 2014 MD, PhD Service d Hépatologie & INSERM U773 University Paris Diderot Hôpital Beaujon, Clichy tarik.asselah@bjn.aphp.fr
More informationClinical Сase A previously relapse to PEG IFN + RBV in HCV G3a patient. Konstantin Zhdanov
Clinical Сase A previously relapse to PEG IFN + RBV in HCV G3a patient Konstantin Zhdanov Genotype 3 in Europe Canada Norway Germany Sweden Czech Republic Poland Approximately 1/3 of HCV-infected patients
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 informationHepatitis C: Management of Treatment Naïve Patients with First Line Protease Inhibitors
Hepatitis C: Management of Treatment Naïve Patients with First Line Protease Inhibitors Eric Lawitz, MD, AGAF, CPI The Texas Liver Institute Clinical Professor of Medicine University of Texas Health Science
More informationGareth Tudor-Williams
DEBATE! HCV + HIV co-infected children in Russia should be treated now Gareth Tudor-Williams Children and HIV: Problems and Prospects St. Petersburg Russia 26 th Sept 2014 Dr. José Tomás Ramos Amador One
More informationWe have now entered a new era in hepatitis C
Will IL28B Polymorphism Remain Relevant in the Era of Direct-Acting Antiviral Agents for Hepatitis C Virus? Alexander J. Thompson 1,2,3 and John G. McHutchison 4 See Editorial on Page 5 We have now entered
More informationMassimo Puoti Dept. of Infectious Diseases AO Ospedale Niguarda Cà Granda
Massimo Puoti Dept. of Infectious Diseases AO Ospedale Niguarda Cà Granda Innovative strategies in viral hepatitis : Hepatitis C: Interferon and/or Ribavirin free regimens 10th International Workshop on
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 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 informationCurrent Treatments for HCV
Current Treatments for HCV Mitchell L. Shiffman, MD, FACG Advisory Committee/Board Member: Achillion, Anadys, Boehringer-Ingelheim, BMS, Conatus, Genentech, Gen-Probe, Gilead, Globeimmune, GSK, Janssen,
More informationNorth Africa) The prevalence of CHB varies widely across EMEA (Europe, Middle East & 8% High 2 8% Intermediate <2% Low
The prevalence of CHB varies widely across EMEA (Europe, Middle East & North Africa) 8% High 2 8% Intermediate
More informationInterferon-Based Therapy for Chronic Hepatitis C : Present and Future Perspectives
TAJ December 2008; Volume 21 Number 2 ISSN 1019-8555 The Journal of Teachers Association RMC, Rajshahi Review Article Interferon-Based Therapy for Chronic Hepatitis C : Present and Future Perspectives
More information