HIV/HCV coinfection. Jürgen K. Rockstroh, Department of Medicine I, Bonn University Hospital, Bonn, Germany
|
|
- Sheryl Pierce
- 6 years ago
- Views:
Transcription
1 HIV/HCV coinfection Jürgen K. Rockstroh, Department of Medicine I, Bonn University Hospital, Bonn, Germany
2 Conflict of Interest Honoraria for lectures and/or consultancies from Abbott, AbbVie, Bionor, BMS, Cipla, Gilead, Janssen, Merck, Roche, ViiV. Research grants from Dt. Leberstiftung, DZIF, NEAT ID.
3
4 Burden of HIV/HCV co-infection 37 million HIV infected 2.3 million co-infected with HCV North America ~1.6 million ~32, Latin America (South & Central America, Caribbean) ~1.8 million ~18, MSM Western & Central Europe ~1 million ~14, Middle East & North Africa 24, ~54, South, West, East & Central Africa 26 million ~43, HCV co-infected Eastern Europe & Central Asia ~1.5 million ~68, HIV only East Asia 82, ~19, South & South-East Asia 3.1 million ~29 Western Pacific ~74, ~115, Heterosexual IDUs % 2% 4% 6% 8% 1% IDU: injecting drug user; MSM: men who have sex with men Platt L, et al. Lancet Infect Dis 216; doi: 1.116/S (15)485-5
5 Acute outbreaks of HCV have been reported in HIV+ MSM across the world Canada 1 51 cases UK 4,5 589 cases Belgium 1 69 cases Germany cases Swiss cases France 7 29 cases Denmark cases The Netherlands 8,9 127 cases Japan cases USA 2,3 44 cases Korea 15 3 cases Lebanon 13 1 case Taiwan cases Hong Kong cases Australia cases Total number of cases reported in the literature from these countries 1. Burchell AN, et al. Can J Infect Dis Med Microbiol 215;26:17 22; 2. Luetkemeyer A, et al. J Acquir Immune Defic Syndr 26;41:31 6; 3. Cox A, et al. Gastroenterology 29;136:26 31; 4. Giraudon I, et al. Sex Transm Infect 28;84:111 5; 5. Ruf M, et al. Euro Surveill 28;13:1 3; 6. Vogel M, et al. Clin Infect Dis 29;49:317 8; 7. Gambotti L, et al. Euro Surveill 25;1:115 7; 8. Urbanus A, et al. AIDS 29;23:F1 F7; 9. Arends JE, et al. Neth J Med 211;69:43 9; 1. Bottieau E, et al. Euro Surveill 21;15:1 8; 11. Rauch A, et al. Clin Infect Dis 25;41:395 42; 12. Barfod TS et al. Scand J Infect Dis. 211;43:145 8; 13. Dionne-Odom J, et al. Lancet Infect Dis 29;9:775 83; 14. Nishijima T, et al. J Acquir Immune Defic Sundr 214;65:213 7; 15. Lee S, et al. Korean J Intern Med 216; doi: 1.394/kjim ; 16. Sun YH, et al. J Clin Microbiol 212;5:781 7; 17. Lin AWC, et al. J Int AIDS Soc 214;17:19663; 18. Matthews GV, et al. Clin Infect Dis 29;48:65 8
6 HCV seroconversion Patient * * * * * * * testing for anti-hcv may not be enough after a first positive HCV-RNA 37% anti-hcv positive 3 months later 86% anti-hcv positive 6 months later 5% without seroconversion after 1 year Thomson et al. AIDS 29, 23:89 93
7 Cumulative incidence HCV Disease Progression Remains Faster in Coinfected Patients, Despite Effective ART.2 HCV-monoinfected patients (n=679) Antiretroviral-treated patients coinfected with HIV/HCV (n=428) x Time to hepatic decompensation (years) p<.1 Adapted from: Lo Re 3rd V, et al. Ann Intern Med 214;16:
