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Hepatitis C virus: a critical appraisal of new approaches to therapy.

Nelson DR, Jensen DM, Sulkowski MS, Everson G, Fried MW, Gordon SC, Jacobson I, Reau NS, Sherman K, Terrault N, Thomas D - Hepat Res Treat (2012)

Bottom Line: The council investigated 10 clinical practice statements related to HCV treatment that reflect key topical areas.Faculty members reviewed and discussed the data related to each statement, and voted on the nature of the evidence and their level of support for each statement.In this new era of DAAs, a comprehensive and critical analysis of the literature is needed to equip clinicians with the knowledge necessary to design, monitor, and modify treatment regimens in order to optimize patient outcomes.

View Article: PubMed Central - PubMed

Affiliation: Clinical and Translational Science Institute, University of Florida, 1600 SW Archer Road, Room M440, Medical Science Building, Gainesville, FL 32610, USA.

ABSTRACT
The HCV council 2011 convened 11 leading clinicians and researchers in hepatitis C virus from academic medical centers in the United States to provide a forum for the practical and comprehensive evaluation of current data regarding best practices for integrating new direct-acting antiviral agents into existing treatment paradigms. The council investigated 10 clinical practice statements related to HCV treatment that reflect key topical areas. Faculty members reviewed and discussed the data related to each statement, and voted on the nature of the evidence and their level of support for each statement. In this new era of DAAs, a comprehensive and critical analysis of the literature is needed to equip clinicians with the knowledge necessary to design, monitor, and modify treatment regimens in order to optimize patient outcomes.

No MeSH data available.


Related in: MedlinePlus

SVR rates in patients across All IL28B genotypes [16].
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: SVR rates in patients across All IL28B genotypes [16].

Mentions: Evidence for IL28B genotyping in patients on triple therapy comes from one published randomized controlled trial and multiple look-back investigations of randomized, placebo-controlled trials. The likelihood that PEG-IFN/RBV treatment of HCV infection will result in an RVR or SVR depends on nucleotide sequences near IL28B [13]. Although several single-nucleotide polymorphisms are highly predictive of treatment response, none is more strongly associated than detection of the C or T allele at position rs12979860. Among Caucasians with chronic HCV genotype 1 infection treated with PEG-IFN/RBV, SVR is achieved in 69%, 33%, and 27% who have the CC, CT, and TT genotypes, respectively [14]. Among African Americans, SVR rates were 48%, 15%, and 13% for CC, CT, and TT genotypes, respectively. No other test is a stronger pretreatment predictor of response to PEG-IFN/RBV. Preliminary data indicate that IL28B genotype also predicts SVR with PI-based triple therapy [15–17]. Among Caucasian patients taking a telaprevir-based regimen, SVR was achieved by 84%–90%, 57%–71%, and 59%–73% of patients with CC, CT, and TT genotypes, respectively (Figure 1) [16]. In patients taking boceprevir-based regimen, SVR was achieved by 80%–82%, 65%–71%, and 55%–59% of patients with CC, CT, and TT genotypes, respectively [17]. Similar trends have been noted in treatment-experienced patients. Prior treatment response provides superior information on the likelihood of SVR with retreatment; thus, the test is less useful in that patient group. However, when prior treatment response information is not available, IL28B testing may be considered for its contribution to pretreatment decision-making.


Hepatitis C virus: a critical appraisal of new approaches to therapy.

Nelson DR, Jensen DM, Sulkowski MS, Everson G, Fried MW, Gordon SC, Jacobson I, Reau NS, Sherman K, Terrault N, Thomas D - Hepat Res Treat (2012)

SVR rates in patients across All IL28B genotypes [16].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3472509&req=5

fig1: SVR rates in patients across All IL28B genotypes [16].
Mentions: Evidence for IL28B genotyping in patients on triple therapy comes from one published randomized controlled trial and multiple look-back investigations of randomized, placebo-controlled trials. The likelihood that PEG-IFN/RBV treatment of HCV infection will result in an RVR or SVR depends on nucleotide sequences near IL28B [13]. Although several single-nucleotide polymorphisms are highly predictive of treatment response, none is more strongly associated than detection of the C or T allele at position rs12979860. Among Caucasians with chronic HCV genotype 1 infection treated with PEG-IFN/RBV, SVR is achieved in 69%, 33%, and 27% who have the CC, CT, and TT genotypes, respectively [14]. Among African Americans, SVR rates were 48%, 15%, and 13% for CC, CT, and TT genotypes, respectively. No other test is a stronger pretreatment predictor of response to PEG-IFN/RBV. Preliminary data indicate that IL28B genotype also predicts SVR with PI-based triple therapy [15–17]. Among Caucasian patients taking a telaprevir-based regimen, SVR was achieved by 84%–90%, 57%–71%, and 59%–73% of patients with CC, CT, and TT genotypes, respectively (Figure 1) [16]. In patients taking boceprevir-based regimen, SVR was achieved by 80%–82%, 65%–71%, and 55%–59% of patients with CC, CT, and TT genotypes, respectively [17]. Similar trends have been noted in treatment-experienced patients. Prior treatment response provides superior information on the likelihood of SVR with retreatment; thus, the test is less useful in that patient group. However, when prior treatment response information is not available, IL28B testing may be considered for its contribution to pretreatment decision-making.

Bottom Line: The council investigated 10 clinical practice statements related to HCV treatment that reflect key topical areas.Faculty members reviewed and discussed the data related to each statement, and voted on the nature of the evidence and their level of support for each statement.In this new era of DAAs, a comprehensive and critical analysis of the literature is needed to equip clinicians with the knowledge necessary to design, monitor, and modify treatment regimens in order to optimize patient outcomes.

View Article: PubMed Central - PubMed

Affiliation: Clinical and Translational Science Institute, University of Florida, 1600 SW Archer Road, Room M440, Medical Science Building, Gainesville, FL 32610, USA.

ABSTRACT
The HCV council 2011 convened 11 leading clinicians and researchers in hepatitis C virus from academic medical centers in the United States to provide a forum for the practical and comprehensive evaluation of current data regarding best practices for integrating new direct-acting antiviral agents into existing treatment paradigms. The council investigated 10 clinical practice statements related to HCV treatment that reflect key topical areas. Faculty members reviewed and discussed the data related to each statement, and voted on the nature of the evidence and their level of support for each statement. In this new era of DAAs, a comprehensive and critical analysis of the literature is needed to equip clinicians with the knowledge necessary to design, monitor, and modify treatment regimens in order to optimize patient outcomes.

No MeSH data available.


Related in: MedlinePlus