Dr. Siddharth Srivastava
|
|
- Kelley Jones
- 5 years ago
- Views:
Transcription
1 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. Multiple publications in indexed journals
2 Hepatitis C: Current Perspectives This Session is sponsored by MYLAN PHARMACEUTICALS (P) LTD.
3 Introduction Viral hepatitis kills about 1.45 million people per year globally Slightly lesser deaths than due to HIV But much more than TB and Malaria HBV and HCV cause most of viral hepatitis due to Cirrhosis and HCC Deaths due to HBV plateau since 1990 but due to HCV continues to rise Gut; 64:2015
4 Mortality Rates in the US, Rate per 100,000 PY* HIV Hepatitis C Hepatitis B *Mortality rates = HBV, HCV, HIV listed as cause of death Because decedent can have multiple causes of death, a record listing more than 1 type of infection was counted for each type of infection Ly KN, et al. Ann Intern Med. 2012;156: Yr
5 Natural History
6 Natural History
7 Natural History Depends on: Gender (Male > Female) Age at infection IL28 gene polymorphism Co infection with HIV Concomitant alcohol use
8 Lancet 2009 Age and Natural history
9 Nature 2009 IL28B and Natural history
10 Hepatology 2001 HIV Coinfection
11 Hepatology 1998 Alcoholism
12 Management of HCV
13 HCV Viral Replication: Higher All-Cause Mortality Cumulative Mortality (%) All Causes Anti-HCV seropositives, HCV RNA detectable Anti-HCV seropositives, HCV RNA undetectable Anti-HCV seronegatives P <.001 for comparison among 3 groups P <.001 for HCV RNA detectable vs undetectable 30.1% 12.8% 12.4% Follow-up (Yrs) Lee MH, et al. J Infect Dis. 2012;206:
14 HCC Incidence in Cirrhotic Patients: SVR vs No SVR No SVR SVR HCC Incidence (%) % 7.7% P = Time (Yrs) Median follow-up: 10 yrs Purevsambuu T, et al. EASL Abstract O125.
15 SVR Prevents Development of Insulin Resistance 25 P =.007 P =.1 P =.04 Rates of de Novo IR (%) % 17% 8% 16% 7% 20% SVR Non-SVR 0 17/230 21/124 6/78 15/94 11/152 6/30 Overall HCV GT 1/4 HCV GT 2/3 Aghemo A, et al. Hepatology. 2012;58:
16 When and whom to initiate therapy Non-Modifiable factors Fibrosis stage Inflammation grade Age at infection Gender Organ transplant Modifiable Alcohol NAFLD Obesity Insulin resistance Viral Genotype 3 Coinfection
17 Cirrhosis: A Continuous Spectrum of Disease ESLD Child-Pugh B Portal hypertension high risk Cirrhosis treatment candidate Liver disease is not optimally represented by Child-Pugh stage (A, B, or C) or MELD score
18 Severity of Disease Increases Need for HCV Therapy but Also Impairs Response May not need immediate treatment BUT Easier to treat High likelihood of response Greater need for treatment BUT Response to current IFN-based therapy may be impaired Mild disease Advanced disease/ cirrhosis
19 Drugs for HCV
20 Very Few HCV Patients treated million infected 50% HCV detected 32% to 38% referred for care 7% to 11% treated Asrani SK, et al. Curr Gastroenterol Rep. 2014;16:381.
21 Milestones in Therapy of CHC: Average SVR Rates from Clinical Trials + Ribavirin Standard 1998 Interferon DAAs Peginterferon % 55% 34% 42% 39% 6% 16% Lawitz et al Antiviral Drugs Advisory Committee Meeting, April 27-28, 2011
22 Direct acting antivirals Suffix: Asvir Suffix: buvir Suffix: Previr
23 EASL 2015 HCV: Tx-Naive & PR-Exp d, GT2 or 3 No Cirrhosis Compensated Cirrhosis (Child-Pugh A) Regimen GT2 GT3 GT2 GT3 SOF + PR 12 wks 12 wks 12 wks 12 wks SOF + RBV 12 wks 24 wks wks Not recommended SOF + DCV 12 wks, no RBV 12 wks, no RBV 12 wks, no RBV 24 wks + RBV EASL HCV Guidelines. April 2015.
