Page 2 - EASL Recommendations on Treatment of Hepatitis C 2014
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APRIL 2014 EASL Recommendations on Treatment of Hepatitis C 2014 Contents Page 1. Introduction 1 2. The standard of care up to 2014 1 3. Methodology 1 4. Recommendations 1 4.1. Diagnosis of acute and chronic hepatitis C 1 4.2. Goals and endpoints of HCV therapy 2 4.3. Pre-therapeutic assessment 2 4.3.1. Search for other causes of liver disease 4.3.2. Assessment of liver disease severity 4.3.3. HCV RNA level and genotype determination 4.3.4. Determination of host genetics 4.4. Contra-indications to therapy 3 4.4.1. IFN-α and ribavirin 4.4.2. Approved DAAs 4.5. Indications for treatment: who should be treated? 3 4.6. Available drugs (approved by EMA before the end of 2014) 4 4.7. Treatment of chronic hepatitis C 4 4.7.1. Treatment of HCV genotype 1 infection 4.7.2. Treatment of HCV genotype 2 infection 4.7.3. Treatment of HCV genotype 3 infection 4.7.4. Treatment of HCV genotype 4 infection 4.7.5. Treatment of HCV genotype 5 or 6 infection 4.8. Treatment monitoring 10 4.8.1. Monitoring of treatment efficacy 4.8.2. Stopping (futility) rules 4.8.3. Virological response-guided triple therapy 4.8.4. Monitoring treatment safety 4.8.5. Treatment dose reductions 4.9. Measures to improve treatment adherence 11 4.10. Post-treatment follow-up of patients who achieve an SVR 11 4.11. Retreatment of non-sustained virological responders 12 4.12. Treatment of patients with severe liver disease 12 4.12.1. Compensated cirrhosis 4.12.2. Patients with an indication for liver transplantation 4.12.3. Post-liver transplantation recurrence 4.13. Treatment of special groups 14 4.13.1. HBV co-infection 4.13.2. Treatment of patients with co-morbidities 4.14. Follow-up of untreated patients and of patients with treatment failure 17 4.15. Treatment of acute hepatitis C 17 4.16. Perspective of new treatments 18 References 18 EASL Office Coordinator: Jean-Michel Pawlotsky 7 rue Daubin, 1203 Geneva, Switzerland Panel members: Alessio Aghemo (EASL governing Board) Geoffrey Dusheiko Tel: (+41) 22 807 03 67 Xavier Forns Fax: (+41) 22 510 24 00 Massimo Puoti e-mail: easloffice@easloffice.eu Christophe Sarrazin
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