by:samia b pharmd candidate’14 viral hepatitis c and newer pharmacologic therapies
TRANSCRIPT
By:Samia BPharmD Candidate’14
Viral Hepatitis C and Newer Pharmacologic
Therapies
Overview: Hepatitis C
Hepatitis is a condition marked by inflammation of the liver secondary to a virus. Hepatitis C is a chronic infection transmitted via blood usually by intravenous means. Six known genotypes of the hepatitis C virus Half life of 2-3 hours Lacks proofreading function
Epidemiology Most common blood-borne pathogen Hepatitis C affects 3.2 million people in the United States Largest risk factor: IV drug use
Risk factors Most common: IVDU Diagnosis of HIV Born to mother with Hep C
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.Hepatitis C Information for Health Professionals. Centers for Disease Control and Prevention, 03 Mar. 2014. Web.
Overview: Hepatitis C
Pathophysiology
Image from Heim, Markus H. "25 Years of Interferon-based Treatment of Chronic Hepatitis C: An Epoch Coming to an End." Nature Reviews Immunology 13.7 (2013): 535-42. Print.
Overview: Hepatitis C
Clinical Presentation Weeks 1-2: Asymptomatic Weeks 3-12: Symptoms such as fatigue, anorexia, weakness,
jaundice, abdominal pain, or dark urine can appear in 30% of patients
If infection lasts >6 months: Notable for diagnosis of chronic HCV Symptoms include: persisting fatigue, right upper quadrant
pain, nausea, or poor appetite. At chronic stage, necroinflammatory disease progresses
Diagnosis Testing
HCV antibody test• If reactive, PCR test required
If known exposure within last 6 months, re-testing required if negative antibody test
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.
Therapy: Hepatitis C
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.
Therapy: Hepatitis C
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.
Genotype Therapeutic Regimen
Duration of Therapy
1 Peg-IFN + ribavirin + boceprevir or telaprevir
Variable, but 24-48 weeks
2,3,4 Peg-IFN + ribavirin
24 weeks
Therapy: Hepatitis C
Pegylated Interferon • Comes in two types• Achieves sustained virologic response in only 10% of
patients if taken as monotherapy-may work alone if acute HCV
• Dosage form: solution for injection
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.Pegasys Solution. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014Peg-Intron Solution. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
Pegasys Solution. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014Peg-Intron Solution. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.Pegasys Solution. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014Peg-Intron Solution. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014Ribavirin Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
Ribavirin Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
Ribavirin Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.Boceprevir Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
DiPiro, Joseph T. "Viral Hepatitis." Pharmacotherapy: A Pathophysiologic Approach. New York: McGraw-Hill, 2014. N. pag. Print.Telaprevir Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
Liang, T. Jake, and Marc G. Ghany. "Current and Future Therapies for Hepatitis C Virus Infection." New England Journal of Medicine 368.20 (2013): 1907-917. Print.
Therapy: Hepatitis C
Olysio Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014Solvadi Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
Olysio Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
"Simeprevir (Olysio) for Chronic Hepatitis C." Medical Letter (6 Jan. 2014): n. pag. Web.
Therapy: Hepatitis C
"Sofosbuvir (Sovaldi) for Chronic Hepatitis C." Medical Letter (20 Jan. 2014): n. pag. Print.Solvadi Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
"Sofosbuvir (Sovaldi) for Chronic Hepatitis C." Medical Letter (20 Jan. 2014): n. pag. Print.Solvadi Oral. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2014
Therapy: Hepatitis C
"Simeprevir (Olysio) for Chronic Hepatitis C." Medical Letter (6 Jan. 2014): n. pag. Web.
Therapy: Hepatitis C
"Sofosbuvir (Sovaldi) for Chronic Hepatitis C." Medical Letter (20 Jan. 2014): n. pag. Print..
Therapy: Hepatitis C
"HIV and ID Observations." HIV and ID Observations. NEJM Journal Watch, n.d. Web"Simeprevir (Olysio) for Chronic Hepatitis C." Medical Letter (6 Jan. 2014): n. pag. Web
Misc.
Reading material on Hepatitis C and emerging therapies “Current and Future Therapies for Hepatitis C Virus Infection” (
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893124/?report=classic)
The Medical Letter on Drugs and Therapeutics Sofosbuvir (Sovaldi) for Chronic Hepatitis C Simeprevir (Olysio) for Chronic Hepatitis C
News articles “New hepatitis C drugs must be affordable worldwide, say
campaigners-The Guardian (http://www.theguardian.com/society/sarah-boseley-global-health/2014/mar/17/hepatitis-c-pharmaceuticals-industry)
“Prices of new hepatitis C drugs are tough to swallow for insurers”
(http://articles.latimes.com/2014/mar/09/business/la-fi-hepatitis-c-drug-costs-20140310)
Questions?