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    5 comments / Last Comment: 5/26/2015
    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.
  • HCV Treatment in Liver Transplantation Recipients: My Take on the Latest HCV Guidance

    Nezam H. Afdhal MD, FRCPI - 4/7/2015    2 comments / Last Comment: 6/3/2015
    In starting HCV treatment after liver transplant, how soon is soon enough?
  • My Take on New Guidance for Treating Genotype 1 HCV–Infected Patients With Decompensated Cirrhosis

    Norah Terrault MD, MPH - 5/5/2015    2 comments / Last Comment: 5/19/2015
    We now have safe and effective treatment options for HCV infection in patients with decompensated cirrhosis. But how do ribavirin tolerability and treatment experience factor into how they should be used?
  • 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    3 comments / Last Comment: 6/15/2015
    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?