24 BOSON: SOF + PegIFN/RBV for 12 Wks vs SOF + RBV for 16 or 24 Wks in GT2/3 HCV Multicenter, randomized, open-label study Key baseline characteristics: 92% GT3, ~ 38% IL28B CC, ~ 53% previously treated, ~ 37% with cirrhosis Stratified by cirrhosis, HCV GT, previous HCV tx Wk 12 Wk 16 Wk 24 SVR12, % (n/n) GT2 GT3 GT2 HCV infected txexperienced pts with cirrhosis and GT3 HCV infected tx-naive or txexperienced pts with or without cirrhosis (N = 592) Sofosbuvir 400 mg QD + RBV* (n = 196) Sofosbuvir 400 mg QD + RBV* (n = 199) Sofosbuvir 400 mg QD + PegIFN + RBV* (n = 197) 87 (13/15) 100 (17/17) 94 (15/16) 71 (128/181) 84 (153/182) 93 (168/181) *RBV: mg/day. PegIFN alfa-2a: 180 μg/wk. Foster GR, et al. EASL Abstract LO5.
25 BOSON: SVR12 in GT3 by Tx History and Cirrhosis Status SVR12 (%) SOF + RBV 16 wks SOF + RBV 24 wks SOF + PegIFN/RBV 12 wks n/n = 0 58/ 70 65/ 72 68/ 71 12/ 21 Treatment Naive Treatment Experienced Foster GR, et al. EASL Abstract LO5. Reproduced with permission. 18/ 22 21/ 23 No Cirrhosis Cirrhosis No Cirrhosis Cirrhosis 41/ 54 44/ 54 49/ 52 17/ 36 26/ 34 30/ 35
26 BOSON: Pts Without SVR12 and Safety/Tolerability Outcome 16 Wks SOF + RBV (n = 196) 24 Wks SOF + RBV (n = 199) 12 Wks SOF + PegIFN/RBV (n = 197) On-treatment failure, n (%) 0 3 (2) 0 Relapse, n/n (%) 52/195 (27) 24/195 (12) 9/195 (5) Other,* n (%) 3 (2) 2 (1) 5 (3) Safety Outcome, n (%) AEs 185 (94) 188 (95) 195 (99) Grade 3/4 AE 11 (6) 7 (4) 15 (8) Serious AE 8 (4) 10 (5) 12 (6) Tx discontinuation for AE 3 (2) 2 (1) 1 (<1) Grade 3/4 lab abnormality 30 (15) 29 (15) 74 (38) Hemoglobin < 10 g/dl 7 (4) 12 (6) 24 (12) Hemoglobin < 8.5 g/dl (1) Platelets < 50,000 cells/mm 3 1 (1) 0 9 (5) *Pts who discont. before achieving HCV RNA < LLOQ or did not return for Wk 12 posttreatment visit. Foster GR, et al. EASL Abstract LO5. Reproduced with permission.
27 Treatment for GT1 Option I (12 weeks, no Cirrhosis): Daclatasvir (60mg) + Sofosbuvir (400mg) ± Riba Option II (24 weeks, cirrhosis): Daclatasvir + Sofosbuvir ± Riba Option III (12 weeks): Ledipasvir 90 mg + Sof Option IV (24 weeks): RBV+SOF Option V (12-48 weeks): PegIFN+SOF+RIba AASLD 2015
28 Treatment for GT3 Option I (12 weeks, no Cirrhosis): Daclatasvir (60mg) + Sofosbuvir (400mg) ± Riba Option II (24 weeks, cirrhosis): Daclatasvir + Sofosbuvir ± Riba Option III (12 weeks): PegIFN+SOF+RIba Option IV (24 weeks): RBV+SOF AASLD 2015
29 EASL HCV Guidelines 2014: Genotype 2-6 EASL. J Hepatology. 2014;60:
30 Genotype GT 2 Options Sofosbuvir + ribavirin: 12 wks (16-20 weeks in cirrhotic patients, especially treatment experienced) (A1) PegIFN/ribavirin + sofosbuvir: 12 wks for cirrhotic and/or treatment-experienced patients (B1) GT 4 PegIFN/ribavirin + daclatasvir: 12 wks followed by 12 wks of pegifn/ribavirin alone or a further 12 wks of pegifn/ribavirin + daclatasvir (response-guided therapy) (B1) Sofosbuvir + ribavirin: 24 wks for interferon-intolerant patients (C2) Sofosbuvir + simeprevir: 12 wks (ribavirin may be added in previous nonresponders and cirrhotics) (B2) GT5/6 Sofosbuvir + daclatasvir: 12 wks in previously untreated patients; 24 wks in treatment-experienced patients (ribavirin may be added in previous nonresponders and cirrhotics) (B2) PegIFN/ribavirin + sofosbuvir 12 wks (B1) Sofosbuvir + ribavirin: 24 wks for interferon-intolerant patients (C2)
31 Conclusion Peg IFN is backbone of treatment for HCV geno 3 Inclusion of Peg IFN decreases cost by almost 50% as compared to all oral regimen Newer DAAs are better tolerated Pangenotypic DAAs have changed algorithms for management of HCV DAAs: GT 3 treatment results are suboptimal
32 Conclusions For hepatitis prevention is better than cure Follow 3 golden S of safety with safe: Sex Syringes (needles. Razors and tattoo equipments) Surgery (Blood and blood products, surgical instruments) Don t panic All contacts should be screened for HBV and HCV Excellent treatment options available
33 THANKS
5/12/2016. 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 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 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 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 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 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 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 informationInterferon free therapy Are we getting there? Graham R Foster Queen Marys University of London
