Wednesday, August 16, 2017

Hepatitis C - DAAs reduces the risk of mortality in the first 18 months after the completion of treatment

Source - infohep

Treatment with DAAs reduces the risk of mortality in the first 18 months after the completion of treatment
Michael Carter
Published:10 August 2017
The study – published in Clinical Infectious Diseases – matched people who received therapy with all-DAA regimens with untreated controls. Mortality rates in the first 18 months after therapy were significantly lower among people who received DAAs. After controlling for other factors, treatment with DAAs was associated with a 57% reduction in the risk of death.

“To our knowledge, this is the first large-scale study to demonstrate the effect of newer DAA regimens upon survival,” write the authors. “Treatment with 2 commonly used DAA regimens…was associated with significant improvements in survival within the first 18 months of treatment, compared with demographically and clinically similar untreated HCV-infected controls.”
Continue reading.....

View full text article online at NATAP
Effect of paritaprevir/ritonavir/ombitasvir/dasabuvir and ledipasvir/sofosbuvir regimens on survival compared with untreated hepatitis C virus-infected persons: results from ERCHIVES

Tuesday, August 15, 2017

How Do Direct-Acting Antivirals for HCV Affect HCC Risk?

How Do Direct-Acting Antivirals for Hepatitis C Affect the Risk for Hepatocellular Carcinoma?
Sheila L. Eswaran, MD, MS; Nancy Reau, MD
August 15, 2017

The latest data on the controversial hepatitis C-hepatocellular carcinoma treatment link are examined.

Hepatocellular carcinoma (HCC), which has an annual incidence rate of 1%-4%,[1] is a potential complication of hepatitis C virus (HCV) cirrhosis owing to a multistep carcinogenesis pathway. Previous HCV treatment with interferon was associated with poor cure rates and was limited to individuals with early fibrosis or well-compensated cirrhosis. Such therapy, however, also led to a decrease in HCC after a sustained viral response (SVR).[2,3] Although remarkable progress has occurred in curing HCV in the current direct-acting antiviral (DAA) era, there is controversy regarding the associated risk of patients developing either incident (new, de novo) or recurrent HCC after DAA treatment. Additional data also suggest a lower SVR rate in patients with HCC.

Blogs & Updates: Triple Drug Regimen Succeeds Against Treatment-Resistant HCV

Blogs & Updates
Discover what's new by reading the following popular HCV blogs.

Of Interest - Can anyone treat hepatitis C?

PodMed – Johns Hopkins Medicine Podcasts
Aug 11, 2107
This week’s topics include complications of aortic valve surgery, effectiveness of nasal flu vaccination, testing for Epstein Barr virus and nasopharyngeal cancer, and hepatitis C treatment.
Listen here.....

MD Magazine | Hepatitis C
The MD Magazine Hepatitis C condition center provides clinical news and articles, information about upcoming conferences and meetings, updated clinical trial listings, and other resources.

Triple Drug Regimen Succeeds Against Treatment-Resistant HCV
AUGUST 15, 2017
Kenneth Bender
A triple drug regimen effectively cured patients with hepatitis C virus (HCV) after they had failed to respond to a combination of 2 oral direct-acting antivirals (DAA), according to a report of 2 international trials.

Hep C: Speak Up
Aug 15, 2017
Philip Christopher Baldwin   Human Rights Activist
Hep C does not get the attention it deserves. Many patients are diagnosed by chance. Better screening for Hep C needs to be put in place in the UK. Patients also need more support after initial diagnosis. In the past, some people may not have sought Hep C treatment, due to the problems and uncertainty associated with interferon-based treatments, or because of the length of NHS waiting lists for the new DAA medications. The situation in the UK is now changing and people living with the virus can increasingly get it treated quickly and effectively by the NHS.
Continue reading....

Weekly Bull
HepCBC is a non-profit organization run by and for people infected and affected by hepatitis C. Our mission is to provide education, prevention and support to those living with HCV.

News Recap
Mini livers,  new tests to predict liver transplant outcomes, HBV vaccine shortage and the effectiveness of antiviral therapy in reducing incidence of HCC in people with HBV. Also, check out the great photos from the Vancouver Pride festival.
Read The Latest Issue: Weekly Bull

At we empower patients and caregivers to take control of Hepatitis C by providing a platform to learn, educate, and connect with peers and healthcare professionals

By Daryl Luster - August 14, 2017
Is there even such a thing as being absolutely certain? Some will argue the issue, and of course, we are all entitled to our own opinions based on whatever we believe in....

Just the Facts Please 
By Daryl Luster - August 11, 2017
There was a TV program in my youth where one of the lead characters was famous for saying “just the facts Ma’am” and for many of us it was and even remains...
Continue reading...

