Clinical Liver Disease

Issues in Selecting HCV-infected Candidates for Anti-viral Treatment
Anna S. Lok, M.D., F.R.C.P.
With the rapid development of DAAs for HCV and the improved SVR rate with the new standard of HCV therapy, healthcare providers are challenged by the need to balance excitement around new therapeutic options with careful selection of patients to optimize benefits and minimize harm. Dr. Lok explains several factors that should inform decision-making around patient selection.

Is There Still a Role for Liver Biopsy in Managing Hepatitis C Virus Infections?
Syed-Mohammed R. Jafri, M.D. and Stuart C. Gordon, M.D.

Current guidelines emphasize the importance of liver biopsy in the management of patients with hepatitis C. Recent improvements in antiviral therapy along with the development of alternate modes of evaluating fibrosis have led to a global reassessment of the risks and benefits and the overall wisdom of performing liver biopsy in these patients. Watch, read, or listen to Drs. Jafri and Gordon discuss the potential risks and benefits associated with liver biopsy in managing HCV.

Managing Drug-Drug Interactions With Boceprevir and Telaprevir
Amol S. Rangnekar, M.D. and Robert J. Fontana, M.D.
Although DAA therapy in combination with PEG-IFN and RIB may result in improved antiviral efficacy and shorter durations of therapy, there are also potentially severe drug-drug interactions involving protease inhibitors and other commonly used agents. Drs. Rangnekar and Fontana provide the information healthcare providers need to familiarize themselves with these interactions before they use these agents.

Importance of Patient Education and Monitoring among HCV-infected Patients Selected for Anti-viral Treatment
Corinne Wentworth-Kotara, P.A-C.
As advanced and complex HCV therapies evolve, healthcare providers will have to overcome a steep learning curve to ensure that patients are appropriately managed and successfully complete their treatment. Read, watch, or listen to Corrine Wentworth describe the importance of patient education and monitoring when prescribing new therapies for HCV.

Predicting the Response to the Treatment of Hepatitis C Virus Infection
David L. Thomas, M.D.
As long as the treatment of HCV is expensive and is associated with adverse events, patients and providers will need to know the likelihood of a response so that they can decide whether the benefits outweigh the risks. Dr. Thomas summarizes approaches that providers can use to provide patients relatively precise estimates of their odds of being cured with today’s standard of care.

Treatment Options for Anti-HCV Treatment-Experienced Patients
Peter Ferenci, M.D.
The development of new antivirals has allowed significant improvements in the effectiveness of the management of treatment-experienced patients. In order to choose the optimal treatment regiment, though, an assessment of the pattern of previous nonresponsiveness is essential. Dr. Ferenci provides insights into determining this pattern and its impact on designing future treatment plans.

HCV Infection On-Treatment Viral Kinetics: Do They Still Have a Role?
Jordan J. Feld, M.D., M.P.H.

Since the identification of early virological response as a useful stopping rule, the kinetics of viral decline during therapy have been carefully evaluated and have proven useful in a number of different areas of HCV treatment, including predicting favorable responses, developing mathematical models to shed light on the mechanisms of action of antiviral agents, and now, in the era of direct-acting antivirals, for determining the treatment duration. Dr. Feld discusses the role that on-treatment viral kinetics have in the treatment of HCV.

Management of Adverse Events During the Treatment of Chronic Hepatitis C
Douglas L. Nguyen, M.D. and Timothy R. Morgan, M.D.
Adverse events, or side effects, are commonly observed in patients undergoing treatment for chronic hepatitis C. Treatment with telaprevir and boceprevir can worsen side effects frequently associated with PEG-IFN and RBV treatment and can cause different adverse events. Drs. Nguyen and Morgan discuss how to manage various types of adverse events during HCV treatment.

Drug Resistance: Prevalence and Clinical Implications During the Treatment of Chronic Hepatitis C Infection
Jean-Michel Pawlotsky, M.D., Ph.D.
Read, watch, or listen to Dr. Pawlotsky discuss the principles of HCV resistance to DAAs, the mechanisms of treatment failure during triple-combination therapy, and the consequences and implications of treatment failure on future therapeutic options.