60 for 28 days 5971.20 for 48-week course CrCl > 50 mL/min: Initiate at normal dose CrCl 30–50 mL/min: reduce by 25% CrCl 15–29 mL/min: reduce by 50% CrCl < 15 mL/min: avoid Avoid in combination with ribavirin when CrCl < 50 mL/min None in mild and moderate impairment Avoid in decompensated cirrhosis

638.04 Tamoxifen clinical trial for 28 days 7656.48 for 48-week course (person of average weight 79 kg) Chronic hepatitis C infection in adults without liver decompensation, in combination with peginterferon alpha 2a or 2b. In triple therapy with boceprevir or telaprevir in genotype 1 infection, with compensated liver disease* No dose reduction required in patients with compensated cirrhosis Use with caution with careful monitoring in patients with decompensated liver disease 267.81 to £321.38 for 28 days (Rebetol) 308.31 to £369.98 for 28 days (Copegus) Copegus Genotype 1: <75 kg: 1000 mg; ≥ 75 kg: 1200 mg [off-label] Copegus Genotype 2–4: 800 mg daily Rebetol Genotype 1–4: <65 kg: 800 mg; 65–80 kg: 1000 mg; 81–105 kg: 1200 mg; > 105 kg: 1400 mg 1866.50 for 7 days 22,398 For a 12-week course IL28B genotype has been associated with response to pegylated interferon and ribavirin in monoinfected and coinfected

populations with a similar effect on outcome in both in a recent meta-analysis [82]. The Sprint 2 study demonstrated response rates to PEG-IFN and RBV with boceprevir were 80%, 71% and 59% with CC, CT and TT genotype respectively [83]. Similar data have been reported with telaprevir [84]. In the context of DAA-based therapy the role selleck kinase inhibitor of IL28B testing is unclear. If the very high rate of durable virological success reported with newer PIs and interferon-sparing approaches in monoinfected patients is translated into similar results in the coinfected, the use of IL28B testing will become redundant in the clinical setting. Although some physicians

and patients may find IL28B testing of use in making a decision selleck inhibitor to initiate or defer therapy, IL28B testing is not routinely recommended. In a potentially rapidly changing landscape of treatment it is essential that all individuals with chronic HCV undergo adequate liver disease staging prior to a decision being made on whether anti-HCV therapy should be deferred or initiated. If deferred, restaging should occur at least annually (Section 4). An accurate assessment of alcohol and injecting drug use should be sought. Alcohol use should be minimised as this not only accelerates disease progression but also may reduce treatment efficacy through non-compliance; ongoing injecting drug use has previously been considered a relative contraindication for anti-HCV therapy, but there is now a growing body of experience of treatment in this group. Those continuing to inject should be warned about the potential for re-infection and receive education to prevent this.