≡ Menu

What You Want Your Doctor to Know About Hepatitis C

What You Want Your Doctor to Know About Hepatitis C

What You Want Your Doctor to Know About Hepatitis C

I am in touch with quite a few hepatitis C patients, many of whom who are interested in the new hepatitis C drugs, sofosbuvir (Sovaldi) and simeprevir (Olysio). They tell me, “I talked to my doctor, but he/she told me I didn’t need treatment.” I also hear, “My doctor wants to treat me with such-and-such, and I am not sure I want to take those drugs.” Hepatitis C treatment is rapidly changing, and doctors and patients are having a hard time keeping track of these changes. How do people get answers to their questions about hepatitis C?

The answers are here. The American Association for the Study of Liver Diseases and the Infectious Diseases Society released Recommendations for Testing, Managing, and Treating Hepatitis C. Guidelines from these two medical associations carry huge weight, as many medical providers use this expert advice in their own practices. These guidelines are simply written and public, allowing patients access to the latest advice from leading authorities on hepatitis C.

The Recommendations cover testing, managing and treating hepatitis C. The guidelines are not complete—coming soon are “In Whom and When to Initiate Treatment,” Monitoring Patients Who are On or Have Completed Treatment,” and “Managing Acute Hepatitis C.”  However, the information on treating and retreating hepatitis C patients is so compelling, that I am blogging about it now so you will know what the experts are recommending for hepatitis C treatment. I will provide more information when the rest of the guidelines are available.

Genotype 1 Hepatitis C Patients

New to Treatment

Those able to take pegylated interferon (PEG): Daily sofosbuvir and weight-based ribavirin (RBV) plus weekly PEG for 12 weeks

Those unable to take PEG: Daily sofosbuvir plus simeprevir with or without weight-based RBV for 12 weeks

Retreatment

If prior treatment did not use a hepatitis C protease inhibitor: Daily sofosbuvir plus simeprevir with or without weight-based RBV for 12 weeks – Alternative regimen: Daily sofosbuvir plus simeprevir with or without weight-based RBV for 12 weeks – Alternative regimen for those who can take PEG: Daily simeprevir for 12 weeks plus weight-based RBV and weekly PEG for 48 weeks

Alternative regimen for genotype 1 patients who were treated with PEG/RBV (with or without an HCV protease inhibitor) and who are able to take PEG: Daily sofosbuvir for 12 weeks and weight-based RBV plus weekly PEG for 12 to 24 weeks

Genotype 2 Hepatitis C Patients

New to Treatment

Daily sofosbuvir and weight-based RBV for 12 weeks

Retreatment

Daily sofosbuvir and weight-based RBV for 12 weeks – patients with cirrhosis may benefit from 16 weeks of treatment

Alternative regimen for PEG/RBV nonresponder genotype 2 patients who can take PEG: Retreatment with daily sofosbuvir and weight-based RBV plus weekly PEG for 12 weeks

Genotype 3 Hepatitis C Patients

New to Treatment

Daily sofosbuvir and weight-based RBV for 24 weeks

Alternative regimen for genotype 3 hepatitis C patients who have never been treated before who can take PEG: Daily sofosbuvir, weight-based RBV, plus weekly PEG for 12 weeks

Retreatment

Daily sofosbuvir and weight-based RBV for 24 weeks

Alternative regimen for PEG/RBV nonresponder genotype 3 patients who can take PEG: Daily sofosbuvir and weight-based RBV plus weekly PEG for 12 weeks

Genotype 4 Hepatitis C Patients

New to Treatment

Those who can take PEG: Daily sofosbuvir, weight-based RBV, plus weekly PEG for 12 weeks

Those who cannot take PEG: Daily sofosbuvir and weight-based RBV for 24 weeks

Alternative regimen for genotype 4 hepatitis C patients who can take PEG: Daily simeprevir, weight-based RBV, plus weekly PEG for 24 to 48 weeks

Retreatment

Daily sofosbuvir and weight-based RBV plus weekly PEG for 12 weeks

Alternate regimen: Daily sofosbuvir and weight-based RBV plus weekly PEG for 24 weeks

Genotype 5 and 6 Hepatitis C Patients

New to Treatment

Those who can take PEG: Daily sofosbuvir, weight-based RBV, plus weekly PEG for 12 weeks

Alternative regimen for genotype 5 and 6 hepatitis C patients who can take PEG: Daily weight-based RBV plus weekly PEG for 48 weeks

Note: No data are available to support the use of a non-PEG containing regimen for patients with HCV genotype 5 or 6 infection.

Retreatment

Daily sofosbuvir and weight-based RBV plus weekly PEG for 12 weeks

What’s Missing?

Did you notice what is not in the guidelines? The panel did not recommended using boceprevir (Victrelis) or telaprevir (Incivek). PEG plus RBV dual therapy was only recommended as an alternative regimen for genotype 5 and 6 hepatitis C patients.

What Now?

These recommendations are from some of the top experts in the U.S., but not all the regimens were approved by the Food and Drug Administration (FDA). Your medical provider may endorse these treatments, but getting insurance to cover them is an entirely different matter. If you are denied, request an appeal and either give these recommendations to the insurance company, or ask your medical provider’s office to.  Be persistent, and never give up.

{ 2 comments… add one }