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AASLD announces 2012 hepatitis C treatment guidelines
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New practice guidelines for hepatitis C treatment are based on limited data, so “there may be a need to reconsider some of the recommendations as additional data become available,” according to an online announcement by the American Association for the Study of Liver Diseases.
The AASLD said the 2012 optimal treatment regimen includes two major advances: development of direct-acting antiviral agents and identification of several single-nucleotide polymorphisms associated with spontaneous and treatment-related clearance of hepatitis.
The announcement focuses on recent protease inhibitor trial results. Both boceprevir and telaprevir have demonstrated “potent inhibition of HCV genotype 1 replication and markedly improved [sustained virologic response] rates in treatment-naïve and treatment-experienced patients,” the announcement said.
However, the guidelines advise that neither drug should be used to treat patients with genotype 2 or 3 hepatitis infections.
The announcement was cautious regarding the benefits of a lead-in treatment phase.
“Theoretically, a peginterferon alfa and ribavirin lead-in phase may serve to improve treatment efficacy,” the announcement said.
Because both boceprevir and telaprevir are known to cause interactions with several other common medications, the guidelines emphasize the importance of checking drug labels, the FDA website or a related hepatitis drug interactions website before starting chronic hepatitis C treatment.
The 2012 AASLD guidelines are endorsed by the Infectious Diseases Society of America, the American College of Gastroenterology and the National Viral Hepatitis Roundtable.
Disclosure: Nelson receives research support from Vertex, Merck, Phamassett, Genentech/Roche, Gilead, Bristol-Myers Squibb, Tibotec, and Bayer/Onyx and serves on advisory boards of Merck, Pharmassett, Genentech/Roche, Gilead, Tibotec, and Bayer/Onyx and is a consultant for Vertex. Thomas receives research support from Merck and Gilead and serves on a Merck advisory board.