Access to HCV treatment in Egypt
|
|
- Posy Palmer
- 6 years ago
- Views:
Transcription
1 Access to HCV treatment in Egypt Prof. Gamal Esmat Prof. Hepatology &Vice President of Cairo University, Egypt Member of WHO Strategic Committee for Viral Hepatitis
2 Global genotype distribution
3 Egyptian National Control Strategy for Viral Hepatitis April 2008 Arab Republic of Egypt, Ministry of Health and Population National Committee for the Control of Viral Hepatitis
4 Objectives National Survey Availability of treatment Awareness and Media Campaign Infection Control Research
5 National Survey 2008(DHS) Population-level surveys to ascertain national prevalence rates that can be broken down by age, sex, and region Household survey in 28 governorates. Total of 12,780 women and men aged consented to blood sampling. ELISA test used to determine presence of antibodies. Real time PCR testing for HCV RNA for all antibody positive samples to detect active infections.
6 Prevalence of HCV in Egypt Socioeconomic characteristic Urban-rural residence Urban Rural Place of residence Urban Governorates Lower Egypt Urban Rural Upper Egypt Urban Rural Frontier Governorates Education No education Some primary Primary complete/some secondary Secondary complete/higher Wealth quintile Lowest Second Middle Fourth Highest HCV antibody positive, % Total 14.7 El-Zanaty F & Way A. Egypt Demographic & Health Survey 2008
7 HCV Egypt 2008 Overall Prevalence 14% Women 2008 Men 2008
8 Total Number of HCV Positive Cases in ,244,604 5,839,102 6,008,993 4,379,326 HCV all cases AB chronic HCV HCV PCR
9 40 HCV Prevalence National Surveys 1996 vs 2008 Women Ys 35 Women 1966 Women
10 60 50 HCV Prevalence National Surveys 1996 vs 2008 Men Ys Men 1996 Men
11 Egyptian Strategy for HCV Control Nile River in Cairo
12 PEG INF Cost Per Course (MSF)
13 Opening of 23 national treatment centres, Total number of patients treated with PEG-IFN ( ): 350,000 Annual number of new patients treated: 45,000 Annual budget from the Ministry of Health: 90 million $
14 Percent Ministry of Health, Egypt National Committee for Control of Viral Hepatitis National HCV Treatment Program Response Rates of treated patients EVR Week 24 respone ETR SVR
15 National HCV treatment program: Positive outcomes Governmental appreciation of the magnitude of HCV problem in Egypt National guidelines for treatment of chronic HCV MOH and universities cooperation Treatment for more than 350,000patients >90% governmental funding Data to answer a lot of questions
16 Number of Patients with Hepatitis C in Egypt Current Incidence (2.5/1000) 16,000,000 12,000,000 8,000,000 4,000, Current therapy 50% Efficacy, 50,000/yr Current therapy 50% Efficacy, 100,000/yr DAA, 90% Efficacy, 250,000/yr Annual mortality assumed at: 50/100,000 Or 5/1000 for HCV positive patients
17 Number of Patients with Hepatitis C in Egypt 90% Reduction in Incidence (0.25/1000) 16,000,000 12,000,000 8,000,000 4,000, Current therapy 50% Efficacy, 50,000/yr Current therapy 50% Efficacy, 100,000/yr DAA, 90% Efficacy, 250,000/yr Annual mortality assumed at: 50/100,000 Or 5/1000 for HCV positive patients
18 HCV in EGYPT from Control to Elimination To decrease HCV prevalence to< 2 % in Egypt in 10 years(mathematical modeling) Effective treatment SVR > 90% Annual treatment of to patients Prioritize treatment early and to most frequent injectors
19 Elimination of HCV in Egypt Overcoming the Barriers Ideal drug Decrease incidence Mass treatment
20 % SVR 12 Summary of Currently Available Therapies for HCV G4 Triple Therapy with PEG-RBV Interferon Free DCV PEG-RBV wks SMV PEG-RBV Experienced wks SOF RBV 24-wks Naiive LED SOF 12 wks PAR/r-OMB RBV Naiive ASV+BCV+DCV 1. He zode C, et al. Gut, Moreno, C., et al. J Hepatol, 2014, 3. Lawitz, E., et al. N Engl J Med, Ruane P et al. EASL 2014, 5. Esmat G el al. AASLD 2014, 6. Kapoor et al. AASLD 2014, 7. Pol S. et al. Hepatology 2014
21 Esmat G. et al. AASLD 2014,J.Hepatology,April,2015 IFN-Free Therapy in Genotype 4 SOF + RBV in Treatment-Naïve and Experienced Egyptian Patients Naiive Randomized, open-label, multi-center study conducted in Egypt of the safety and efficacy of all-oral SOF + RBV in Egyptian patients with HCV GT 4, 103 patients Treatmentexperienced Treatmentnaive SOF+ RBV (n=25) SOF+ RBV (n=27) SOF + RBV (n=24) SOF + RBV (n=27) Week SOF 400 mg + Weight-based RBV dosing ( mg). Male (67%), cirrhosis (17%), 52% high viral load (>800,000 IU/ml), IL28B non-cc (81%) Overall wks 24 wks wks 24 wks Experienced Naïve patients, with <=F2 Fibrosis, low viral load (<600,000 IU): 100% SVR with 12 wks treatment wks 24 wks
