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Updated Hepatitis C Practice Guidelines Now Available from AASLD
Date:9/28/2011

A. The newly approved treatment schedules have more side effects than pegylated interferon and ribavirin, and should be managed carefully. The drugs are intended for use only in combination with pegylated interfreron and ribavirin, and if not used in combination with those drugs, treatment will be ineffective and will cause emergence of antiviral-resistant mutants that could be difficult to treat subsequently.

Dr. Liang said, "The DAAs will likely change the landscape of treatment for hepatitis C. However a note of caution is necessary to remind all of us that the treatment regimens are complicated and different. They are associated with more side effects than the standard peginterferon and ribavirin combination, and therefore need careful management."

Some of the concerns noted by AASLD are:

  • They are only approved for use in patients with HCV genotype 1.
  • They are not approved for use in post-transplant recurrent HCV.
  • They are not approved for use in HIV/HCV coinfected patients.
  • They are not approved for use in children.

Gary Davis, MD, Chair of AASLD's special interest group on hepatitis C acknowledges the complexities the new DAAs pose, but is still optimistic about these recent developments and the promise of new drugs. Dr. Davis said, "Hepatologists, gastroenterologists, and others who treat patients with chronic hepatitis C now have the option of two newly approved drugs that directly interfere with the ability of the hepatitis C virus to persist in the patient. Administration of these drugs is not straight-forward and increases the complexities of patient management. The new AASLD guidelines review how and when to use these agents in the clinic. This timely document should be a great asset in the management of our patients with hepatitis C."

Dr. Liang echoes those sentiments, adding, "The approval of DAAs for t
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SOURCE American Association for the Study of Liver Diseases (AASLD)
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