Treatment Options for Hepatitis C in the Post Transplant Patient

Size: px
Start display at page:

Download "Treatment Options for Hepatitis C in the Post Transplant Patient"

Transcription

1 Treatment Options for Hepatitis C in the Post Transplant Patient Caroline Rochon, MD, FACS,FRCSC Transplant and Hepatobiliary Surgery Hartford Hospital Assistant Professor of Surgery, University of Connecticut

2 Presentation Outline Brief overview of HCV post transplant course First, avoid the problem! Donor and Recipient Factors implicated in Recurrent HCV post transplantation Second, who should we treat? Third: How should we treat them? Fibrosing Cholestatic Hepatitis Re-transplantation for HCV Hartford Hospital Transplant Team approach

3 Introduction HCV is the cause of about 40 % of all chronic liver disease in the United States. HCV-associated cirrhosis is the most common indication for liver transplantation (OLT) among adults. Second most common indication is HCC Most common cause of HCC in US HCV!!! HCV infection remains a problem after transplantation and recurrent hepatic infection is the leading cause of graft failure.

4 Adult liver transplants

5 Patient survival by HCV status Berenguer et al. Hepatology 2002

6 Graft survival among adult liver transplant recipients transplanted in 2006: deceased donors

7 HCV: Call me EL Senior Bad Guy

8 Recurrent HCV Recurrent HCV infection of the allograft is universal in the anti- HCV positive candidate who is HCV RNA positive at the time of transplantation Rare if HCV RNA has been eradicated prior to transplantation. Early studies of recurrent hepatitis C following liver transplantation underestimated both the incidence and severity of recurrence because of retrospective design, small numbers, and short follow-up. Most relied on serum transaminases elevations rather than histology for the diagnosis of recurrence, despite a lack of correlation between these. The incidence and natural history of recurrent hepatitis C can be determined accurately only through prospective, longitudinal studies with frequent serial, protocol allograft biopsies.

9 FACTORS AFFECTING RECURRENT HCV Donor factors Age Gender (?) Ischemic time HCV+ LDLT (?) Steatosis Recipient factors Gender (?) Posttransplant Rejection CMV Immunosuppression Biliary complications Viral levels

10 When to Biopsy and When to Treat: Risks and Benefits Most centers perform protocol biopsies at 12months post transplant. Patients also get biopsied at any time post transplant if clinically indicated abnormal Liver function tests Earlier protocol biopsies are interesting academically but in the absence of clinical indication, it can be hard/risky to treat a patient too early post transplantation (immunosuppresion modulation/high risk of rejection/anemia...). Treatment is usually considered in patients with F2. Some studies have all patients with post transplant viremia or all patients with abnormal liver function test and a biopsy showing hepatitis without rejection but the 30% risk of rejection and multiple potential complications have to be weight agains the benefits of treatment.

11

12 Fibrosing Cholestatic Hepatitis (FCH) Rare form of RHCV with agressive course and rapid deterioration known as FCH. Can affect transplant recipients with hepatitis B virus or HCV. Characterized histologically by extensive pericellular/sinusoidal fibrosis and cholestasis Early control of this entity is imperative if the allograft is to be salvaged however prognosis is poor no matter what In the transplantation setting the most common diagnostic considerations are acute cellular rejection (ACR) and a more routine recurrent RHCV. Important to distinguish FCH from other complications to ensure proper therapy. Recognition of FCH is imperative due to the rapid progression of this disease.

13

14

15

16 What to do when it hits?

17 Standard Treatment of Recurrent HCV Antiviral therapy with interferon based regimens is the standard of care. Treatment is usually considered in patients with F2. Double therapy with peginterferon and ribavirin results in sustained viral response (SVR) rates: 25-40% HCV genotype % in non-1 HCV genotypes

18 Standard Treatment of Recurrent HCV Most side effects are of hematologic (anemia, neutropenia, thrombocyotpenia), or psychiatric nature (depression). Rejection and de novo autoimmune hepatitis can be triggered by the use of interferon (Up to 40% rate). Treatment discontinuation is frequently recorded, with over 25% of patients failing to complete therapy Common reasons for treatment discontinuation include fatigue, depression, and cytopenias

19

20

21

22

23

24

25 (a) Receptor binding and cell entry can be blocked by entry inhibitors and neutralizing antibodies. Hepatitis C virus receptor complex contains several components including binding/attachment factors, which concentrate hepatitis C virus on the cell surface (low density lipoprotein receptor). (b) Uncoating and viral RNA release activates endogenous interferon pathways. (c) RNA to endoplasmic reticulum activates innate immunity. The internal ribosome entry site (IRES) acts as the GPS system to direct the virus to the endoplasmic reticulum. Antisense, ribozymes (heptazyme), sirna, and IRES-eIF3-binding blocker are all potential methods for the inhibition of IRES. (d) Translation and polyprotein processing requires viral NS3/NS4a protease and can be blocked by protease inhibitors. (e) Transcription can be inhibited by translational arrest (protease inhibitors), inhibiting the binding of RNA and polymerase to the replicase complex (cyclophilin inhibitors), NS5A/B inhibition (polymerase inhibitors), and preventing the unwinding of template and progeny plus-strand RNA (helicase inhibitors). (f) Viral assembly and export can be blocked by impairing envelope glycosylation (UT-231B, celgosivir) or NS5A inhibition. Macmillan Publishers Ltd: [Moradpour et al. 2007] copyright 2007.

26 The hepatitis C virus protease enzyme is a serine proteinase with a catalytic site, two substrate binding sites, an NS4A-binding site and NS2/NS3 proteinase substrate-recognition site, a helicase single-strand RNA-binding site, and a zincbinding site. This offers multiple potential avenues to inhibit the enzyme and block HCV-RNA translation. Elsevier [Pawlotsky et al. 2007].