Dry Mouth Causes and Treatment 
By Karen Hoyt - August 10, 2017
Dry mouth is annoying! Your tongue feels like it is getting bigger and bigger, words get stuck to the side of your mouth, and food is hard to swallow! It can be...
Continue reading...

The AJKD blog is the official blog of American Journal Of Kidney Diseases.

Hepatitis C and Kidney Transplantation: Past, Present, and Future
August 14, 2017 by AJKDblog
This is Part 1 of a 2-part series on Hepatitis C and kidney transplantation, highlighting some of the exciting breakthroughs impacting this field that have come about as a result of promising antiretroviral therapy.
Continue reading....

HEP - Blog Updates
Hep is an award-winning print and online brand for people living with and affected by viral hepatitis. Offering unparalleled editorial excellence since 2010, Hep and Hep Magazine are the go-to source for educational and social support for people living with hepatitis.

To view a list of all bloggers please click here, and here to read personal stories about HCV.

Hepatitis C News That Isn’t Fake
August 14, 2017 • By Lucinda K. Porter, RN
A couple of months ago, headlines in the Guardian stated, “’Miracle’ hepatitis C drugs costing £30k per patient ’may have no clinical effect’.” These were horrible headlines, first because they were false; second because until you looked at the facts, it was disturbing.

Hepatitis-C Doesn’t Discriminate Neither Should We
August 14, 2017
By Carleen McGuffey
National organizations with influence should avoid making public statements that are political. The Leaders of our Hepatitis-C organizations know that politics are always divisive. Always. Our alliances are predicated on one thing only. Eradicating the Hepatitis-C virus. When we allow our feelings to dictate our advocacy it distorts the purity of the mission and disrupts our congruity of purpose. 

AGA Journals Blog
Dr. Kristine Novak is the science editor for Gastroenterology and Clinical Gastroenterology and Hepatology. She has worked as an editor at biomedical research journals and as a science writer for 15 years, covering advances in gastroenterology, hepatology, cancer, immunology, biotechnology, molecular genetics, and clinical trials.

What is the Best Management Strategy for Patients With NAFLD?

Kristine Novak
Management of patients with non-alcoholic fatty liver disease (NAFLD) requires combined efforts of general practitioners, hepatologists, and other experts, Herbert Tilg explains in a Mentoring, Education, and Training Corner article in the August issue of Gastroenterology. NAFLD has become the most common liver disease worldwide. It ranges from simple steatosis in the absence
Continue reading.....

Creating a World Free of Hepatitis C
Welcome to my website and blog. My name is Lucinda Porter and I am a nurse committed to raising awareness about hepatitis C. I believe that we can create a world free of hepatitis C. We do this together, one step at a time.

Surviving Illness: Tips for Patients, Family, Friends, and Coworkers

By Lucinda K. Porter, RN
A patient once told me, “Illness is a way to health.” This is a simple but profound concept. We have many responses and approaches to illness and health. Some of us use denial in order to cope. Others respond by feeling scared or overwhelmed. Anger and resentment are common reactions.
Continue reading....

Infectious Disease Advisor
Infectious Disease Advisor offers infectious disease specialists and other healthcare professionals a comprehensive knowledge base of practical information and resources to assist in making the right decisions for their patients.

Steatosis: An Independent Risk Factor for Fibrosis in Chronic HCV

Thanks for stopping by!

Monday, August 14, 2017

Hepatitis C - Everyone Has The Right To Be Cured

"Life is inherently risky. There is only one big risk you should avoid at all costs, and that is the risk of doing nothing."
Denis Waitley

Greetings, I have this passion, an obsession if you will, it started at the tender age of ten, the moment my father flew us over Lake Superior in his Cessna. From that day on, I was hooked.

The Landing & A Life Lesson
I remember as we were heading in for a landing, my father turned to me and said, "Flying a plane is a lot like life, taking off is easy, but the landing can kill ya." We both laughed, but I will never forget what he said that day, it was my first life lesson, with more to follow.

My father was a man who took risks, we both did, I still do. Before his success he explored several business ventures, so he knew about failure. Knowing this, and now in my thirties, I asked him what he thought about a business I was about to start. Enter my second lesson.

Looking at me with that half smile, he offered this, "You may fail, but I would rather go somewhere than go nowhere at all." Off I went, the business was successful for years, but eventually it came to an end. However, it was a learning experience, one I completely embraced at the time. The good news? I knew when to get out. The bad news? I had to start all over.

Years later, when my father was very ill, he asked for a glass of water, for reasons I won't go into, it wasn't allowed. Again, I heard, "Take a risk, break the rules, if you won't get me a glass of water, can you get me a burrito." I smuggled in the water.

