1. VIRTUAL MEDZONE Your Resource for Hepatitis Related Innovative Medical Communication

2. Hepatitis Case Presentations John Farley MD FRCPC Mike Silverman MD FRCPC David Fletcher MD FRCPC

3. CASE 1 47 yr-old man Genotype 1a chronic hepatitis C Compensated cirrhosis Baseline HCV RNA 3.65x10 7

4. CASE 1 2010 Treatment with PEGINF/RBV WEEKHCV RNA 03.65x10 7 42.45x10 7 123.25x10 7

5. CASE 1 2010 Neutropenia noted as of week 6 and GCSF 300mcg TIW administered Despite the above, admitted to hospital at week 12 with febrile neutropenia for 10 days – therapy discontinued

6. CASE 1 2012 Patient wants a trial of triple therapy Would you retreat? If so, with what and why?