Interferon free therapy Are we getting there? Graham R Foster Queen Marys University of London IFN free therapy Disclosures I have received personal and institutional funding from companies that sell drug
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 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 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 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 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 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 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 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 informationManagement of HCV Tawesak Tanwandee
Management of HCV 2016 Tawesak Tanwandee Topics Burden of HCV in our countries Natural history and unmet need for HCV treatment Current treatment as for 2016 Conclusion Evolution from HCV infection to
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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 informationHighlights of AASLD 2012 CCO Official Conference Coverage of the 2012 Annual Meeting of the American Association for the Study of Liver Diseases
Highlights of AASLD 12 CCO Official Conference Coverage of the 12 Annual Meeting of the American Association for the Study of Liver Diseases November 9-13, 12 Boston, Massachusetts In partnership with
More 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 informationChronic viral hepatitis and liver disease in Belgium Pierre Deltenre
Chronic viral hepatitis and liver disease in Belgium Pierre Deltenre Brussels, November 7, 2017 Hepatitis B and C in Belgium What we need to know 1. Who is at risk of infection? 2. What is the natural
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 informationGlecaprevir-Pibrentasvir in Cirrhotic Genotype 1, 2, 4, 5, and 6 EXPEDITION-1
Phase 3 Treatment-Naïve and Treatment-Experienced Glecaprevir-Pibrentasvir in Cirrhotic Genotype 1, 2, 4, 5, and 6 EXPEDITION-1 EXPEDITION-1: Study Features EXPEDITION-1 Trial Design: Open-label, single-arm,
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 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 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 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 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 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 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; [Epub ahead of print]
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 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 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 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 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 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 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 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 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 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: 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 information2017 UnitedHealthcare Services, Inc.
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2017 P 1146-7 Program Prior Authorization/Notification Medication Harvoni (ledipasvir/sofosbuvir) P&T Approval Date 10/2014, 2/2015,
More informationCurrent HCV Treatment by Genotype
Current HCV Treatment by Genotype Ari Bunim, MD Assistant Professor Clinical Medicine Weill Cornell Medical College Clinical Director of Hepatology New York-Presbyterian/Queens Objectives To understand
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 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 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 informationSaeed Hamid, MD Alex Thompson, MD, PhD
Saeed Hamid, MD Alex Thompson, MD, PhD 1 We will review some top line data from EASL Majority of the time discussing how the data affects daily practice 2 Grazoprevir (GZR; MK-5172) + Elbasvir (EBR; MK-
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 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 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 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 informationUpdate on the Treatment of HCV
Update on the Treatment of HCV K. Rajender Reddy, MD Professor of Medicine Director of Hepatology Director, Viral Hepatitis Center University of Pennsylvania Philadelphia, USA 1 K. Rajender Reddy, MD Disclosure
More informationWill difficult-to-treat patients remain difficultto-treat. generation of treatments?