8 Cumulative incidence Cumulative incidence HCV Disease Progression Remains Faster in Coinfected Patients, Despite Effective ART.2 HCV-monoinfected patients.2 HCV-monoinfected patients Antiretroviral-treatment patients coinfected with HIV/HCV: HIV RNA level < 1 copies/ml Antiretroviral-treatment patients coinfected with HIV/HCV: HIV RNA level > 1 copies/ml Antiretroviral-treatment patients coinfected with HIV/HCV: CD4 count <.2 x 1 9 cells/l Antiretroviral-treatment patients coinfected with HIV/HCV: CD4 count 1 9 cells/l Time to hepatic decomposition (years) Time to hepatic decomposition (years) If HIV RNA <1 copies/ml: +65% excess risk If HIV RNA >1 copies/ml: +82% excess risk If CD4 < 2/mm 2 : +23% excess risk If CD4 > 2/mm 2 : 56 63% excess risk ART, antiretroviral therapy; HCV, hepatitis C virus; HIV, human immunodeficiency virus. Adapted from: Lo Re 3rd V, et al. Ann Intern Med 214;16:
9 Treatment of chronic hepatitis C, including patients without cirrhosis and patients with compensated (Child-Pugh A) cirrhosis EASL 216 Guidelines, Sept.22,216
10 HCV life cycle New HCV virion HCV virion Endocytosis Cyclophilin A inhibitor 4 Inhibition of cyclophilin A reduces HCV replication NS3 inhibitor 2 Inhibits activity of NS3 protease Prevents processing of HCV proteins required for replication -previr CD81 Cytoplasm Liver cell ER Adapted from reference 1 SR-B1 Cytoplasm Nucleus Uncoating RNA replication NS4A NS4B Virion assembly ER Lumen Adapted from reference 2 Maturation Golgi PEG-IFN lambda 3 Type III pegylated interferon Expression of receptor is more limited than Alfa, should lead to improved tolerability and safety NS5B inhibitor(s) 2 Inhibits NS5B RNA replicase Prevents replication of viral genome -buvir NS5A inhibitor 2 Inhibits activity of NS5A, a multifunctional protein Prevents viral replication -asvir 1. Manns MP, et al. Nat Rev Drug Discov 27;6: Rice C. Top Antivir Med 211;19(3): Donnelly R, et al. Trends Immunol 211;32(9): Gallay P, Lin K. Drug Des Devel Ther 213;7:15-15.
11 216 EASL Guidelines Journal of Hepatology 217;66:
12 SVR 12(%) DAA Really Similarly Effective in HIV Coinfection? GECCO Cohort (9 German centres) n= mono-, 349 coinfected Liver cirrhosis 29% (31% vs. 22%) Overall-SVR 95%, 95% monoinfected, 94% coinfected SVR12 According to CD4 and Cirrhosis Status ,2 9,9 88,4 82,8 CD4 35 CD4 <35 CD4 35 CD4 <35 Non-cirrhotic Cirrhotic SVR lower in pts. with CD4 <35/µl and liver cirrhosis Boesecke C, et al. 24th CROI; Seattle, WA; February 13-16, 217. Abst. 551.
13 SVR12 (%) SVR12 in GT 1 HIV/HCV Coinfected Patients Treated with LDV/SOF for Weeks: Clinical Trials Compared to Real-World Cohorts Clinical Trials 96% 98% 1% 98% Real World Cohorts 91% 91% 98% ION 4 Study * ERADICATE * ANRS HC31 SOFTRI ** TRIO Cohort 1,2 * ASCEND 2 ** VA USC 1,2 ** Portugal 1 ** ITT analysis in GT1 patients; *ITT analysis; ** Per Protocol; ¹ ±RBV; ² small number of patients may have received 8 weeks of LDV/SOF Naggie S, et al. 67th AASLD; Boston, MA; November 11-15, 216; Abst. 892.
