The 2012 Flying Short Publisher Guide to Hepatitis C by Stefan Mauss, Thomas Berg, Juergen Rockstroh, Christoph

By Stefan Mauss, Thomas Berg, Juergen Rockstroh, Christoph Sarrazin, Heiner Wedemeyer

Interesting new therapy ways make the administration of hepatitis C some of the most swiftly constructing parts of medication. The Flying writer brief advisor to Hepatitis C is an up to date resource of data for physicians, citizens and complex scientific scholars.

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However, R155 is the main overlapping position for resistance and different mutations at this amino acid site within the NS3 protease confer resistance to nearly all protease inhibitors currently in advanced clinical development (Sarrazin 2010). An exception is MK-5172, which exhibits potent antiviral activity against variants carrying mutations at position R155. In addition, MK-5172 has potent antiviral activity against both HCV genotype 1 and 3 isolates (Brainard 2010). 64 | The 2012 Short Guide to Hepatitis C A) ADVANCE 80 ILLUMINATE (response-guided) 75 72 69 60 REALIZE 92 88 100 % SVR % SVR 100 44 86 80 57 60 40 40 20 20 0 0 31 24 15 5 relapser B) 67 69 53 60 40 40 100 relapser 80 75 Black 42 23 % SVR % SVR 80 Caucasian nullresponder RESPOND-2 SPRINT-2 100 part.

Therefore, telaprevir- and boceprevir-based triple therapy can be considered standard of care for HCV genotype 1 patients. 3. 1) and will significantly increase treatment options for chronic hepatitis C in the near future. In general, comparable antiviral activities to telaprevir and boceprevir in HCV genotype 1 infected patients were observed during mono(and triple-) therapy studies (Brainard 2010, Manns 2011, Reesink 2010). , TMC435, BI201335). Different resistance profiles between linear tetrapeptide and macrocyclic inhibitors binding to the active site of the NS3 protease have been revealed.

Reduction of the PI or irregular intake bears the risk for rapid emergence of drug resistance. Dose reduction of the PI is associated with 52 | The 2012 Short Guide to Hepatitis C significantly diminished SVR (Gordon 2011) and is therefore not an option to manage side effects. An optimal management of PEG-IFN/RBV side effects therefore is essential in order to optimise treatment responses. In the case of anemia, dose reduction of ribavirin is possible and not associated with impaired SVR to triple therapy (Roberts 2011).

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