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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EA choice of all-oral regimens to treat patients with hepatitis C virus is available in the United States, and more are expected to be approved soon. This article reviews the current regimens and trial data from those that are expected to be approved soon.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EViral Infections\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELiver Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EViral Infections\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELiver Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHepatology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EExclusive Article - For home page\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EA choice of all-oral regimens to treat patients with hepatitis C virus (HCV) is available in the United States, and more are expected to be approved soon. Andrew J. Muir, MD, Duke University Department of Medicine, Durham, North Carolina, USA, reviewed the current regimens and trial data from those that are expected to be approved soon.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EKey data on which to base treatment decisions include prior HCV treatment; if it included interferon and ribavirin, a protease inhibitor, or sofosbuvir; and whether these treatments failed. Fibrosis, if present, should be managed. Decompensated cirrhosis might indicate the need for a transplant evaluation.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EUS Food and Drug Administration-approved all-oral regimens for HCV include treatments for HCV genotypes 1, 2, and 3. There are no approved all-oral regimens for HCV genotypes 4, 5, or 6. For HCV genotype 1, the sustained virologic response (SVR) rates are \u0026gt; 90%, which should be considered the benchmark for treatment. Treatment regimens for patients with genotype 1 are summarized in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15582\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15582\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15582\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003ETreatment Regimens for HCV Genotype 1\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EThe TURQUOISE-II study [Poordad F et al. \u003Cem\u003EN Engl J Med.\u003C\/em\u003E 2014] compared 12 vs 24 weeks of paritaprevir\/ritonavir, dasabuvir, ombitasvir, and ribavirin in treatment-na\u00efve and treatment-experienced patients (n = 380) with genotype 1 HCV and compensated cirrhosis. The overall SVR was 92% at 12 weeks and 96% at 24 weeks; responses for genotype 1b were 99% and 100%, respectively, and for genotype 1a were 89% and 94%, respectively.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EAmerican Association for the Study of Liver Diseases (AASLD)-Infectious Disease Society of America (IDSA) guidelines recommend sofosbuvir and ribavirin for treatment-na\u00efve and peginterferon alpha\/ribavirin-resistant, genotype 2 HCV.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003ETreatment of genotype 3 HCV remains challenging. AASLD-IDSA guidelines recommend sofosbuvir plus ribavirin for treatment-na\u00efve and peginterferon alpha\/ribavirin-resistant, genotype 3 HCV. However, in treatment-experienced patients, particularly those with cirrhosis, response rates are low [Zeuzem S et al. AASLD 2013. Abstract 1085]. The addition of ribavirin to sofosbuvir plus ledipasvir improves SVR rates in treatment-na\u00efve (100%, n = 26) and treatment-experienced (82%, n = 50) patients with genotype 3 HCV, although the SVR rates are lower in patients with (73%, n = 22) than without (89%, n = 28) cirrhosis [ELECTRON2; Gane EJ et al. EASL. 2014. Abstract O6; Gane EJ et al. AASLD 2014. Abstract 79]. Response rates were 90% (n = 101) vs 86% (n = 51) for treatment-na\u00efve versus treatment-experienced patients with genotype 3 HCV treated with daclatasvir plus sofosbuvir [ALLY 3; Nelson DR et al. AASLD 2014. Abstract LB-3].\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EFor treatment-na\u00efve and peginterferon alpha\/ribavirin-nonresponsive, genotype 3 HCV, AASLD-IDSA guidelines recommend sofosbuvir and ribavirin for patients ineligible for interferon, adding peginterferon alpha for those eligible for interferon. A small study (n = 25) suggests that the off-label combination of sofosbuvir plus ledipasvir is an option for genotype 6 HCV [ELECTRON2; Gane EJ, et al. AASLD. 2014. LB-11].\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EA key message for patients with HCV is that effective therapies are available, and more treatments, including ribavirin-free regimens, are expected to be approved soon.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/48\/30.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlwcd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlwcd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}