Understanding HCV Nonresponse and Identifying Candidates for Retreatment
Source: New Management Strategies for HCV Nonresponders and Relapsers

Module

Mitchell L. Shiffman, MD, reviews the various types of virologic response in hepatitis C virus–infected patients treated with interferon and ribavirin-based regimens and explains how to identify patients who would be good candidates for retreatment if they fail to achieve sustained virologic response.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Specify standard definitions of response and nonresponse to hepatitis C virus therapy
  • Discuss factors associated with nonresponse to hepatitis C virus therapy
  • Report criteria that may help to identify nonresponders who are good candidates for retreatment
  • Summarize data from studies of different retreatment strategies
  • Describe appropriate virologic goals of therapy for nonresponders undergoing retreatment

Topics covered include:

  • Introduction
  • Defining the Patterns of Virologic Response and Nonresponse
  • Rapid Virologic Response
  • Achieving Undetectable HCV RNA After Week 4 and Slow Virologic Response
  • Early Virologic Response and Nonresponse Virologic Patterns
  • Breakthrough and Relapse
  • Identifying Candidates for Retreatment: Null Response
  • Identifying Candidates for Retreatment: Partial Virologic Response
  • Identifying Candidates for Retreatment: Noncompliance, Medication Errors and Dose Reduction
  • Identifying Candidates for Retreatment: Failure to Recognize That Virologic Response Has Occurred
  • Identifying Candidates for Retreatment: Insufficient Treatment Duration
  • Conclusions
  • Summary of Clinical Implications
 

Faculty

  • Mitchell L. Shiffman
    MD

Credit Information

  • Release Date:
    October 04, 2007
  • Expiration Date:
    October 03, 2008
  • Physicians:
    maximum of 1.0 AMA PRA Category 1 Credit
  • Registered Nurses:
    1.0 Nursing contact hour
  • My Take on the Guidance From AASLD/IDSA for Treating PI-Experienced Patients With Genotype 1 HCV Infection

    Norah Terrault MD, MPH - 11/4/2014    1 comment / Last Comment: 11/16/2014
    In this rapidly evolving treatment environment, the best available regimen may not yet have been incorporated into the expert guidance.
  • My Take on the Guidance From AASLD/IDSA for Managing Treatment-Experienced Patients With Genotype 1 HCV Infection and Cirrhosis

    Nezam H. Afdhal MD, FRCPI - 11/4/2014    2 comments / Last Comment: 11/15/2014
    New regimens are becoming available for genotype 1 HCV infection that offer more data and apparently better efficacy than previously recommended regimens in patients with cirrhosis who have experienced previous treatment failure.
  • My Take on the Guidance From AASLD/IDSA for Treating Patients With Genotype 2 HCV Infection

    Norah Terrault MD, MPH - 11/4/2014    
    The AASLD/IDSA HCV guidance is straight forward regarding treatment-naive patients with genotype 2 HCV infection, but there are a few considerations to keep in mind.
  • My Take on the Guidance From AASLD/IDSA for Managing Treatment-Experienced Patients With Genotype 3 HCV Infection and Cirrhosis

    Ira M. Jacobson MD - 11/5/2014    1 comment / Last Comment: 11/16/2014
    When treatment-experienced patients with genotype 3 HCV infection and evidence of advanced liver disease seek care, it’s important to treat them now, even if evidence defining the best regimen is limited.
  • All-Oral Therapy for HCV: Rewriting the Course of the Disease

    Nancy Reau MD - 11/3/2014    2 comments / Last Comment: 11/19/2014
    All-oral HCV therapies are erasing the importance of traditional obstacles to cure