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on 5 November 2013

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Transcript of Sofosbuvir

Interferon free
Given only with Ribavirin
NS5B polymerase inhibitor
Trials for all genotypes
Treatment length 12 to 16 weeks

(Brown, 2013)

Future of Treatment

Dry, Dry & More Dry
Mouth, Skin
Ulcers & Rashes
Diarrhea, Nausea & Vomiting
Fluid intake, hard candies, lotions,
increase fiber, avoid spicy foods
Take medications with food.
(Substance, 2011)

Treatment: Being the Cheerleader

(IL)28 Gene
Predictor of Treatment Success
C/C with SVR’s of 60-80%
C/T or T/T with less than 30%
(Tran, 2012)
Genes: The Right Fit

Sustained Virological Response
Hepatitis C viral load that is undetectable
Those that achieve an SVR rate post 6 months of treatment
Never achieved SVR
Lowest chance of further treatment being successful
Achieved SVR but not maintained
Improved chance that triple therapy might work if not already attempted

Treatment Outcomes

Peginterferon alfa 2B combined w/ Ribavirin
Boost the immune system and inhibits replication (Tran, 2012)
Cure Rates less than 50% for G1 & approximately 80% for G2 & G3
Typical Course 1 Year (Substance, 2012)
Triple Therapy
Recommended only for G1(Tran, 2012)
Addition of a protease inhibitor
Boceprevir or Telaprevir
Only one shot at a cure
Typical Course 24 to 48 Weeks

Treatment Options

Mode of Transmission
Blood borne pathogen
Needle sticks, STD, blood transfusions

Chronic Liver Disease
Leading cause of complications; cirrhosis, liver failure, hepatocellular carcinoma, and death (Chou, Hartung, Rahman, Wasson, Cottrell, & Rongwei, 2013)

Hepatitis C: Background

Present by Sarah Bennett, RN ADN-BSN

Hepatitis C - A Deeper Look at Genotypes, Genes and Treatment

Brown, T. (2013). FDA panel backs sofosbuvir for hepatitis. Medscape. Retrieved
October 30th, 2013, from http://www.medscape.com/viewarticle/812383
Chou, R., Hartung, D., Rahman, B., Wasson, N., Cottrell, E., & Rongwel, F. (2013).
Comparative Effectiveness of Antiviral Treatment for Hepatitis C Virus Infection in Adults: A Systematic Review. Annals Of Internal Medicine, 158(2), 114-W-80.
Liu, S., Cipriano, L., Holodniy, M., Owens, D., & Goldhaber-Fiebert, J. (2012). New
protease inhibitors for the treatment of chronic hepatitis C: a cost-effectiveness analysis. Annals Of Internal Medicine, 156(4), 279-290. doi:10.7326/0003-4819-156-4-201202210-00005
Substance Abuse and Mental Health Services Administration (2011). Addressing
Viral Hepatitis in People With Substance Use Disorders. Treatment Improvement Protocol (TIP) Series 53. HHS Publication No. (SMA) 11-4656. Rockville, MD: Substance Abuse and Mental Health Services Administration
Tran, T. T. (2012). A Review of Standard and Newer Treatment Strategies in
Hepatitis C. American Journal Of Managed Care, 18S340-9.


Poor Appetite
Small freqent meals
Protain drinks & snacks
Muscle, Head & Body Aches
Drink Fluids
Warm Heating Pads
Take Tylenol or Ibuprofen
Injections changed to bedtime
Tylenol, ibuprofen, naproxen
(Substance, 2011)

Cheer On

Host (IL)28B
C/T or T/T
G2 & G3
Previously Treated?
Type of Treatment?

Tailoring the Right Treatment

There are six genotypes
No particular genotype is associated with worse outcomes (Substance, 2011)
United States
Genotype 1, 2, 3 are most predominant (Substance, 2011)
Genotype 1 accounts for 75% of cases in the U.S. (Substance, 2011)


Ineffective Coping

Decrease fluid intake
Nausea & vomiting
Evidence by tenting, dry skin, rash

Fluid Volume Deficit

Nursing Diagnosis

Lack of Support System
Evidenced by crying spontaneously and reports of sleepless nights

Decreased H/H
Skin Pallor
Apply basic knowledge of Hepatitis C genotypes, host genes and previous treatment history in counseling the patient in treatment options.
Demonstrate nursing care that is associated with managing side effects of patients undergoing Hepatitis C treatment.
Apply nursing diagnoses to Hepatitis C patients receiving treatment.

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