1. Hepatitis Tutoring Part 2
By Alaina Darby

2. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1 and is started on peginterferon + ribavirin. When should you assess therapy?
4 weeks
12 weeks
24 weeks
48 weeks b

3. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1 and is started on peginterferon + ribavirin. At 12 weeks, he has the targeted virological response. What is the shortest duration for therapy to be continued?
4 weeks
12 weeks
24 weeks
48 weeks d

4. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1 and is started on peginterferon + ribavirin. Which of the following DAA’s would be most likely included with this regimen?
Dasabuvir
Ombitasvir
Grazoprevir
Sofosbuvir c

5. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1. For DAA treatment, which of the following classes would be best if you expect resistance to be an issue?
PI’s
NS5Ai’s
NS5B NUCi’s
NS5B non-NUCi’s c

6. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1. For DAA treatment, which of the following drugs would be best if you expect resistance to be an issue?
Dasabuvir
Ombitasvir
Grazoprevir
Sofosbuvir d

7. RNA replication and assembly
Agents
PI’s
NS5Ai’s
NS5B NUCi’s
NS5B non-NUCi’s
MOA
Protein transport/ processing
RNA replication and assembly
Potency
High
Intermediate
GT coverage
Limited
Multiple
Low
Barrier to resistance

8. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1. For DAA treatment, which of the following drugs would be most likely to complicate treatment if he also has HIV?
Dasabuvir
Ombitasvir
Grazoprevir
Sofosbuvir c

9. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. He is determined to have HCV genotype 1. Assuming that he is taking all of the following medications, which would you change/discontinue should you start Harvoni?
Omeprazole
Clopidogrel
Metformin
Lisinopril a

10. Ledipasvir/sofosbuvir Paritaprevir/ritonavir/ombitasvir + dasabuvir
Your patient is a heavy drinker who has an elevated INR, AST/ALT are within normal limits, SCr is 2.4, and he has also been diagnosed with HCV. Which of the following would be preferred?
Ledipasvir/sofosbuvir
Paritaprevir/ritonavir/ombitasvir + dasabuvir
Daclatasvir/sofosbuvir
Elbasvir/grazoprevir d

11. Ledipasvir/sofosbuvir Paritaprevir/ritonavir/ombitasvir + dasabuvir
Your patient has been diagnosed with GT 2. Which of the following should he receive?
Ledipasvir/sofosbuvir
Paritaprevir/ritonavir/ombitasvir + dasabuvir
Daclatasvir/sofosbuvir
Elbasvir/grazoprevir c

12. Approved regimens by genotype/daa1 2 3 4
5/6
Lepidasvir/sofosbuvir X
Daclatasvir/sofosbuvir
Paritaprevir/ritonavir/ ombitasvir
Paritaprevir/ritonavir/ ombitasvir + dasabuvir

13. Ledipasvir/sofosbuvir Paritaprevir/ritonavir/ombitasvir + dasabuvir
Your patient has recently had a cardiac stent placed and is taking clopidogrel. Which of the following should be avoided?
Ledipasvir/sofosbuvir
Paritaprevir/ritonavir/ombitasvir + dasabuvir
Daclatasvir/sofosbuvir
Elbasvir/grazoprevir b

14. WATCH OUT! … for drug interactions
CYP & pgp… Daclatasvir, Elbasvir, Grazoprevir
Pgp only… Ledipasvir, Sofosbuvir