27 Telaprevir

28 Boceprevir

29 Safety and Efficacy of Protease Inhibitors to Treat Hepatitis C After Liver Transplantation, a Multicenter Experience Methods Coilly A, et al.hôpital Paul Brousse, Villejuif France; J Hepatol Aug 29. [Epub ahead of print] 37 liver transplant recipients (male: 92%, age 57±11years), treated with boceprevir (n=18) or telaprevir (n=19). The indication for therapy was HCV recurrence (fibrosis stage F2 (n=31, 83%) or fibrosing cholestatic hepatitis (n=6, 16%). Results 22 patients received cyclosporine and 15 tacrolimus. After 12 weeks, a complete virological response was obtained in 89% of patients treated with boceprevir, and 58% with telaprevir (P=0.06). The end of treatment virological response rate was 72% (13/18) in the boceprevir group and 40% (4/10) in the telaprevir group (P=0.125). A sustained virological response 12 weeks after treatment discontinuation was observed in 20% (1/5) and 71% (5/7) of patients in the telaprevir and boceprevir groups, respectively (P=0.24). Treatment was discontinued in 16 patients (treatment failures (n=11), adverse events (n=5)). Infections occurred in 10 patients (27%), with three fatal outcomes (8%). The most common adverse effect was anemia (n=34, 92%), treated with erythropoietin and/or a ribavirin dose reduction; thirteen patients (35%) received red blood cell transfusions. The cyclosporine dose was reduced by 1.8±1.1-fold and 3.4±1.0-fold with boceprevir and telaprevir, respectively. The tacrolimus dose was reduced by 5.2±1.5-fold with boceprevir and 23.8±18.2-fold with telaprevir.

30 Protease Inhibitors: Multicenter experience using telaprevir or boceprevir with peginterferon and ribavirin to treat hepatitis C genotype 1 after liver transplantation. The safety, efficacy, and effect on immunosuppression levels of telaprevir (TVR) or boceprevir (BOC) when combined with peginterferon and ribavirin (Peg-IFN/RBV) in liver transplant recipients has not been defined. Patients with biopsy-proven HCV recurrence (METAVIR grade 3 and/or stage 2) received TVR with Peg-IFN/RBV for 12 weeks, then Peg- IFN/RBV for 36 weeks or BOC with Peg-IFN/RBV for 44 weeks after 4 weeks of lead-in Peg-IFN/RBV. immunosuppression changed to cyclosporine 86% treated with TVR achieved an undetectable HCV RNA after an average of 6 weeks, while 48% in the BOC-treated group achieved an undetectable HCV RNA after a mean of 11 weeks. By intention-to-treat analysis, 67% of TVR-treated patients and 45% patients who received BOC achieved undetectable HCV RNA levels at week 24, without viral breakthrough at the last follow-up. TVR or BOC combined with Peg-IFN/RBV achieved on-treatment virological response rates of approximately 50-60% in patients with recurrent HCV after LT but significant side-effects were common. Liver Transpl Jul;19(7): ]

31

32

33

34 Re-Transplantation for recurrent HCV Has gotten a lot of bad press due to early very low survivals some centers consider it a contraindication Multicenter studies are now showing acceptable outcomes with improved patient selection FCH patients probably need be excluded Patient with Clinically Recurrent HCV within 6 months of OLTx probably should be excluded

35 CHALLENGES How to maximize viral clearance pre transplant given the extensive side effects How to adapt pre transplant treatment algorithms to post transplant patients How to improve access to transplant to HCV patients and wisely use marginal and older donor livers How to modulate immunosuppression? Preventing rejection without overimmunosuppressing patients may result in better HCV outcomes after transplant

36 Hartford Hospital Team Approach Treat patients pre transplant if they can tolerate it We Try to use donors less than 60 yo in HCV+ recipients We avoid donor livers with steatosis > 30% We always minimize CIT and WIT Rapid steroid taper with no PO steroids by the time patients go home We perform protocol biopsies at 12 months and treat patients with Stage 2 fibrosis post transplant We consider patient with cirrhosis from recurrent HCV on a case by case basis

37 Thank You!!

38 Factors Affecting Recurrent HCV Donor factors Age YES!! Gender (?) Ischemic time HCV+ LDLT (?) Steatosis NO!! NO(if >20)!! YES!! Recipient factors Gender (?) Posttransplant Rejection CMV Immunosuppression Biliary complications Viral levels YES!!

39 Impact of using HCV+ donors Transplant Intl (23) 2010;

40 Posttransplant Factors Biliary complications Steroids Rejection Viral levels Immunosuppression

41 Recurrent HCV Recurrent HCV infection of the allograft is universal in the anti- HCV positive candidate who is HCV RNA positive at the time of transplantation Rare if HCV RNA has been eradicated prior to transplantation. Early studies of recurrent hepatitis C following liver transplantation underestimated both the incidence and severity of recurrence because of retrospective design, small numbers, and short follow-up. Most relied on serum transaminases elevations rather than histology for the diagnosis of recurrence, despite a lack of correlation between these. The incidence and natural history of recurrent hepatitis C can be determined accurately only through prospective, longitudinal studies with frequent serial, protocol allograft biopsies.

Update on Hepatitis C. Sally Williams MD

Update on Hepatitis C. Sally Williams MD Update on Hepatitis C Sally Williams MD Hep C is Everywhere! Hepatitis C Magnitude of the Infection Probably 8 to 10 million people in the U.S. are infected with Hep C 30,000 new cases are diagnosed annually;

More information

Management of hepatitis C: pre- and post-liver transplantation. Piyawat Komolmit Bangkok

Management of hepatitis C: pre- and post-liver transplantation. Piyawat Komolmit Bangkok Management of hepatitis C: pre- and post-liver transplantation Piyawat Komolmit Bangkok Liver transplantation and CHC Cirrhosis secondary to HCV is the leading cause of liver transplantation in the US

More information

Focus on Transplantation: Treatment Post-transplant for HBV and HCV

Focus on Transplantation: Treatment Post-transplant for HBV and HCV Focus on Transplantation: Treatment Post-transplant for HBV and HCV The Viral Hepatitis Congress, Frankfurt, 09. September 2012 Christoph Sarrazin J. W. Goethe-University Hospital Medizinische Klinik I

More information

Cirrhosis and HCV. Jonathan Israel M.D.