22 Agreement with Gilead The course for 3 months will cost 900 $ instead of $ in USA. Manufactured outside Egypt but with different color(fda approved) and written on it(to be sold only in Egypt). Renewal of the agreement every year.
23 Ideal Drug It is important for patients treatment but more important for control and eradication of any infectious disease
24 Elimination of HCV in Egypt Overcoming the Barriers Ideal drug Decrease incidence Mass treatment
25 National Plan of Action: conclusions Increase policymakers commitment to supporting the policy change necessary to prevent viral hepatitis transmission. Educate healthcare workers to prevent transmission of viral hepatitis in Egypt. Increase public awareness of viral hepatitis prevention. Promote safe injection practices in the community. Egyptian National Plan of Action for the Preventton, Care & Treatment of Viral Hepatitis
26 Decrease incidence Blood safety. Avoid unneeded injection. Auto destructive syringes. Infection control. Media awareness. Case detection and treatment by Ideal drug
27 Quantifying Epidemic Severity in Egypt R0 theory R0: the expected number of secondary cases that an infected individual causes in a fully susceptible population during their entire infectious period. R0 of the untreated HCV epidemic in the Egyptian community is 3.50 (95% CI ). The treat early strategy would be more effective because it reduces transmission by timely treatment and decreases incidence..
28 High Injection Rate There is high heterogeneity in health care access in Egypt; 5% of the population takes more than 50% of all injections (2008 DHS). The epidemic is maintained by <5% of the population, consisting mostly of individuals with high injection rates. Prioritizing access to treatment early and by injection rate may be highly effective in reducing incidence.
29 Economic Burden of Hepatitis C in Egypt HCV infection is a huge economic burden in Egypt Direct healthcare cost EGP 3Bln Indirect economic impact of disability EGP 26Bln Intangible costs to society and families not assessed. Treatment of large numbers of patients with effective therapy is the only option for control Curing a patient saves EGP 50,000 for the next 15 years. Preventing a case saves EGP 120,000 for the next 40 years. One $ = 7.7 EGP. Waked, NLI.
30 Elimination of HCV in Egypt Overcoming the Barriers Ideal drug Decrease incidence Mass treatment
31 Mass Treatment Improving Access to Therapy in Egypt Availability of other DAA in Egypt by a reduced price like sofosbuvir. Implementation of national program for HCV screening. Increasing the treatment centers to be more than 50 centers this year. Simplification of the treatment guidelines aiming for faster evaluation and less investigations. Extension of treatment to all HCV PCR positive patients. Raising fund from NGOs for evaluation and treatment of HCV patients.
32 National HCV Treatment Program Real life experience National Committee for Control of Viral Hepatitis April 2015
33 No of patients registered on the NCCVH Portal since 18 Sep 2014 till 28 Feb 2015
34 Registry in first 3 days of NCCVH portal /09/ /09/ /09/2014
35
36 Week 4 viremia (n=7409) positive viremia, 627 negative viremia, %
37 Week 12 viremia (n=1958) ISVHLD 2015,P 149 positive viremia, 39 negative viremia, 1919
38 SVR of Triple Therapy In the multi-center national treatment program that started including patients in late October 2014, a total 21,318 patients(>f2) have started triple therapy with 12 weeks of SOF- PEG-RBV till June By the end of November 2014, 547 patients included, and have currently reached 12 weeks after the end of therapy. By end of treatment (week 12) 527 had HCV-RNA below level of quantification (15 IU.ml) (96.3%). Subsequently, 65 patients relapsed (11.9%), and by 12 weeks after end of treatment, 462 patients (84.5%) achieved SVR 12. Treatment experienced patients showed significantly lower SVR rate (153 of 194, 78.9%) compared to treatment naïve patients (309 of 353, 87.5%,OR 2.3, 95% CI p<0.01)..
