Hepatitis C Virus: A Critical Appraisal of New Approaches to Therapy

Table 1

HCV council statements for evaluation.

Workshop 1: Treatment strategies (statements 1–5)
(1) PI/PEG-IFN/RBV is the standard of care in all HCV genotype 1 treatment-naïve patients.
(2) PI/PEG-IFN/RBV is the standard of care in all HCV genotype 1 treatment-experienced patients.
(3) Response-guided therapy should be utilized in all:
(a) treatment-naïve patients treated with PI/PEG-IFN/RBV regimens.
(b) treatment-experienced patients treated with PI/PEG-IFN/RBV regimens.
(4)  IL28B genotyping should be performed in all candidates for PI/PEG-IFN/RBV therapy.
(5) Null responders to previous PEG-IFN/RBV with minimal liver disease should not be treated with PI-based therapy.
Workshop 2: Treatment challenges (statements 6–10)
(6) Viral resistance testing has no clinical utility in the management of HCV patients receiving PI/PEG-IFN/RBV therapy.
(7) Response to lead-in therapy should not influence the decision to initiate a PI-based regimen.
(8) Patients treated with a telaprevir-based regimen who develop a severe rash should be switched to a boceprevir-based regimen.
(9) In PI-based HCV treatment regimens, erythropoietin should be used to manage anemia prior to RBV dose reduction.
(10) PI/PEG-IFN/RBV combinations are first line therapy in:
(a) patients with HCV-HIV coinfection.
(b) HCV-transplant populations.