Easl recommendations on the treatment of Hepatitis C
•Download as PPTX, PDF•
3 likes•1,389 views
Pakistan has the second highest prevalence of hepatitis C virus (HCV) infection in the world, with 4.4-9% of the population affected. Testing for HCV involves initial screening with ELISA antibody tests, followed by PCR testing to detect HCV RNA if ELISA is positive. The goal of HCV treatment is sustained virological response (SVR), defined as undetectable HCV RNA 12 or 24 weeks after the end of therapy. Treatment is recommended for all treatment-naive and experienced patients with compensated chronic liver disease due to HCV, prioritizing those with severe fibrosis. Monitoring during and after treatment involves regular clinical and laboratory assessments to check for efficacy and side effects.
Report
Share
Report
Share
Recommended
Hepatitis c new guidelines 2014 by aasld idsa sofosbuvir
The document summarizes new guidelines from the AASLD, IDSA, and IAS-USA for screening, treating, and managing hepatitis C virus (HCV) patients. A panel of 27 specialists and a patient advocate developed evidence-based consensus recommendations that are available online at hcvguidelines.org. The guidelines classify recommendations as "Recommended," "Alternative," or "Not Recommended." They define patients ineligible for interferon and provide information on medications Sofosbuvir and Simeprevir, including trials supporting their use against various HCV genotypes. The document concludes that safer and more effective interferon-free regimens will likely be available by 2015.
HCV management, guidelines 2016
1) Hepatitis C virus genotype 4 is predominant in Egypt, with a prevalence of around 9%.
2) New direct-acting antiviral agents have improved treatment outcomes, but the virus's ability to mutate rapidly can lead to resistance.
3) The document provides treatment recommendations and regimens using direct-acting antivirals like sofosbuvir and daclatasvir to treat hepatitis C genotype 4, including for different patient populations and treatment experiences. It establishes guidelines for Egyptian treatment protocols.
Hepatitis C - Recent advances
Chronic hepatitis C is caused by the hepatitis C virus (HCV). It was previously called "non-A, non-B hepatitis". HCV has 6 major genotypes. Genotype 1 is the most common in the United States and has the lowest response rates to treatment. Standard treatment was pegylated interferon and ribavirin for 48 weeks for genotype 1 and 24 weeks for genotypes 2 and 3. New direct acting antivirals like sofosbuvir have improved treatment outcomes with higher cure rates and fewer side effects while allowing treatment without interferon for most patients. Sofosbuvir inhibits the HCV RNA polymerase and costs around $1,800 for a 24 week course in developing countries, compared to $84,
Harvoni and Hepatitis C revised
This document discusses Harvoni and its role in treating Hepatitis C. It provides an overview of Hepatitis C, including epidemiology and clinical presentation. It describes the mechanism of action and pharmacokinetics of the two drugs in Harvoni - Ledipasvir and Sofosbuvir. It summarizes several clinical trials that evaluated Harvoni's efficacy and safety in treating genotype 1 Hepatitis C in treatment-naive and experienced patients, with and without cirrhosis, finding high sustained virologic response rates with 12 weeks of Harvoni treatment.
Hepatitis c treatment in ESRD patients , update Dr Ayman Seddik
This document discusses hepatitis C treatment in patients with end-stage renal disease. It outlines that newer direct-acting antiviral drug regimens have achieved over 90% sustained virological response rates in clinical trials, regardless of fibrosis stage, genotype, or viral load. The KDIGO 2008 guidelines recommended liver biopsy for evaluating fibrosis, but non-invasive methods are now sufficient. Recent trials like TARGET and C-SURFER showed high cure rates of over 95% with direct-acting antiviral regimens in dialysis patients. The AASLD recommendations designate specific direct-acting antiviral combinations as recommended or alternative regimens for different genotypes in patients with severe renal impairment or on dialysis.
Challenges in HCV Management
This document summarizes guidelines from the American Association for the Study of Liver Diseases (AASLD) regarding the management of hepatitis C virus (HCV)-infected patients. It discusses recommendations for treating special populations including nonresponders, patients with normal ALT levels, children, and patients coinfected with HIV. It provides data from clinical studies on treatment outcomes for these groups. The guidelines recommend individualized treatment decisions based on factors like biopsy results, comorbidities, and likelihood of response. Peginterferon and ribavirin are generally recommended treatment options.
Hepatitis C : Complete Overview and Recent Updates 2019
Hepatitis C : Complete Overview and Recent Updates 2019 Introduction, Classification, Clinical features, Staging, Investigation, Management Guidelines, Drugs, Updates 2019 Heaptobiliary disorder Sheila Sherlok Harrison
Update on Hepatitis C Virus
The document discusses the rapidly evolving landscape of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) infection. Three key studies demonstrated that all-oral, interferon-free combinations of DAAs achieved high sustained virologic response rates (SVR) of over 90% for various genotypes and patient populations. These include a combination of sofosbuvir and ledipasvir, a triple therapy of ABT-450/r, ABT-267 and ABT-333, and a combination of daclatasvir and asunaprevir. Several DAAs are now approved or in late-stage trials. These new interferon-free regimens have the potential
Recommended
Hepatitis c new guidelines 2014 by aasld idsa sofosbuvir
The document summarizes new guidelines from the AASLD, IDSA, and IAS-USA for screening, treating, and managing hepatitis C virus (HCV) patients. A panel of 27 specialists and a patient advocate developed evidence-based consensus recommendations that are available online at hcvguidelines.org. The guidelines classify recommendations as "Recommended," "Alternative," or "Not Recommended." They define patients ineligible for interferon and provide information on medications Sofosbuvir and Simeprevir, including trials supporting their use against various HCV genotypes. The document concludes that safer and more effective interferon-free regimens will likely be available by 2015.
HCV management, guidelines 2016
1) Hepatitis C virus genotype 4 is predominant in Egypt, with a prevalence of around 9%.
2) New direct-acting antiviral agents have improved treatment outcomes, but the virus's ability to mutate rapidly can lead to resistance.
3) The document provides treatment recommendations and regimens using direct-acting antivirals like sofosbuvir and daclatasvir to treat hepatitis C genotype 4, including for different patient populations and treatment experiences. It establishes guidelines for Egyptian treatment protocols.
Hepatitis C - Recent advances
Chronic hepatitis C is caused by the hepatitis C virus (HCV). It was previously called "non-A, non-B hepatitis". HCV has 6 major genotypes. Genotype 1 is the most common in the United States and has the lowest response rates to treatment. Standard treatment was pegylated interferon and ribavirin for 48 weeks for genotype 1 and 24 weeks for genotypes 2 and 3. New direct acting antivirals like sofosbuvir have improved treatment outcomes with higher cure rates and fewer side effects while allowing treatment without interferon for most patients. Sofosbuvir inhibits the HCV RNA polymerase and costs around $1,800 for a 24 week course in developing countries, compared to $84,
Harvoni and Hepatitis C revised
This document discusses Harvoni and its role in treating Hepatitis C. It provides an overview of Hepatitis C, including epidemiology and clinical presentation. It describes the mechanism of action and pharmacokinetics of the two drugs in Harvoni - Ledipasvir and Sofosbuvir. It summarizes several clinical trials that evaluated Harvoni's efficacy and safety in treating genotype 1 Hepatitis C in treatment-naive and experienced patients, with and without cirrhosis, finding high sustained virologic response rates with 12 weeks of Harvoni treatment.
Hepatitis c treatment in ESRD patients , update Dr Ayman Seddik
This document discusses hepatitis C treatment in patients with end-stage renal disease. It outlines that newer direct-acting antiviral drug regimens have achieved over 90% sustained virological response rates in clinical trials, regardless of fibrosis stage, genotype, or viral load. The KDIGO 2008 guidelines recommended liver biopsy for evaluating fibrosis, but non-invasive methods are now sufficient. Recent trials like TARGET and C-SURFER showed high cure rates of over 95% with direct-acting antiviral regimens in dialysis patients. The AASLD recommendations designate specific direct-acting antiviral combinations as recommended or alternative regimens for different genotypes in patients with severe renal impairment or on dialysis.
