HCV: Identifying and Monitoring Disease Progression and Treatment Efficacy
PROGRAM DESCRIPTION Over the last few years, a number of rapidly evolving new treatment options for chronic hepatitis C virus (HCV) infection have become available, including the emergence of new …
Over the last few years, a number of rapidly evolving new treatment options for chronic hepatitis C virus (HCV) infection have become available, including the emergence of new direct-acting antiviral agents (DAAs). Treatment with these DAAs—which include 3 NS3-4A protease inhibitors, 5 NS5A inhibitors, and 2 NS5B polymerase inhibitors in multiple combination regimens for the management of 6 HCV genotypes—has led to dramatic advances in terms of treatment efficacy, with sustained viral response (SVR) rates greater than 95% and minimal associated side effects. Although monitoring of clinical response and adverse events has been greatly simplified, many factors should be considered to determine the most appropriate DAA regimen, such as HCV genotype (including associated subtypes). Identifying genotype at baseline to differentiate treatment failure or re-infection has an important role. Assessment of liver fibrosis in HCV infection also is considered a relevant part of patient care and key for decision making.
After participating in this activity, clinicians should be better able to:Select the appropriate direct-acting antiviral agent (DAA) for hepatitis C virus (HCV) infection based on viral genotypes (and subtype) and associated complicationsIdentify the emergence of HCV resistance-associated variants (RAVs) following treatment with selected DAA regimensImplement strategies, including the spectrum of molecular testing protocols, to identify and monitor disease progression and treatment efficacy and potentially avert HCV treatment resistanceFacilitate better linkage of care among specialists and other providers to strengthen screening, treatment, and monitoring practices, particularly for underserved and marginalized populations
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