Hepatitis

Question 1

When is hepatitis said to be cured

Answer 1

When there is sustained virologic response 12 weeks after treatment

Question 2

What is sustained virlogic response

Answer 2

No detectable virus in the RNA

Question 3

Mechanism of ribavirin

Answer 3

guanosine analog
blocks capping of rna
inhibits viral RNA-dependent polymerase

Question 4

Why is Ribavirin not a preferred treatment?

Answer 4

Lifelong hemolytic anemia in 10-20% of patients

Question 5

Mechanism of interferon

Answer 5

Immune modulator- antiviral and antiproliferative

• increase major histocompatibility complex (MHC) antigens
• increase macrophage activity
• increase cytotoxic t cells

Question 6

Why is interferon not tolerated?

Answer 6

Severe flu like symptoms

Question 7

what are the “direct acting” drug classes

Answer 7

Protease inhibitors (NS3/4)
Polymerase inhibitors (NS5B)
NS5A inhibitors

Question 8

What class is simeprevir

Answer 8

NS3/4 (protease inhibitor)

Question 9

What class is ledispavir

Answer 9

NS5A inhibitor

Question 10

what class is sofosbuvir

Answer 10

NS5B (polymerase inhibitor)

Question 11

Which genotype is inhibited by simeprevir

Answer 11

1

Question 12

Toxicities of simeprevir

Answer 12

photosensitivity
rash
cyp 3a4 inhibitor- causes rx-rx interactions

Question 13

which genotypes are inhibited by sofosbuvir

Answer 13

1-6

Question 14

Toxicities of sofosbuvir

Answer 14

renal dysfunction

Question 15

What is the first line treatment for HCV

Answer 15

Sofosbuvir- alone for genotypes 2 and 3, in combo with ledipasvir if genotype 1, 4-6.