39 NCCVH HCV Treatment Protocol Update, April 2015 Treatment will be available to all HCV PCR positive patients Regimens will be categorized as follows: IFN-based regimen: PegIFN alpha +Ribavirin (weight based; 1200 mg if 75 Kg or 1000 mg if < 75 Kg of body weight) +Sofosbuvir 400 mg/d for 12 weeks; basically received by INF-eligible patients
40 IFN-free regimens: Sofosbuvir 400 mg/d + Simeprevir 150 mg/d for 12 weeks. Basically received by IFN-ineligible patients. Sofosbuvir 400 mg/d + Ribavirin (weight based; 1200 mg if 75 Kg or 1000 mg if < 75 Kg of body weight) for 24 weeks received by organ transplant cases who have to receive specifically cyclosporine in their immunosupressive regimenr or any other drugs contraindicated with semiprevir
41 Philippa Easterbrook, MD, FRCP, MPH World Health Organization, Geneva Geoff A. Beckett, PA-C, MPH Centers for Disease Control and Prevention, Atlanta 15 June, 2015
42 Successes and opportunities 82,000 on DAAs since September 2014 Expansion from 26 to 32 treatment clinics High levels of commitment: National Committee Site clinical staff: High standards of medical clinic staff Clinics open until 6pm, three shifts, 6 days a week including during Ramadan. Achieved lowest negotiated drug costs worldwide. High profile treatment programme Well thought through (though complex) patient pathway Opportunity to develop a model for assessment of hepatitis treatment programmes National database with comprehensive dataset from largest patient population worldwide
43 Challenges and Threats Large and increasing patient volume requiring increased staff, space, clinics. Lack/loss of prioritisation of those with advanced disease Decompensated excluded Inequity in treatment access by geographic region No programmatic analysis of national database using key performance indicators along cascade of care, or feedback to sites. Delays in data entry: Requirement for live data entry; slow internet; Only 3 ports linked to server. Insufficient data entry staff and obstacles to recruitment Sub-optimal staging of liver disease: Discontinued Fibroscan; Fib-4 sub-optimal staging of liver disease. No routine clinical examination Multiple changes to protocols since start of programme. Multiple steps in patient pathway: Uncertainty over level of private prescribing of sofosbuvir and data capture
44 Conclusion We are looking to say Goodbye Interferon The ideal drug for treatment of HCV will be soon within our reach. ( oral, short duration, SVR >90%, minimal side effects and affordable) The ideal drug has an important role in prevention.
45
Real-life results of triple therapy with the combination of sofosbuvir-pegylated interferon-ribavirin for Egyptian patients with hepatitis C
Real-life results of triple therapy with the combination of sofosbuvir-pegylated interferon-ribavirin for Egyptian patients with hepatitis C Prof. Gamal Esmat Prof. Hepatology & Vice President of Cairo
More informationGenotype 4, finally cured? Imam Waked Professor of Medicine National Liver Institute
Genotype 4, finally cured? Imam Waked Professor of Medicine National Liver Institute Paris, January 12, 215 Disclosures Investigator, speaker, and advisory board member for: Roche, MSD, BMS, Gilead, Janssen,
More informationHCV Elimination in Egypt
HCV Elimination in Egypt Prof. Gamal Esmat Prof. Hepatology &Ex. Vice President of Cairo University, Egypt Member of WHO Strategic Committee for Viral Hepatitis www.gamalesmat.com Disclosure Slide Advisory
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 informationOvercoming barriers to access to hepatitis C treatment in a rapidly changing landscape
Overcoming barriers to access to hepatitis C treatment in a rapidly changing landscape HIV/AIDS Department and Global Hepatitis Programme Dr. Stefan Wiktor Outline Global Hepatitis Strategy New HCV treatment
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 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 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 informationDr. Siddharth Srivastava
Dr. Siddharth Srivastava MD, DM (Gastroenterology) Associate Professor GIPMER, New Delhi Rashtriya Gaurav Award 2013 for work on hepatitis B and C Set up Liver clinic at GIPMER and in charge EUS laboratory.