Will difficult-to-treat patients remain difficultto-treat with the new generation of treatments? Jordan J Feld MD MPH Toronto Centre for Liver Disease Sandra Rotman Centre for Global Health University
More informationTreatement Experienced patients without cirrhosis. Rafael Esteban Hospital Universitario Valle Hebron Barcelona
Treatement Experienced patients without cirrhosis Rafael Esteban Hospital Universitario Valle Hebron Barcelona Agenda With IFN PegIFN+ Ribavirin + Simeprevir PegIFN+ Ribavirin+ Sofosbuvir Without IFN Sofosbuvir
More informationHCV disease: treatment or deferral? Antonio Craxì Gastroenterologia & Epatologia, Di.Bi.M.I.S., Università di Palermo
HCV disease: treatment or deferral? Antonio Craxì Gastroenterologia & Epatologia, Di.Bi.M.I.S., Università di Palermo antonio.craxi@unipa.it Key factors in deciding to treat or wait Patient factors Urgency
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 informationPhase 3. Treatment Experienced. Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2. Afdhal N, et al. N Engl J Med. 2014;370:
Phase 3 Treatment Experienced Ledipasvir-Sofosbuvir +/- Ribavirin in HCV Genotype 1 ION-2 Afdhal N, et al. N Engl J Med. 2014;370:1483-93. Ledipasvir-Sofosbuvir +/- Ribavirin in Treatment-Experienced HCV
More informationUpdate 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 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 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 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 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 informationSVR Updates from the 2013 EASL
Updates from the 2013 EASL By Tracy Swan, Treatment Action Group Streamlining HCV Treatment Treatment for hepatitis C virus (HCV) is becoming simpler, shorter, and more effective. All-oral combinations
More information2017 Bruce Lucas Hepatology and Liver Transplant Symposium October 13th 2017 Management of Hepatitis C in Pre- and Post-Transplant Patients
2017 Bruce Lucas Hepatology and Liver Transplant Symposium October 13th 2017 Management of Hepatitis C in Pre- and Post-Transplant Patients Jens Rosenau, MD Associate Professor of Medicine Acting Director
More informationProgram Disclosure. Provider is approved by the California Board of Registered Nursing, Provider #13664, for 1.5 contact hours.
Program Disclosure This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint-sponsorship
More information4/30/2015. Interactive Case-Based Presentations and Audience Discussion. Debika Bhattacharya, MD, MSc. Learning Objectives
4/3/215 Interactive Case-Based Presentations and Audience Discussion Debika Bhattacharya, MD, MSc Assistant Clinical Professor University of California Los Angeles Los Angeles, California Formatted:4-27-215
More 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 informationMassimo Puoti SC Malattie Infettive AO Ospedale Niguarda Cà Granda, Milano. Eradicazione da HCV e nuove prospettive: Prospetive Terapeutiche future
Massimo Puoti SC Malattie Infettive AO Ospedale Niguarda Cà Granda, Milano Eradicazione da HCV e nuove prospettive: Prospetive Terapeutiche future DAA classes and subclasses Drug Class Subclass Potency
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 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 informationWhat Should We Do With Difficult to Treat HCV Populations?
What Should We Do With Difficult to Treat HCV Populations? Norah Terrault, MD Professor of Medicine and Surgery Director, Viral Hepatitis Center University of California San Francisco Disclosures Norah
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 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 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 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 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 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 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 informationAddressing Unmet Medical Needs in HCV Genotype 3
Addressing Unmet Medical Needs in HCV Genotype 3 Karen Doucette, MD, MSc (Epi), FRCPC Associate Professor, Division of Infectious Diseases, Department of Medicine University of Alberta Objectives Identify
More informationWorldwide Causes of HCC
Approach to HCV Treatment in Patients with HCC Mark W. Russo, MD, MPH, FACG Carolinas HealthCare System Charlotte Worldwide Causes of HCC 60% 50% 40% 30% 20% 10% 0% 54% 31% 15% Hepatitis B Hepatitis C
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 informationHEPATITIS WEB STUDY. Treatment of Hepatitis C following Liver Transplantation
HEPATITIS WEB STUDY Treatment of Hepatitis C following Liver Transplantation Terry D. Box, MD Associate Professor of Medicine Division of Gastroenterology/Hepatology University of Utah Health Sciences
More informationThe impact of the treatment of HCV in developing Hepatocellular Carcinoma
The impact of the treatment of HCV in developing Hepatocellular Carcinoma Paul Y Kwo, MD Professor of Medicine Medical Director, Liver Transplantation Gastroenterology/Hepatology Division Indiana University
More informationTREATMENT OF HEPATITIS C IN THE LIVER TRANSPLANT SETTING. Dra. Zoe Mariño Liver Unit. Hospital Clinic Barcelona
TREATMENT OF HEPATITIS C IN THE LIVER TRANSPLANT SETTING Dra. Zoe Mariño Liver Unit. Hospital Clinic Barcelona Hepatitis C after LT Survival (%) HCV negative HCV positive Time from LT (years) HCV treatment
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 informationPopulation Viral Kinetic Modeling: SVR Prediction in HCV GT-3 Cirrhotic Patients With 24 Weeks of Daclatasvir + Sofosbuvir Administration
Population Viral Kinetic Modeling: SVR Prediction in HCV GT-3 Cirrhotic Patients With 24 Weeks of Daclatasvir + Sofosbuvir Administration Emi Tafoya, Yasong Lu, Melody Luo, Premkumar Narasimhan, Neelima
More information