Cirrhosis and HCV. Jonathan Israel M.D. Cirrhosis and HCV Jonathan Israel M.D. Outline Relationship of fibrosis and cirrhosisprevalence and epidemiology. Sequelae of cirrhosis Diagnosis of cirrhosis Effect of cirrhosis on efficacy of treatment

More information

Recurrent HCV Following Liver Transplantation

Recurrent HCV Following Liver Transplantation Recurrent HCV Following Liver Transplantation Russell H. Wiesner, MD Professor of Medicine Mayo Clinic College of Medicine Rochester, MN, USA ILTS Western/Eastern Perspective Hong Kong, CHINA April 5-6,

More information

Viral Hepatitis Prevention Board Meeting November 2013. The Netherlands: Hepatitis C treatment guidelines

Viral Hepatitis Prevention Board Meeting November 2013. The Netherlands: Hepatitis C treatment guidelines Viral Hepatitis Prevention Board Meeting November 2013 The Netherlands: Hepatitis C treatment guidelines Floor Berden MD, PhD student Radboud university medical center Nijmegen, the Netherlands Conflicts

More information

HIV/Hepatitis C co-infection. Update on treatment Eoin Feeney

HIV/Hepatitis C co-infection. Update on treatment Eoin Feeney HIV/Hepatitis C co-infection Update on treatment Eoin Feeney HIV/Hepatitis C coinfection Where we are now Current treatment regimens and outcomes What s coming soon Direct acting antivirals (DAAs) What

More information

boceprevir 200mg capsule (Victrelis ) Treatment naïve patients SMC No. (723/11) Merck Sharpe and Dohme Ltd

boceprevir 200mg capsule (Victrelis ) Treatment naïve patients SMC No. (723/11) Merck Sharpe and Dohme Ltd boceprevir 200mg capsule (Victrelis ) Treatment naïve patients SMC No. (723/11) Merck Sharpe and Dohme Ltd 09 September 2011 The Scottish Medicines Consortium (SMC) has completed its assessment of the

More information

boceprevir 200mg capsule (Victrelis ) Treatment experienced patients SMC No. (722/11) Merck, Sharpe and Dohme Ltd

boceprevir 200mg capsule (Victrelis ) Treatment experienced patients SMC No. (722/11) Merck, Sharpe and Dohme Ltd boceprevir 200mg capsule (Victrelis ) Treatment experienced patients SMC No. (722/11) Merck, Sharpe and Dohme Ltd 09 September 2011 The Scottish Medicines Consortium (SMC) has completed its assessment

More information

Hepatitis C Monitoring and Complications (and Treatment!) Dr Mark Douglas

Hepatitis C Monitoring and Complications (and Treatment!) Dr Mark Douglas Hepatitis C Monitoring and Complications (and Treatment!) Dr Mark Douglas Hepatitis C Virus Shimizu et al., 1996 Positive single strand RNA virus Flaviviridae family, Hepacivirus genus 9.6 kbp genome ~3000

More information

HCV in 2020: Any cases left? Rafael Esteban Hospital General Universitario Valle Hebron Barcelona. Spain

HCV in 2020: Any cases left? Rafael Esteban Hospital General Universitario Valle Hebron Barcelona. Spain HCV in 2020: Any cases left? Rafael Esteban Hospital General Universitario Valle Hebron Barcelona. Spain Yes, still too many Measures to eradicate an Infectious Disease Prevention: Vaccination Screening

More information

Hepatitis C Glossary of Terms

Hepatitis C Glossary of Terms Acute Hepatitis C A short-term illness that usually occurs within the first six months after someone is exposed to the hepatitis C virus (HCV). 1 Antibodies Proteins produced as part of the body s immune

More information

Therapy of decompensated cirrhosis Pre-transplant for HBV and HCV

Therapy of decompensated cirrhosis Pre-transplant for HBV and HCV Therapy of decompensated cirrhosis Pre-transplant for HBV and HCV Universitätsklinikum Leipzig Thomas Berg Sektion Hepatologie Klinik und Poliklinik für Gastroenterologie und Rheumatologie Leber- und Studienzentrum

More information

Hepatitis Update. Study 110: SVR at post-treatment week 24 (SVR24) Jürgen Rockstroh, MD. No ART EFV/TDF/FTC ART/r/TDF/FTC Total

Hepatitis Update. Study 110: SVR at post-treatment week 24 (SVR24) Jürgen Rockstroh, MD. No ART EFV/TDF/FTC ART/r/TDF/FTC Total Hepatitis Update Jürgen Rockstroh, MD Study 11: SVR at post-treatment week 24 (SVR24) Patients with Undetectable HCV RNA (Percentage) 8 7 6 5 4 3 2 1 71 No ART EFV/TDF/FTC ART/r/TDF/FTC Total 69 8 74 n/n

More information

Hepatitis C Class Review

Hepatitis C Class Review Hepatitis C Class Review Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-945-5220 Fax 503-947-1119 Month/Year of Review: January

More information

Debate: To Treat Now or Not to Treat Now. Age, Disease Stage, Resistance, and Comorbidities

Debate: To Treat Now or Not to Treat Now. Age, Disease Stage, Resistance, and Comorbidities Debate: To Treat Now or Not to Treat Now Age, Disease Stage, Resistance, and Comorbidities Moderator: Raymond T. Chung, MD Associate Professor of Medicine, Harvard Medical School Director of Hepatology

More information

Hepatitis C and Liver Transplantation. Dinesh Ranjan, M.D. Professor of Surgery Director of Liver Transplantation University of Kentucky

Hepatitis C and Liver Transplantation. Dinesh Ranjan, M.D. Professor of Surgery Director of Liver Transplantation University of Kentucky Hepatitis C and Liver Transplantation Dinesh Ranjan, M.D. Professor of Surgery Director of Liver Transplantation University of Kentucky History Known as Non-A A Non-B B Hepatitis in 1974 HCV identified

More information

Case Study in the Management of Patients with Hepatocellular Carcinoma

Case Study in the Management of Patients with Hepatocellular Carcinoma Management of Patients with Viral Hepatitis, Paris, 2004 Case Study in the Management of Patients with Hepatocellular Carcinoma Eugene R. Schiff This 50-year-old married man with three children has a history

More information

PRIOR AUTHORIZATION PROTOCOL FOR HEPATITIS C TREATMENT

PRIOR AUTHORIZATION PROTOCOL FOR HEPATITIS C TREATMENT PRIOR AUTHORIZATION PROTOCOL FOR HEPATITIS C TREATMENT HARVONI (90mg ledipasvir/400mg sofosbuvir): tablet (PREFERRED AGENT) SOVALDI (sofosbuvir ): 400mg tablets (PREFERRED AGENT ) OLYSIO (simeprivir) PEG-INTRON

More information

Innovazione farmacologica e farmacologia clinica

Innovazione farmacologica e farmacologia clinica Innovazione farmacologica e farmacologia clinica Francesco Scaglione, MD, PhD Department of Medical Biotechnology and Translational Medicine School of medicine Postgradute School of clinical pharmacology

