New Hepatitis C Guidelines

[Guest guest]

http://www.hcvadvocate.org/news/newsRev/2004/HJR-1.7.html

New Hepatitis C Guidelines

Finally, new practice guidelines from the American Association for the Study

of Liver Diseases (AASLD) for the diagnosis, management, and treatment of

hepatitis C were published in the April 2004 issue of Hepatology. The

recommendations are based on a review of worldwide medical literature,

existing guidelines from other groups and agencies (such as the Centers for

Disease Control and Prevention), and the experience of recognized experts.

The guidelines cover issues such as who should be tested for hepatitis C

(people with risk factors, including anyone who has ever injected drugs) and

the utility of liver biopsy (laboratory markers of fibrosis are “currently

insufficiently accurate” and biopsy “remains the only means of defining the

severity of damage from HCV infection in many patients”). Pegylated

interferon is recommended as the “treatment of choice,” with no distinction

made between Pegasys and Peg-Intron.

The guidelines also include discussion about managing hepatitis C in several

special populations, including previous non-responders and relapsers

(retreatment is recommended for those previously treated with conventional

interferon); patients with persistently normal ALT (treatment decisions

should not be based solely on ALT level); children (those over age 3 may be

treated with conventional interferon plus ribavirin, but pegylated

interferon is not yet approved); individuals coinfected with HIV (should be

carefully monitored for side effects and drug interactions); people with

kidney disease (should not receive ribavirin); patients with decompensated

cirrhosis and transplant recipients (both should be managed by experienced

practitioners); individuals with acute HCV (no definitive recommendations

can be made, but it seems reasonable to delay treatment for 2-4 months to

allow for spontaneous HCV clearance); and active drug users or those on

methadone maintenance (treatment should not be withheld).

In summary, these guidelines do not include any drastic departures in

standards of care, but they reflect the latest refinements in testing,

diagnosis, and therapy suggested by the most recent clinical studies.

[Guest guest]

http://www.hcvadvocate.org/news/newsRev/2004/HJR-1.7.html

New Hepatitis C Guidelines

Finally, new practice guidelines from the American Association for the Study

of Liver Diseases (AASLD) for the diagnosis, management, and treatment of

hepatitis C were published in the April 2004 issue of Hepatology. The

recommendations are based on a review of worldwide medical literature,

existing guidelines from other groups and agencies (such as the Centers for

Disease Control and Prevention), and the experience of recognized experts.

The guidelines cover issues such as who should be tested for hepatitis C

(people with risk factors, including anyone who has ever injected drugs) and

the utility of liver biopsy (laboratory markers of fibrosis are “currently

insufficiently accurate” and biopsy “remains the only means of defining the

severity of damage from HCV infection in many patients”). Pegylated

interferon is recommended as the “treatment of choice,” with no distinction

made between Pegasys and Peg-Intron.

The guidelines also include discussion about managing hepatitis C in several

special populations, including previous non-responders and relapsers

(retreatment is recommended for those previously treated with conventional

interferon); patients with persistently normal ALT (treatment decisions

should not be based solely on ALT level); children (those over age 3 may be

treated with conventional interferon plus ribavirin, but pegylated

interferon is not yet approved); individuals coinfected with HIV (should be

carefully monitored for side effects and drug interactions); people with

kidney disease (should not receive ribavirin); patients with decompensated

cirrhosis and transplant recipients (both should be managed by experienced

practitioners); individuals with acute HCV (no definitive recommendations

can be made, but it seems reasonable to delay treatment for 2-4 months to

allow for spontaneous HCV clearance); and active drug users or those on

methadone maintenance (treatment should not be withheld).

In summary, these guidelines do not include any drastic departures in

standards of care, but they reflect the latest refinements in testing,

diagnosis, and therapy suggested by the most recent clinical studies.

[Guest guest]

http://www.hcvadvocate.org/news/newsRev/2004/HJR-1.7.html

New Hepatitis C Guidelines

Finally, new practice guidelines from the American Association for the Study

of Liver Diseases (AASLD) for the diagnosis, management, and treatment of

hepatitis C were published in the April 2004 issue of Hepatology. The

recommendations are based on a review of worldwide medical literature,

existing guidelines from other groups and agencies (such as the Centers for

Disease Control and Prevention), and the experience of recognized experts.

The guidelines cover issues such as who should be tested for hepatitis C

(people with risk factors, including anyone who has ever injected drugs) and

the utility of liver biopsy (laboratory markers of fibrosis are “currently

insufficiently accurate” and biopsy “remains the only means of defining the

severity of damage from HCV infection in many patients”). Pegylated

interferon is recommended as the “treatment of choice,” with no distinction

made between Pegasys and Peg-Intron.

The guidelines also include discussion about managing hepatitis C in several

special populations, including previous non-responders and relapsers

(retreatment is recommended for those previously treated with conventional

interferon); patients with persistently normal ALT (treatment decisions

should not be based solely on ALT level); children (those over age 3 may be

treated with conventional interferon plus ribavirin, but pegylated

interferon is not yet approved); individuals coinfected with HIV (should be

carefully monitored for side effects and drug interactions); people with

kidney disease (should not receive ribavirin); patients with decompensated

cirrhosis and transplant recipients (both should be managed by experienced

practitioners); individuals with acute HCV (no definitive recommendations

can be made, but it seems reasonable to delay treatment for 2-4 months to

allow for spontaneous HCV clearance); and active drug users or those on

methadone maintenance (treatment should not be withheld).

In summary, these guidelines do not include any drastic departures in

standards of care, but they reflect the latest refinements in testing,

diagnosis, and therapy suggested by the most recent clinical studies.

[Guest guest]

http://www.hcvadvocate.org/news/newsRev/2004/HJR-1.7.html

New Hepatitis C Guidelines

Finally, new practice guidelines from the American Association for the Study

of Liver Diseases (AASLD) for the diagnosis, management, and treatment of

hepatitis C were published in the April 2004 issue of Hepatology. The

recommendations are based on a review of worldwide medical literature,

existing guidelines from other groups and agencies (such as the Centers for

Disease Control and Prevention), and the experience of recognized experts.

The guidelines cover issues such as who should be tested for hepatitis C

(people with risk factors, including anyone who has ever injected drugs) and

the utility of liver biopsy (laboratory markers of fibrosis are “currently

insufficiently accurate” and biopsy “remains the only means of defining the

severity of damage from HCV infection in many patients”). Pegylated

interferon is recommended as the “treatment of choice,” with no distinction

made between Pegasys and Peg-Intron.

The guidelines also include discussion about managing hepatitis C in several

special populations, including previous non-responders and relapsers

(retreatment is recommended for those previously treated with conventional

interferon); patients with persistently normal ALT (treatment decisions

should not be based solely on ALT level); children (those over age 3 may be

treated with conventional interferon plus ribavirin, but pegylated

interferon is not yet approved); individuals coinfected with HIV (should be

carefully monitored for side effects and drug interactions); people with

kidney disease (should not receive ribavirin); patients with decompensated

cirrhosis and transplant recipients (both should be managed by experienced

practitioners); individuals with acute HCV (no definitive recommendations

can be made, but it seems reasonable to delay treatment for 2-4 months to

allow for spontaneous HCV clearance); and active drug users or those on

methadone maintenance (treatment should not be withheld).

In summary, these guidelines do not include any drastic departures in

standards of care, but they reflect the latest refinements in testing,

diagnosis, and therapy suggested by the most recent clinical studies.