Monthly Archives: September 2011

Special categories of patients. Part 2

Data on PegIFN monotherapy and PegIFN/RBV therapy in hemodialysed patients are limited. Very low amounts of RBV are removed via dialysis, leading to drug accumulation and exacerbating hemolysis in this population, already at significant risk for anemia. Therefore, the decision … Continue reading

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Special categories of patients

Given the increased prevalence of HCV infection among special populations there is a stringent need to broaden the spectrum of patients eligible for therapy. Injecting drug users (IDUs) CHC is hyperendemic among IDUs. There are several challenging aspects that have … Continue reading

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How to manage genotype 2 and 3 non-responders and relapsers?

Nonresponders/relapsers infected with HCV G2/3 Genotype 2 or 3 infected patients are easier to treat and require only 24 weeks of therapy with PegIFN and low-dose of RBV (800 mg/day) (Zeuzem 2004). Patients who are intolerant of a planned 24-week … Continue reading

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Triple-combination therapy.

Triple therapy combination of PegIFN/RBV with a protease inhibitors (telaprevir or boceprevir) in HCV genotype 1-experienced patients has been shown to produce high rates of virological response in both prior relapsers and, to a lesser extent, prior non-responders in phase … Continue reading

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Optimizing PegIFN and RBV dosing during retreatment

When combined with PegIFN, RBV is critical to prevent relapse after treatment cessation. A small prospective study on 10 patients with HCV genotype 1 infection and high baseline VL (>800, 000 IU/ml) showed feasibility and high efficacy of treatment with … Continue reading

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Antiviral therapy in non-responders, relapsers and special populations. Part 2

The most common correctable factors that can significantly diminish the rate of SVR include: Dose reduction, transient discontinuation or premature interruption of therapy, due to side effects such as anemia, neutropenia or depression. Close monitoring and judicious interventions (modest dose … Continue reading

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Antiviral therapy in non-responders, relapsers and special populations

More than 50% of genotype 1 and 20% of genotypes 2/3 HCVinfected patients fail to achieve a sustained virologic response (SVR) when treated with PegIFN/RBV. Non-sustained responders to PegIFN/RBV comprise a heterogeneous group of patients (non-responders, on-therapy and post-therapy relapsers) … Continue reading

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Assessment of hepatic fibrosis. Part 3

The progression of fibrosis and other HCV-associated histopathologic changes may also be related to coagulationcascade activity and hepatic accumulation of iron, which have been associated with mutations in factor V and hemochromatosis genes, respectively. The HIV-HCV coinfection is a particularly … Continue reading

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Assessment of hepatic fibrosis. Part 2

The results are less certain in patients with a thick chest wall, hepatic congestion of cardiac origin and acute exacerbations of hepatitis. However, it has improved the ability to define the extent of fibrosis without a LB, particularly when combined … Continue reading

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