14 Check for DDIs between HCV and HIV drugs! Drug interactions List of CYP substrates, inhibitors, inducers HIV drug interactions Khoo S. 15th International Workshop on Clinical Pharmacology of HIV & Hepatitis Therapy, May 214 [oral presentation]. CYP, cytochrome
15 Low potential for drug drug interactions with some HCV DAA and HIV antiretrovirals Gilead Sciences is not responsible for the content of third party websites. DDI: drug drug interaction; NNRTI: non-nucleoside reverse transcriptase inhibitor; NRTI: nucleoside reverse transcriptase inhibitor Regularly updated Information on DDIs can be found at: EASL Recommendations on treatment of hepatitis C. Available at: (accessed September 216) DDI: drug drug interaction; NNRTI: non-nucleoside reverse transcriptase inhibitor; NRTI: nucleoside reverse transcriptase inhibitor
16 SVR12 (%) High SVR in adult patients with HIV/HCV coinfection treated with DAAs 1 ALLY-2: 1 GT 1 4, TN & TE SOF + DCV ION-4: 2 GT 1 or 4, TE & TN LDV/SOF 1 96 TURQUOISE-1, part 2: 3 GT 1 or 4, TN and TE OMV/PTV/RTV + DSV ± RBV 97 1 C-EDGE: 4 GT 1, 4 or 6, TN GRZ/EBV /11 51/52 TN TE 12 weeks 322/3 217/ weeks 12 or 24 weeks 21/ Weeks 1. Wyles D, et al. N Engl J Med 215;373:714 25; 2. Naggie S, et al. N Engl J Med 215;373:75 13; 3. Rockstroh JK, et al. IAS 216; Abstract # 1333; 4. Rockstroh JK, et al. Lancet HIV 215;2:e Studies included non-cirrhotic and cirrhotic patients. TE: treatment-experienced NOT HEAD-TO-HEAD COMPARISONS
17 SVR12 (%) ASTRAL-5: high SVR across genotypes 1 4 in adult HIV/HCV coinfected patients treated with 12 weeks SOF/VEL ASTRAL-5: HIV/HCV co-infected Treatment-naïve and -experienced, non-cirrhotic and cirrhotic GT 1 4 adults relapse 1 LTFU 1 LTFU 1 withdrew consent 2 11/16 63/66 11/12 11/11 11/12 5/5 Total 1a 1b Genotype Brau N, et al. IAS 216; Abstract #78 Error bars represent 95% confidence intervals. LTFU: lost to follow-up
18 SVR12 (%) ASTRAL-5: high SVR across all patient types in adult HIV/HCV co-infected patients treated with 12 weeks SOF/VEL ASTRAL-5: HIV/HCV co-infected Treatment-naïve and -experienced, non-cirrhotic and cirrhotic GT 1 4 adults /16 Total 82/87 19/19 71/75 3/31 No Yes Naïve Experienced Cirrhosis status Treatment history Brau N, et al. IAS 216; Abstract #78 Error bars represent 95% confidence intervals
19 DAAs were well-tolerated in clinical trials of HIV/HCV co-infected patients Adverse events common across all DAA regimens in HIV/HCV co-infection trials ALLY-2 DCV + SOF N=23 ION-4 LDV/SOF N=335 TURQUOISE-I Part 2 OMV/PTV/RTV + DSV ± RBV N=228 C-EDGE CO-INFECTION GRZ/EBV N=218 ASTRAL-5 SOF/VEL N=16 Fatigue 17% 21% 23% 13% 25% Headache 11% 25% 14% 12% 13% Diarrhoea 7% 11% 14% 7% 8% Nausea 13% 1% 2% 9% 7% D/C due to AE 2 (2%) Wyles D, et al. N Engl J Med 215;373:714 25; Rockstroh JK, et al. IAS 216; Abstract # 1333; Naggie S, et al. N Engl J Med 215;373:75 13; Rockstroh JK, et al. Lancet HIV 215;2:e319 27; Brau N, et al. IAS 216; Abstract #78 NOT HEAD-TO-HEAD COMPARISONS This table illustrate adverse events obtained between different regimens from different studies and are therefore not directly comparable as study populations are NOT matched
20 SVR 12 (%) SVR 12 (%) Real Life DAA Data from Germany: GECCO Cohort 1346 patients from 9 centres: 21% HIV/HCV co-infected, 29% F4 fibrosis/cirrhosis Pretreatment F4 Diabetes HIV-HCV yes no 459/57 379/ / /723 53/61 851/947 2/218 74/79 175/191 24/26 5/5 13/13 13/15 26/28 2 SL8 all Good response rates also in Tx experienced, F4, diabetics, coinfected HIV- HCV F4 PPI High VL Pretreatment 8 weeks of SOF/LDV very effective even in problematic patients Christensen S, et al. 23rd CROI; Boston, MA; February 22-25, 216. Abst. 584.
