what do i need to understand about treatment for hcv genotype 2

For patients chronically infected with genotype 2 HCV, two key factors influence the choice and duration of therapy: cirrhosis

status and prior treatment experience. In addition, the cost of the regimen, insurance coverage, concurrent medications, and patient and provider preference can play a major role in the regimen choice.

Full Answer

What are the treatment options for hepatitis C virus (HCV) genotype 2?

For initial treatment of HCV genotype 2 in adults with compensated cirrhosis, the recommended regimens are sofosbuvir-velpatasvir for 12 weeks or glecaprevir-pibrentasvir for 8 weeks. If the individual has HCV-HIV coinfection, and compensated cirrhosis, the glecaprevir-pibrentasvir treatment should be extended to 12 weeks.

What is the AASLD-IDSA HCV guidance for initial treatment of chronic HCV genotype 2?

The following is a summary of the AASLD-IDSA HCV Guidance for initial treatment of persons with chronic HCV genotype 2 infection. [ 20, 21] For individuals with cirrhosis, the AASLD-IDSA HCV Guidance defines compensated cirrhosis as Child-Turcotte-Pugh class A and decompensated cirrhosis as Child-Turcotte-Pugh class B or C.

What factors influence the optimal regimen for retreatment of HCV genotype 2?

For retreatment of adults with HCV genotype 2, four major factors influence the optimal regimen for retreatment, including (1) the prior regimen the patient failed, including whether there was prior exposure to an NS5A inhibitor, (2) the presence or absence of cirrhosis, (3) cost or insurance considerations.

What is the outlook for hepatitis C genotype 2?

The outlook for hepatitis C genotype 2 is very favorable. That’s especially true if you start treatment early, before the virus has the chance to damage your liver. If you successfully clear hepatitis C genotype 2 from your system, you’ll have antibodies to help protect you from future attacks.

What does HCV genotype 2 mean?

Hepatitis C genotype 2 is often curable. But chronic infection can lead to serious complications. Most people with hepatitis C experience no symptoms or only mild symptoms, even when the liver is becoming damaged. The first six months after infection is defined as acute hepatitis C infection.

Which HCV genotype is easiest to treat?

In the United States, hepatitis C genotype 3 is less commonly contracted than genotype 1, but genotype 3 is also harder to treat....Genotype 3 has been found to respond better to newer drug combinations, including:glecaprevir-pibrentasvir (Mavyret)sofosbuvir-velpatasvir (Epclusa)daclatasvir-sofosbuvir (Sovaldi)

Which HCV is better response for treatment?

Hepatitis C virus (HCV) genotype 2a has a better virologic response to antiviral therapy than HCV genotype 1b - PMC. The . gov means it's official. Federal government websites often end in .

What is the most commonly recommended treatment protocol for HCV?

Hepatitis C is treated using direct-acting antiviral (DAA) tablets. DAA tablets are the safest and most effective medicines for treating hepatitis C. They're highly effective at clearing the infection in more than 90% of people. The tablets are taken for 8 to 12 weeks.

Can all genotypes of Hep C be cured?

Once-daily combination pills that can treat all genotypes of hepatitis C infection are curing almost everyone who completes a course of treatment, and drop-out rates during treatment are low, large 'real-world' cohort studies reported this week at The International Liver Congress in Vienna.

Can HCV genotype change?

Six major genotypes of the hepatitis C virus (HCV) have been described; it is assumed to be uncommon for genotypes to change in chronically infected individuals.

Do you still test positive for hep C after treatment?

Other things to know: After a successful course of treatment for hepatitis C, the hepatitis C antibody remains detectable, but the hepatitis C RNA will be undetectable. If you plan to donate blood, you will be tested for the hepatitis C antibody and will be turned away even if you do not have an active infection.

How many genotypes are there for Hep C?

Scientists call the different types of hepatitis c “genotypes.” Each hepatitis C genotype has a different genetic makeup that helps define it. There are six basic genotypes. Scientists break down each of these numbers into subtypes by letters, like 1a, 1b, etc.

