HCV Weekend Reading - Liver enzymes, New Mid-Month Newsletter and Hot Topics

Here in Michigan its a lovely Autumn day, a perfect day for apples and cider. Is everyone enjoying all fall has to offer, I hope so.  Well, its that time again to catch up on what you missed in this issue of weekend reading.

HCV and Exercise 

Here's an interesting article which was recently published in the African Journal of Health Sciences. The aim of the paper was to investigate the effects of aerobic exercise in 50 male chronic HCV patients. The men were put evenly in two groups, first group (A) received aerobic exercise training in addition to their regular medical treatment; three times a week over a three month period. The second group (B) received no training, only regular medical treatment. Ages ranged from 30 to 50 years, all men had elevated liver enzymes. The study reported significantly improved liver enzymes in the men who received aerobic exercise, group (A), in addition, mental well-being was also improved in the exercise group. Read the full text article, here.

So what are liver enzymes?

Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests.

The specific elevated liver enzymes most commonly found are:
Alanine transaminase (ALT)
Aspartate transaminase (AST)

(ALT; sometimes listed as "SGPT"): About two thirds of people with chronic hepatitis C have continuously elevated ALT levels, reflecting ongoing damage to liver cells. In one third of people with chronic hepatitis C, the ALT levels remain normal, even though they have a detectable HCV viral load. Although most of these people will live with HCV infection without any liver-related problems, roughly one quarter of people may have progression of liver disease even when ALT levels are normal. ALT, in particular, is often one of the criteria in deciding when to start HCV treatment.

AST levels are often elevated in people with chronic hepatitis C. However, AST levels are usually lower than ALT levels. If cirrhosis occurs, AST levels can increase higher than ALT levels—a sign that damage to the liver is worsening.

Anyone Up For Reading More Liver Health Articles?
A collection of October research, news and videos. 

Hot Topics


Gilead's HarvoniTM (Ledipasvir/Sofosbuvir) - Health Canada Issues Notice of Compliance
Harvoni: What You Need to Know about the Newest Hepatitis C Treatment

Joe Galati, M.D.
(This video has been reuploaded, is reuploaded even a word?)
Watch Joe Galati, M.D./Harvoni Hepatitis C Therapy New FDA Approval and Patient Information

Fair Pricing Coalition
Fair Pricing Coalition Welcomes Approval of Gilead Sciences’ Combination Tablet for Hepatitis C, Urges a Uniform Price for Curative Treatment

Gilead U.S. Patient Assistance Programs


Last week HCV Advocate announced a new publication, here you go folks. 

Welcome to the first edition of the HCV Advocate: Mid-Month Edition. We decided to publish an additional mid-monthly edition because there is so much more news now and we wanted to make sure we are keeping our readership up to date on the latest information. The “Mid-Month Edition” will feature Jacques Chambers’ monthly benefits column, fact sheet updates and other critical updates.

HCV Drugs
Alan Franciscus, Editor-in-Chief
FDA Approves Harvoni (Sofosbuvir/Ledipasvir)
As mentioned above the therapy that we have all been waiting for has been approved.  For some background information, you can read about the completed Phase 3 studies that I wrote about in the October 1, 2014 HCV Advocate newsletter. 

HealthwiseAlan Franciscus, Editor-in-Chief
This is our first issue of the new fact sheet and it is appropriate that Egypt is the topic since Egypt has the highest prevalence of chronic HCV of any country worldwide. Egypt also has one of the oldest civilizations in the world and has survived thousands of years, so conquering HCV may just be a matter of a united will. 

HCV Genotype Subtype
Alan Franciscus, Editor-in-Chief
HCV genotype subtypes are becoming increasing important in regards to treatment medications.  In this article I discuss the various subtypes, what distinguishes subtypes from each other, and why re-testing for subtype might be an important reason if people are treated and not cured. 

Patients FirstJacques Chambers, CLU
Medicare Open Enrollment starts October 15, 2014 and ends December 7, 2014. All changes made during this time are effective January 1, 2015. Obamacare has its second Open Enrollment this year. It runs from November 15, 2014 to February, 2015. Take the time to read this important article that can help you make the right choices when it comes to choosing the right healthcare plan. 

Thank you HCV Advocate

October Newsletters

Liver Lowdown just published their October Newsletter

Liver Lowdown is the monthly general interest e-newsletter of the American Liver Foundation. 