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 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 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 informationThe Egyptian HCV Control Program
The Egyptian HCV Control Program Wahid Doss, MD Professor of Hepatology,Cairo University Head, National Committee for control of Viral Hepatitis, Egypt Disclosure speaker interests Disclosure of speaker
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 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 informationNational Hepatitis C Elimination Program of Georgia
European Roundtable on Hepatitis Cure & Eradication 2015 9-10 September 2015, Frankfurt, Germany National Hepatitis C Elimination Program of Georgia Tengiz Tsertsvadze MD, PhD Director General Infectious
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 informationTreatment and Access to Drugs
Treatment and Access to Drugs Presenter: Co-leads: Peter Beyer & Philippa Easterbrook WHO Regional Advisor for South East Asia (SEARO): Razia Narayan Pendse Session Objectives By the end of this session,
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 informationLatest 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 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 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 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 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 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 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 informationPrior Authorization Guideline
Prior Authorization Guideline Guideline Name Sovaldi (sofosbuvir) Formulary UnitedHealthcare Community & State Formulary Note Approval Date 2/19/2014 Revision Date 7/8/2014 1. Indications Drug Name: Sovaldi
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 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 informationTreatment of HCV infection in daily clinical practice. Which are the optimal options for Genotypes 2 and 3? Jiannis Vlachogiannakos
Treatment of HCV infection in daily clinical practice. Which are the optimal options for Genotypes 2 and 3? Jiannis Vlachogiannakos Associate Professor of Gastroenterology Academic Department of Gastroenterology
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 information29th Viral Hepatitis Prevention Board Meeting
29th Viral Hepatitis Prevention Board Meeting Madrid, November 2006 Treatment of chronic hepatitis C José M. Sánchez-Tapias Liver Unit Hospital Clínic University of Barcelona Spain CHRONIC HEPATITIS C
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 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 Treatment in Oregon
The Hepatitis C Advisory Group, 12/21/2014 Hepatitis C Treatment in Oregon Introduction The rising health care burden of HCV infection in Oregon is occurring at this time of growing interest in containing
More informationAccess to Innovation: Hepatitis C and the Egyptian National Experience
Access to Innovation: Hepatitis C and the Egyptian National Experience Manal El Sayed Professor of Pediatrics Ain Shams University NCCVH, MOH (EGYPT) Stepwise Solution for LMIC (Real Life Experience) Data
More informationFINANCIAL DISCLOSURE
FINANCIAL DISCLOSURE People who work at NIH only dream about having financial disclosures Wait, this just in. The US government has now banned dreaming CRITICAL NON-FINANCIAL DISCLOSURES Nothing I say
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 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 informationNovel Combination Therapies for the Treatment of Patients with Genotype 1 Hepatitis C Public Meeting
Novel Combination Therapies for the Treatment of Patients with Genotype 1 Hepatitis C Public Meeting December 18, 2014 1 CTAF Overview Core program of the Institute for Clinical and Economic Review (ICER),
More informationBaseline and acquired viral resistance to DAAs: how to test and manage
Baseline and acquired viral resistance to DAAs: how to test and manage Round table discussion by Marc Bourliere, Robert Flisiak, Vasily Isakov, Mark Sulkowsky & Konstantin Zhdanov Prevalence of baseline
More informationPrior Authorization Guideline
Prior Authorization Guideline Guideline Name Olysio (simeprevir) Formulary UnitedHealthcare Community & State Formulary Note Approval Date 2/19/2014 Revision Date 7/9/2014 1. Indications Drug Name: Olysio
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 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 informationHCV TREATMENT PRE- AND POST TRANSPLANTATION
HCV TREATMENT PRE- AND POST TRANSPLANTATION Mitchell L. Shiffman, MD, FACG Medical Director Liver Institute of Virginia Bon Secours Health System Richmond and Newport News, VA, USA IVer Liver Institute