Which cluster of side effects are commonly found in HCV treatments?

The most common side effects include: Fatigue. Headache. Nausea....RibavirinFlu-like side effects (fever, headache, chills, muscle aches)Gastrointestinal problems (low appetite, nausea, vomiting, diarrhea)Low blood cell counts.Depression.Insomnia.Hair loss.

What is the newest treatment for hep C?

Recent advances in antiviral treatment have led to the development of new highly effective drugs for the treatment of all types of hepatitis C. The new hepatitis C treatments are sofosbuvir with ledipasvir (Harvoni); sofosbuvir (Sovaldi); daclatasvir (Daklinza); and ribavirin (Ibavyr).

What is the first line of treatment in hepatitis?

Currently, pegylated interferon alfa (PEG-IFN-a), entecavir (ETV), and tenofovir disoproxil fumarate (TDF) are the first-line agents in the treatment of hepatitis B disease.

How long do you have to be clean to get hep C treatment?

Researchers studied Medicaid programs in the United States from 2017 to 2020. They found that many states require a 6-month to 1-year period of sobriety before someone can start HCV treatment.

What is the SVR rate for HCV genotype 2?

Historically, in the interferon era, treatment of persons with HCV genotype 2 infection achieved higher sustained virologic response (SVR) rates than those with HCV genotype 1 infection, even with a shorter duration of therapy and lower doses of ribavirin. Prior to the availability of DAAs, the standard of care for treatment-naïve patients with HCV genotype 2 consisted of a 24-week course of peginterferon plus fixed-dose ribavirin, with SVR rates of 75 to 85%. [ 6, 7, 8, 9] In 2013, the combination of sofosbuvir with peginterferon and ribavirin showed greater than 90% SVR12 rates in HCV genotype 2 infection. [ 10] Later that year, the FDA approved a 12-week course with the all-oral regimen of sofosbuvir plus ribavirin for the treatment of HCV genotype 2 infection based on data from several studies showing SVR rates of approximately 92 to 97% with this regimen. [ 11, 12, 13] In 2015, daclatasvir plus sofosbuvir was FDA-approved as the first interferon- and ribavirin-free combination for HCV genotype 2 infection and this 12-week combination produced SVR rates of greater than 95%. [ 14, 15] Subsequently, SVR rates of 99% have been reported with sofosbuvir-velpatasvir or glecaprevir-pibrentasvir for initial treatment of individuals with HCV genotype 2. [ 16, 17, 18, 19]

What are the factors that influence the choice of treatment for genotype 2?

For patients chronically infected with genotype 2 HCV, two key factors influence the choice and duration of therapy: cirrhosis status and prior treatment experience. In addition, the cost of the regimen, insurance coverage, concurrent medications, and patient and provider preference can play a major role in the regimen choice. The following treatment recommendations are based on the AASLD-IDSA HCV Guidance for initial treatment of adults with HCV genotype 2 and for retreatment of adults in whom prior therapy failed, including those with HCV genotype 2. [ 4, 5]

What is the AASLD-IDSA HCV guidance?

The following is a summary of the AASLD-IDSA HCV Guidance for adults with HCV genotype 2 infection who failed prior DAA therapy , including those without cirrhosis and those with compensated cirrhosis. [ 24, 25, 26] For these purposes, compensated cirrhosis is defined as Child-Turcotte-Pugh class A and decompensated cirrhosis as Child-Turcotte-Pugh class B or class C. The AASLD-IDSA HCV Guidance for retreatment is no longer genotype specific, but instead emphasizes a pangenotypic approach to retreatment based on the prior treatment regimen. In addition, the AASLD-IDSA HCV Guidance no longer includes recommendations for the retreatment of persons who experienced prior treatment failure with interferon-based therapy, including interferon plus first-generation protease inhibitors ( telaprevir , boceprevir ); these individuals have robust cure rates with modern DAA regimens similar to that observed with treatment-naïve persons. The recommended retreatment regimens are based on prior regimen failure and listed by evidence level; when the evidence level is considered equivalent, the regimens are listed alphabetically.