More information

Update on hepatitis C: treatment and care and future directions

Update on hepatitis C: treatment and care and future directions Update on hepatitis C: treatment and care and future directions Professor Greg Dore Viral Hepatitis Clinical Research Program, National Centre in HIV Epidemiology and Clinical Research, University of New

More information

UPDATE ON NEW HEPATITIS C MEDICINES

UPDATE ON NEW HEPATITIS C MEDICINES UPDATE ON NEW HEPATITIS C MEDICINES Diana Sylvestre, MD 2014 AASLD/IDSA Guidelines: Gt 1 Treatment naïve Interferon eligible: sofosuvir + ribavirin + PEG-IFN x 12 weeks Interferon ineligible: sofosbuvir

More information

Monitoring of Treatment of viral hepatitis C

Monitoring of Treatment of viral hepatitis C Monitoring of Treatment of viral hepatitis C J.Boubaker Department of Gastroenterology La Rabta hospital Tunis-Tunisia Monitoring of Hepatitis C Treatment Aims of Monitoring : Evaluate Efficacy. Detect

More information

Safety and Efficacy of DAA + PR in HCV/HIV co-infected patients. Mark Sulkowski, MD Johns Hopkins University Baltimore Maryland USA

Safety and Efficacy of DAA + PR in HCV/HIV co-infected patients. Mark Sulkowski, MD Johns Hopkins University Baltimore Maryland USA Safety and Efficacy of DAA + PR in HCV/HIV co-infected patients Mark Sulkowski, MD Johns Hopkins University Baltimore Maryland USA Liver disease is the second leading cause of death amongst HIV-positive

More information

The question and answer session is not available after the live webinar.

The question and answer session is not available after the live webinar. 1 Read verbatim. 2 The Infectious Diseases Society of America (IDSA) Hepatitis C Knowledge Network offers monthly, 1 hour webinars to educate IDSA members on current recommended practices and treatments

More information

Review: How to work up your patient with Hepatitis C

Review: How to work up your patient with Hepatitis C Review: How to work up your patient with Hepatitis C You screened your patient, and now the HCV antibody test is positive. What do you do next? The antibody test only means they have been exposed to HCV.

More information

Commonly Asked Questions About Chronic Hepatitis C

Commonly Asked Questions About Chronic Hepatitis C Commonly Asked Questions About Chronic Hepatitis C From the American College of Gastroenterology 1. How common is the hepatitis C virus? The hepatitis C virus is the most common cause of chronic viral

More information

Peg-IFN and ribavirin: what sustained virologic response can be achieved by using HCV genotyping and viral kinetics?

Peg-IFN and ribavirin: what sustained virologic response can be achieved by using HCV genotyping and viral kinetics? Peg-IFN and ribavirin: what sustained virologic response can be achieved by using HCV genotyping and viral kinetics? Prof. I. Bakulin Gastroenterology Department Key Questions Background Worldwide prevalence

More information

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Hepatitis C Agents

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Hepatitis C Agents MEDICAL ASSISTANCE HBOOK PRI AUTHIZATION OF PHARMACEUTICAL SERVICES I. Requirements for Prior Authorization of Hepatitis C Agents A. Prescriptions That Require Prior Authorization Prescriptions for Interferon,

More information

17/01/14. What are special patient groups? Management of hepatitis C in special patient groups. Management of hepatitis C in

17/01/14. What are special patient groups? Management of hepatitis C in special patient groups. Management of hepatitis C in Management of hepatitis C in special patient groups Minisymposium Challenges in viral hepatitis 14 Lausanne 16.1.14 B. Müllhaupt Gastroenterology and Hepatology Swiss HPB- and Transplant-Center University

More information

Transmission of HCV in the United States (CDC estimate)

Transmission of HCV in the United States (CDC estimate) Transmission of HCV in the United States (CDC estimate) Past and Future US Incidence and Prevalence of HCV Infection Decline among IDUs Overall incidence Overall prevalence Infected 20+ years Armstrong

More information

Ledipasvir/Sofosbuvir (Harvoni) for Treatment of Hepatitis C

Ledipasvir/Sofosbuvir (Harvoni) for Treatment of Hepatitis C Ledipasvir/Sofosbuvir (Harvoni) for Treatment of Hepatitis C Policy Number: Original Effective Date: MM.04.034 12/1/2014 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 12/1/2014

More information

After the Cure: Long-Term Management of HCV Liver Disease Norah A. Terrault, MD, MPH

After the Cure: Long-Term Management of HCV Liver Disease Norah A. Terrault, MD, MPH After the Cure: Long-Term Management of HCV Liver Disease Norah A. Terrault, MD, MPH Professor of Medicine Department of Gastroenterology Director, Viral Hepatitis Center University of California San Francisco

More information

What does Hepatitis C mean to me as a CKD Patient?

What does Hepatitis C mean to me as a CKD Patient? What does Hepatitis C mean to me as a CKD Patient? Clinical Practice Guidelines for the Prevention, Diagnosis, Evaluation and Treatment of Hepatitis C in CKD Introduction Worldwide, about 170 million people

More information

HCV Case Study. Optimizing Outcomes with Current Therapies

HCV Case Study. Optimizing Outcomes with Current Therapies HCV Case Study Optimizing Outcomes with Current Therapies This program is supported by educational grants from Kadmon and Merck Pharmaceuticals. Program Disclosure This activity has been planned and implemented

More information

HIV and Hepatitis Co-infection. Martin Fisher Brighton and Sussex University Hospitals, UK

HIV and Hepatitis Co-infection. Martin Fisher Brighton and Sussex University Hospitals, UK HIV and Hepatitis Co-infection Martin Fisher Brighton and Sussex University Hospitals, UK Useful References British HIV Association 2010 http://www.bhiva.org/documents/guidelines/hepbc/2010/ hiv_781.pdf

More information

Current Opinion in Hepatitis C Treatment

Current Opinion in Hepatitis C Treatment White Nights of Hepatology 2011 Current Opinion in Hepatitis C Treatment George V. Papatheodoridis, MD Associate Professor in Medicine & Gastroenterology 2nd Department of Internal Medicine, Athens University

More information

Management of Chronic HCV Cirrhosis: Pre and Post-Liver Transplantation

Management of Chronic HCV Cirrhosis: Pre and Post-Liver Transplantation Management of Chronic HCV Cirrhosis: Pre and Post-Liver Transplantation K.Rajender Reddy M.D., Professor of Medicine and Surgery Director of Hepatology Director, Viral Hepatitis Center Transplantation