More informationHarvoni. Harvoni (ledipasvir & sofosbuvir) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.01.32 Subject: Harvoni Page: 1 of 9 Last Review Date: December 2, 2016 Harvoni Description Harvoni (ledipasvir
More informationHepatitis C: New Antivirals in the Liver Transplant Setting. Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona
Hepatitis C: New Antivirals in the Liver Transplant Setting Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona Patient survival Hepatitis C and Liver Transplantation Years after transplantation
More informationTreatment of Hepatitis C Recurrence after Liver Transplantation. Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona
Treatment of Hepatitis C Recurrence after Liver Transplantation Maria Carlota Londoño Liver Unit Hospital Clínic Barcelona Agenda 1. Introduction 2. Treatment options for hepatitis C recurrence after transplantation
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 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 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 informationDAAs in the era of decompensated liver disease. Piero L. Almasio University of Palermo
DAAs in the era of decompensated liver disease Piero L. Almasio University of Palermo piero.almasio@unipa.it HCV therapy in the era of interferon based therapy Priority Compensated cirrhosis Decompensated
More informationHepatitis C Update: What s New in 2017
Hepatitis C Update: What s New in 2017 Cody A. Chastain, MD Assistant Professor of Medicine Viral Hepatitis Program Division of Infectious Diseases Vanderbilt University Medical Center Cody.a.Chastain@Vanderbilt.edu
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 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 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 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 informationScaling up screening, diagnostic and treatments for people living with HCV in 2014?
Scaling up screening, diagnostic and treatments for people living with HCV in 2014? Isabelle Andrieux-Meyer, MD Médecins Sans Frontières Access Campaign WHO Technical Briefing Seminar November 6 th,2014
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 informationHEPATITIS C: UPDATE AND MANAGEMENT
HEPATITIS C: UPDATE AND MANAGEMENT José Franco, MD Professor of Medicine Associate Dean for Educational Improvement Associate Director, Kern Institute STAR Center Director José Franco, MD Disclosures I
More informationHow do you optimize HCV Treatment for Cirrhotic Patients APASL STC Cebu
How do you optimize HCV Treatment for Cirrhotic Patients APASL STC Cebu Seng Gee Lim Chairman, APASL Liver Week 2013 Professor of Medicine Dept of Gastroenterology and Hepatology NUHS, Singapore Disclosures
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 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 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 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 informationHepatitis C: How sick can we treat? Robert S. Brown, Jr., MD, MPH Vice Chair, Transitions of Care Interim Chief, Division of
Hepatitis C: How sick can we treat? Robert S. Brown, Jr., MD, MPH Vice Chair, Transitions of Care Interim Chief, Division of Gastroenterology & Hepatology www.livermd.org HCV in advanced disease In principle
More informationHCV Treatment in 2016: is there still a role for IFNa and ribavirin?
HCV Treatment in 2016: is there still a role for IFNa and ribavirin? Heiner Wedemeyer Hannover Medical School Germany 1 Disclosures Honoraria for consulting or speaking (last 5 years): Abbott, AbbVie,
More informationHarvoni. Harvoni (ledipasvir & sofosbuvir) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.03.32 Subject: Harvoni Page: 1 of 7 Last Review Date: December 3, 2015 Harvoni Description Harvoni (ledipasvir
More informationHarvoni. Harvoni (ledipasvir & sofosbuvir) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.01.32 Subject: Harvoni Page: 1 of 9 Last Review Date: March 18, 2016 Harvoni Description Harvoni (ledipasvir
More informationSOLAR-1 (Cohorts A and B)
Phase 2 Treatment Naïve and Treatment Experienced Ledipasvir-Sofosbuvir + RBV in HCV GT 1,4 and Advanced Liver Disease SOLAR-1 (Cohorts A and B) Charlton M, al. Gastroenterology. 2015; 149:649-59. Ledipasvir-Sofosbuvir
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 informationNational Clinical Guidelines for the treatment of HCV in adults. Version 3
National Clinical Guidelines for the treatment of HCV in adults Version 3 January 2017 Sponsors and Authorship The guidelines have been authored on behalf of the viral hepatitis clinical leads and MCN
More informationAbout the National Centre for Pharmacoeconomics
