Managing Hepatitis C: Issues and Challenges for Managed Care

Instructions

For each question, please circle the best response on the answer key provided on pages S43/S44. A statement of credit will be mailed to those who successfully complete the examination with a minimum score of 75%.

1. In the late 1980s, the number of new cases of hepatitis C virus (HCV) infections occurring annually in the United States was

• 48 000
• 242 000

2. By 1998, HCV incidence in the United States was

• 40 000 per year
• 550 000 per year

3. The overall prevalence of HCV infection in the general US population in 1998 was estimated to be

• 1.8%
• 5.0%

4. Between 1990 and 2015, the number of patients diagnosed with HCV in the United States is projected to

• Remain stable
• Increase 4-fold

5. The major risk factor for HCV infections in the United States today is

• Blood transfusions and hemodialysis
• Undetermined

6. Of patients infected with HCV who go on to develop chronic hepatitis, the percentage of patients who will eventually develop cirrhosis is approximately

• 5%
• 17%

7. The rate of progression to cirrhosis in patients with chronic HCV infection is influenced by

• Ongoing alcohol use
• All of the above

8. The most accurate measure of HCV disease severity is

• Branched-chain DNA test for HCV
• HCV ribonucleic acid level + genotyping

9. Patients with HCV genotype 1 have a higher response rate to antiviral therapy than patients with genotypes 2 and 3.

• False

10. In all patients infected with HCV who receive a combination of interferon and ribavirin, the overall sustained virologic response rate is approximately

• 30% to 40%
• 80% to 95%

11. The enhanced virologic response rate of the pegylated interferons in HCV infections is related to

• Prolonged duration of pharmacologic activity
• Enhanced activity in patients with concomitant human immunodeficiency virus infection

12. There is evidence that HCV cirrhosis can actually be reversed by HCV antiviral therapy.

• False

13. In large clinical trials of patients treated with interferon, the incidence of fatigue, headache, and myalgia was approximately

• 30% to 40%
• 80% to 90%

14. The interferon/ribavirin dosing strategy that has been shown to improve sustained virologic response in the most difficult-totreat genotype of HCV is

• Weight-based dosing
• Individualized dosing based on HCV viral load

15. Absolute contraindications to interferon alfa treatment include

• Pregnancy
• Old age

16. The most common dosing regimen for pegylated interferon (Peg IFN) and ribavirin (RI antiviral therapy today is

• Peg IFN twice weekly + RIB BID
• Peg IFN once weekly + RIB once daily

17. Dose reduction is a common strategy for reducing the impact of the common ribavirin-induced side effect of

• Fatigue
• Depression

18. Pharmacists can assure patients that there is absolutely no risk of intrahousehold HCV transmission with the sharing of common household items such as razors or toothbrushes.

• False

19. The most recent Consensus Statement from the National Institutes of Health states that antiviral therapy is absolutely NOT recommended for HCV-infected patients with

• Persistently elevated ALT levels and no liver fibrosis
• Age less than 18 years or over 60 years

20. Nonresponders to interferon plus ribavirin therapy are candidates for further treatment.

• False

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