Mihro Kostelo

Racial differences in the response to PegIFNRBV therapy have been signaled, with Hispanics and AfricanAmericans https://hall.com/u/korvin-dalas/1616224

https://hall.com/users/1616224 less likely to respond compared to Whites or Taiwanese patients (Ghany 2009).

 Comorbidities Obesity and its histological correlate, steatosis, are common determinants of liver disease progression in HCV infection.

 We must keep in mind that “not all hepatic fat is alike” and that the etiology of steatosis makes an important difference in the progression of hepatic http://korvin.listal.com/ http://www.podclass.com/korvin/ https://www.xing.com/profile/Korvin_Dalas https://issuu.com/mihrokomishe fibrosis, the development of HCC, extrahepatic manifestations, and prognosis.

 Patients with BMI30 kgm2 are more likely to be insulinresistant, to have more advanced hepatic steatosis or fibrosis 20 Hepatitis C Treatment and to experience a reduced response to combination therapy (Khattab 2010).

 Insulin resistance (IR) is one of the strongest negative predictors of response to HCV therapy.

 Improved insulin sensitivity may http://www.zillow.com/profile/mihrokomishe/ http://dev5.uid.me/mihro_komishe http://30boxes.com/user/8467600/KOrvinKosta  be associated with better treatment response and even with HCV clearance.

 It is important to control diabetes before starting PegIFNRBV therapy, because IFN induces a decrease in glucose uptake by peripheral tissue and the liver.

 New HCV protease inhibitors can restore insulin sensitivity in patients chronically infected with G1 HCV.

 HCV G3 has a direct steatogenic effect independent of IR.

 Coinfections.

 Patients with human immunodeficiency virusHIVHCV coinfection have been shown to respond less favorably to antiviral therapy than patients infected with HCV alone.

 Moreover, serious AEs were far more frequent (35%) than have been reported among HIVseronegative patients (1015%).

 However, coinfected patients have a rapid fibrosis progression rate and experience complications of portal hypertension and PegIFNRBV should be initiated, http://30boxes.com/user/8469065/KorvinDalas 

http://community.elgg.org/profile/korvin if treatment response outweigh the risks of complications from the AEs of therapy (see chapter 3 for details).

 Dual infections of HCV and hepatitis B virus (HBV) occur in up to 5% of the general population in HCVendemic areas and lead to more severe liver disease.

 Recently, a large, openlabel, comparative multicenter study confirmed the efficacy of PegIFNRBV for patients with chronic HCVHBV dual infection in Taiwan (Jamma 2010).

 Treatment related  factors The key components of therapy that affect the success rate are: the optimal duration of therapy (48 or 24 weeks depending on the viral genotype), the need for different regimens for patients with G14 versus G23 infections, the appropriate doses of both PegIFN and RBV and the effective management of the treatmentassociated side effects (Ferenci 2008).

 Antiviral Therapy: The Basics 21 Treatment interruption due to AEs are more frequent in patients receiving PegIFNRBV for the longer duration of 48 weeks.

 All studies show the importance of adherence (McHutchison 2002) using the 808080 rule (patients who took more than 80% of their prescribed IFN, more than 80% of their prescribed RBV, and are treated for more than 80% of the planned treatment duration).