Some of us are risk-takers, some of us make mistakes, maybe from a lack of knowledge or a lapse in judgement. In any event, missteps, mess-ups happen to everyone, learning from the experience is what matters most, moving boldly forward isn't easy but it beats moving backward, or worse yet, going nowhere at all. 

My Misstep
While very much in love, no, while I fell into a lapse in judgement, I used IV drugs, twice. That's all it took. My next risk? I was tested for HCV 20 years later, I was in my early forties, went on treatment and came in for a smooth landing, I was cured. I seldom discuss my mistakes, but this one needs to be told.  I get the stigma, the fear of being tested, however, my journey to wellness was well worth it.  

If  HCV is, or was, your unfortunate misstep, where ya going next? You can't go backward, but you can move forward, take that first step, get tested. Start by making an appointment with your physician, or search for a testing organization near you. It's a fair compromise, right? Either you'll put this behind you, or have an opportunity to turn things around.

Ohhh That Stigma 
Today in our society the stigma associated with HCV and drug use is still ongoing, sadly this stigma plays a huge part in the number of people forgoing HCV testing. Years ago if you were battling addiction it was impossible to get into a clinical trial, or treatment was denied because of concerns over adherence to the therapy. But today, just like a message in the famous song; The Times They Are a-Changin'....

I hope you watch this video, its an important starting point. 

Uploaded by the Harm Reduction Coalition.
Harm Reduction Coalition - Wesbite
Blog - Demand Access

Articles & Stuff
Watch ASCEND Documentary: Patients, Providers, and Hepatitis C
Article - Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers
"In this phase 4 prospective, observational study, task shifting of DAA-based HCV therapy to nonspecialist providers was safe and effective.

Primary Care Providers Can Treat Hep C
Primary care providers can successfully manage direct-acting antiviral (DAA) treatment for hepatitis C, though some complicated cases should still be referred to specialists, experts say.
* free registration may be required to view article, I know, I hate that too.

I have no idea how I contracted HCV
Today we have two different groups of people that are at risk for hepatitis C, young people who have used IV drugs and well, older people. The latter falls under the baby boomer generation, that is people born between 1945 and 1965. Rather you contracted HCV recently through drug use, or years ago from another route of transmission, it really doesn't matter, does it? Get tested.

Baby Boomers
If you're a baby boomer, and the whole stigma thing is keeping you from getting tested, know this, in 2016, the Lancet published research showing the hepatitis C epidemic in baby boomers, for the most part, can be traced to hospital transmissions caused by the practice of reusing glass and metal syringes in the 50’s and 60’s.

The bottom line? Living with HCV for years is reason enough to get tested, you are putting yourself at risk for serious liver damage, complications, and other liver related disease.

Disease Progression
Published in the November 2014 issue of Journal of Hepatology; Natural history of hepatitis C
Chronic hepatitis C infection causes cirrhosis in approximately 16% of patients over 20 years. However, fibrosis progression rates are extremely variable and can be influenced by host, viral and environmental factors. The rates of progression are not linear and may vary between fibrosis stages and accelerate with duration of infection or aging. In patients who have had hepatitis for 30 years cirrhosis rates are estimated at 41%, almost 3 times higher than the rates predicted at 20 years duration.
Getting back to HCV and young people, according to a report released this year by the CDC: New Hepatitis C Infections Nearly Tripled over Five Years
New hepatitis C virus infections are increasing most rapidly among young people, with the highest overall number of new infections among 20- to 29-year-olds. This is primarily a result of increasing injection drug use associated with America’s growing opioid epidemic.
The following links focus on research and access to care for people with HCV who use drugs. By using Twitter and Facebook you will find helpful resources with peer support in or around your community.

Start Your Recovery is committed to using evidence-based methods that encourage people to find the support they need.
Hear Stories
Get Support

Here are a few research articles to get you started, never mind, skip down to those great Twitter and Facebook links.
National Viral Hepatitis Roundtable
Twitter - NVHR
Follow On Facebook
The National Viral Hepatitis Roundtable is a broad coalition working to fight, and ultimately end, the hepatitis B and hepatitis C epidemics.
Read - Tested Cured, Project Empowers Drug Users to Take Control of Their Health

Harm Reduction
On Twitter - Harm Reduction
Follow On Facebook
Harm Reduction Coalition: promoting the health and dignity of those impacted by drug use.

Twitter HarborPath
Follow On Facebook
Website - HarborPath
HarborPath is a non-profit safety-net for Uninsured with HIV, hepatitis C; Clinics can access lifesaving medications through our online portal.