Challenges in HCV Management
This document summarizes guidelines from the American Association for the Study of Liver Diseases (AASLD) regarding the management of hepatitis C virus (HCV)-infected patients. It discusses recommendations for treating special populations including nonresponders, patients with normal ALT levels, children, and patients coinfected with HIV. It provides data from clinical studies on treatment outcomes for these groups. The guidelines recommend individualized treatment decisions based on factors like biopsy results, comorbidities, and likelihood of response. Peginterferon and ribavirin are generally recommended treatment options.
Hepatitis C : Complete Overview and Recent Updates 2019
Hepatitis C : Complete Overview and Recent Updates 2019 Introduction, Classification, Clinical features, Staging, Investigation, Management Guidelines, Drugs, Updates 2019 Heaptobiliary disorder Sheila Sherlok Harrison
Update on Hepatitis C Virus
The document discusses the rapidly evolving landscape of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) infection. Three key studies demonstrated that all-oral, interferon-free combinations of DAAs achieved high sustained virologic response rates (SVR) of over 90% for various genotypes and patient populations. These include a combination of sofosbuvir and ledipasvir, a triple therapy of ABT-450/r, ABT-267 and ABT-333, and a combination of daclatasvir and asunaprevir. Several DAAs are now approved or in late-stage trials. These new interferon-free regimens have the potential
[2015] hcv direct acting antivirals [da as] stumbling
This document summarizes direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV). It describes the HCV lifecycle and targets of DAAs, including NS3/4A protease inhibitors, NS5A inhibitors, and NS5B nucleoside/non-nucleoside inhibitors. Clinical trials show high sustained virologic response rates for DAA combinations compared to pegylated interferon/ribavirin. However, treatment can fail if resistance-associated variants are present or develop. The document discusses factors influencing treatment failure and common resistance mutations for different DAA classes and genotypes. It emphasizes the importance of achieving high barrier to resistance through appropriate drug selection and combination therapy.
HBV EASL 2017
This document summarizes updated guidelines from the European Association for the Study of the Liver (EASL) on the management of hepatitis B virus (HBV) infection. It classifies chronic HBV infection into five phases based on markers like HBeAg and HBV DNA levels. All chronic HBV patients are at risk of cirrhosis and liver cancer, with risks varying based on host and viral factors. The guidelines provide recommendations on treatment indications, goals, and options including long-term use of potent antivirals. Ongoing monitoring of treated and untreated patients is important to prevent disease progression and complications like liver cancer.
Hepatitis C Current progress in management
A power point presentation on Hepatitis C virus on epidemiology, presentation, diagnosis and current treatment strategies we are practicing in BSMMU at a international standerd.
Hepatitis C
The patient has abnormal liver enzymes and tested positive for hepatitis C virus antibodies and RNA. She has a history of injection drug use 18 years ago. Her current rash and abnormal liver enzymes suggest she may have cryoglobulinemia associated with her hepatitis C infection. Measuring her serum cryoglobulins would be the most appropriate next step to evaluate for this potential extrahepatic manifestation of hepatitis C.
Hepatitis c
This document provides information on hepatitis C, including its types, sources of infection, epidemiology, treatment options, and key details about specific medications used to treat hepatitis C. It discusses the types of hepatitis C as acute or chronic. It notes that the WHO estimates that around 3% of the world's population has been infected with hepatitis C virus (HCV) and over 170 million people have chronic hepatitis C infection. The document discusses classes of antiviral medications used to treat hepatitis C including protease inhibitors, polymerase inhibitors, NS5A inhibitors, and interferons. It provides details on particular protease inhibitors like simeprevir and daclatasvir, the polymerase inhibitor sofosbuvir, and combination treatments containing sofosbuvir
Hcv 4 ttt
This document provides an overview and update on treatments for Hepatitis C genotype 4. It discusses direct-acting antiviral (DAA) medications including NS3/4A protease inhibitors, NS5A inhibitors, NS5B polymerase inhibitors, and specific medications from each class. It covers dosing, mechanisms of action, drug interactions and side effects for medications like sofosbuvir, simeprevir, daclatasvir, and paritaprevir/ombitasvir. Guidelines from EASL and AASLD are summarized for genotype 4 treatment and special populations like renal impairment, HIV co-infection, and treatment failure.
Best Practices in the Management of HCV. 2015
In this downloadable slideset, Andrew J. Muir, MD, reviews the evidence informing current guidance and best practices on treating patients with hepatitis C.
Format: Microsoft PowerPoint (.ppt)
File size: 1.97 MB
Hepatitis c infection, causes, treatment, and prevention
1) Hepatitis C virus (HCV) was identified in 1989 and is a leading cause of liver disease. Egypt has the largest HCV epidemic in the world with a prevalence of 14.7% based on antibody testing.
2) HCV is a small enveloped RNA virus that is classified into 6 major genotypes. Genotypes 1 and 4 typically require longer treatment than genotypes 2, 3, 5 and 6.
3) HCV infection may be acute or chronic. About 60-70% of infections become chronic and 20% of chronic carriers may develop cirrhosis or liver cancer over time if left untreated.
Ppt
The document discusses hepatitis C, including its virology, transmission, symptoms, screening, treatment and prevention. It provides epidemiological data on chronic hepatitis C in Georgia from 2009-2014. Specifically, it finds that 50% of reported viral hepatitis cases in Georgia during this period were chronic hepatitis C. It also analyzes the age distribution and geographic distribution of chronic hepatitis C cases.
Treatment of HCV Genotype 4
This lecture is about Treatment of HCV Genotype 4 presented by Dr. Tamer Elbaz, Assistant professor of Hepatology & Gastroenterology, Cairo University.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
Hbv reactivation
Reactivation of hepatitis B virus (HBV) can occur when a patient with resolved or inactive HBV undergoes immunosuppression. This document discusses the definition, causes, incidence, risk factors, clinical manifestations, outcomes, prevention and treatment of HBV reactivation. Key points include: screening patients for HBV before immunosuppression, using prophylactic antiviral therapy for high risk patients, and monitoring or using pre-emptive therapy for moderate risk patients. Entecavir is recommended over lamivudine or tenofovir for prevention due to lower resistance risk. Therapy should begin before and continue after immunosuppression.
March 192015talkforresidents final03232015 (1)
This document provides an update on viral hepatitis and discusses two case studies. It begins by describing a 71-year-old male presenting with jaundice who is diagnosed with acute hepatitis A infection based on a reactive HAV IgM test. It then reviews hepatitis A virus and the diagnosis and management of acute hepatitis A. The second case discusses a 26-year-old male diagnosed with chronic hepatitis B infection based on positive HBsAg, anti-HBc IgM, and HBV DNA tests. The document concludes by discussing chronic hepatitis B infection and approved treatments.
HCV Story ---by Mohammed Hussien
Hepatitis (C) Story …. Past & Present & future
Most Recant Updating Guidelines by ASSLD & FDA
RAVS &How to deal with It ----12/7/2016.....
((Residents Lectures))
Spectrum of HCV infection
This lecture is about Spectrum of HCV infection presented by Dr. Muhammad Mostafa Abdel Ghaffar, Head of Tropical Medicine Department, Ahmed Maher Teaching Hospital.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
Advances in Management of Hepatitis C
Patients with acute hepatitis C virus (HCV) infection appear to have an excellent chance of responding to 6 months of standard therapy with interferon (IFN). Because spontaneous resolution is common, no definitive timing of therapy initiation can be recommended; however, waiting 2-4 months after the onset of illness seems reasonable.
Treatment for chronic HCV is based on guidelines from the Infectious Diseases Society of America (IDSA) and the American Associations for the Study of Liver Diseases (AASLD), in collaboration with the International Antiviral Society-USA (IAS-USA). These guidelines are constantly being updated. For more information, see HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C.
The guidelines propose that because all patients cannot receive treatment immediately upon the approval of new agents, priority should be given to those with the most urgent need.