More information

Clinical Criteria for Hepatitis C (HCV) Therapy

Clinical Criteria for Hepatitis C (HCV) Therapy Diagnosis Clinical Criteria for Hepatitis C (HCV) Therapy Must have chronic hepatitis C (HCV infection > 6 months), genotype and sub-genotype specified to determine the length of therapy; Liver biopsy

More information

New IDSA/AASLD Guidelines for Hepatitis C

New IDSA/AASLD Guidelines for Hepatitis C NORTHWEST AIDS EDUCATION AND TRAINING CENTER New IDSA/AASLD Guidelines for Hepatitis C John Scott, MD, MSc Associate Professor, UW SoM Asst Director, Liver Clinic, Harborview Medical Center Presentation

More information

The following should be current within the past 6 months:

The following should be current within the past 6 months: EVALUATION Baseline Labs Obtain at time or prior to initial evaluation CBC with diff PT/INR CMP HCV Genotype (obtained PRIOR TO consult visit) HCV RNA (obtained PRIOR TO consult visit) Hep A IgG Hep BsAg,

More information

HIV/HCV Co-infection. HIV/HCV Co-infection. Epidemiology. Dr Ranjababu Kulasegaram Guy s & St Thomas Hospital London. Extrahepatic manifestations

HIV/HCV Co-infection. HIV/HCV Co-infection. Epidemiology. Dr Ranjababu Kulasegaram Guy s & St Thomas Hospital London. Extrahepatic manifestations HIV/HCV Co-infection Dr Ranjababu Kulasegaram Guy s & St Thomas Hospital London HIV/HCV Co-infection Epidemiology Impact of HIV on HCV Epidemiology Impact of HCV on HIV Management issues Future Extrahepatic

More information

NP/PA Clinical Hepatology Fellowship Summary of Year-Long Curriculum

NP/PA Clinical Hepatology Fellowship Summary of Year-Long Curriculum OVERVIEW OF THE FELLOWSHIP The goal of the AASLD NP/PA Fellowship is to provide a 1-year postgraduate hepatology training program for nurse practitioners and physician assistants in a clinical outpatient

More information

Preamble. Introduction. Marc G. Ghany, 1 David R. Nelson, 2 Doris B. Strader, 3 David L. Thomas, 4 and Leonard B. Seeff 5 *

Preamble. Introduction. Marc G. Ghany, 1 David R. Nelson, 2 Doris B. Strader, 3 David L. Thomas, 4 and Leonard B. Seeff 5 * An Update on Treatment of Genotype 1 Chronic Hepatitis C Virus Infection: 2011 Practice Guideline by the American Association for the Study of Liver Diseases A new section on Use and Interpretation of

More information

Robert G. Knodell, M.D. Maryland Chapter, American College of Physicians Fb February 3, 2012

Robert G. Knodell, M.D. Maryland Chapter, American College of Physicians Fb February 3, 2012 Treatment of Hepatitis C:Present and Future Robert G. Knodell, M.D. Scientific Meeting Maryland Chapter, American College of Physicians Fb February 3, 2012 Presentation Objectives Appreciate the Public

More information

Newton Kendig, MD RADM, Assistant Surgeon General, USPHS Assistant Director Health Services Division, FBOP

Newton Kendig, MD RADM, Assistant Surgeon General, USPHS Assistant Director Health Services Division, FBOP Newton Kendig, MD RADM, Assistant Surgeon General, USPHS Assistant Director Health Services Division, FBOP I do not have any relevant financial relationships with any commercial interests. At the end of

More information

NEW DRUGS FOR THE TREATMENT OF HEPATITIS C. Marcella Honkonen, PharmD, BCPS AzPA Annual Convention. Sunday, June 29 th, 2014 (1:15-2:15)

NEW DRUGS FOR THE TREATMENT OF HEPATITIS C. Marcella Honkonen, PharmD, BCPS AzPA Annual Convention. Sunday, June 29 th, 2014 (1:15-2:15) NEW DRUGS FOR THE TREATMENT OF HEPATITIS C Marcella Honkonen, PharmD, BCPS AzPA Annual Convention. Sunday, June 29 th, 2014 (1:15-2:15) Objectives Determine initial treatment options for patients with

More information

Boehringer Ingelheim- sponsored Satellite Symposium. HCV Beyond the Liver

Boehringer Ingelheim- sponsored Satellite Symposium. HCV Beyond the Liver Boehringer Ingelheim- sponsored Satellite Symposium HCV Beyond the Liver HCV AS A METABOLIC MODIFIER: STEATOSIS AND INSULIN RESISTANCE Francesco Negro University Hospital of Geneva Switzerland Clinical

More information

PHARMACY PRIOR AUTHORIZATION

PHARMACY PRIOR AUTHORIZATION PHARMACY PRIOR AUTHORIZATION Hepatitis C Clinical Guideline Harvoni (sofosbuvir/ledipasvir), Sovaldi (sofosbuvir), Viekira PAK (ombitsavir, paritapravir/ritonavir, dasubavir), and Olysio (simeprevir) Authorization

More information

Disclosure of Conflicts of Interest Learner Assurance Statement:

Disclosure of Conflicts of Interest Learner Assurance Statement: Raj Reddy, MD Ruimy Family President's Distinguished Professor of Medicine Professor of Medicine in Surgery Director of Hepatology Director, Viral Hepatitis Center Medical Director, Liver Transplantation

More information

Post AASLD Update in HCV Torino, 10 Gennaio 2013. Fattori che possono influenzare il trattamento: RVR e Lead in

Post AASLD Update in HCV Torino, 10 Gennaio 2013. Fattori che possono influenzare il trattamento: RVR e Lead in Post AASLD Update in HCV Torino, 10 Gennaio 2013 Fattori che possono influenzare il trattamento: RVR e Lead in Alessia Ciancio Università di Torino Città della Salute e delle Scienze Will predictors usefull

More information

In this study, the DCV+ASV regimen had low rates of discontinuation (5%) due to adverse events, and low rates of serious adverse events (5.

