Thank you, HectorSF
General FYI for anyone
Always check the hcvguidlines for any updates before commenting, posting or discussing.
Personally I start here
http://hcvguidelines.org/news
accessed September 15, 2015 (hcvguidelines mentions using the source link with the date you accessed it.)
for example when scrolling found
Guidance Sections Updated
Friday, August 7, 2015
The Initial, Retreatment, Monitoring, and Unique Populations (HIV/HCV Coinfection, Decompensated Cirrhosis, Post-Liver Transplantation, and Renal Impairment) sections have been revised based on newly available therapies and data.
There are text hot links to these updated sections. You can also go to the full report to access the particular section your interested in.
The following is only from one section
http://hcvguidelines.org/full-report/unique-patient-populations-patients-decompensated-cirrhosis
accessed September 15, 2015
Box recommendations excerpt - see complete text for reasoning, trial info etc. at the linked page.
Patients with HCV genotype 1 or 4 infection with decompensated cirrhosis (moderate or severe hepatic impairment; Child Turcotte Pugh [CTP] class B or C) should be referred to a medical practitioner with expertise in that condition (ideally in a liver transplant center).
Rating: Class I, Level C
Recommended regimens for patients with genotype 1 or 4 HCV infection with decompensated cirrhosis (moderate or severe hepatic impairment; CTP class B or C) who may or may not be candidates for liver transplantation, including those with hepatocellular carcinoma.
Daily daclatasvir (60 mg), sofosbuvir (400 mg), and low initial dose of RBV (600 mg, increased as tolerated) for 12 weeks is recommended for patients with HCV genotype 1 or 4 with decompensated cirrhosis.
Rating: Class II, Level A
Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) and low initial dose of RBV (600 mg, increased as tolerated) for 12 weeks is recommended for patients with HCV genotype 1 or 4 with decompensated cirrhosis.
Rating: Class IIb, Level C
Recommended regimen for patients with genotype 1 or 4 HCV infection with decompensated cirrhosis who are RBV intolerant or ineligible.
Daily daclatasvir (60 mg) and sofosbuvir (400 mg) for 24 weeks is recommended for patients with decompensated cirrhosis who are RBV intolerant or ineligible.
Rating: Class IIb, Level C
Recommended regimen patients with genotype 1 or 4 HCV infection with decompensated cirrhosis in whom prior sofosbuvir-based treatment has failed.
Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) and low initial dose of RBV (600 mg, increased as tolerated) for 24 weeks is recommended for patients with genotype 1 or 4 HCV infection with decompensated cirrhosis in whom prior sofosbuvir-based treatment has failed.
Rating: Class IIb, Level C
Decompensated Cirrhosis: Genotype 2 and 3 HCV Infection
Patients with HCV genotype 2 or 3 infection with decompensated cirrhosis (moderate or severe hepatic impairment; Child Turcotte Pugh [CTP] class B or C) should be referred to a medical practitioner with expertise in that condition (ideally in a liver transplant center).
Rating: Class I, Level C
Recommended regimens for patients with HCV genotype 2 or 3 infection who have decompensated cirrhosis (moderate or severe hepatic impairment; CTP class B or C) and who may or may not be candidates for liver transplantation, including those with hepatocellular carcinoma.
Daily daclatasvir (60 mg), sofosbuvir (400 mg), and low initial dose of RBV (600 mg, increased as tolerated) for 12 weeks is recommended for patients with HCV genotype 2 or 3 infection who have decompensated cirrhosis and who may or may not be candidates for liver transplantation, including those with hepatocellular carcinoma.
Rating: Class II, Level A
Daily sofosbuvir (400 mg) and weight-based RBV (1000 mg [75 kg]) (with consideration of the patient’s creatinine clearance rate and hemoglobin level) for up to 48 weeks is recommended for patients with HCV genotype 2 or 3 infection who have decompensated cirrhosis and who may or may not be candidates for liver transplantation, including those with hepatocellular carcinoma.
Rating: Class IIb, Level B
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http://hcvguidelines.org/
lower home page
NOTICE: Guidance for hepatitis C treatment in adults is changing constantly with the advent of new therapies and other developments. A static version of this guidance, such as printouts of this website material, booklets, slides, and other materials, may be outdated by the time you read this. We urge you to review this guidance on this website (www.hcvguidelines.org) for the latest recommendations.
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By using date webpage was accessed, it informs readers that information quoted was current as of that date on the source link (In my situation the same date as my reply post. You should always check the information by going to the link to verify if it's still current and if there were any copying errors.
HectorSF, It's just fantastic how you manage to spend so much time offing support, advice and love to many here after all you have been through. Plus the hours helping at the transport center. I hope you get some time to relax and enjoy other activities.
I will be posting soon about my cirrhosis class A after 15 months SVR. My labs , tests and any questions I should ask my Gastro before my Oct 15th appointment.
Great info Hector
Thanks for posting.
.....Kim