The recommendations include the following :
Patients with advanced fibrosis, those with compensated cirrhosis, liver transplant recipients, and those with severe extraheptic hepatitis are to be given the highest priority for treatment
Based on available resources, patients at high risk for liver-related complications and severe extrahepatic hepatitis C complications should be given high priority for treatment
Treatment decisions should balance the anticipated reduction in transmission versus the likelihood of reinfection in patients whose risk of HCV transmission is high and in whom HCV treatment may result in a reduction in transmission (eg, men who have high-risk sex with men, active injection drug users, incarcerated persons, and those on hemodialysis)
Who.hcv treatment guidelines 2016
GUIDELINES FOR THE SCREENING, CARE AND TREATMENT OF PERSONS WITH CHRONIC HEPATITIS C
INFECTION UPDATED VERSION
APRIL 2016 GUIDELINES
Hcv presentation
This document discusses advances in treatment for hepatitis C virus (HCV) infection. It provides information on:
- The primary goals of HCV treatment as viral eradication and prevention of liver disease progression.
- Definitions of sustained virological response (SVR) and response rates achieved with pegylated interferon and ribavirin treatment.
- New direct-acting antiviral drugs in development that target specific steps in the HCV lifecycle, including protease, polymerase, and NS5A inhibitors.
Recent advances in the management of viral hepatitis handout
Dr Mona Abdel-Hady
Consultant Paediatric Hepatologist
Liver Unit
Birmingham Children’s Hospital
Birmingham,UK
Case Studies: HBeAg Negative Chronic Hepatitis B
This document presents a clinical case scenario of a 45-year-old man with chronic hepatitis B infection. Key details include that he is HBeAg negative with normal liver enzymes and ultrasound. His HBV DNA level is 55,000 copies/ml. He was started on lamivudine and had an initial good response but later experienced a virologic breakthrough associated with development of lamivudine resistance. Treatment options for lamivudine resistant HBV are discussed.
A Comparison of different treatments for Hepatitis C virus (HCV)
Here your going to see the presentation of my Review Paper about the different treatments that we have for the Hepatitis C virus.
Chronic Hepatitis C WHO Guideline 2016
This document provides guidelines from the WHO on chronic hepatitis C infection from April 2016. It discusses the global burden of HCV, noting over 700,000 deaths per year. New direct-acting antiviral medications have transformed HCV treatment, enabling shorter, oral regimens with over 90% cure rates and fewer side effects. The guidelines recommend screening high-risk populations and using RNA testing to confirm chronic infection before treatment. They provide guidance on clinical assessment, noting the importance of staging liver fibrosis/cirrhosis and assessing severity. Successful treatment results in reduced liver inflammation and fibrosis regression, lowering risks of liver cancer and transplant.
Hepatitis C and its Treatment
This document discusses hepatitis C virus (HCV) and its treatment. It begins by defining hepatitis as inflammation of the liver and describing the various causes, including viral hepatitis from hepatitis viruses A-E. It then focuses on HCV, describing it as an RNA virus that infects liver cells. The document discusses HCV transmission, signs and symptoms, natural progression to chronic infection, and treatment options to cure HCV including various antiviral medications like interferons, ribavirin, boceprevir, and sofosbuvir. It provides details on treatment regimens and success rates depending on HCV genotype.
More Related Content
What's hot
[2015] hcv direct acting antivirals [da as] stumbling
This document summarizes direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV). It describes the HCV lifecycle and targets of DAAs, including NS3/4A protease inhibitors, NS5A inhibitors, and NS5B nucleoside/non-nucleoside inhibitors. Clinical trials show high sustained virologic response rates for DAA combinations compared to pegylated interferon/ribavirin. However, treatment can fail if resistance-associated variants are present or develop. The document discusses factors influencing treatment failure and common resistance mutations for different DAA classes and genotypes. It emphasizes the importance of achieving high barrier to resistance through appropriate drug selection and combination therapy.
HBV EASL 2017
This document summarizes updated guidelines from the European Association for the Study of the Liver (EASL) on the management of hepatitis B virus (HBV) infection. It classifies chronic HBV infection into five phases based on markers like HBeAg and HBV DNA levels. All chronic HBV patients are at risk of cirrhosis and liver cancer, with risks varying based on host and viral factors. The guidelines provide recommendations on treatment indications, goals, and options including long-term use of potent antivirals. Ongoing monitoring of treated and untreated patients is important to prevent disease progression and complications like liver cancer.
Hepatitis C Current progress in management
A power point presentation on Hepatitis C virus on epidemiology, presentation, diagnosis and current treatment strategies we are practicing in BSMMU at a international standerd.
Hepatitis C
The patient has abnormal liver enzymes and tested positive for hepatitis C virus antibodies and RNA. She has a history of injection drug use 18 years ago. Her current rash and abnormal liver enzymes suggest she may have cryoglobulinemia associated with her hepatitis C infection. Measuring her serum cryoglobulins would be the most appropriate next step to evaluate for this potential extrahepatic manifestation of hepatitis C.
Hepatitis c
This document provides information on hepatitis C, including its types, sources of infection, epidemiology, treatment options, and key details about specific medications used to treat hepatitis C. It discusses the types of hepatitis C as acute or chronic. It notes that the WHO estimates that around 3% of the world's population has been infected with hepatitis C virus (HCV) and over 170 million people have chronic hepatitis C infection. The document discusses classes of antiviral medications used to treat hepatitis C including protease inhibitors, polymerase inhibitors, NS5A inhibitors, and interferons. It provides details on particular protease inhibitors like simeprevir and daclatasvir, the polymerase inhibitor sofosbuvir, and combination treatments containing sofosbuvir
Hcv 4 ttt
This document provides an overview and update on treatments for Hepatitis C genotype 4. It discusses direct-acting antiviral (DAA) medications including NS3/4A protease inhibitors, NS5A inhibitors, NS5B polymerase inhibitors, and specific medications from each class. It covers dosing, mechanisms of action, drug interactions and side effects for medications like sofosbuvir, simeprevir, daclatasvir, and paritaprevir/ombitasvir. Guidelines from EASL and AASLD are summarized for genotype 4 treatment and special populations like renal impairment, HIV co-infection, and treatment failure.
Best Practices in the Management of HCV. 2015
In this downloadable slideset, Andrew J. Muir, MD, reviews the evidence informing current guidance and best practices on treating patients with hepatitis C.
Format: Microsoft PowerPoint (.ppt)
File size: 1.97 MB
Hepatitis c infection, causes, treatment, and prevention
1) Hepatitis C virus (HCV) was identified in 1989 and is a leading cause of liver disease. Egypt has the largest HCV epidemic in the world with a prevalence of 14.7% based on antibody testing.
2) HCV is a small enveloped RNA virus that is classified into 6 major genotypes. Genotypes 1 and 4 typically require longer treatment than genotypes 2, 3, 5 and 6.
3) HCV infection may be acute or chronic. About 60-70% of infections become chronic and 20% of chronic carriers may develop cirrhosis or liver cancer over time if left untreated.
Ppt
The document discusses hepatitis C, including its virology, transmission, symptoms, screening, treatment and prevention. It provides epidemiological data on chronic hepatitis C in Georgia from 2009-2014. Specifically, it finds that 50% of reported viral hepatitis cases in Georgia during this period were chronic hepatitis C. It also analyzes the age distribution and geographic distribution of chronic hepatitis C cases.
Treatment of HCV Genotype 4
This lecture is about Treatment of HCV Genotype 4 presented by Dr. Tamer Elbaz, Assistant professor of Hepatology & Gastroenterology, Cairo University.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
Hbv reactivation
Reactivation of hepatitis B virus (HBV) can occur when a patient with resolved or inactive HBV undergoes immunosuppression. This document discusses the definition, causes, incidence, risk factors, clinical manifestations, outcomes, prevention and treatment of HBV reactivation. Key points include: screening patients for HBV before immunosuppression, using prophylactic antiviral therapy for high risk patients, and monitoring or using pre-emptive therapy for moderate risk patients. Entecavir is recommended over lamivudine or tenofovir for prevention due to lower resistance risk. Therapy should begin before and continue after immunosuppression.
