hcv guidelines 2014 sofosbuvir aasld idsa

1. New Hepatitis C Guidelines
(AASLD, IDSA, IAS-USA)
Dr. Ahsan
MBBS,FCPS (Medicine)
Senior Registrar Medical Unit-1

2. • The Evidence based consensus
recommendations for the screening, treatment
and management of patients with HCV were
developed by a panel of 27 liver disease and
infectious disease specialists and a patient
advocate.
• Available Online on;
• www.hcvguidelines.org

4. Types of Recommendations
• "Recommended”: when regimen is favored for
most patients
• "Alternative" when optimal in a particular
subset of patients in that category.
• "Not Recommended" When a treatment is
clearly inferior or is deemed harmful, such
regimens should not be administered to
patients with HCV infection

5. IFN ineligible
IFN ineligible is defined as one or more of the below:
• Intolerance to IFN
• Autoimmune hepatitis and other autoimmune disorders
• Hypersensitivity to PEG or any of its components
• Decompensated hepatic disease
• History of depression, or clinical features consistent with
depression
• A baseline neutrophil count below 1500/μL, a baseline
platelet count below 90,000/μL or baseline hemoglobin
below 10 g/dL
• A history of preexisting cardiac disease

6. SOFOSBUVIR
• Sofosbuvir (Tab. Sovaldi 400mg) is a prodrug
of a nucleotide analogue inhibitor of the HCV
NS5B RNA-dependent RNA polymerase.
• NEUTRINO, COSMOS trial: Genotype 1,4
• VALENCE
, POSITRON, FISSION, FUSION, PROTON
, ELECTRON : Genotype 2,3
• Approved By FDA In DEC 2013.

7. SIMEPREVIR
• Simeprevir (150 mg daily), a specific inhibitor
of the HCV NS3/4A serine protease.
• COSMOS TRIAL: GENOTYPE 1

8. Genotype 3 Recommendations

9. • It is anticipated that safer and more effective
IFN-free regimens will be available by 2015.