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
  • Using Ledipasvir/Sofosbuvir in Cirrhotic, Treatment-Experienced GT1 Patients: 12 Weeks With Ribavirin or 24 Weeks Without?

    Ira M. Jacobson MD - 3/23/2015    
    Although new data suggest comparable efficacy of ledipasvir/sofosbuvir with ribavirin for 12 weeks vs 24 weeks without ribavirin in genotype 1 cirrhotic, treatment-experienced patients, I am not convinced that shortening treatment is the best approach.
  • Improving Access to HCV Treatment: The Clinician’s Role

    Norah Terrault MD, MPH - 3/13/2015    1 comment / Last Comment: 3/19/2015
    In the current era of HCV therapy, my evaluation of patients now includes more comprehensive screening for extrahepatic disease manifestations and cofactors.
  • Looking Beyond Liver Disease Stage When Determining Need for HCV Therapy

    Mark S. Sulkowski MD - 12/31/2014    10 comments / Last Comment: 3/8/2015
    Coverage of treatment was recently denied for my 23-year-old patient interested in starting therapy to prevent mother-to-child HCV transmission.
  • 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    7 comments / Last Comment: 1/25/2015
    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.
  • Genotype 3 HCV: Still Difficult to Treat?

    Jordan J. Feld MD, MPH - 2/10/2015    1 comment / Last Comment: 2/25/2015
    My take on how to manage genotype 3 HCV and how evolving therapeutic options will likely improve outcomes for treatment-experienced cirrhotic patients with genotype 3 HCV infection.