21 Number of Patients Dutch Athena Cohort Rapid and early treatment uptake of DAAs Since 11/215 unrestricted access to DAA Early treatment initiation in n=736 7% cure - Jan HCV Infected Never treated Unsuccessfully treated with DAA Unsuccessfully treated with (PEG-)IFN +/- BOC or TVR Currently on treatment Treatment with DAA Treatment with (PEG-) IFN +/- BOC or TVR Retained in care Ever treated Treatment completed SVR Boerekamps A, et al. 24th CROI; Seattle, WA; February 13-16, 217. Abst. 136.
22 Dutch Acute HCV in HIV Study (DAHHS; 8 Centres) Declining Acute HCV epidemic Due to DAA? 214 A-HCVn=93 PYFU n= /1PYFU (95% CI 9-14) 1.1% per year 216 A-HCVn=49 PYFU n= /1PYFU (95% CI 4-7),55% per year IRR.49 (95% CI ) Jan-Dec /1 Jan-Jun /1 Jul-Dec /1 BUT: 41% Increase in Syphilis Cases in 216 vs. 215 Boerekamps A, et al. 24th CROI; Seattle, WA; February 13-16, 217. Abst. 137LB.
23 Re-treatment after failure to LDV/SOF 9 patients without SVR in ION-4 after 12 weeks of LDV/SOF Wk Wk 12 Wk 24 Wk 36 LDV/SOF Failure N=9 LDV/SOF + RBV SVR12 GT NS5A RAVs Before Primary Study (%) NS5A RAVs at Virologic Rlapse After Primary Study (5) 1a None None Yes 1a None None Yes 1a L31M (>99), H58D (92) L31M (>99), H58D (92) Yes 1a Y93F (1), Y93N (1) Y93N (<99) Yes 1a L31M (>99), Y93N (<25) L31M (>99), Y93N (>99) Yes 1a* None Y93N (>99) Yes 1b Y93H (>99) L31I (11), Y93H (>99) Yes 1b None L31V (>99) Yes 1a None L31M (>99) No SRV12 SVR in 8/9 1 relapse 4 weeks after EOT: GT1a, no cirrhosis Cooper C, et al. 23rd CROI; Boston, MA; February 22-25, 216. Abst. 573.
24 GEHEP 2 Spanish HCV/HIV Cohort HCC after DAA therapy 319 HCV/HIV patients with HCC from 32 Spanish centres 45% pretreated HCC after median months after SVR No increased HCC recurrence rate after SVR 1% n HCC After SVR/Total n HCC 8% p <.1* 6% 4% 2% 1 (16,7%) 16 1 (9,9%) (9%) ,7%) % < Oct 214 Oct Total HCC Cases N=6 N=161 N=111 N=41 Merchante N, et al. 24th CROI; Seattle, WA; February 13-16, 217. Abst. 139.
25 Frequency of HCC Diagnosis After SVR in HIV/HCV Coinfected Patients with Cirrhosis 19 centers from the GEHEP-2 cohort reported data of the number of HIV/HCV-coinfected patients with cirrhosis who achieved SVR in each period % 15 11,72 N=135 HIV/HCV cirrhotic with SVR before January ,66 5 1,68,88 IFN PEG-IFN + RBV DAA + PR DAA IFN free HCC after SVR No. with SVR Merchante N, et al. 24th CROI; Seattle, WA; February 13-16, 217. Abst. 139.
26 HCV Reinfection Incidence and Outcomes Among HIV-positive MSM in Western Europe Incident infection 1 st Reinfection Number included Number reinfected (%) N/A 149 (24.6) Median time (years) to reinfection (IQR) N/A 1.8 ( ) Genotypes (%) G1: 376(7.5) G2: 13(2.4) G3: 46(8.6) G4: 96 (18) G1: 14(73.2) G2: 1(.7) G3: 12(8.5) G4: 25(17.6) Genotype switches (%) N/A 71/136 (52.2) Median age at reinfection (IQR) 39 (34-44) 41 (37-45) Median CD4 at reinfection 553 (412-76) Proportion with suppressed HIV VL 91/111 (82.%) Spontaneously cleared proportion 111/65 (18.3%) 21/135 (15.6%) Martin T, et al. 51st EASL; Barcelona, Spain; April 13-17, 216. Abst. PS6 Ingiliz P et al. J Hepatol treated with 87 achieving SVR (78%)
27 Chronic hepatitis and HIV: implications for care HIV infected individuals with HCV coinfection remain at higher risk for fibrosis progression and hepatic decompensation Therefore HCV therapy is prioritized in most guidelines in this patient group The short- and mid-term effects of ART on the progression of HCVrelated liver disease largely outweigh the potential risks for longterm toxicity. HIV therapy needs to consider coadministration with all oral DAA combination therapy and possible drug interactions as well as potential dose modifications with advanced liver disease. Strategies beyond administration of DAA therapy are needed to prevent HCV reinfection in HIV-coinfected individuals HCV elimination in HIV-coinfected populations appears targetable
HIV/hepatitis co-infection. Christoph Boesecke Department of Medicine I University Hospital Bonn Germany
HIV/hepatitis co-infection Christoph Boesecke Department of Medicine I University Hospital Bonn Germany Clinical Management and Treatment of HBV and HCV Co-infection in HIVpositive Persons Hepatitis B
More informationDebate: Do We Need More HCV Drugs Con Standpoint
Debate: Do We Need More HCV Drugs Con Standpoint 18 th Antivirals PK Workshop, Friday 16 th June 2017, Chicago Jürgen Rockstroh Department of Medicine I University Hospital Bonn, Bonn, Germany Conflict
More informationIs HCV drug resistance an issue?