March 192015talkforresidents final03232015 (1)
This document provides an update on viral hepatitis and discusses two case studies. It begins by describing a 71-year-old male presenting with jaundice who is diagnosed with acute hepatitis A infection based on a reactive HAV IgM test. It then reviews hepatitis A virus and the diagnosis and management of acute hepatitis A. The second case discusses a 26-year-old male diagnosed with chronic hepatitis B infection based on positive HBsAg, anti-HBc IgM, and HBV DNA tests. The document concludes by discussing chronic hepatitis B infection and approved treatments.
HCV Story ---by Mohammed Hussien
Hepatitis (C) Story …. Past & Present & future
Most Recant Updating Guidelines by ASSLD & FDA
RAVS &How to deal with It ----12/7/2016.....
((Residents Lectures))
Spectrum of HCV infection
This lecture is about Spectrum of HCV infection presented by Dr. Muhammad Mostafa Abdel Ghaffar, Head of Tropical Medicine Department, Ahmed Maher Teaching Hospital.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
Advances in Management of Hepatitis C
Patients with acute hepatitis C virus (HCV) infection appear to have an excellent chance of responding to 6 months of standard therapy with interferon (IFN). Because spontaneous resolution is common, no definitive timing of therapy initiation can be recommended; however, waiting 2-4 months after the onset of illness seems reasonable.
Treatment for chronic HCV is based on guidelines from the Infectious Diseases Society of America (IDSA) and the American Associations for the Study of Liver Diseases (AASLD), in collaboration with the International Antiviral Society-USA (IAS-USA). These guidelines are constantly being updated. For more information, see HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C.
The guidelines propose that because all patients cannot receive treatment immediately upon the approval of new agents, priority should be given to those with the most urgent need.
The recommendations include the following :
Patients with advanced fibrosis, those with compensated cirrhosis, liver transplant recipients, and those with severe extraheptic hepatitis are to be given the highest priority for treatment
Based on available resources, patients at high risk for liver-related complications and severe extrahepatic hepatitis C complications should be given high priority for treatment
Treatment decisions should balance the anticipated reduction in transmission versus the likelihood of reinfection in patients whose risk of HCV transmission is high and in whom HCV treatment may result in a reduction in transmission (eg, men who have high-risk sex with men, active injection drug users, incarcerated persons, and those on hemodialysis)
Who.hcv treatment guidelines 2016
GUIDELINES FOR THE SCREENING, CARE AND TREATMENT OF PERSONS WITH CHRONIC HEPATITIS C
INFECTION UPDATED VERSION
APRIL 2016 GUIDELINES
Hcv presentation
This document discusses advances in treatment for hepatitis C virus (HCV) infection. It provides information on:
- The primary goals of HCV treatment as viral eradication and prevention of liver disease progression.
- Definitions of sustained virological response (SVR) and response rates achieved with pegylated interferon and ribavirin treatment.
- New direct-acting antiviral drugs in development that target specific steps in the HCV lifecycle, including protease, polymerase, and NS5A inhibitors.
Recent advances in the management of viral hepatitis handout
Dr Mona Abdel-Hady
Consultant Paediatric Hepatologist
Liver Unit
Birmingham Children’s Hospital
Birmingham,UK
Case Studies: HBeAg Negative Chronic Hepatitis B
This document presents a clinical case scenario of a 45-year-old man with chronic hepatitis B infection. Key details include that he is HBeAg negative with normal liver enzymes and ultrasound. His HBV DNA level is 55,000 copies/ml. He was started on lamivudine and had an initial good response but later experienced a virologic breakthrough associated with development of lamivudine resistance. Treatment options for lamivudine resistant HBV are discussed.
A Comparison of different treatments for Hepatitis C virus (HCV)
Here your going to see the presentation of my Review Paper about the different treatments that we have for the Hepatitis C virus.
What's hot (20)
[2015] hcv direct acting antivirals [da as] stumbling
[2015] hcv direct acting antivirals [da as] stumbling
Hepatitis c infection, causes, treatment, and prevention
Hepatitis c infection, causes, treatment, and prevention
Recent advances in the management of viral hepatitis handout
Recent advances in the management of viral hepatitis handout
A Comparison of different treatments for Hepatitis C virus (HCV)
A Comparison of different treatments for Hepatitis C virus (HCV)
Viewers also liked
Chronic Hepatitis C WHO Guideline 2016
This document provides guidelines from the WHO on chronic hepatitis C infection from April 2016. It discusses the global burden of HCV, noting over 700,000 deaths per year. New direct-acting antiviral medications have transformed HCV treatment, enabling shorter, oral regimens with over 90% cure rates and fewer side effects. The guidelines recommend screening high-risk populations and using RNA testing to confirm chronic infection before treatment. They provide guidance on clinical assessment, noting the importance of staging liver fibrosis/cirrhosis and assessing severity. Successful treatment results in reduced liver inflammation and fibrosis regression, lowering risks of liver cancer and transplant.
Hepatitis C and its Treatment
This document discusses hepatitis C virus (HCV) and its treatment. It begins by defining hepatitis as inflammation of the liver and describing the various causes, including viral hepatitis from hepatitis viruses A-E. It then focuses on HCV, describing it as an RNA virus that infects liver cells. The document discusses HCV transmission, signs and symptoms, natural progression to chronic infection, and treatment options to cure HCV including various antiviral medications like interferons, ribavirin, boceprevir, and sofosbuvir. It provides details on treatment regimens and success rates depending on HCV genotype.
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...
Treating hepatitis C patients with direct-acting antiviral drugs (DAAs) could significantly reduce disease burden in the UK. Strategies focusing only on advanced disease may reduce liver disease cases but will have little impact on transmission. Models show treating mild and moderate cases, including people who inject drugs (PWID), could reduce prevalence and incidence of hepatitis C among PWID by over 50% by 2030, curbing new infections. Achieving WHO elimination targets by 2030 will be challenging and require improved testing, treatment, and harm reduction for PWID. Monitoring outcomes like new infections and liver disease cases can assess progress toward elimination goals.
AN INNOVATIVE APPROACH TOWARDS THE TREATMENT of HEPATITIS C
Lecture on Hepatitis C by Dr. Aftab Mohsin during the 6th International Infection Control Conference 2006
Hepatitis c
Hepatitis C is a major global public health problem, infecting around 180 million people worldwide. It is a leading cause of liver disease and liver transplants. The hepatitis C virus is a RNA virus that primarily infects liver cells. Around 70-85% of infections become chronic, and 20-40% of chronic infections can lead to severe liver disease like cirrhosis or liver cancer over time. The most common modes of transmission are through blood exposure, though sexual transmission risk is low. There is no vaccine, but effective antiviral treatment exists.
Hepatitis C Treatment Questions
This document discusses hepatitis C virus (HCV) and current treatment options. It provides the following key points:
- HCV is the most common blood-borne pathogen in the US, with around 3.2 million people chronically infected. Chronic infections often progress to cirrhosis over 20-30 years.
- New all-oral treatment regimens that do not require interferon are highly effective. Sofosbuvir-based combinations can achieve over 90% sustained virologic response rates.
- Treatment is now recommended for most patients with chronic HCV to prevent long-term complications like cirrhosis and liver cancer. However, costs remain very high, with prices over $80,000 for a
Hcv, difficult gps (shebeen)
This document discusses various difficult-to-treat groups for hepatitis C virus (HCV) infection, including:
1. Acute HCV cases can often clear spontaneously, so treatment can be delayed up to 24 weeks to allow for this. Treatment of acute HCV achieves success rates over 80%.
2. Patients with thalassemia or sickle cell disease require careful monitoring and management by hematology and hepatology specialists during HCV treatment due to risks of anemia and other complications.
3. Morbidly obese HCV patients and those with psychiatric comorbidities present challenges for treatment and require multidisciplinary care and monitoring to successfully complete therapy.
