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  • ClinicalThought Discussions

    The Age-Old Debate of Whether to Biopsy in HCV: My Answer for 2013

    Mark S. Sulkowski MD - 1/23/2013 14 comments / Last Comment: 3/20/2013
    With interferon-free, all-oral therapies on the near-term horizon, I am increasingly comfortable relying on patient history, physical exam, routine laboratory tests, and liver imaging as well as noninvasive serum markers to obtain a picture of liver health.
  • ClinicalThought Discussions

    Management of Acute HCV Infection in the DAA Era

    Raymond T. Chung MD - 1/23/2013 25 comments / Last Comment: 5/11/2013
    A recent patient experience has underscored some key issues regarding the vigilance required and current management considerations with acute HCV infection.
  • ClinicalThought Discussions

    A New Tool for HCV Patients With Low Platelet Counts

    Raymond T. Chung MD - 1/7/2013 18 comments / Last Comment: 5/12/2013
    Although the use of a platelet-boosting agent will assist certain subsets of patients who cannot wait for the approval of direct-acting antivirals, we can envision that the need for such a strategy will steadily wane over time.
  • ClinicalThought Discussions

    Time to Change Our Management Approach in HBV-Immunotolerant Patients?

    Graham R. Foster FRCP, PhD - 1/4/2013 30 comments / Last Comment: 5/6/2013
    New data suggesting that young adults with hepatitis B who have “immunotolerant” disease may actually have very active immune responses raise difficult questions about when to initiate therapy.
  • ClinicalThought Discussions

    Weighing the Benefits and Challenges of HCV Protease Inhibitors in Patients with HIV Coinfection

    Mark S. Sulkowski MD - 1/3/2013 3 comments / Last Comment: 1/10/2013
    Treatment of HCV in HIV-coinfected patients can be effective, but preparation and diligent monitoring are required.
  • ClinicalThought Discussions

    Anemia Management During PI-based HCV Therapy: Ribavirin Dose Reduction is the Right Course of Action

    Mark S. Sulkowski MD - 12/12/2012 5 comments / Last Comment: 2/7/2013
    Here’s the new thinking for the management of anemia with triple therapy including telaprevir or boceprevir: We need to dose reduce ribavirin in patients with anemia, and we need to do it relatively aggressively.
  • ClinicalThought Discussions

    Why I’m Starting to Use HCV Protease Inhibitors in Active Drug Users

    Graham R. Foster FRCP, PhD - 12/3/2012 4 comments / Last Comment: 12/7/2012
    With a pool of experienced nurses, a population of patients with advancing disease, and a determination not to discriminate against any patient group, we believe that we should be offering protease inhibitors to active drug users.
  • ClinicalThought Discussions

    What Will Be the Impact of CDC’s New Birth Cohort Screening Recommendations?

    Raymond T. Chung MD - 11/26/2012 3 comments / Last Comment: 4/9/2013
    With the next wave of DAA-based therapy associated with sustained virologic response rates exceeding 90%, there is no excuse not to diagnose.
  • ClinicalThought Discussions

    Why IL28B Genotype Remains Important With DAA Regimens

    Raymond T. Chung MD - 11/1/2012 5 comments / Last Comment: 11/29/2012
    For the HCV-infected patient with limited disease in whom we could justifiably defer therapy, the finding of a CC genotype may persuade the patient toward giving treatment a try.
  • ClinicalThought Discussions

    Avoiding Missteps When Evaluating New HCV Trial Data

    Graham R. Foster FRCP, PhD - 10/30/2012 5 comments / Last Comment: 1/10/2013
    I will be studying with great care the “withdrawn for adverse event” and the “failed to attend” rates in studies presented at AASLD.
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