Exam III Hepatitis Flashcards

1
Q

Hepatitis C Virus (HCV) Treatment types

A

Direct-acting agents (DAAs)

NS5B Polymerase inhibitor

NS3/4A Protease inhibitor

NS5A inhibitor

Non-Nucleoside NS5B Palm Polymerase inhibitor

3A4 PK Booster

Interferon

Peginterferon alfa-2a

Peginterferon alfa-2b

Ribavirin

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2
Q

HCV treatment targets

A

NS5B Polymerase

Enzyme that incorporates nucleoside/nucleotide analogs into RNA chain

NS3/4A Protease

Cleaves non-structural polyproteins that are utilized in HCV RNA replication

NS5A

Phosphorylates proteins required for replication

NS5B Palm Polymerase

Enzyme that incorporates nucleoside/nucleotide analogs into RNA chain (similar to NS5B)

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3
Q

NS5B Polymerase Inhibitor

A

Sofosbuvir

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4
Q

NS3/4A Protease Inhibitor

A

Glecaprevir

Grazoprevir

Paritaprevir

Simeprevir

Voxilaprevir

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5
Q

NS5A Inhibitor

A

Daclatasvir

Elbasvir

Ledipasvir

Ombitasvir

Pibrentasvir

Velpatasvir

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6
Q

Non-nucleoside NS5B Palm Polymerase Inhibitor

A

Dasabuvir

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7
Q

3A4 PK Booster

A

Ritonavir

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8
Q

Direct acting agents RNA locations

A
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9
Q

Genotypes 1A/1B

A
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10
Q

Genotype 2

A
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11
Q

Genotype 3

A
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12
Q

Genotype 4

A
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13
Q

Genotype 5&6

A
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14
Q

DAA Side Effects & Monitoring PT 1

A
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15
Q

DAA Side Effects & Monitoring PT 2

A
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16
Q

NS5A Inhibitor Resistance

A

NS5A inhibitors are the most susceptible to Viral resistance

  • Avoid monotherapy*
  • Some populations may need testing and/or alternative regimens*

Q80K

17
Q

Treatment-Naive: Therapy

A
18
Q

Interferon

A

MoA

Induces innate antiviral immune response

Drugs

Peginterferon alfa2a

Peginterferon alfa2b

Dosing

Weekly SQ injection

ADE

Injection site reaction, flu-like symp, alopecia, thrombocytopenia, leukopenia, photosensitivity

Black Box Warning

Fatal neuropsychiatric, autoimmune, ischemic and infectious disease

19
Q

Ribaviron

A
20
Q

Hepatitis C Medication Monitoring

A

Prior to antiviral therapy (within 12 weeks)

  • Complete blood count (CBC)*
  • International Normalized Ratio (INR)*
  • Complete Liver Function Panel (i.e. albumin, total and direct bilirubin, ALT, AST, ALP)*
  • Estimated glomerular filtration rate (eGFR)*

During therapy

  • Check HCV viral load at week 4 and end of therapy*
  • Check routine labs (at 8-12 weeks)*
  • Monitor for DDI*

After Therapy

  • Check HCV viral load 12 weeks after the end of therapy*
    • Must be undetecatble for SVR*
21
Q

DDA DDIs

A