Latest Updates

• Updated based on revised AASLD/IDSA and EASL guidelines:
  • Removal of less efficacious, complex, and alternative regimens and ones no longer available in the United States
  • New treatment regimens for children 3-11 years of age
  • Update on recommended regimens for patients who experienced treatment failure with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir/voxilaprevir
  • Updated treatment regimens for recurrent HCV in the posttransplantation setting

• New information on HCV prevalence, treatment, and management of reinfection among persons who inject drugs

• Revised HCV treatment recommendations in patients with severe renal impairment or ESRD based on the latest guidance from AASLD/IDSA and EASL

• Modified HCV treatment recommendations for children older than 3 years of age to reflect latest AASLD/IDSA guidance

• Updated guidance on drug–drug interactions between HCV therapies and HIV antiretroviral agents

• Updated EASL recommendations on HCV treatment for individuals with HIV and genotype 1 HCV coinfection

• Modified HCV treatment recommendations for individuals with HIV and genotypes 2-6 HCV coinfection to incorporate newest guidance from AASLD/IDSA and EASL

• Updated AASLD/IDSA guidance on universal screening for HCV infection in pregnant women

• Incorporated latest guidance from AASLD/IDSA and EASL on HCV management in patients with decompensated liver disease

• Updated AASLD/IDSA and EASL recommendations on management of HCV recurrence and drug–drug interactions between HCV therapies and immunosuppressants in recipients posttransplantation

• Latest guidance from AASLD/IDSA regarding NS5A RAV pretreatment testing when considering specific regimens for certain patient populations with genotype 1a or 3 HCV infection, where resistance testing results may alter HCV management

• Updated guidance from EASL on treatment recommendations for treatment-naive, peginterferon/ribavirin with or without sofosbuvir–experienced, and sofosbuvir plus ribavirin–experienced patients with genotypes 4-6 HCV infection

• Newest EASL recommendations for genotype 3 HCV–infected patients who are treatment naive, experienced with ribavirin, or experienced with peginterferon/ribavirin with or without sofosbuvir

• Revised AASLD/IDSA guidance on treatment of genotype 2 HCV–infected patients with sofosbuvir and NS5A inhibitor experience

• Latest recommendations from EASL on treatment of genotype 1 HCV–infected patients who are treatment naive or experienced

• Updated guidance expanding treatment candidacy to all patients with HCV infection, excepting those with short life expectancy and pregnant women

• Updated data on global prevalence of HCV infection
• New data on HCV transmission via organ transplant from seropositive, NAT-negative donors
• Updated IDU prevalence rates and reinfection risk estimates
• Recent studies on HCV sexual transmission highlight risk factors among women sex workers and MSM
• New data on HCV seroprevalence and reinfection risk among incarcerated persons
• Latest risk-based guidance on anti-HCV screening
• HCV testing algorithm for follow-up of individuals testing anti-HCV positive
• Currently available assays for HCV RNA detection and guidance on interpreting assay results
• Recent data on risk factors for and rate of liver biopsy-associated complications
• Updated data on primary HCV infection in the United States

• New guidance on clinical strategies to reduce risk of HCV reinfection among at-risk populations, including persons who inject drugs, HIV-coinfected men who have sex with men, and individuals in correctional settings
• Updated data from phase II C-SCAPE and phase III C-EDGE TE of elbasvir/grazoprevir ± ribavirin in treatment-naive and treatment-experienced patients
• Updated data from phase III ENDURANCE-1 trial of 8- vs 12-week courses of glecaprevir/pibrentasvir in noncirrhotic patients with genotype 1 HCV, including HIV coinfection
• Updated real-world data for ledipasvir/sofosbuvir-containing regimens in patients with genotype 1 HCV

• Updated AASLD/IDSA HCV management guidance includes recommendations on use of newly approved HCV regimens

• FDA and EMA approve glecaprevir/pibrentasvir for 8-week treatment of all HCV genotypes
• FDA approves sofosbuvir/velpatasvir/voxilaprevir for 12-week retreatment of all HCV genotypes following failure of an NS5A inhibitor–containing regimen

• Updated AASLD/IDSA guidance on initial HCV treatment now recommends 8-week ledipasvir/sofosbuvir for treatment-naive nonblack patients with genotype 1 HCV infection, no cirrhosis, no HIV coinfection, and baseline HCV RNA < 6 million IU/mL
• Revised AASLD/IDSA guidance on retreatment of genotype 3 HCV infection

• Updated global epidemiologic data from the CDC
• Data suggesting rate of reinfection among IDUs low after treatment with antiviral therapy
• Interferon-free regimens provide means of treating HCV-related autoimmune conditions with contraindications to interferon
• Study suggesting no association between HCV and diabetes in US population
• New data demonstrating predominant role of host genetic variants in MHC in accelerated liver fibrosis
• Updated to reflect current guidance from EASL

• Revised guidance for AASLD/IDSA on diagnosis of acute HCV infection

• Updated to include new data and statistics on HCV prevalence
• New section added with considerations for primary care physicians

• New HCV management guidelines from EASL published in April 2014

Updated to include revised guidelines from the AASLD/IDSA on the following topics:

• Situations where barrier protection during intercourse is recommended to prevent sexual transmission of HCV 
• HCV testing recommendations for persons with tattoos received in unregulated settings
• Counseling patients with HCV infection on measures to prevent transmission to others
• Birth cohort and risk-based screening for HCV infection
• Serologic assays for initial detection of HCV infection
• HCV RNA testing 
• Strategies for assessing liver disease in patients with HCV infection

• Journal Highlight: Hashem El-Serag, MD, MPH, comments on recent data suggesting that mortality in the United States due to liver disease–related complications has been underestimated

• New epidemiologic data on prevalence of HCV infection among injection drug users
• Epidemiologic data supporting the relatively low risk of sexual transmission of HCV
• A study from the CDC reporting outbreaks of HCV in the healthcare setting
• Changes in supplemental testing for HCV infection due to discontinuation of a previously recommended immunoblot assay
• New data on the use of rapid testing for HCV
• New data on HCV reinfection and liver disease progression following liver transplantation

• Video Insight: Updated to include a video commentary from John W. Ward, MD, discussing the new guidance from the CDC on one-time HCV screening for all US residents born between 1945 and 1965.

• Updated to include new guidance from the US Centers for Disease Control and Prevention for one-time HCV screening of all persons within the United States born between 1945 and 1965

• Now available: Francesco Negro, MD, provides an in-depth review of past and current HCV transmission trends, the latest understanding of HCV pathogenesis, key assays and recommendations for the diagnosis of HCV, and the natural history of both acute and chronic HCV infection.