Saturday, May 16, 2015

DDW2015- Experts to discuss rapidly evolving hepatitis C recommendations

Experts to discuss rapidly evolving hepatitis C recommendations
Posted By: DDW Daily News on: May 16, 2015

Even with the groundbreaking oral regimens to fight hepatitis C, certain populations still require special care. Those populations will be a primary focus of Sunday’s AASLD Clinical Symposium Hepatitis C Recommendations for 2015.

The symposium will also provide a comprehensive overview of regimens to fight hepatitis C
virus (HCV) treatment options that will be available for clinical use in 2015. The session will open with a review of current treatment protocols for patients across the disease spectrum, followed by three talks about the treatment of special populations.

The special patient groups to be discussed are: recipients of liver transplants, patients with HIV co-infection and patients with renal failure, said Raymond T. Chung, MD, FAASLD, director of hepatology and the Liver Center at Massachusetts General Hospital, Boston. Dr. Chung will co-moderate the symposium with Paul Martin, MD, FRCP, FRCPI, chief of the division of hepatology at the University of Miami Miller School of Medicine, FL.

“Broadly, what we will see [this year] is an extension of treatment to populations that had been underserved by regimens that were interferon based,” Dr. Chung said. “Many more patients will become eligible for treatment.”

The new antiviral HCV drugs have been game-changers for liver transplant patients and persons with HIV co-infection, Dr. Chung added. This is particularly remarkable for recipients of liver transplants for HCV liver disease, he said, because essentially all of these patients experience a recurrence of hepatitis C, and previous interferon-based regimens produced limited response rates and often-intolerable side effects.

Yet, Dr. Chung noted, the advent of new oral agents does not eliminate the need to take special steps with these populations. This is due in large part because of the other types of medications these patients take, such as anti-rejection drugs prescribed for transplant recipients or anti-retroviral agents for HIV-infected patients.

“Those populations, in some cases, will need to be navigated carefully with the regimens that we are talking about using for hepatitis C,” Dr. Chung said. “But are they manageable? Absolutely, with a little bit of forethought.”

Dr. Martin noted that patients with genotype-3 infection remain a hard-to-serve population. The same goes for patients with renal failure, Dr. Chung said, because the kidneys clear or filter some of the key antiviral medications.

The session will draw from the HCV guidance developed by AASLD and the Infectious Diseases Society of America. Drs. Martin and Chung helped develop the guidance, which are published online at www.hcvguidelines.org. The guidance will be updated as new information becomes available and new sections will be added to the website as needed. Visitors will be able to access an ongoing summary of “recent changes” for updates.

Creating a living document is a major boon to physicians and patients, Dr. Martin said. “I think it’s one of the best things I have ever been involved in,” he said. “And, very importantly, it is driving practice.”

Please refer to the schedule-at-a-glance in Sunday’s issue for the time and location of this and other DDW® events.

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