Hepatitis C 8% Flashcards
What is the most common length of treatment for Hep C?
8 to 12 weeks
How are treatments adjusted for Hep C patients with Genotype 3 or decompensated cirrhosis?
For GT3:
- Epclusa for 12 weeks if non-cirrhotic or compensated cirrhotic without baseline resistance for velpatasvir
- Mavyret
- for 8 weeks
- for 12 weeks w/PT or transplant
- Vosevi for 12 weeks w/PT
For CTP B/C:
- Harvoni plus ribavirin for 12 weeks for GT1 or 24 wks alone
- Epclusa plus ribavirin for 12 weeks for GT1 or 24 wks alone
Which Metavir Score indicates cirrhosis?
F4
How is HCV viral load reported?
HCV RNA or HCV QUANT
What are the 3 categories of cirrhosis, based on CTP scores?
- Class A = 5 to 6 points (compensated)
- Class B = 7 to 9 points (decompensated)
- Class C = 10 to 15 points (decompensated)
Draw the CTP Score table
Ascites: none, mild/mod (diuretic works), severe (diuretic resists)
Encephalopathy: none, grade 1-2 (or precipitated), grade 3-4 (or chronic)
INR: <1.7, 1.7-2.3, >2.3
Bilirubin (mg/dL): <2, 2-3, >3
Albumin (g/dL): >3.5, 2.8-3.5, <2.8
What is the goal of therapy in HCV treatment?
The GOT is a sustained virologic response (SVR), which is undetectable HCV RNA at least 12 weeks after completion
What are the suffixes of the 3 classes of drugs used in HCV treatment?
- Protease Inhitors end with previr
- NS5A inhibitors end in asvir
- NS5B inhibitors end in buvir
What are the 7 commercially available direct acting antivirals?
Harvoni®
Epclusa®
Mavyret®
Vosevi®
Sovaldi®
Zepatier®
Copegus/Ribapak®
What are the 2 pancynogenic first-line regimens for HepC treatment?
Epclusa and Mavyret, but only Epclusa can be used in HCV 1 decompensated cirrhosis and HCV 3 cirrhosis CPT 1
Harvoni is not used in which genotypes?
2 and 3
Zepatier is only used in which genotypes?
1 and 4
Which regimen has a length of therapy of 8 weeks for patients with a viral load <6 million, and not co-infected with HIV?
Harvoni (othewise, it’s 12 weeks); Mavyret is 8 weeks regardless and is pancynogenic (but can not be used in decompensated cirrhosis)
Patients with NS5A polymorphisms should avoid which regimen?
Zepatier, but if needed
- extend tx to 16 weeks and add ribavirin
In HCV and HIV coinfected patients, renal function monitoring is needed when ART contains which drug?
tenofovir