What is genotype 2?

In the United States, genotype 2 accounts for approximately 13 to 15% of all hepatitis C virus (HCV) infections. [ 1] In the era before direct-acting antiviral agents (DAAs), sustained virologic response rates at 12 weeks post-treatment (SVR12) were relatively higher in persons with genotype 2 HCV than those with genotype 1, 3, or 4 HCV. Thus, data regarding retreatment of individuals with genotype 2 in whom prior therapy failed are limited. The following discussion regarding initial treatment and retreatment of persons with genotype 2 chronic HCV assumes the individual and their clinician have already made the decision to proceed with hepatitis C therapy. This topic review does not address the treatment of HCV genotype 2 in persons with decompensated cirrhosis, severe renal impairment (or end-stage renal disease), or post-liver transplantation.

What are the factors that influence the choice of regimen and duration of therapy?

For initial treatment of persons with chronic HCV genotype 2 infection, three major factors influence the choice of regimen and duration of therapy: (1) the presence or absence of cirrhosis, (2) drug interactions, and (3) medication cost and/or insurance considerations.

Is genotype 2 retreatment less clinical experience than genotype 1?

Accordingly, less clinical experience exists with retreatment of patients with genotype 2 than with genotype 1 infection. In particular, very limited data exist with retreatment of genotype 2 patients with cirrhosis.

The Goal Of Hepatitis C Therapy

Hepatitis C virus was discovered by Choo et al. in the United States of America in 1989, and it has become clear that at least 90% of patients who were diagnosed as non-A, non-B hepatitis and at least half of all patients who were diagnosed as alcoholic liver diseases have liver damages caused by HCV.

Factors To Consider Prior To Choosing Retreatment Regimen

For retreatment of adults with HCV genotype 2, four major factors influence the optimal regimen for retreatment, including the prior regimen the patient failed, including whether there was prior exposure to an NS5A inhibitor, the presence or absence of cirrhosis, cost or insurance considerations.

Outcome Of Patients With Genotype 2 Or 3

Patients with genotype 2 or 3 showed an initial virological response rate of 100% under daily dose IFN-2a treatment. During treatment, however, three genotype 3 patients were excluded from the study due to incompliance. Thus, at that time the drop outs were virological responders.

Epidemiologyglobal Comparison And Resource Factors

When the epidemiology of HCV infection globally is being discussed, it is imperative to discuss northwest and eastsouth differences as well.

Hyperlipidemia Diabetes Mellitus Or Ir

Lipid metabolism is intimately involved in the molecular mechanisms of the HCV infectious cycle. HCV replication influences and depends upon cholesterol uptake and efflux through different lipoprotein receptors during its entry into the hosts cells .

Treatment Of Hcv Genotype 3 With Compensated Cirrhosis: Sofosbuvir Plus Ribavirin

SOF plus RBV for 12 weeks is not recommended for treatment of cirrhotic patients with HCV genotype 3 infections. The overall SVR rates in naive cirrhotic patients treated for 12 weeks ranged from 21 to 34% . Two trials found that SOF plus RBV for 12 weeks for naive patients with cirrhosis resulted in SVR rates of 21% and 34% .

Sofosbuvir Plus And Ribavirin

The combination SOF plus PegIFN/RBV for 12 weeks is recommended by EASL and AASLD for the treatment of naive or treatment-experienced patients with compensated cirrhosis and HCV genotype 3 infection . This recommendation is based in only one study, which observed an overall SVR rate of 8692% in compensated cirrhotic patients .

What are the different types of genotypes?

These can be further specified as: 1 Genotype 1a or 1b 2 Genotype 2a or 2b or 2c 3 Genotype 3a or 3b

Does genotype 2a change over time?

Genotype 2a or 2b or 2c. Genotype 3a or 3b. A person's hepatitis C genotype does not change over time. It needs to be tested only once. If you are treated for hepatitis C, your genotype will determine your treatment plan, such as which medications are prescribed and how long the treatment will be. < Previous.