Welcome to the October 2014 edition of the Liver Lowdown. Click on the links below and check out our featured stories for the month!

This month we focus on liver cancer, which strikes 33,000 Americans each year. We welcome your thoughts and comments and invite you to share your experiences.

Gretta Goodis knows how lucky she is. Five years ago, she was diagnosed with primary liver cancer (hepatocellular carcinoma). Today, she is cancer-free.

There is always a lot going on at the American Liver Foundation. During the last month, we weighed in on liver transplant organ allocation, hosted an awards gala, held liver health and wellness seminars and hosted several Flavors and Liver Life Walk events throughout the country. We welcome you to join us.

The American Liver Foundation is making news on topics including liver wellness, disease prevention, screening and treatment.

Looking for a delicious recipe to try tonight? We have one for you! Have a recipe to share? We would love to hear from you.

ALF hosts a number of events throughout the year to support liver disease awareness. Check our events calendar and find one to participate in.

Click here to review all October newsletters published by other advocacy groups devoted to increasing awareness and information about viral hepatitis. 

Please get your flu shot!
Always Tina

New pill-only regimens cure patients with hardest-to-treat hepatitis C infection

  • Friday, October 17, 2014
  • Posted by HCV New Drugs
  • File Under

New pill-only regimens cure patients with hardest-to-treat hepatitis C infection 

(Vienna, October 17, 2014) Two new pill-only regimens that rapidly cure most patients with genotype 1 hepatitis C (HCV) infection could soon be widely prescribed across Europe. Two recently-published studies1,2 confirmed the efficacy and safety of combination therapy with two oral direct-acting antiviral agents (DAAs), with around 90% of patients cured after just 12-weeks of treatment.

At the 22nd United European Gastroenterology Week (UEG Week 2014) in Vienna, Austria, Professor Michael P. Manns from Hannover Medical School in Germany will be presenting this data and says this represents a massive step forward in the treatment of this life-threatening infection. 

These new pill-only regimens have the potential to offer more effective, safer and faster virus eradication than current therapies, even in traditionally hard-to-cure patients," he says. "We hope that a pill-only regimen will encourage more people to come forward and accept treatment so we can one day eradicate this deadly virus."

Burden of hepatitis C infection

Hepatitis C virus (HCV) infection is a global epidemic, with more than 180 million people thought to have chronic HCV infection worldwide. HCV genotype 1 represents the majority of infections in Europe and is considered the most difficult to cure. Until recently, the standard of care for chronic HCV genotype 1 infection involved a combination of drugs, was associated with severe side-effects and involved complicated injection and tablet regimens lasting up to 1 year.

"These treatment regimens, although effective, are difficult to manage and poorly tolerated by many patients, and some clinicians won't even use them," says Prof. Manns. "We desperately need simpler treatment regimens that are highly effective, that can be used in more patients, and that do not cause such severe toxicity."

New pill-only regimens

Two recently-published studies used different combinations of oral antivirals to treat patients with chronic HCV genotype 1 infection. In the first study – called the HALLMARK-DUAL study1 – 645 patients with HCV genotype 1b infection received an NS3 protease inhibitor twice-daily plus once-daily NS5A replication complex inhibitor or placebo. Twelve weeks after the end of a 24 week treatment period (the primary endpoint), the combination regimen had provided a sustained virological response (SVR) – which is considered a cure – in 90% of previously untreated patients and 82% of patients who had failed to respond to, or could not tolerate, their previous treatment.

"This is a vast improvement over standard triple therapy, with efficacy observed across the board – even in patients with liver cirrhosis and those who have failed other treatments," says Prof. Manns. "The combination treatment was also well tolerated by most patients."

In a second study – called the COSMOS study2 – 167 patients with HCV genotype 1a and 1b infection were randomized and treated with a second generation NS3/4A protease inhibitor once-daily plus a NS5B polymerase inhibitor once-daily with or without ribavirin. After 12 weeks of treatment, 93% of patients (including those with cirrhosis and interferon non-responders) had achieved an SVR. Again, the combination regimen was well tolerated, with less than 2% of patients reporting serious adverse events or withdrawing from treatment because of adverse events.

"The results from these two studies suggest that interferon- and ribavirin- based treatment for chronic HCV infection may soon become a thing of the past," says Prof. Manns. "With several more pill only regimens having also been reported this year, this is a key moment in the history of HCV treatment and represents an important step towards universally effective, needle-free treatments for HCV."3,4,5.