Cost effectiveness of sofosbuvir (in combination with either ribavirin or pegylated interferon + ribavirin) (Sovaldi ) for the treatment of hepatitis C infection The NCPE has issued a recommendation regarding
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 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 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 informationThe Dawn of a New Era: Hepatitis C
The Dawn of a New Era: Hepatitis C Naudia L. Jonassaint Assistant Professor of Medicine and Surgery University Pittsburgh School of Medicine December 1, 2015 Objectives After presentation the learner should
More informationHarvoni. Harvoni (ledipasvir & sofosbuvir) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Harvoni Page: 1 of 7 Last Review Date: June 19, 2015 Harvoni Description Harvoni (ledipasvir &
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 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 informationApproved regimens for cirrhotic patients
5th Workshop on HCV THERAPY ADVANCES New antivirals in clinical practice Approved regimens for cirrhotic patients Amsterdam, 4-5 december 2015 Disease burden in Spain 400000 350000 300000 F0 Peak cirrhosis
More informationELIMINATION OF VIRAL HEPATITIS IN ROMANIA LESSONS LEARNT AND THE WAY FORWARD
ELIMINATION OF VIRAL HEPATITIS IN ROMANIA LESSONS LEARNT AND THE WAY FORWARD 17 May 2018 Bucharest, Romania Organisers Associations Collaborating on Hepatitis to Immunize and Eliminate the Viruses in Europe
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 informationHCV treatment options in clinical practice. Current treatment options for HCV-G4
HCV treatment options in clinical practice Current treatment options for HCV-G4 C. Triantos Gastroenterology Department University Hospital of Patras Conflicts of interest Speaker and research/travel grants
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 informationManagement of Chronic HCV 2017 and Beyond
Management of Chronic HCV 2017 and Beyond Blaire E Burman, MD Virginia Mason Gastroenterology & Hepatology Relevant Disclosures No financial disclosures to report Leaning Objectives Burden of HCV Prevalence
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 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 informationHIV and HCV coinfection - Barriers in Central and Eastern Europe
HIV and HCV coinfection - Barriers in Central and Eastern Europe Jerzy Jaroszewicz Vice President of Polish Association for the Study of Liver Department of Infectious Diseases and Hepatology, Medical
More informationA Nation-wide Investigation of Real-World Community Effectiveness in HCV Treatment for Policy-making Toward Elimination of HCV by 2030 in Taiwan
A Nation-wide Investigation of Real-World Community Effectiveness in HCV Treatment for Policy-making Toward Elimination of HCV by 2030 in Taiwan MING-LUNG YU Distinguished Professor, Hepatobiliary Division,
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 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 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 informationRisk Factors for Hepatitis C Infection in a National Adult Population: Evidence from the 2008 Egypt DHS
Risk Factors for Hepatitis C Infection in a National Adult Population: Evidence from the 2008 Egypt DHS Jasbir Sangha*, Ann Way*, Fatma El-Zanaty, and Nasr El-Sayed *ICF Macro, Demographic and Health Surveys,
More informationHepatitis C 17 months experience with Sofosbuvir/Ledipasvir (Harvoni)
Hepatitis C 17 months experience with Sofosbuvir/Ledipasvir (Harvoni) Prof. Dr. Markus Cornberg Klinik für Gastroenterologie, Hepatologie und Endokrinologie Antalya, 13.05.2016 Markus Cornberg, Hannover
More informationIL TRAPIANTO DI FEGATO: QUALE FUTURO CON LE NUOVE TERAPIE PER LE MALATTIE EPATICHE?
IL TRAPIANTO DI FEGATO: QUALE FUTURO CON LE NUOVE TERAPIE PER LE MALATTIE EPATICHE? Francesco Paolo Russo Department of Surgery, Oncology and Gastroenterology Multivisceral/ Gastroenterology Section University
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 informationGeneral Statement for Drugs for the Treatment of Hepatitis C
General Statement for Drugs for the Treatment of Hepatitis C Use the following criteria to determine patient eligibility for subsidisation under the PBS for hepatitis C treating agents. By writing a PBS
More informationThe American University in Cairo. School of Global Affairs and Public Policy
The American University in Cairo School of Global Affairs and Public Policy ESTIMATING ECONOMIC AND EPIDEMIOLOGICAL BURDEN OF HEPATITIS C IN EGYPT, 2015-2025 A Thesis Submitted to the Public Policy and
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 information