In this study, the DCV+ASV regimen had low rates of discontinuation (5%) due to adverse events, and low rates of serious adverse events (5. BMS Submits First All-Oral, Interferon-Free and Ribavirin-Free Treatment Regimen for Regulatory Review in Japan for Patients with Chronic Hepatitis C Infection An overall SVR 24 rate of 84.7 percent was

More information

HEPATITIS C THERAPY PRIOR AUTHORIZATION FORM: Page 1 of 3 Patient Information. Diagnosis Acute Hep C Chronic Hep C Hepatocellular Carcinoma

HEPATITIS C THERAPY PRIOR AUTHORIZATION FORM: Page 1 of 3 Patient Information. Diagnosis Acute Hep C Chronic Hep C Hepatocellular Carcinoma HEPATITIS C THERAPY PRIOR AUTHORIZATION FORM: Page 1 of 3 Patient Information Recipient: MA#: Date of Birth: Phone #: Body Weight: Treatment Plan Sovaldi (sofosbuvir) 400mg: Take once daily for weeks Olysio

More information

Molecular Diagnosis of Hepatitis B and Hepatitis D infections

Molecular Diagnosis of Hepatitis B and Hepatitis D infections Molecular Diagnosis of Hepatitis B and Hepatitis D infections Acute infection Detection of HBsAg in serum is a fundamental diagnostic marker of HBV infection HBsAg shows a strong correlation with HBV replication

More information

LIVER FUNCTION TESTS AND STATINS

LIVER FUNCTION TESTS AND STATINS LIVER FUNCTION TESTS AND STATINS Philippe J. Zamor and Mark W. Russo Current Opinion in Cardiology 2011,26:338 341 SUMMARY Purpose of review: To discuss recent data on statins in patients with elevated

More information

What to Do with the Patient With Abnormal Liver Enzymes? Nizar N. Zein, M.D. The Cleveland Clinic

What to Do with the Patient With Abnormal Liver Enzymes? Nizar N. Zein, M.D. The Cleveland Clinic What to Do with the Patient With Abnormal Liver Enzymes? Nizar N. Zein, M.D. The Cleveland Clinic Introduction Elevated liver enzymes is often not a clinical problem by itself. However it is a warning

More information

Victrelis: hints for success. Katarnya Gilbert Hepatology MSL MSD

Victrelis: hints for success. Katarnya Gilbert Hepatology MSL MSD Victrelis: hints for success Katarnya Gilbert Hepatology MSL MSD 1 Some Facts: BOC has no clinically significant activity against other HCV genotypes. Resistance with protease inhibitor monotherapy can

More information

MEDICAL POLICY STATEMENT

MEDICAL POLICY STATEMENT MEDICAL POLICY STATEMENT Original Effective Date Next Annual Review Date Last Review / Revision Date 5/21/2014 3/24/2016 3/24/2015 Policy Name Policy Number Hepatitis C Oral SRx-0003 Medical Policy Statements

More information

Prior Authorization Policy

Prior Authorization Policy Prior Authorization Policy http://www.paramounthealthcare.com/providers Ribavirin Rebetol (ribavirin capsule or oral solution) Copegus (ribavirin tablet), Moderiba (ribavirin tablet), Ribasphere (ribavirin

More information

The Use of Protease Inhibitors for the Treatment of Hepatitis C in Liver Transplant Recipients: Is a Bird in the Hand Worth Two in the Bush?

The Use of Protease Inhibitors for the Treatment of Hepatitis C in Liver Transplant Recipients: Is a Bird in the Hand Worth Two in the Bush? The Use of Protease Inhibitors for the Treatment of Hepatitis C in Liver Transplant Recipients: Is a Bird in the Hand Worth Two in the Bush? Christina Guerra, PharmD PGY-1 Pharmacy Resident University

More information

Hepatitis C Treatment Advocacy: Ireland. Brian O Mahony

Hepatitis C Treatment Advocacy: Ireland. Brian O Mahony Hepatitis C Treatment Advocacy: Ireland Brian O Mahony Haemophilia and Hepatitis C 775 people with Haemophilia in Ireland 252 people with Haemophilia infected with Hepatitis C before 1992 106 of these

More information

Introduction. Background

Introduction. Background INFORMATION DRIVES SOUND ANALYSIS, INSIGHT PHARMACY BENEFIT ADVISORY Introduction According to the Centers for Disease Control and Prevention (CDC), the rate of new hepatitis C virus (HCV) infections in

More information

Technology appraisal guidance Published: 25 November 2015 nice.org.uk/guidance/ta364

Technology appraisal guidance Published: 25 November 2015 nice.org.uk/guidance/ta364 Daclatasvir for treating chronic hepatitis C Technology appraisal guidance Published: 25 November 2015 nice.org.uk/guidance/ta364 NICE 2015. All rights reserved. Contents 1 Guidance... 3 Table 1 Daclatasvir

More information

Treatment of Hepatitis C in Patients with Renal Insufficiency

Treatment of Hepatitis C in Patients with Renal Insufficiency HEPATITIS WEB STUDY HEPATITIS C ONLINE Treatment of Hepatitis C in Patients with Renal Insufficiency Robert G. Gish MD Professor Consultant, Stanford University Medical Center Senior Medical Director,

More information

Hepatitis C Treatment Expansion Initiative Multi-Site Conference Call. March 16, 2011

Hepatitis C Treatment Expansion Initiative Multi-Site Conference Call. March 16, 2011 Hepatitis C Treatment Expansion Initiative Multi-Site Conference Call March 16, 2011 Case Presentations Kansas City Free Health Clinic Carilion Clinic Didactic Session Challenges in Determining HCV Treatment

More information

Clinical Criteria for Hepatitis C (HCV) Therapy

Clinical Criteria for Hepatitis C (HCV) Therapy Diagnosis Clinical Criteria for Hepatitis C (HCV) Therapy Must have chronic hepatitis C, genotype and sub-genotype specified to determine the length of therapy; Liver biopsy or other accepted test demonstrating

More information

Management of non response or relapse following HCV therapy. Greg Dore Darrell Crawford

Management of non response or relapse following HCV therapy. Greg Dore Darrell Crawford Management of non response or relapse following HCV therapy Greg Dore Darrell Crawford Learning objectives To understand importance of characterisation of prior HCV therapy response To explore options

More information

Hepatitis C. David Mutimer Queen Elizabeth Hospital Liver Unit Birmingham. Substance Misuse Treatment in the West Midlands. How can we reduce harm?

