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task 1 Key features of history to stratify possible hep-C INFECTON, TASK 3…
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TASK 3: You plan to offer treatment for chronic HCV infection. What important aspects of management do you need to discuss with Farhan.
Treatment Goals: Discuss the aim of treatment, which is to achieve sustained virologic response (SVR) and eliminate the hepatitis C virus from the body.
Treatment Options: Explain the available antiviral medications, emphasizing the effectiveness and tolerability of the new oral direct-acting antiviral (DAA) treatments.
Duration of Treatment: Discuss the expected duration of treatment based on factors such as HCV genotype and cirrhotic status.
Potential Side Effects: Inform about possible side effects of the prescribed medications and strategies for managing them.
Adherence to Medication: Emphasize the importance of consistent adherence to the prescribed medication regimen for successful treatment.
Monitoring during Treatment: Describe the need for periodic monitoring of liver function tests (LFTs) and other relevant parameters during the course of treatment.
Follow-up Appointments: Schedule regular follow-up appointments to assess treatment response, manage side effects, and address any concerns.
post treatment followup
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If cure is achieved
If at risk for hcv reinfection, counsel on risk education and tes for hcv RNA annually or with elevated ALT/AST
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Risks and Benefits: Discuss the potential risks and benefits of treatment, considering Farhan’s overall health and specific circumstances.
Precautions during Treatment: Provide guidance on lifestyle modifications and precautions to optimize treatment outcomes.
Maintain a balanced diet with fruits, veggies, whole grains, lean proteins, and healthy fats.
Exercise regularly, aiming for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise weekly.
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Keep personal items (toothbrushes, razors) for individual use to prevent infections.
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Inform sexual partners if you've been diagnosed with an STI, encouraging them to get tested.
Psychosocial Support: Acknowledge the potential impact on mental health and offer psychosocial support, considering the stigma associated with hepatitis C.
Confirmation of Diagnosis: Conduct HCV RNA test to confirm active infection. Perform genotype testing to guide treatment decisions
Pre-treatment Evaluation: Assess liver fibrosis using elastography (FibroScan) or alternative non-invasive tools. Ensure optimization of comorbid conditions and psychological well-being. Confirm absence of contraindications and address potential drug–drug interactions
TREATMENT OPTIONS
NON-CIRRHOTIC
Genotype1:ledipasvir and sofosbuvir (8 or 12 weeks)
●Genotype 2: sofosbuvir +ribavirin (12weeks)
●Genotype 3 Declatasvir+sofosbuvir (12weeks)
●Genotype 4-6: sofosbuvir +PEG IFN+ribavirin (12 weeks)
Treatment experienced
●Genotype 1 ledipasvir +sofosbuvir (12weeks) ●Genotype 2:sofosbuvir +Ribavirin (12weeks) ●Genotype 3:Declatasvir+sofosbuvir(12weeks) ●Genotype 4-6: sofosbuvir +PEG IFN+ ribavirin (12weeks)
CIRRHOTIC
Genotype 1 ledipasvir +sofosbuvir (12 weeks) ●Genotype 2:sofosbuvir+ribavirin(12weeks) ●Genotype 3:Declatasvir+sofosbuvir(24weeks) ●Genotype 4-6:sofosbuvir +PEG IFN +ribavirin (12 weeks) :
Treatment experienced
●Genotype 1: ledipasvir+sofosbuvir (24weeks) ●Genotype2: sofosbuvir +ribavirin (12weeks) ●Genotype 3: Declatasvir+sofosbuvir(24weeks) ●Genotype 4-6: sofosbuvir PEG IFN+ribavirin (12 weeks)
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Fam-Med Discussion Forum
SCENARIO 2: Farhan is a 46-year-old site supervisor in an Architectural firm. You have been following him for persistent mildly elevated LFTs. He is asymptomatic, drinks minimal alcohol (social drinker) is not overweight and takes no medications. You wish to explore his risks of hepatitis C infection.
Task 1: What are the most important key features of history in helping to stratify his risk of possible hepatitis C infection?
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