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Pharmacotherapy. 2016 Feb;36(2):203-17. doi: 10.1002/phar.1700. Epub 2016 Feb 5.

Therapeutic Advances in HCV Genotype 1 Infection: Insights from the Society of Infectious Diseases Pharmacists.

Author information

1
Department of Pharmacy Practice, University of New Mexico College of Pharmacy, Albuquerque, New Mexico.
2
Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
3
Colleges of Pharmacy and Medicine, University of Illinois at Chicago, Chicago, Illinois.
4
Gastroenterology/Hepatology, Illinois Department of Corrections Hepatology Telemedicine, Sections of Hepatology, Digestive Diseases and Nutrition, University of Illinois Hospital & Health Sciences Center, Chicago, Illinois.
5
Department of Pharmacy, Wheaton Franciscan Healthcare - St. Francis, Milwaukee, Wisconsin.
6
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
7
Pharmacy Education and Training, Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
8
Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, Columbia, South Carolina.
9
Department of Clinical, Social, and Administrative Sciences, University of Michigan College of Pharmacy, Ann Arbor, Michigan.
10
University of Michigan Health System, Ann Arbor, Michigan.
11
Gallup Indian Medical Center, Gallup, New Mexico.
12
Pharmacy Practice, School of Pharmacy Worcester/Manchester, MCPHS University, Worcester, Massachusetts.
13
Infectious Diseases, Saint Vincent Hospital, Worcester, Massachusetts.
14
Penn Highlands DuBois, DuBois, Pennsylvania.

Abstract

Hepatitis C virus (HCV) is the most common blood-borne infection in the United States. The high morbidity and mortality due to untreated infection have prompted updated screening recommendations that now include one-time HCV screening for all patients born between 1945 and 1965, in addition to risk factor-based screening. Current guidelines recommend treatment for all patients with chronic HCV. Treatment for HCV genotype 1 has evolved dramatically since the approval of the direct-acting antivirals. The approval of ledipasvir-sofosbuvir, ombitasvir-paritaprevir-ritonavir and dasabuvir, and simeprevir with sofosbuvir has dramatically altered the treatment landscape. High sustained virologic response (SVR) rates favor treatment, yet access to care poses a challenge for patients and providers. Current and emerging data with new therapies indicate high SVR rates in treatment-naïve and treatment-experienced patients, including patients with cirrhosis and in other special populations. Additional data suggest the addition of ribavirin can decrease treatment duration without compromising SVR rates. Resistance is an increasing area of interest in HCV, with baseline mutations identified and the potential for the development of resistance-associate variants in patients undergoing treatment. Due to the rapid evolution of HCV treatment, pharmacists should address challenges and play an integral role in agent selection, dosing, drug interaction screening, adverse effect monitoring, and the coordination of treatment. Clinical application of the latest information will reduce patient risk and improve outcomes.

KEYWORDS:

antivirals; dasabuvir; hepatitis C; ledipasvir-sofosbuvir; ombitasvir-paritaprevir-ritonavir; simeprevir; sofosbuvir

PMID:
26846728
DOI:
10.1002/phar.1700
[Indexed for MEDLINE]

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