Resistance in Hepatitis C
Source: Clinical Implications of HCV Resistance: Laying the Foundation for Optimal Treatment Today and in the Future

Module

Join Stephane Chevaliez, PharmD, PhD; Paul J. Pockros, MD; and Stefan Zeuzem, MD, as they review and discuss key principles of HCV resistance with currently approved direct-acting antiviral agents, the latest resistance data on agents in development, and important considerations for potential future anti-HCV regimens. These expert faculty members also provide practical strategies for clinical challenges with the newly approved direct-acting agents through a case-based analysis.

Learning Objectives

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

  • Apply strategies to reduce the development/expansion of resistance to direct-acting antiviral agents when managing patients receiving treatment with approved direct-acting antiviral agents in combination with peginterferon/ribavirin
  • Integrate key principles regarding antiviral resistance when evaluating data on the direct-acting antiviral agents currently in development
  • Evaluate potential future strategies for HCV treatment based on resistance considerations, including the barrier to resistance and patterns of cross-resistance among classes of direct-acting antiviral agents

Topics covered include:

  • Introduction to Drug Resistance in Hepatitis C Virus
  • Key Resistance Principles for Currently Approved Direct-Acting Antiviral Agents
  • Considerations for Retreatment of Previous Peginterferon/Ribavirin Null Responders and Potential Consequences of Protease Inhibitor Resistance
  • Genotype and Resistance Testing
  • Case 1: Previous Null Responder
  • Case 2: Stopping Rules
  • Case 3: Boceprevir Resistance–Associated Variant
  • Future Regimens
  • Future Protease Inhibitors
  • Nucleos(t)ide Polymerase Inhibitors
  • Nonnucleos(t)ide Polymerase Inhibitors
  • NS5A Inhibitors
  • Cyclophilin Inhibitors
  • Summary: Important Considerations to Avoid Resistance-Associated Variants
  • Appendix: Principles of HCV Resistance
 

Program Directors

  • Stefan Zeuzem
    MD

Faculty

  • Stéphane Chevaliez
    PharmD, PhD
    Paul J. Pockros
    MD

Credit Information

  • Release Date:
    October 25, 2011
  • Expiration Date:
    October 24, 2012
  • Physicians:
    maximum of 1.25 AMA PRA Category 1 Credits
  • Using Ledipasvir/Sofosbuvir in Cirrhotic, Treatment-Experienced GT1 Patients: 12 Weeks With Ribavirin or 24 Weeks Without?

    Ira M. Jacobson MD - 3/23/2015    4 comments / Last Comment: 4/20/2015
    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.
  • Using Ombitasvir/Paritaprevir/Ritonavir Plus Dasabuvir in Cirrhotic, Treatment-Experienced GT1 Patients: 12 or 24 Weeks, With or Without Ribavirin?

    Paul Y. Kwo MD - 4/8/2015    2 comments / Last Comment: 4/24/2015
    Until more data are available on the use of the 3-DAA regimen in genotype 1 cirrhotic, treatment-experienced patients, I prefer to err on the side of caution to maximize opportunity for achieving SVR.
  • When Should Patients on the Liver Transplant Waitlist Receive HCV Therapy?

    John Roberts MD - 4/24/2015    
    Now that highly tolerable, highly effective HCV treatments are available, treatment in the pretransplant setting is a viable approach for many patients currently on the waitlist. Does this approach have a downside?
  • HCV Treatment in Liver Transplantation Recipients: My Take on the Latest HCV Guidance

    Nezam H. Afdhal MD, FRCPI - 4/7/2015    1 comment / Last Comment: 4/13/2015
    In starting HCV treatment after liver transplant, how soon is soon enough?
  • Improving Access to HCV Treatment: The Clinician’s Role

    Norah Terrault MD, MPH - 3/13/2015    3 comments / Last Comment: 4/19/2015
    In the current era of HCV therapy, my evaluation of patients now includes more comprehensive screening for extrahepatic disease manifestations and cofactors.