Management of patients with a lapse in antiviral therapy
May 24, 2022
Clinical Challenge
x 2
Restart glecaprevir-pibrentasvir now and treat for another 4 weeks
45%
Restart glecaprevir-pibrentasvir now and treat for another 8 weeks
42%
Retreat him with 12 weeks of sofosbuvir-velpatasvir-voxilaprevir
12%
Another option not listed above
1%
Results are based on 77 responses from our registered members.
Expert Opinions
Paula P. Cox-North, PhD, MN, ARNP
Hepatitis and Liver Clinic
Harborview Medical Center
University of Washington
Hepatitis and Liver Clinic
Harborview Medical Center
University of Washington
Disclosures
Disclosures for Paula P. Cox-North, PhD, APRN
Grant to Institution: Arnold Ventures
Grant to Institution: Arnold Ventures
Submitted
Restart glecaprevir-pibrentasvir now and treat for another 4 weeks
He took 28 days of therapy and has now been off for 14 days. An HCV RNA was done that showed a level of 25IU/mL, which is the cutoff point for a negative test, so I would consider this a negative HCV RNA result. Since he has been off for 2 weeks and still has a negative HCV RNA, with genotype 1a HCV and minimal fibrosis, I would restart medication and have him finish out the planned 8 week treatment regimen.
If his viral load was >25 IU/mL, or he had HCV genotype 3, or had cirrhosis, or if I did not have repeat HCV RNA results, then I would treat him for another 8 weeks rather than 4 weeks.