Monday, December 13, 2010

Hepatitis C Updates:Pre-treatment with Ribavirin Improves Response


Pre-treatment with Ribavirin Improves Response to Interferon-based Therapy for Hepatitis C

SUMMARY: Ribavirin "priming" -- or starting ribavirin monotherapy before adding pegylated interferon -- was associated with a small but significant improvement in sustained virological response in patients with chronic hepatitis C virus (HCV) infection, according to a German study presented at the recent American Association for the Study of Liver Diseases "Liver Meeting" (AASLD 2010) in Boston.


Does Previous Hepatitis B Exposure Increase Liver Cancer Risk?

SUMMARY: People who were previously exposed to hepatitis B virus (HBV) have an increased likelihood of developing hepatocellular carcinoma (HCC) even if they clear the virus, according to a study presented at the recent American Association for the Study of Liver Diseases "Liver Meeting" (AASLD 2010) in Boston. These results suggest that individuals with prior HBV exposure, as well as those with chronic hepatitis B, could benefit from regular liver cancer monitoring.

Artificial Liver Device Improves Survival for Hepatitis B and C Patients with Decompensated Disease

SUMMARY: An artificial liver device known as ELAD -- which runs a patient's blood through cartridges containing human liver cells -- conferred a significant survival advantage for people with acute decompensated liver disease related to chronic hepatitis B or C, according to a Chinese study presented at the recent American Association for the Study of Liver Diseases "Liver Meeting" (AASLD 2010) in Boston. After 3 years, 44% of ELAD users were still alive without liver transplants, compared with 18% in the standard therapy group.

Coinfected People May Control HIV but not HBV on a Tenofovir Regimen

SUMMARY: More then one-third of people coinfected with HIV and hepatitis B virus (HBV) did not achieve or maintain HBV suppression after 1 year of taking tenofovir (Viread), even though they had undetectable HIV viral load indicating good adherence, according to study findings presented at the recent American Association for the Study of Liver Diseases "Liver Meeting" (AASLD 2010) in Boston.

Hepatitis B and Hepatitis C Articles

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Differentiating Between Hepatitis C Genotypes and the IL-28B Genotype

Hepatitis C research represents how far the me edical application of genetics has come in the past decade. Although they analyze different genetic material, tests that determine Hepatitis C genotype and IL-28B genotype will help guide the future of Hepatitis C treatment.

December 13, 2010

Coffee Slows Progression of Hep C Liver Disease
People living with chronic hepatitis C virus (HCV) infection and advanced liver disease who drink three or more cups of coffee per day have a 53 percent lower risk of liver disease progression than non-coffee drinkers, according to a new study published in the November issue of Hepatology. According to the paper, authored by Neal Freedman, PhD, MPH, of the National Cancer Institute and his colleagues, patients with hepatitis C–related bridging fibrosis or cirrhosis who did not respond to standard treatment benefited from increased coffee intake.
This study included 766 participants enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial who had hepatitis C–related bridging fibrosis or cirrhosis and failed to respond to standard treatment with pegylated interferon and ribavirin. Upon entering the study, HALT-C volunteers were asked to report their typical frequency of coffee intake and portion size over the past year.

A similar question was asked for black and green tea intake.
Participants were seen every three months during the 3.8–year study period to assess clinical outcomes that included: ascites (abnormal accumulation of fluid in the abdomen), prognosis of chronic liver disease, death related to liver disease, hepatic encephalopathy (brain and nervous system damage), hepatocellular carcinoma (liver cancer), spontaneous bacterial peritonitis, variceal hemorrhage and/or increase in fibrosis. Liver biopsies were also taken at 1.5 and 3.5 years to determine the progression of liver disease.

Results showed that participants who drank three or more cups of coffee per day had a relative risk (RR) of 0.47 for reaching one of the clinical outcomes. An RR above 1.00 suggests an increase in the risk of disease progression, whereas an RR below 1.00 suggests a decrease in the risk of disease progression.

Researchers did not observe any association between tea intake and liver disease progression, though tea consumption was low in the study.
“Given the large number of people affected by HCV, it is important to identify modifiable risk factors associated with the progression of liver disease,” Freedman said. “Although we cannot rule out a possible role for other factors that go along with drinking coffee, results from our study suggest that patients with high coffee intake had a lower risk of disease progression.”
Results from this study should not be generalized to healthier populations, the authors cautioned.

FDA

Reese Pharmaceutical Company OTC Products: Recall - Mislabeled Guaifenesin Tablets
FDA MedWatch FDA

Reese Pharmaceutical Company OTC Products: Recall - Mislabeled Guaifenesin Tablets Refenesen Expectorant (guaifenesin 200 mg tablets) Select Brand Mucus Relief Expectorant (guaifenesin 200 mg) QC Medifin Expectorant (guaifenesin 200 mg) Leader Cough Tabs Expectorant (guaifenesin 200 mg)

AUDIENCE:

Consumer, Pharmacist ISSUE: Reese Pharmaceutical Company has voluntarily recalled lot# 091612 only in 60-count size bottles identified under four different brand names: Refenesen Expectorant (guaifenesin 200 mg tablets), Select Brand Mucus Relief Expectorant (guaifenesin 200 mg), QC Medifin Expectorant (guaifenesin 200 mg), and Leader Cough Tabs Expectorant (guaifenesin 200 mg) because cold decongestant tablets (containing Acetaminophen 325 mg, Phenylephrine 5 mg & Chlorpheniramine Maleate 2 mg) were mislabeled as containing only 200mg Guaifenesin tablets.

BACKGROUND:

The mislabeled product does not warn consumers that Acetaminophen may cause liver damage. Ingesting high doses of Acetaminophen can potentially cause severe liver damage. The likelihood of acute liver damage is higher among consumers with pre-existing liver disease and those who drink three or more alcoholic drinks per day. Overdose may specially occur if consumers are also taking other cold/cough products that contain Acetaminophen in addition to the mislabeled product. Contraindications for Phenylephrine are high-blood pressure, poor blood flow to the extremities, and patients on antidepressants known as MAO Inhibitors. Furthermore, products that contain Phenylephrine should be used with caution in patients with high blood pressure, diabetes, heart disease, increased intraocular pressure, hyperthyroidism, or enlarged prostate. Consumers who are allergic to any of the ingredients or who have narrow angle glaucoma, or are pregnant or nursing mothers, also should not take the product.

RECOMMENDATION:

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program: Complete and submit the report Online: www.fda.gov/MedWatch/report.htm

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