Is HCV drug resistance an issue? 5TH ASIAN CONFERENCE ON HEPATITIS&AIDS NANJING, CHINA 28-29 MAY 2016 FROM BASIC SCIENCE TO CLINICAL PRACTIC Jürgen Kurt Rockstroh Department of Medicine I, University Hospital
More informationInfluence of Baseline HCV Genotype upon Treatment Outcome of Acute HCV Infection in HIV Co-Infected Individuals
Influence of Baseline HCV Genotype upon Treatment Outcome of Acute HCV Infection in HIV Co-Infected Individuals Christoph Boesecke, Hans-Jürgen Stellbrink, Stefan Mauss, Emma Page, Mark Nelson, Sanjay
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 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 informationHepatitis C and HIV. Stanislas Pol
Hepatitis C and HIV Stanislas Pol Unité d Hépatologie, Hôpital Cochin Inserm U1223 & USM20 Institut Pasteur Université Paris Descartes Paris, France stanislas.pol@cch.aphp.fr Lisboa, 30 January 2017 Disclosures
More informationAcute hepatitis C The European Experience
Acute hepatitis C The European Experience Dr Emma Page MBBS MRCP MD(Res) Chelsea and Westminster Hospital, London AHC the European Experience 1. Epidemic 2. CNS sequelae 3. Incidence 4. Re-infection Reports
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 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 informationReal-World Outcomes with New HCV Antivirals in HIV/HCV-Coinfected Subjects: Madrid Coinfection Registry (Madrid-CoRE) Findings
Real-World Outcomes with New Antivirals in HIV/-Coinfected Subjects: Madrid Coinfection Registry (Madrid-CoRE) Findings J. Berenguer, J. Gonzalez-García, M. Montes, Gil-Martin, E. Cruz-Martos, M. Calvo,
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 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 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 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 informationOptimal therapy of HIV/HCV co-infected patients with direct acting antivirals
Liver International ISSN 1478-3223 REVIEW ARTICLE Optimal therapy of HIV/HCV co-infected with direct acting antivirals J urgen K. Rockstroh 1,2 1 Department of Internal Medicine I, Bonn University Hospital,
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 informationHepa%%s C elimina%on needs involvement of all turn the page. Graham R Foster Professor of Hepatology Queen Mary University of London
Hepa%%s C elimina%on needs involvement of all turn the page Graham R Foster Professor of Hepatology Queen Mary University of London Conflicts of Interest Speaker and consultancy fees received from AbbVie,
More informationHepatitis C: Difficult-to-treat Patients 11th Paris Hepatology Conference 16th January 2018 Stefan Zeuzem, MD University Hospital, Frankfurt, Germany
Hepatitis C: Difficult-to-treat Patients 11th Paris Hepatology Conference 16th January 2018 Stefan Zeuzem, MD University Hospital, Frankfurt, Germany PHC 2018 - www.aphc.info Disclosures Advisory boards:
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 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 informationProfessor Mark Nelson. Chelsea and Westminster Hospital, London, UK
Professor Mark Nelson Chelsea and Westminster Hospital, London, UK Treatment should be prioritized Treatment Indicated All naive and experienced pts with liver disease Prioritized Pts with fibrosis (F3)
More informationHepatitis C Highlights from ILC / EASL 2016
Hepatitis C Highlights from ILC / EASL 2016 VIII International Update Workshop in Hepatology Curitiba, 26.08.2016 Christoph Sarrazin St. Josefs-Hospital Wiesbaden and Goethe-University, Frankfurt am Main
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 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 informationAcute Hepatitis C Are we finding it? Are we treating it? Dr Emma Page MBBS MRCP MD Chelsea and Westminster Hospital NHS Trust London
Acute Hepatitis C Are we finding it? Are we treating it? Dr Emma Page MBBS MRCP MD Chelsea and Westminster Hospital NHS Trust London Need sensitive & specific diagnostic tools Need a standardised case
More informationManagement of HIV/HCV Coinfection. Kristen M. Marks, MD Assistant Professor Weill Cornell Medical College New York, NY
Management of HIV/HCV Coinfection Kristen M. Marks, MD Assistant Professor Weill Cornell Medical College New York, NY Disclosure Dr. Marks has received grants and research support from Gilead Sciences
More informationEliminating Hepatitis C from New Zealand