11. chronic hepatitis
Chronic hepatitis is broadly defined as liver inflammation that lasts at least 6 months and can have various etiologies. The document discusses chronic hepatitis caused by hepatitis B and C viruses, which can lead to complications like liver cirrhosis and cancer over time. Autoimmune hepatitis and drug or toxic-induced chronic liver disease are also examined, along with their diagnostic features and treatment approaches.
Revision of treatment protocols for hcv genotype 4 infection 2016
The presentation summarize the latest recommendations of AASLD and EASL as well as the Egypt's National Guidelines for management of HCV Genotype 4
Chronic hepatits
This document summarizes chronic hepatitis, defining it as hepatitis lasting more than 3-6 months or presenting with signs of liver decompensation or failure. The causes discussed include chronic viral hepatitis (types B, C, and D), autoimmune liver diseases, drug-induced hepatitis, and various metabolic disorders. Clinical presentation can range from being asymptomatic to acute decompensation or signs of chronic liver disease. Management involves diagnostic testing to determine the cause and severity of liver dysfunction, with treatment being specific to the underlying condition such as antiviral medication for hepatitis B or immunosuppressants for autoimmune hepatitis.
Guidelines update
This document provides a historical timeline of hepatitis C virus (HCV) and recommendations for testing and treating HCV infection. It discusses how HCV was first described thousands of years ago but its origin was not uncovered until the 20th century. Major milestones included identifying HCV in 1988 and fully understanding its lifecycle in 2005. The document summarizes guidelines for HCV testing, counseling infected individuals, evaluating for treatment, and recommended treatment regimens based on HCV genotype.
Chronic hepatitis
1. Chronic hepatitis represents liver inflammation that lasts at least 6 months and can range from mild and nonprogressive to severe, leading to cirrhosis.
2. Chronic hepatitis is classified by cause, grade or stage of liver damage, and different types include hepatitis B, C, NAFLD, alcoholic hepatitis, and autoimmune hepatitis.
3. Hepatitis B is further classified into phases including immune tolerant, immune clearance, and inactive or reactivation phases based on viral markers and liver damage.
Liver Chronic Hepatitis
Chronic hepatitis refers to hepatic inflammation and necrosis that lasts more than 6 months. Chronic hepatitis B is defined by the presence of hepatitis B surface antigen for over 6 months. The risk of chronic infection is related to the age at which hepatitis B is acquired and the immune status of the host. Chronic hepatitis is classified based on cause, grade of histologic activity (inflammation), and stage of progression (fibrosis). Grading considers portal inflammation and lobular inflammation while staging evaluates the degree of fibrosis from none to cirrhosis. Chronic hepatitis can range from chronic persistent hepatitis with mild inflammation to chronic active hepatitis with piecemeal necrosis, bridging necrosis, and possible progression to cirrhosis. Several new antiviral drugs including lamiv
Chronic hepatitis introduction
Chronic hepatitis is characterized by a persistent inflammatory process in the liver lasting over 6 months. It is classified into three types based on histological features: chronic active hepatitis marked by necrosis and fibrosis carrying the worst prognosis; chronic persistent hepatitis with portal inflammation but no significant necrosis; and chronic lobular hepatitis involving hepatocyte apoptosis. Chronic hepatitis can be caused by viruses, metabolic disorders, drugs, or autoimmune conditions. Patients may be asymptomatic or experience fatigue, abdominal pain, jaundice, or liver abnormalities. Liver biopsy examines inflammation grade and fibrosis stage and helps establish etiology through immunological testing.
Management Of Chronic Hepatitis B
Management Of Chronic Hepatitis B
by Dr S Khan
Courtesy Of Javed iqbal Farooqi
http://www.drkhanblogs.com/2015/05/management-of-chronic-hepatitis-b.html
Chronic hepatitis ppt
Dr. Manoj Ghoda discusses chronic hepatitis and hepatic encephalopathy. For a 12-year-old boy presenting with jaundice, abdominal distension, and edema, findings suggest longstanding liver disease. Potential causes discussed include viral hepatitis, autoimmune hepatitis, and genetic disorders. Chronic hepatitis results from long-term liver inflammation and can progress to cirrhosis if left untreated. Hepatic encephalopathy ranges from subtle changes to coma and is caused by increased brain ammonia levels in liver disease. Treatment focuses on removing triggers and lowering ammonia through lactulose, antibiotics, and other medications.
Chronic hepatitis
Chronic hepatitis is defined as ongoing liver inflammation lasting over 6 months. It is commonly caused by hepatitis B, C, or a combination. Clinical features include fatigue, loss of appetite, jaundice, and elevated liver enzymes. On microscopy, chronic hepatitis shows piecemeal necrosis around the portal tract, interface hepatitis between liver lobes, and bridging fibrosis linking different areas. The activity of chronic hepatitis is assessed based on necrosis, inflammation, and fibrosis levels, and used to classify it as persistent, lobular, or active hepatitis. Carriers have no symptoms but can transmit hepatitis viruses through detectable surface antigens in their blood.
Chronic Hepatitis
1. Chronic liver disease includes chronic hepatitis and liver cirrhosis. Chronic hepatitis can be caused by viruses, autoimmune disorders, drugs, genetics, and other factors.
2. Chronic hepatitis presents with a range of symptoms depending on pathology and cause, from mild illness to more severe liver disease. Treatment aims to eliminate the cause and reduce liver cell damage.
3. Chronic hepatitis B, C, and D are treated to eliminate the viruses and stop liver disease progression. Treatment includes antiviral drugs and interferon. Transplant may be used for decompensated disease.
Chronic hepatitis
Chronic hepatitis refers to ongoing liver inflammation that persists for over 6 months. It can be caused by hepatitis B or C viruses, autoimmune conditions, drugs, alcohol, or genetic disorders. Diagnosis involves blood tests showing elevated liver enzymes and dysfunction. Histopathological grading assesses necrosis and staging evaluates fibrosis progression which can lead to cirrhosis. Chronic hepatitis B infection may be HBeAg positive or negative and natural history depends on factors like viral genotype and host immunity. Treatment algorithms consider liver enzyme levels and biopsy findings to determine if antiviral therapy is needed.
Chronic hepatitis
This document discusses chronic hepatitis in children. It begins by defining chronic hepatitis as ongoing liver inflammation persisting for more than six months that is detectable biochemically and histologically. Chronic hepatitis in children is often asymptomatic with mild illness and normal growth, though it can progress to cirrhosis or liver cancer at any age. The causes include hepatitis B, C, autoimmune hepatitis, and metabolic disorders. The document outlines approaches to diagnosing and classifying chronic hepatitis and reviews treatment options and goals in the pediatric population.
Viewers also liked (20)
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...
AN INNOVATIVE APPROACH TOWARDS THE TREATMENT of HEPATITIS C
AN INNOVATIVE APPROACH TOWARDS THE TREATMENT of HEPATITIS C
Revision of treatment protocols for hcv genotype 4 infection 2016
Revision of treatment protocols for hcv genotype 4 infection 2016
Similar to Easl recommendations on the treatment of Hepatitis C
Hcv
Hepatitis C is a global problem caused by the hepatitis C virus (HCV). HCV is a blood-borne virus that infects approximately 200 million people worldwide. Laboratory testing plays an important role in diagnosing HCV, evaluating patients for treatment, monitoring patients during treatment, and following up after treatment. There are 6 major genotypes of HCV with genotypes 1 and 4 being more difficult to treat and less responsive to interferon-based therapy.
Hepatitis C:Diagnosis and management.pdf
This document summarizes information about Hepatitis C virus (HCV) including its structure, life cycle, transmission, natural history of infection, pathogenesis, screening recommendations, diagnosis, assessment of fibrosis, and initial evaluation of persons with chronic HCV infection. Key points include that HCV is a spherical RNA virus that causes a spectrum of liver disease, it is primarily transmitted through blood exposure, around 55-85% of infections become chronic, and diagnosis involves antibody testing, RNA detection, genotyping, and noninvasive or biopsy-based staging of fibrosis.