Hepatitis C. David Mutimer Queen Elizabeth Hospital Liver Unit Birmingham. Substance Misuse Treatment in the West Midlands. How can we reduce harm? Hepatitis C David Mutimer Queen Elizabeth Hospital Liver Unit Birmingham Substance Misuse Treatment in the West Midlands. How can we reduce harm? Birmingham October 19 th 2007 infection HCV Natural History

More information

Daclatasvir for treating chronic hepatitis C

Daclatasvir for treating chronic hepatitis C NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Appraisal consultation document Daclatasvir for treating chronic hepatitis C The Department of Health has asked the National Institute for Health and Care

More information

The Comparative Clinical Effectiveness and Value of Simeprevir and Sofosbuvir in the Treatment of Chronic Hepatitis C Infection

The Comparative Clinical Effectiveness and Value of Simeprevir and Sofosbuvir in the Treatment of Chronic Hepatitis C Infection The Comparative Clinical Effectiveness and Value of Simeprevir and Sofosbuvir in the Treatment of Chronic Hepatitis C Infection A Technology Assessment Final Report April 15, 2014 Completed by: Institute

More information

Efficacy of lead-in silibinin and subsequent triple therapy in difficult-to-treat HIV/hepatitis C coinfected patients

Efficacy of lead-in silibinin and subsequent triple therapy in difficult-to-treat HIV/hepatitis C coinfected patients Second Silibinin Workshop, Cologne, 23 rd May 2014 Efficacy of lead-in silibinin and subsequent triple therapy in difficult-to-treat HIV/hepatitis C coinfected patients Dominique L Braun, MD Division of

More information

Coinfezione HIV-HCV. Raffaele Bruno, MD. Department of Infectious Diseases, University of Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Coinfezione HIV-HCV. Raffaele Bruno, MD. Department of Infectious Diseases, University of Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy Coinfezione HIV-HCV Raffaele Bruno, MD This program is supported by educational grants from Department of Infectious Diseases, University of Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

More information

PRIOR AUTHORIZATION POLICY

PRIOR AUTHORIZATION POLICY PRIOR AUTHORIZATION POLICY Harvoni (sofosbuvir/ledipasvir tablets Gilead) To initiate a Coverage Review, Call 1-800-417-1764 OVERVIEW Harvoni is a fixed-dose combination of ledipasvir, a hepatitis C virus

More information

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Hepatitis C Agents

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Hepatitis C Agents MEDICAL ASSISTANCE HBOOK I. Requirements for Prior Authorization of Hepatitis C Agents A. Prescriptions That Require Prior Authorization Prescriptions for Hepatitis C Agents that meet any of the following

More information

A 55 year old man with cirrhosis due to chronic hepatitis C (CHC) genotype 3a is referred for liver transplantation.

A 55 year old man with cirrhosis due to chronic hepatitis C (CHC) genotype 3a is referred for liver transplantation. A 55 year old man with cirrhosis due to chronic hepatitis C (CHC) genotype 3a is referred for liver transplantation. Three years ago he was treated with 24 weeks of peginterferon alfa-2a (180 µg/wk, PEGIFN)

More information

Putting progress into practice for HCV care in Egypt

Putting progress into practice for HCV care in Egypt Putting progress into practice for HCV care in Egypt Chairs: Maria Buti, Ashraf Abou-Gabal, Sami Abdel Fattah, Ali Farag, Faisal Sanai This session has been funded by Gilead Sciences Europe The content

More information

Hepatitis C Second Generation Antivirals (Harvoni, Technivie TM, Viekira Pak ) Prior Authorization - Through Preferred Agent(s) Program Summary

Hepatitis C Second Generation Antivirals (Harvoni, Technivie TM, Viekira Pak ) Prior Authorization - Through Preferred Agent(s) Program Summary Hepatitis C Second Generation Antivirals (Harvoni, Technivie TM, Viekira Pak ) Prior Authorization - Through Preferred Agent(s) Program Summary This program applies to Health Insurance Marketplace, FlexRx

More information

SCIENTIFIC DISCUSSION

SCIENTIFIC DISCUSSION London, 13 October 2005 Product name: PEGINTRON Procedure No. EMEA/H/C/280/II/54 SCIENTIFIC DISCUSSION 7 Westferry Circus, Canary Wharf, London E14 4HB, UK Tel. (44-20) 74 18 84 00 Fax (44-20) 74 18 86

More information

A JOURNAL OF CURRENT TRENDS IN MEDICINE FROM IU HEALTH PHYSICIANS, A PARTNERSHIP OF IU SCHOOL OF MEDICINE AND INDIANA UNIVERSITY HEALTH

A JOURNAL OF CURRENT TRENDS IN MEDICINE FROM IU HEALTH PHYSICIANS, A PARTNERSHIP OF IU SCHOOL OF MEDICINE AND INDIANA UNIVERSITY HEALTH O C T O B E R 2 0 1 3 V O L. 1 3, I S S U E 4 ADVANCEDpraxis A JOURNAL OF CURRENT TRENDS IN MEDICINE FROM IU HEALTH PHYSICIANS, A PARTNERSHIP OF IU SCHOOL OF MEDICINE AND INDIANA UNIVERSITY HEALTH C A

More information

Hepatitis C treatment update

Hepatitis C treatment update Hepatitis C treatment update Viral Hepatitis Workshop Hepatitis Foundation and Regional Public Health December 2013 Jeffrey S Wong Hepatitis C treatment Non-A non-b hepatitis History of HCV treatment Hutt

More information

Hepatitis C Virus (HCV)

Hepatitis C Virus (HCV) HFS Report to Legislative Task Force Hepatitis C Arvind Goyal MD, MPH, MBA Medical Director Illinois Department of Healthcare and Family Services Hepatitis C Virus (HCV) Slowly progressive disease 40 years-median

More information

New treatment options for HCV: implications for the Optimal Use of HCV Assays

New treatment options for HCV: implications for the Optimal Use of HCV Assays New treatment options for HCV: implications for the Optimal Use of HCV Assays Hans Orlent Dept. of Gastroenterology & Hepatology AZ Sint Jan Brugge-Oostende, Brugge This program is supported by educational

More information

Ledipasvir and Sofosbuvir for 8 or 12 Weeks for Chronic HCV without Cirrhosis

Ledipasvir and Sofosbuvir for 8 or 12 Weeks for Chronic HCV without Cirrhosis Ledipasvir and Sofosbuvir for 8 or 12 Weeks for Chronic HCV without Cirrhosis Massachusetts Medical Society, April 2014 sponsored by Gilead Sciences 23.04.2014 Marie-Luise Lauterjung 1 Zweck der Studie