Eliminating Hepatitis C from New Zealand Catherine Stedman Associate Professor of Medicine, University of Otago, Christchurch Gastroenterology Department, Christchurch Hospital Disclosures I have the following
More informationTreating now vs. post transplant
Resistance with treatment failure Treating now vs. post transplant Pros (for treating pre transplant) If SVR efficacy means Better quality of life Removal from waiting list No post transplant recurrence
More informationHCV Resistance Clinical Aspects. Sanjay Bhagani Royal Free Hospital/UCL London
HCV Resistance Clinical Aspects Sanjay Bhagani Royal Free Hospital/UCL London DAAs in 2018, and beyond % patients % patients Changing characteristics of patients treated with DAA over time Prospective,
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 informationAntiretroviral Therapy in HIV and Hepatitis Coinfection: What Do We Need to Consider?
Antiretroviral Therapy in HIV and Hepatitis Coinfection: What Do We Need to Consider? Saturday 22nd March 2014, Mumbai, India Jürgen K. Rockstroh Department of Internal Medicine I University Hospital Bonn,
More informationHCV care after cure. This program is supported by educational grants from
HCV care after cure This program is supported by educational grants from Raffaele Bruno,MD Department of Infectious Diseases, Hepatology Outpatients Unit University of Pavia Fondazione IRCCS Policlinico
More informationUpdate on HCV Treatment
Update on HCV Treatment Ajay Bharti, MD Associate Professor of Medicine Division of Infectious Diseases University of California San Diego 2018 April 28, 2018 Clinically relevant questions in HCV-HIV coinfected
More informationHCV Infection: EASL Clinical Practice Guidelines Francesco Negro University Hospital Geneva Switzerland
HCV Infection: EASL Clinical Practice Guidelines 2016 Francesco Negro University Hospital Geneva Switzerland Panel Codinat: Jean-Michel Pawlotsky Panel: Alessio Aghemo David Back Geoffrey Dusheiko Xavier
More informationHCV Management in Decompensated Cirrhosis: Current Therapies
Treatment of Patients with Decompensated Cirrhosis and Liver Transplant Recipients Paul Y. Kwo, MD, FACG Professor of Medicine Gastroenterology/Hepatology Division Stanford University email pkwo@stanford.edu
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 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 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 informationTreatment of Unique Populations Raymond T. Chung, MD
Treatment of Unique Populations Raymond T. Chung, MD Director of Hepatology and Liver Center Vice Chief, Gastroenterology Kevin and Polly Maroni Research Scholar Mass General Hospital Disclosures Research
More informationViva La Revolución: Options to Combat Hepatitis C
Viva La Revolución: Options to Combat Hepatitis C David L. Wyles, MD Professor of Medicine University of Colorado Chief, Division of Infectious Disease Denver Health Learning Objectives After attending
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 informationSpecial developments in the management of Hepatitis C. Disclosures
Special developments in the management of Hepatitis C Sandeep Mukherjee,MD Division of Gastroenterology CHI Health and Creighton University Medical Center Omaha, NE 68154 Sandeep.Mukherjee@alegent.org
More informationHIV-HCV Co-Infection in Shobha Swaminathan, MD Associate Professor of Medicine Rutgers New Jersey Medical School
HIV-HCV Co-Infection in 2018 Shobha Swaminathan, MD Associate Professor of Medicine Rutgers New Jersey Medical School AASLD/IDSA and DHHS Guidance: HIV/HCV Coinfection All pts with HIV should be screened
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 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 informationNew Hepatitis C Antivirals
New Hepatitis C Antivirals Kris Stewart, BSP, MD, FRCPC Drug Therapy Conference College of Medicine, University of Saskatchewan September 23, 2016 Disclosures I have received research and program support
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 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 informationHepatitis C: a treatment revolution
Sunday, 10th July 2016 Michaelmas Cay 2 Room Concurrent 11 Health Innovation Hepatitis C: a treatment revolution Dr. Heather McNamee Hepatitis C a treatment revolution Dr Heather McNamee Medical Director
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 informationNeed to Assess HCV Resistance to DAAs: Is it Useful and When?