Revision of treatment protocols for hcv genotype 4 infection 2016
This presentation describes the updated protocols for management of HCV G4 infection highlighting the most recent Egyptian Consensus
Lab support in hiv treatment and management
Laboratory tests play an important role in managing HIV infection by aiding diagnosis, determining when to start antiretroviral therapy (ART), monitoring treatment effectiveness and toxicity, and detecting treatment failure. Key tests include nucleic acid testing (NAT) for diagnosis, CD4+ lymphocyte count to assess immune status, viral load testing to monitor response to ART, and drug resistance testing when starting or changing ART due to failure. Regular monitoring with CD4, viral load, and clinical exams is needed for optimal HIV care.
Management of Hepatitis C infection in CKD patients.pptx
This document discusses the management of hepatitis C infection in patients with chronic kidney disease. It provides background on HCV, including its structure and life cycle. It then discusses direct-acting antiviral drugs that target specific HCV proteins, including NS3/4A protease inhibitors, NS5A inhibitors, and NS5B polymerase inhibitors. The document reviews treatment goals of eradicating HCV to prevent liver and kidney complications. It recommends treatment for all patients with access to effective antivirals and discusses regimens like glecaprevir-pibrentasvir and sofosbuvir-containing combinations that have demonstrated efficacy and safety in patients with severe renal impairment including those on dialysis.
Diagnosis of HIV and HCV
Various conventional and molecular methods adopted for the diagnosis of Human Immunodeficiency virus and Hepatitis C Virus
Hep c abhish 27 feb 17.pptx
This document summarizes recent trends in the management of chronic hepatitis C. It discusses the prevalence and genotypes of HCV, the natural history of infection, milestones in treatment including newer direct-acting antiviral drugs, treatment guidelines, and considerations for special populations like those with HIV or renal co-infection. New all-oral interferon-free regimens have high efficacy rates over short durations with improved safety profiles compared to previous interferon-based therapies. Guidelines now recommend treatment for all patients except those with short life expectancy.
Tdm and lcmsms method development, nitin charbe
This study evaluated plasma concentrations of the antiretroviral drug atazanavir (ATV) in 110 HIV-positive patients receiving either ATV 300 mg with ritonavir (ATV300/r) boosting or unboosted ATV 400 mg. Plasma samples were analyzed by HPLC. ATV300/r achieved higher trough concentrations and longer half-life than unboosted ATV 400 mg. Coadministration of drugs that induce or inhibit CYP3A4, the main metabolic pathway of ATV, impacted ATV exposure. Higher ATV concentrations were associated with elevated bilirubin levels. The study confirmed pharmacokinetic variability with ATV dosing and identified
Hepatitis coinfection
This document discusses HIV/HBV and HIV/HCV co-infections, providing perspectives from Thailand on optimal management. It outlines the natural history of HBV infection and conflicting results on whether telbivudine has activity against HIV. Guidelines are presented on determining active liver disease, treating HBV infection based on ART status, causes of transaminitis in coinfected patients, treating HCV infection, and contraindications for interferon and ribavirin use. Terminology for treatment response such as rapid virological response and sustained virological response is also defined.
PHTN PULMONARY HYPERTENSION _080028.pptx
Pulmonary hypertension is defined by a mean pulmonary arterial pressure over 20 mmHg. It affects 1% of the general population and can be caused by various factors like hereditary reasons, drugs, lung diseases, heart diseases, and metabolic disorders. Diagnosis involves screening high risk individuals, evaluating symptoms, performing tests like echocardiogram, CT, and right heart catheterization. Treatment focuses on vasodilator medications, exercise training, and management of right heart failure.
Kings College Hepatitis C Outreach
This document summarizes hepatitis C treatments and outreach efforts. It discusses current and upcoming antiviral treatments including simeprevir, sofosbuvir, and direct-acting antivirals. It also describes side effects of pegylated interferon and ribavirin treatments. The document estimates hepatitis C prevalence in Lambeth and the potential impact of untreated infection based on natural disease progression models. It overviews the antiviral therapy outreach service collaboration between Kings College Hospital and South London and Maudsley to engage patients in drug and alcohol centers through peer advocacy.
Comparison Between Antiviral Combination Therapies Against Hepatitis C Virus ...
This document appears to be a thesis submitted for a degree from the Faculty of Medicine at Ain Shams University in Egypt. It summarizes a clinical study that compared the efficacy and safety of different antiviral combination therapies for hepatitis C virus genotype 4 in 1000 Egyptian patients. The study found overall sustained virological response rates above 95% for all treatment regimens. Sofosbuvir combined with ledipasvir or daclatasvir showed the highest response rates, while sofosbuvir with pegylated interferon and ribavirin showed the lowest. Baseline factors like higher albumin, platelets and lower bilirubin, AFP, and fibrosis scores predicted treatment success.
Hepatitis c.2019
A 45-year-old woman presented with fatigue, weakness, loss of appetite, and slight anemia. Liver function tests showed elevated AST, ALT, and bilirubin levels. An ultrasound found a slightly decreased liver size without nodules or cirrhosis. A liver biopsy revealed inflammation and bridging fibrosis. This suggests a probable diagnosis of chronic hepatitis C infection, which can be confirmed with a HCV RNA test. The best course of action would be to start pharmacotherapy to treat the infection according to guidelines and educate the patient on prevention measures.
Hepatitis c. diagnosis and treatment.assld guidelines.2016 .2017
A 45-year-old woman presented with fatigue, weakness, loss of appetite, and anemia. Liver function tests showed elevated AST, ALT, and bilirubin levels indicating liver inflammation and damage. A liver biopsy revealed necroinflammation and fibrosis. This suggests a diagnosis of chronic hepatitis C, which would be confirmed by a positive HCV RNA test. The best course of action would be to treat the patient with direct-acting antiviral therapy to cure the hepatitis C infection, advise lifestyle changes to protect the liver, and monitor for complications like cirrhosis or liver cancer.
New diagnostic tests for sepsis
This document discusses new diagnostic tests for sepsis. It describes current definitions for sepsis, severe sepsis, septic shock, and SIRS. It then summarizes several new molecular diagnostic techniques that can more rapidly identify pathogens causing bloodstream infections compared to traditional blood culture methods. These include techniques like PCR, fluorescence in situ hybridization, and multiplex assays that can detect bacteria and fungi directly from blood within a few hours rather than the days required for standard culture. This allows for earlier targeted antibiotic treatment which is associated with better outcomes for sepsis patients.
Recent advances in chronic hepatitis
This document discusses recent advances in the diagnosis of chronic hepatitis. It defines chronic hepatitis as liver inflammation and necrosis that continues for over 6 months. The main causes of chronic hepatitis discussed are viral hepatitis (HBV, HCV, HDV), alcohol, autoimmunity, drugs, and other rare genetic conditions. New diagnostic techniques described include non-invasive tests like FibroTest, ActiTest, and NASHtest which analyze serum biomarkers, as well as proteomics which studies differences in protein expression between healthy and diseased tissue. Invasive techniques like liver biopsy are still the gold standard but these new methods provide alternatives to evaluate liver fibrosis and inflammation.
1 | P a g e Online ISSN: 2456-883X Website: www.ajast.net A Complete method o...
1 | P a g e Online ISSN: 2456-883X Website: www.ajast.net A Complete method o...Associate Professor in VSB Coimbatore
Several studies show that acute infections with hepatitis C virus (HCV) frequently progress to chronic diseases, which eventually can lead to liver cirrhosis and hepatocellular carcinoma. Thus, the development of simple and reliable HCV detection methods. In this research paper, I discuss the detection of HCV by PCR based thermal cycler in the CAP/CTM 48 Analyzer.HIV
Clinical features of HIV
Baseline investigations
Laboratory diagnosis of HIV
Algorithm for the use of the diagnosis of HIV-1 or HIV-2 infection.
