gpg koeln Case: HCV-Monoinfection 53 years old woman Former - - PowerPoint PPT Presentation

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Mar 09, 2024 247 likes •346 views

gpg koeln Case: HCV-Monoinfection 53 years old woman Former injection-drug user Has not used injection drugs for 5 yrs Employed and has health insurance Heterosexual but not currently sexually active Smokes 20 packyears

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Case: HCV-Monoinfection

53 years old woman
Former injection-drug user

– Has not used injection drugs for 5 yrs

Employed and has health insurance
Heterosexual but not currently sexually active
Smokes 20 packyears
Drinks alcohol occasionally
HBsAb positive, HIV-Ab negative

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Laboratory Parameters

HCV RNA: 5.8 million IU/mL; HCV genotype 1a
IL 28: CC genotype
AST: 40 U/L (normal < 35); ALT: 35 U/L (normal < 30)
GGT: 42 U/L (normal < 40)
INR: 1.2 (normal 0.8-1.2)
Alkaline phosphatase: 75 IU/L (normal 33-131)
CBC normal except platelet count of 180,000 (normal 100,000-

450,000)

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Clinical Information

On exam, she has small cervical lymph nodes
No ascites, edema, or stigmata of chronic liver disease
He has been compliant with all visits and is anxious to

start treatment for her HCV

Liver biopsy shows grade 1 inflammation but stage 2

fibrosis without any sign of cirrhosis

Co-medication: Trimipramin 25 mg since 2 years because
f reactive depression

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HCV-Therapy

Start therapy on 28.02.2012 with PegIFN alfa-2a 180 µg/wk +

Weight-Based RBV (1200 mg/day)

After 4 weeks lead-in virological response: HCV-RNA 30

IU/ml

start Boceprevir after 4 weeks Lead-in
After 8 weeks therapy : HCV-RNA <12 IU/ml
Treatment is well tolerated

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 RT-PCR NS5 B Region

Sequence analysis

 Submit to geno2pheno[HCV] or COMET  Select Primers for NS3 in case of Genotyp 1  Sequence analysis  Submit to Geno2pheno