More information

REVIEW CLINICAL AND SYSTEMATIC REVIEWS

REVIEW CLINICAL AND SYSTEMATIC REVIEWS CLINICAL AND SYSTEMATIC S nature publishing group 1 Update on the Management and Treatment of Hepatitis C Virus Infection: Recommendations from the Department of Veterans Affairs Hepatitis C Resource Center

More information

The Natural History of Hepatitis C Cirrhosis After Liver Transplantation

The Natural History of Hepatitis C Cirrhosis After Liver Transplantation LIVER TRANSPLANTATION 15:1063-1071, 2009 ORIGINAL ARTICLE The Natural History of Hepatitis C Cirrhosis After Liver Transplantation Roberto J. Firpi,* Virginia Clark,* Consuelo Soldevila-Pico, Giuseppe

More information

The most serious symptoms of this stage are:

The most serious symptoms of this stage are: The Natural Progression of Hepatitis C The natural history of hepatitis C looks at the likely outcomes for people infected with the virus if there is no medical intervention. However, the process of trying

More information

Worse Recent Efficacy of Antiviral Therapy in Liver Transplant Recipients with Recurrent Hepatitis C: Impact of Donor Age and Baseline Cirrhosis

Worse Recent Efficacy of Antiviral Therapy in Liver Transplant Recipients with Recurrent Hepatitis C: Impact of Donor Age and Baseline Cirrhosis LIVER TRANSPLANTATION 15:738-746, 2009 ORIGINAL ARTICLE Worse Recent Efficacy of Antiviral Therapy in Liver Transplant Recipients with Recurrent Hepatitis C: Impact of Donor Age and Baseline Cirrhosis

More information

Treating Chronic Hepatitis C. A Review of the Research for Adults

Treating Chronic Hepatitis C. A Review of the Research for Adults Treating Chronic Hepatitis C A Review of the Research for Adults Is This Information Right for Me? Yes, this information is right for you if: Your doctor* has told you that you have chronic hepatitis C.

More information

Digestive and Liver Disease

Digestive and Liver Disease Digestive and Liver Disease 44 (2012) 603 609 Contents lists available at SciVerse ScienceDirect Digestive and Liver Disease j our nal ho me page: www.elsevier.com/locate/dld Liver, pancreas and biliary

More information

Boceprevir for previously untreated patients with chronic hepatitis C Genotype 1 infection: a US-based cost-effectiveness modeling study.

Boceprevir for previously untreated patients with chronic hepatitis C Genotype 1 infection: a US-based cost-effectiveness modeling study. Boceprevir for previously untreated patients with chronic hepatitis C Genotype 1 infection: a US-based cost-effectiveness modeling study. Shannon Allen Ferrante, Jagpreet Chhatwal, Clifford Brass, Antoine

More information

Managing Treatment Naive Pa/ents in the DAA Era. An Interac/ve Case study

Managing Treatment Naive Pa/ents in the DAA Era. An Interac/ve Case study Managing Treatment Naive Pa/ents in the DAA Era. An Interac/ve Case study Case Prepared by Sinēad Sheils CNC Royal Prince Alfred Hospital, Sydney Friday 17 th May 2013 Nigel 63 yrs old caucasian male HCV

More information

A Proposal for Managing the Harvoni Wave June 22, 2015

A Proposal for Managing the Harvoni Wave June 22, 2015 A Proposal for Managing the Harvoni Wave June 22, 2015 Clinical Background Hepatitis C is an infectious disease caused by the Hepatitis C Virus (HCV) that damages the liver over time. The disease affects

More information

Protease Inhibitors for Chronic Hepatitis C Infection: The New Kids on the Block, But do they have The Right Stuff for all patients?

Protease Inhibitors for Chronic Hepatitis C Infection: The New Kids on the Block, But do they have The Right Stuff for all patients? Protease Inhibitors for Chronic Hepatitis C Infection: The New Kids on the Block, But do they have The Right Stuff for all patients? Lindsey M. Childs, PharmD, MPH PGY2 Infectious Diseases Pharmacy Resident

More information

1.1.2 Amend the that the Special Authority relating to tenofovir for use in pregnancy for postpartum care;

1.1.2 Amend the that the Special Authority relating to tenofovir for use in pregnancy for postpartum care; Anti-Infective Subcommittee of PTAC Meeting held 1 March 2012 (minutes for web publishing) Anti-Infective Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology

More information

Hepatitis Update. HCV Cure As A Paradigm for Convergence of Interests. Evidence Based Nuts and Bolts For the Family Doc 11/5/2014

Hepatitis Update. HCV Cure As A Paradigm for Convergence of Interests. Evidence Based Nuts and Bolts For the Family Doc 11/5/2014 Evidence Based Nuts and Bolts For the Family Doc Hepatitis Update William Carey MD MACG, FAASLD Oct 25, 2014 HCV Cure As A Paradigm for Convergence of Interests Hepatitis C Cure 1 Get Ready Get SET Go

More information

HCV/HIVCo-infection A case study by. Dominic Côté, Nurse Clinician B.Sc Chronic Viral Illness Services McGill University Health Centre

HCV/HIVCo-infection A case study by. Dominic Côté, Nurse Clinician B.Sc Chronic Viral Illness Services McGill University Health Centre HCV/HIVCo-infection A case study by Dominic Côté, Nurse Clinician B.Sc Chronic Viral Illness Services McGill University Health Centre Objectives By sharing a case study of a patient co-infected with HIV/HCV

More information

AASLD PRACTICE GUIDELINE

AASLD PRACTICE GUIDELINE AASLD PRACTICE GUIDELINE An Update on Treatment of Genotype 1 Chronic Hepatitis C Virus Infection: 2011 Practice Guideline by the American Association for the Study of Liver Diseases Marc G. Ghany, 1 David

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Hepatitis C Second Generation Antivirals Page 1 of 22 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Hepatitis C Second Generation Antivirals Through Preferred

More information

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Hepatitis C Agents

MEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Hepatitis C Agents MEDICAL ASSISTANCE HBOOK I. Requirements for Prior Authorization of Hepatitis C Agents A. Prescriptions That Require Prior Authorization Prescriptions for Pegasys and non-preferred Hepatitis C Agents must

More information

Hepatitis C Virus Direct-Acting Antivirals Prior Authorization Request Form

Hepatitis C Virus Direct-Acting Antivirals Prior Authorization Request Form Hepatitis C Virus Direct-Acting Antivirals Prior Authorization Request Form For assistance, please call 1-855-552-6028 or fax completed form to 570-271-5610. Medical documentation may be requested. This

More information