Need to Assess HCV Resistance to DAAs: Is it Useful and When? Stéphane Chevaliez French National Reference Center for Viral Hepatitis B, C and delta Department of Virology & INSERM U955 Henri Mondor Hospital
More informationHepatitis C - results in real life
Hepatitis C - results in real life Robert Flisiak Department of Infectious Diseases and Hepatology Medical University of Białystok, Poland 10th PHC Paris, 30-31 January 2017 Disclosures Advisor and/or
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 trends in CHC 1st genotype treatment
Current trends in CHC 1st genotype treatment Tarik Asselah MD, PhD Professor of Medicine Hepatology, Chief INSERM UMR 1149, Hôpital Beaujon, Clichy, France Disclosures Employee of Paris Public University
More informationSeparate clinical trials for HIV- HCV coinfected patients are NOT a necessity. Patrick Ingiliz, Berlin
Separate clinical trials for HIV- HCV coinfected patients are NOT a necessity Patrick Ingiliz, Berlin Back in the days when HCV genotype 1 was the problem SVR (%) 100 90 80 70 60 50 40 30 20 10 0 35% PRESCO
More informationDisclosures. I have given sponsored lectures for the following pharmaceutical companies: Gilead, Abbvie and MSD. I own shares of Gilead Sciences.
Disclosures I have given sponsored lectures for the following pharmaceutical companies: Gilead, Abbvie and MSD. I own shares of Gilead Sciences. Chronic Hepatitis C Prof CL Lai University Department of
More informationEpclusa (Sofosbuvir/Velpatasvir) for HIV/HCV
Mountain West AIDS Education and Training Center Epclusa (Sofosbuvir/Velpatasvir) for HIV/HCV John Scott, MD, MSc Associate Professor University of Washington Jul 28, 2016 This presentation is intended
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 informationHCV in 2017: New Therapies and New Opportunities. Presentation prepared by: Date prepared: OBJECTIVES
Project ECHO HCV Collaborative HCV in 217: New Therapies and New Opportunities Paulina Deming, PharmD Assistant Director Hepatitis C Programs, ECHO Institute Associate Professor College of Pharmacy University
More informationHepatitis C Introduction and Overview
Hepatitis C Introduction and Overview Michael S. Saag, MD Professor of Medicine Associate Dean of Global Health Director, Center for AIDS Research University of Alabama at Birmingham Birmingham, Alabama
More informationHepatitis C in Special Populations
Hepatitis C in Special Populations David E. Bernstein, MD, FACG Vice Chairman of Medicine for Clinical Trials Chief, Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases Northwell Health
More informationDogma: HCV treatment for eradication. Lisa Barrett MD PhD FRCPC Dept. of Infectious Diseases, Microbiology and Immunology April 18, 2015
Dogma: HCV treatment for eradication Lisa Barrett MD PhD FRCPC Dept. of Infectious Diseases, Microbiology and Immunology April 18, 2015 Disclosures Some discussion of non-hc approved compounds Industry:
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 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 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 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 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/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 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 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 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 informationRecent data in. treatment of acute hepatitis C. Christoph Boesecke Department of Medicine I Bonn University Hospital Bonn, Germany
Recent data in treatment of acute hepatitis C Christoph Boesecke Department of Medicine I Bonn University Hospital Bonn, Germany Conflict of Interest Honoraria for lectures and/or consultancies from abbvie,
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 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 information10/4/2016. Management of Hepatitis C Virus Genotype 2 or 3 Infection
Management of Hepatitis C Virus Genotype 2 or 3 Infection Kenneth E. Sherman, MD, PHD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati Cincinnati, Ohio FORMATTED:
More informationNew York State HCV Provider Webinar Series