PRINCIPLES OF THERAPY OF HIV INFECTION
medications used in treatment
Secondary prophylaxis of opportunistic infections
Prevention of HIV
reference Davidsons Priniciples and Practice of Medicine
and Harrisons Manual Of Internal Medicine
Rivaroxaban (XARELTO)
Rivaroxaban is a Factor Xa inhibitor. This presentation covers in brief regarding need for NOACs, kinetics, effects, indications, dosage, toxity, and antidote of rivaroxaban. It also covers in brief all the published trials
Treatment of hcv in hiv infected patients
Treatment of HCV in HIV-infected patients has historically been challenging with low response rates and side effects. However, recent developments in direct-acting antiviral agents now offer highly effective interferon-free regimens. Studies show sofosbuvir-based combinations achieving over 90% cure rates in HIV/HCV coinfected individuals, including those on antiretroviral therapy. Daclatasvir is being studied in phase III trials and may be co-administered with many antiretrovirals. These developments promise to greatly improve outcomes for people living with HIV/HCV coinfection.
Similar to Easl recommendations on the treatment of Hepatitis C (20)
Revision of treatment protocols for hcv genotype 4 infection 2016
Revision of treatment protocols for hcv genotype 4 infection 2016
Management of Hepatitis C infection in CKD patients.pptx
Management of Hepatitis C infection in CKD patients.pptx
Comparison Between Antiviral Combination Therapies Against Hepatitis C Virus ...
Comparison Between Antiviral Combination Therapies Against Hepatitis C Virus ...
Hepatitis c. diagnosis and treatment.assld guidelines.2016 .2017
Hepatitis c. diagnosis and treatment.assld guidelines.2016 .2017
1 | P a g e Online ISSN: 2456-883X Website: www.ajast.net A Complete method o...
1 | P a g e Online ISSN: 2456-883X Website: www.ajast.net A Complete method o...
More from West Medicine Ward
Organophosphate by dr sulman
This case report describes a 30-year-old male farmer who was found unconscious in his fields. He was brought to the hospital unconscious for 10 hours and having difficulty breathing. On examination, he had pinpoint pupils, frothing at the mouth, and coarse lung sounds. Tests found no abnormalities. The patient was diagnosed with organophosphate poisoning based on his symptoms and occupation. He was treated with atropine, pralidoxime, and supportive care.
Lupus nephritis by dr saddique
This document presents a case study of a 14-year-old female student who presented with abdominal distension and swelling of the feet and legs for two months. She has a history of gangrene and amputation of toes two years prior. On examination, she has pedal edema, abdominal distension, and tenderness. Laboratory tests show elevated inflammatory markers, protein in urine and ascites fluid, and positive markers for autoimmune disease. Imaging found enlarged liver and spleen with ascites fluid present.
Lupus nephritis by dr saddique 2
This document discusses lupus nephritis, including its types, classification, treatment approaches, and role of mycophenolate. It covers the WHO classification system for lupus nephritis and highlights diffuse proliferative glomerulonephritis as the most severe form. Treatment approaches discussed include using cyclophosphamide as the standard induction therapy due to its effectiveness in preserving renal function compared to prednisone alone. Monthly intravenous pulses of cyclophosphamide and methylprednisolone are recommended for induction, followed by azathioprine or mycophenolate as maintenance therapies to prevent relapse.
Post streptococcal gn by dr rashid
This case report describes a 14-year-old male patient who presented with sore throat, cola-colored urine, and decreased urine output. Investigations revealed post-streptococcal glomerulonephritis. His renal function deteriorated and he required dialysis. A renal biopsy showed crescentic glomerulonephritis. He was treated with steroids and cyclophosphamide but later developed aspergiloma due to immunosuppression, which was treated with amphotericin B. His renal function and symptoms improved with treatment.
Acute pancreatitis by dr zulakha
A 33-year-old male presented with one week of continuous high fever and vomiting for three days. On examination, he was found to be drowsy but responsive with abdominal tenderness and swelling. Laboratory tests showed elevated pancreatic and liver enzymes indicative of acute pancreatitis. He was treated conservatively but his condition deteriorated and he eventually suffered cardiac arrest due to complications of his illness.
Dengue by dr umar draz
This document describes the case of a 20-year-old male patient who presented with high fever, body aches, and vomiting over the past week. Upon examination, the patient appeared ill and had low blood pressure, low platelet count, and signs of fluid overload. He was given intravenous fluids and transfusions, and required ventilation support. Over the next few days, his condition fluctuated with episodes of fever, low blood pressure, and arrhythmia. Laboratory tests showed decreasing hemoglobin and platelet counts. The patient was diagnosed with dengue hemorrhagic fever based on his symptoms and lab results.
Fulmanent heptic failure by dr usman
An 18-year-old male presented with one week of high fever followed by three days of jaundice, vomiting, and abdominal pain, and six hours of unconsciousness. Physical examination found jaundice and hepatomegaly. Laboratory results showed elevated liver enzymes and hepatitis C positivity. The patient was diagnosed with acute fulminant viral hepatitis based on laboratory findings and treated supportively.
Cld non hep b,c
This case presentation summarizes a 48-year-old female patient who presented with jaundice for 4 months, abdominal distension for 1 month, constipation for 4 days, rectal bleeding for 3 days, and altered sensorium for 1 day. Her examination revealed pallor, icterus, edema, ascites, splenomegaly, and hemorrhoids. Investigations supported a diagnosis of acute on chronic decompensated liver disease with portal hypertension and grade III hepatic encephalopathy. Further workup was suggested to determine the underlying cause of cirrhosis such as viral hepatitis, autoimmune disease, or genetic conditions.
Right sided valve infective endocarditis by dr adeel
This document describes the case of a 24-year-old intravenous drug user who presented with a 15-day history of fever, malaise, and shortness of breath for 7 days. On examination, he was found to be pale with a heart murmur. Investigations showed anemia, hepatitis C, and HIV positivity. Echocardiography revealed vegetation on the tricuspid valve. He was diagnosed with right-sided infective endocarditis and treated with antibiotics.
Case presentation
- The patient is a 45-year-old male shopkeeper who presented with a history of road traffic accident 3 days prior where he sustained a left tibia and fibula fracture.
- He developed fever, abdominal tenderness, and lockjaw. Examination found decreased consciousness, hemiparesis, upgoing plantars, and coarse lung sounds.
- Investigations confirmed aspiration pneumonia, septicemia, and tetanus. The patient was diagnosed and treated for head injury, tetanus, aspiration pneumonia, and septicemia. Management included antitetanus serum, antibiotics, anxiolytics, and supportive care.
Wpw case presentation by dr adeel
A 35-year-old female presented with a history of palpitations and shortness of breath for the past 6 hours. She has a history of hypertension for the past 3 months and is on medication. On examination, her blood pressure was elevated and heart rate was rapid. An ECG showed Wolff-Parkinson-White syndrome. WPW is a condition where there is an extra pathway between the atria and ventricles that can cause rapid heart rates. Treatment options include medications, cardioversion, catheter ablation to destroy the extra pathway, or surgery.
Tetnus by dr balwant
- The patient is a 45-year-old male shopkeeper who presented with a history of road traffic accident 3 days prior where he sustained a left tibia and fibula fracture.
- He developed fever, abdominal tenderness, and lockjaw. Examination found decreased consciousness, hemiparesis, upgoing plantars, and coarse lung sounds.
- Investigations confirmed aspiration pneumonia, septicemia, and tetanus. The patient was diagnosed and treated for head injury, tetanus, aspiration pneumonia, and septicemia. Management included antitetanus serum, antibiotics, anxiolytics, and supportive care.
Tbm case presentation by dr imtiaz
1. A 21-year-old female presented with progressive weakness on the right side of her body over 1.5 years, along with fever, headache, diplopia, and two seizures.
2. Neurological examination revealed spastic right hemiparesis, internuclear ophthalmoplegia, nystagmus, and ataxic gait.
3. MRI brain showed multiple enhancing lesions in the midbrain, left periventricular area, and left basal ganglia, suggestive of tuberculomas. She was diagnosed with multiple tuberculomas and treated with anti-tuberculosis therapy and steroids.
