Treatment of HCV: approach to difficult cases.

Eugene R Schiff, F. M. Tagle

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The treatment of patients with HCV in itself represents a challenge for the treating physicians, but is particularly difficult in special situations where experience is limited. In patients with normal aminotransferases or an incomplete response to IFN, the safety of IFN administration is not the major issue, but one should consider the limited effectiveness of the therapy. In other patients, such as those with concomitant autoimmune hepatitis, an immunosuppressed state or a major psychiatric illness, IFN can be administered but may be associated with serious risks. In these cases, IFN should be used under strictly supervised circumstances and only by physicians with considerable familiarity with the drug. After needle stick exposures, IFN may prevent progression of acute infection to chronic hepatitis. Finally, in patients with well-established cirrhosis, IFN treatment may prevent decomposition or the development of hepatocellular carcinoma. In each of these categories, treatment must be tailored to the individual case based on good clinical judgment. It is hoped that greater experience, newer therapies, and a better understanding of the natural history of HCV infection will simplify the treatment of these cases that currently present difficult management problems.

Original languageEnglish
JournalClinics in Liver Disease
Volume1
Issue number3
StatePublished - Nov 1 1997

Fingerprint

Therapeutics
Needlestick Injuries
Physicians
Autoimmune Hepatitis
Chronic Hepatitis
Transaminases
Infection
Natural History
Psychiatry
Hepatocellular Carcinoma
Fibrosis
Safety
Pharmaceutical Preparations
Recognition (Psychology)

ASJC Scopus subject areas

  • Hepatology

Cite this

Treatment of HCV : approach to difficult cases. / Schiff, Eugene R; Tagle, F. M.

In: Clinics in Liver Disease, Vol. 1, No. 3, 01.11.1997.

Research output: Contribution to journalArticle

@article{3f172f4185114302a8e9991057d210c4,
title = "Treatment of HCV: approach to difficult cases.",
abstract = "The treatment of patients with HCV in itself represents a challenge for the treating physicians, but is particularly difficult in special situations where experience is limited. In patients with normal aminotransferases or an incomplete response to IFN, the safety of IFN administration is not the major issue, but one should consider the limited effectiveness of the therapy. In other patients, such as those with concomitant autoimmune hepatitis, an immunosuppressed state or a major psychiatric illness, IFN can be administered but may be associated with serious risks. In these cases, IFN should be used under strictly supervised circumstances and only by physicians with considerable familiarity with the drug. After needle stick exposures, IFN may prevent progression of acute infection to chronic hepatitis. Finally, in patients with well-established cirrhosis, IFN treatment may prevent decomposition or the development of hepatocellular carcinoma. In each of these categories, treatment must be tailored to the individual case based on good clinical judgment. It is hoped that greater experience, newer therapies, and a better understanding of the natural history of HCV infection will simplify the treatment of these cases that currently present difficult management problems.",
author = "Schiff, {Eugene R} and Tagle, {F. M.}",
year = "1997",
month = "11",
day = "1",
language = "English",
volume = "1",
journal = "Clinics in Liver Disease",
issn = "1089-3261",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Treatment of HCV

T2 - approach to difficult cases.

AU - Schiff, Eugene R

AU - Tagle, F. M.

PY - 1997/11/1

Y1 - 1997/11/1

N2 - The treatment of patients with HCV in itself represents a challenge for the treating physicians, but is particularly difficult in special situations where experience is limited. In patients with normal aminotransferases or an incomplete response to IFN, the safety of IFN administration is not the major issue, but one should consider the limited effectiveness of the therapy. In other patients, such as those with concomitant autoimmune hepatitis, an immunosuppressed state or a major psychiatric illness, IFN can be administered but may be associated with serious risks. In these cases, IFN should be used under strictly supervised circumstances and only by physicians with considerable familiarity with the drug. After needle stick exposures, IFN may prevent progression of acute infection to chronic hepatitis. Finally, in patients with well-established cirrhosis, IFN treatment may prevent decomposition or the development of hepatocellular carcinoma. In each of these categories, treatment must be tailored to the individual case based on good clinical judgment. It is hoped that greater experience, newer therapies, and a better understanding of the natural history of HCV infection will simplify the treatment of these cases that currently present difficult management problems.

AB - The treatment of patients with HCV in itself represents a challenge for the treating physicians, but is particularly difficult in special situations where experience is limited. In patients with normal aminotransferases or an incomplete response to IFN, the safety of IFN administration is not the major issue, but one should consider the limited effectiveness of the therapy. In other patients, such as those with concomitant autoimmune hepatitis, an immunosuppressed state or a major psychiatric illness, IFN can be administered but may be associated with serious risks. In these cases, IFN should be used under strictly supervised circumstances and only by physicians with considerable familiarity with the drug. After needle stick exposures, IFN may prevent progression of acute infection to chronic hepatitis. Finally, in patients with well-established cirrhosis, IFN treatment may prevent decomposition or the development of hepatocellular carcinoma. In each of these categories, treatment must be tailored to the individual case based on good clinical judgment. It is hoped that greater experience, newer therapies, and a better understanding of the natural history of HCV infection will simplify the treatment of these cases that currently present difficult management problems.

UR - http://www.scopus.com/inward/record.url?scp=16544383181&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16544383181&partnerID=8YFLogxK

M3 - Article

C2 - 15560064

AN - SCOPUS:16544383181

VL - 1

JO - Clinics in Liver Disease

JF - Clinics in Liver Disease

SN - 1089-3261

IS - 3

ER -