AASLD/ESGVH Managing Complex Patients Not Eligible for Simplified Hepatitis C Treatment-AASLD ESGVH Joint Webinar

Video Transcription

Video Summary

This joint webinar by ASLD Hepatitis C Special Interest Group and ESMID focused on managing complex hepatitis C (HCV) cases not eligible for simplified treatment, especially in patients with liver-related conditions and immunosuppression. Dr. David Goldberg discussed treatment options for non-cirrhotic patients who failed prior therapies, including strategies for those co-infected with hepatitis B and patients with active hepatocellular carcinoma (HCC) or post-liver transplant. He emphasized guideline-based regimens, challenges like ribavirin side effects, and insurance constraints affecting treatment choices. He also noted the importance of treating hepatitis B concurrently or monitoring for reactivation during HCV therapy.<br /><br />Professor Massimo Poade addressed HCV management in immunosuppressed patients due to autoimmune diseases, hematopoietic stem cell transplantation (HSCT), and solid organ transplantation. He highlighted higher HCV prevalence and accelerated disease progression in these groups, drug-drug interactions primarily with cyclosporine, tacrolimus, and everolimus, and the safety and efficacy of direct-acting antivirals even during complex immunosuppressive treatments. Special attention was given to using HCV-positive donor organs with prompt antiviral therapy initiation, which improves outcomes. Both speakers advocated individualized treatment timing, careful monitoring, and leveraging guideline recommendations to balance curing HCV while managing comorbidities and immunosuppression complexities, aiming to optimize patient outcomes globally.

Keywords

Hepatitis C

HCV management

complex cases

non-cirrhotic patients

hepatitis B co-infection

hepatocellular carcinoma

immunosuppression

direct-acting antivirals

drug-drug interactions