Sle by dr sadaf b
A 18-year-old female presented with 1 year history of fever, joint pain affecting small joints and progressing to larger joints, rash, oral ulcers, hair loss, and weight loss. Examination found malar rash, joint swelling and deformity, and positive photosensitivity and Raynaud's phenomenon. Tests showed positive ANA and anti-dsDNA antibodies. The presentation is most consistent with systemic lupus erythematosus.
Neutrophilia by dr rabia
A 13-year-old boy presented with 3 days of fever, sore throat, and painful swollen lymph nodes in his neck. On examination, he had enlarged lymph nodes in his neck as well as an enlarged spleen. Laboratory tests showed an elevated white blood cell count with 89% neutrophils. A chest x-ray was normal. The doctor is considering infections like infectious mononucleosis or enteric fever as potential causes and wants to conduct further investigations to make a diagnosis and determine the management plan.
Hemolytic anemia by dr maaz seerat
This document presents the case of a 20-year-old female student who was admitted to the hospital with a 6-month history of progressive weakness and shortness of breath, as well as fever, body aches, and vomiting for the past week. On examination, she was found to be pale and spleen was palpable. Differential diagnoses included various types of anemias, portal hypertension, leukemias, and lymphomas. Further investigations including Coomb's test and hemoglobin electrophoresis were planned to determine the cause of anemia, and initial treatment included blood transfusion and corticosteroids.
Heat stroke by dr nida
Din Muhammad, a 65-year old laborer, presented with altered sensorium, fever, and a body temperature of 106 degrees for 1 day. He has a history of hypertension and diabetes. Initial examinations revealed an unconscious patient with abnormal vital signs. Laboratory investigations showed metabolic acidosis and elevated liver enzymes. Imaging showed diffuse brain edema. He was diagnosed with exertional heat stroke due to his profession involving sun exposure.
More from West Medicine Ward (20)
Right sided valve infective endocarditis by dr adeel
Right sided valve infective endocarditis by dr adeel
Infective endocarditis case presentation by dr imtiaz
Infective endocarditis case presentation by dr imtiaz
Recently uploaded
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
What is Obesity? How to overcome Obesity?
Obesity is a chronic complex disease defined by excessive fat deposits that can impair health.
Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
cosmetics and cosmeceuticals
Muskan
mpharm
2nd semester
Guru Gobind Singh college of pharmacy, yamunanagar, haryana
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Fallopian tube blockage may cause female infertility. For treatment, herbal medicine Fuyan Pill can be a solution.
Know the difference between Endodontics and Orthodontics.
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Pollen and Fungal allergy: aeroallergy.pdf
Pollen and Fungal allergy: aeroallergy.pdfChulalongkorn Allergy and Clinical Immunology Research Group
Pollen and Fungal allergy
Presented by Chaloemchai Chumsaengchotsakul, MD.
June 14, 2024How to choose the best dermatologists in Indore.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Recently uploaded (20)
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
The Nervous and Chemical Regulation of Respiration
The Nervous and Chemical Regulation of Respiration
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
Easl recommendations on the treatment of Hepatitis C
- 1. EASL RECOMMENDATIONS ON THE TREATMENT OF HEPATITIS C
- 2. PAKISTAN HAS 2ND HIGHEST PREVALENCE OF HCV IN THE WORLD 4.4%- 9% POPULATION SUFFERS FROM HCV
- 3. ANTI-HCV BY ELISA …..BEST INITIAL TEST EXCEPTIONS SUSPECTED ACUTE HEP C I IMMUNOCOMPROMISED PT. HCV RNA BY PCR IF ELISA POSITIVE IF ANTI-HCV POSITIVE AND PCR NEGATIVE THEN REPEAT PCR AFTER THREE MONTHS TO CONFIRM CONVALESCENCE
- 5. DEFINITION: SUSTAINED VIROLOGICAL RESPONSE IS UNDETECTABLE HCV RNA AT 12 WKS (SVR 12) OR 24 WKS (SVR24)AT THE END OF THERAPY , AS ASSESSED BY SENSITIVE MOLECULAR METHOD LIKE PCR (THE LOWER LIMIT BEING <15 IU/ML.)
- 6. SEARCH FOR OTHER CAUSES OF LIVER DISEASE ASSESSMENT OF LIVER DISEASE SEVERITY HCV RNA LEVEL AND GENOTYPE DETERMINATION DETERMINATION OF HOST GENETICS
- 7. UNCONTROLLED PSYCHOSIS/ DEPRESSION/ EPILEPSY PREGNANCY RETINAL DISEASE AUTOIMMUNE THYROID DISEASE FOR PEGYLATED INTERFERON -ALPHA ABSOLUTE NEUTROPHIL COUNT <1500/mm PLATELET COUNT < 90,000/mm
- 9. ALL TREATMENT- NAÏVE AND –EXPERIENCED PTs WITH COMPENSATED CLD DUE TO HCV TREATMENT SHOULD BE PRIORTIZED IN PTs WITH SEVERE FIBROSIS (METAVIR SCORE F3/F4) TREATMENT IS JUSTIFIED IN PTs WITH MODERATE FIBROSIS (METAVIR SCORE F2) PTs WITH DECOMPENSAATED CLD WHO ARE ON TRANSPLANT LIST SHOULD BE TREATED WITH INTERFERON FREE AND IDEALLY RIBAVIRIN FREE THERAPY
- 10. TWO DRUG THERAPY TILL 2009 > INTERFERON ALPHA 2a 180 ug/wk INTERFERON ALPHA 2b 1.5 ug/kg/wk > RIBAVIRIN 1000 mg/DAY IF WT <75 kg 1200mg/DAY IF WT >75 kg
- 13. 1- MONITORING OF EFFICACY 2- STOPPING/FUTILITY RULES 3- VIROLOGICAL RESPONSE GUDED TRIPLE THERAPY 4- SIDE EFFECTS MONITORING
- 14. PCR DONE AT 1- BASELINE 2- 4 WKS 3- 12 WKS 4- END OF THERAPY 5- 12 & 24 WKS AFTER THE END OF THERAPY FOR THERAPY TO BE EFFECTIVE HCV RNA SHOULD BE <15IU/mm
- 15. FUTILITY RULES APPLY FOR ONLY TRIPLE COMBINATION THERAPY WITH IFN- ALPHA, RIBAVIRIN AND SIMEPREVIR DISCONTINUE IF HCV RNA AT WKS 4/12/24 IS >25 IU/mm
- 16. TRIPLE THERAPY WITH IFN-ALPHA RIBAVIRIN DECLATASVIR IF HCV RNA >25IU/mm AT 4 WKS AND DETECTABLE AT 10 WKS GIVE TRIPLE THERAPY FOR 24 WKS IF HCV RNA <25 IU/mm AT 4WKS AND UNDETECTABLE AT 10 WKS DISCONTINUE DECLATASVIR AFTER 12 WKS AND GIVE OTHER 2 MEDS FOR 24 WKS
- 17. >PTs RECEIVING IFN AND RIBAVIRIN 1- CLINICAL S/Es AT EACH VISIT 2- HEMATOLOGICAL S/Es AT 2 $ 4 WKS AND THEN AT 4 -8 WK INTERVAL 3- TFTs AT 12 WK INTERVAL > RFTs SHOULD BE MONITORED REGULARLY IN PTs RECEIVING SOFOSBUVIR > PTs RECEIVING SIMEPREVIR SHOULD BE MONITORED FOR RASHES AND BILIRUBIN ELEVATION
- 18. REPEAT HCV RNA AT 48 WKS IF NEGATIVE IT MEANS THAT PT IS HCV FREE IN CIRRHOTICS WHO ACHIEVE SVR THE RISK OF HCC IS DECREASED BUT WE NEED SURVEILLANCE AT 6 MONTHS INTERVAL
- 19. DIAGNOSIS OF ACUTE AND CHRONIC HCV??
- 20. GOALS AND END POINTS OF THERAPY???
- 23. WHO SHOULD BE TREATED???
- 24. MONITORING???
- 25. Feelings are much like waves, we cannot stop them from coming but wee can always choose which one to surf.
- 26. THANKYOU!!!