New York State HCV Provider Webinar Series Treatment of HCV/HIV Co-Infection Dost Sarpel, MD Division of Infectious Disease Viral Hepatology Milford Regional Medical Center Objectives Review the epidemiology
More informationHepatitis C Genotypes
9/2/21 OBJECTIVES Project ECHO HCV Collaborative HCV in 21: New Therapies and New Opportunities Paulina Deming, PharmD Assistant Director Hepatitis C Programs, ECHO Institute Associate Professor College
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 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 informationHCV Treatment of Genotype 1: Now and in the Future
HCV Treatment of Genotype 1: Now and in the Future Bruce R. Bacon, MD, FACG James F. King, MD Endowed Chair in Gastroenterology Professor of Internal Medicine Co-Director of the Abdominal Transplant Program
More informationUniversal HCV treatment: Strategies for simplification
Universal HCV treatment: Strategies for simplification PARIS HEPATOLOGY CONFERENCE 3 January 217 Tarik Asselah (MD, PhD) Hepatology & Chief INSERM UMR 1149, Hôpital Beaujon, Clichy, France. 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 informationThe ASTRAL Program Abstracts LB-2, LB-12, 205, 209
The ASTRAL Program Abstracts LB-2, LB-12, 5, 9 The ASTRAL Program FDC 1. 2. 3. 4. 5. SOF Nucleotide polymerase inhibitor VEL NS5A inhibitor ASTRAL1 GT1, 2, 4 6 ASTRAL2 GT2 Jacobson IM, et al. N Engl J
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 informationVIRAL LIVER DISEASE. OAG Post DDW Course Westin Prince, Toronto, June 13-14, 2015
VIRAL LIVER DISEASE OAG Post DDW Course Westin Prince, Toronto, June 13-14, 2015 Financial Interest Disclosure (over the past 24 months) Dr. Paul Marotta Relationships related to this presentation! Research
More informationHepatitis C: Newest Treatment Options and What To Do When We Cure It!
Hepatitis C: Newest Treatment Options and What To Do When We Cure It! Richard Kalman, MD Division of Hepatology Department of Transplantation Einstein Medical Center Learning Objectives Scope of HCV How
More informationAri Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College
Ari Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College New York State Law Goes into Effect January 1, 2014 Hepatitis C Virus
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 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 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 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 informationA treatment revolution: current management for chronic HCV
A treatment revolution: current management for chronic HCV Ray Chung, M.D. Director of Hepatology and Liver Center Kevin and Polly Maroni Research Scholar Massachusetts General Hospital Disclosures Research
More informationHepatitis C Update: Screening, Diagnosis, and Treatment
Mountain West AIDS Education and Training Center Hepatitis C Update: Screening, Diagnosis, and Treatment Brian R. Wood, MD (bwood2@uw.edu) Assistant Professor of Medicine, University of Washington Medical
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 informationDirect-acting Antiviral (DAA) Regimens in Late-stage Development: Which Patients Should Wait? Fred Poordad, MD
Direct-acting Antiviral (DAA) Regimens in Late-stage Development: Which Patients Should Wait? Fred Poordad, MD The HCV Lifecycle: Multiple Targets Polymerase Inhibitors Protease Inhibitors NS5A Inhibitors
More informationPIB. Next Generation Direct-Acting Antivirals. Collectively: G/P. Pibrentasvir (formerly ABT-530) pangenotypic NS5A inhibitor
Surveyor-II, Part 3: Efficacy and Safety of Glecaprevir/Pibrentasvir (Abt-493/Abt-53) in Patients with Hepatitis C Virus Genotype 3 Infection with Prior Treatment Experience and/or Cirrhosis David L. Wyles,
More informationImpatto della clearance virale e rischio di carcinoma epatocellulare
EPATITE CRONICA DA HCV: Impatto della clearance virale e rischio di carcinoma epatocellulare Rodolfo Sacco, M.D., PhD Direttore U.O.C. Gastroenterologia ed Endoscopia Digestiva A.O.U. Ospedali Riuniti"
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 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 information