Hepatitis C

AASLD Hepatitis C Guidelines Now Include Newer Antivirals

Guidelines introduced last year to help practitioners treating patients with the hepatitis C virus (HCV) have been updated to provide recommendations for treating the virus with direct-acting antiviral drugs.

Created online in 2014 through a partnership between the American Association for the Study of Liver Diseases (AASLD) and the International Antiviral Society-USA (IAS-USA), the guidelines were produced by a panel of 26 hepatologists, infectious disease specialists, and a patient advocate. Their consensus recommendations include providing:

  • HCV testing details and linkage to care,
  • Recommendations for initial treatment of HCV infection in patients starting treatment,
  • Retreatment information in individuals for whom prior therapy has failed, and
  • Unique patient populations data.
     

Primary care practitioners are “extremely important for the ongoing treatment of HCV,” says Michael W. Fried, MD, FAASLD, a professor of medicine and director of the UNC Liver Center at the University of North Carolina, and a member of the panel that created the guidelines.

“Given the near universal efficacy in treating HCV with new direct acting antiviral agents with few side effects, all patients are potentially candidates for HCV therapy, which can be life-saving for many patients,” says Fried, who says it is “incumbent upon primary care physicians to follow recommended screening guidelines, including testing for anti-HCV all adults born between 1945 and 1965.”

For those outside that age range, he suggests eliciting risk factors that could lead to HCV infection, such as prior use of injecting drugs, for example.  

In the event that HCV is identified, Fried recommends:

  • Providing counseling about lifestyle changes to minimize the impact of HCV.
  • Linking patients with specialty providers for further information. “HCV is curable,” says Fried, “with short courses of pills that have few side effects.”
  • Providing counseling about the low risk of sexual transmission and the low risk of vertical transmission to dispel myths about the infectivity of HCV within families.
  • Regularly screening patients who do already have cirrhosis, using hepatic imaging for liver cancer, even after HCV is cured. 
  • Encouraging patients to get further evaluation and offering “a hopeful message regarding the cure of HCV.”

 

—Mark McGraw