Open Society Foundations
International Harm Reduction Development Program works to advance the health & human rights of people who use drugs.
Twitter - OSF Harm Reduction‏ 
Follow on Facebook

Deserve A Cure
Follow On Twitter - Deserve A Cure

Twitter - Don Crocock
Follow On Facebook
This page is dedicated to the dissemination of information; research reports, trends and developments in the areas of Hepatitis C, substance use and misuse and addiction.

Twitter *French & English - CATIE
Follow On Facebook
Canada’s source for HIV and hepatitis C information
Read - Views from the front lines: Getting to undetectable

Harm Reduction Canada
Twitter - Marilou Gagnon RNPhD‏ 
Nurse, Activist, Associate Prof / President, Harm Reduction Nurses Association / Co-President, Nursing Observatory

If you are newly diagnosed I suggest you learn everything you can about the disease, HCV Advocate is a great place to begin, rather you have been tested, been diagnosed, or starting therapy.

Homepage - HCV Advocate
News and Pipeline Blog - HCV Advocate 

Twitter - Henry E. Chang‏ 
Read this - Sobering stats from a study on HCV cure vs. new infections in 91 countries in 2016 (~81% of global burden)

Helpful Links
Premier Hepatitis C Websites, Blogs and Support Forums

In the end just get tested. Like a wise man once said "Mistakes are not for the weak, only the strong make it right and move on." Yep, my dad said that, right after he finished reading my divorce papers. Ugh.

See you soon

Predictors of early discontinuation of interferon-free direct antiviral agents in patients with hepatitis C virus and advanced liver fibrosis: results of a real-life cohort.

Predictors of early discontinuation of interferon-free direct antiviral agents in patients with hepatitis C virus and advanced liver fibrosis: results of a real-life cohort.
Miotto, Noelle; Mendes, Leandro C.; Zanaga, Letícia P.; Goncales, Eduardo S.L.; Lazarini, Maria S.K.; Pedro, Marcelo N.; Gonçales, Fernando L. Jr; Stucchi, Raquel S.B.; Vigani, Aline G.
Eur J Gastroenterol Hepatol. 2017.

Aim: The aim of this study was to determine risk factors for premature treatment discontinuation among patients with hepatitis C and advanced fibrosis with advanced fibrosis treated with interferon (IFN)-free direct antiviral agents (DAA)-based therapy.

Patients and methods: We included all patients with chronic hepatitis C virus infection and advanced liver fibrosis in whom treatment was initiated with IFN-free DAA therapy at a university hospital from December 2015 through June 2016. We prospectively collected data from medical records using standardized questionnaires and evaluated them using Epi Info The primary outcome was treatment interruption and associated factors.

Results: In total, 214 patients were included in this study; 180 patients were treated with sofosbuvir (SOF)+daclatasvir+/-ribavirin (RBV), 31 received SOF+simeprevir+/-RBV, and three were treated with SOF+RBV. Treatment discontinuation rate was 8.9% (19 patients) and cirrhotic decompensation was the main reason [8 (42.1%)]. Among patients with Child B or C cirrhosis (31), 10 (32.2%) prematurely interrupted treatment. The risk factors for treatment discontinuation in univariate analysis were older age (P=0.0252), higher comorbidity index (P=0.0078), higher model for end-stage liver disease (P<0.0001), higher fibrosis index based on the 4 factores (P=0.0122), and lower hemoglobin (P=0.0185) at baseline. Multivariate analysis showed that older age (odds ratio: 1.1, 95% confidence interval: 1.02-1.19) and higher model for end-stage liver disease (odds ratio: 1.27, 95% confidence interval: 1.03-1.56) were associated with premature treatment interruption.

Conclusion: Older age and advanced liver disease were related to treatment interruption. Identification of risk factors associated with treatment discontinuation is important to recognize patients who should be followed up closely during treatment, ando those whom possibly may not benefit from immediate DAA treatment or should be followed up closely during treatment.


Health Matters: Is Hepatitis C Linked to Diabetes?

Health Matters: Is Hepatitis C Linked to Diabetes?
Posted: Aug 14, 2017
Hepatitis C and diabetes are two diseases that can cause long term complications if left untreated.

Diabetes Educator Sharon Krispinsky says the two diseases have a lot in common. “There’s absolutely a link between hepatitis C and the development of type two diabetes.”
View Article, here.

Is Hepatitis C Linked to Diabetes? from Lee Health on Vimeo.

Sunday, August 13, 2017

SVR in HCV leads to an early and significant improvement of liver fibrosis

Original article
Sustained virological response by direct antiviral agents in HCV leads to an early and significant improvement of liver fibrosis
Marcello Persico, Valerio Rosato, Andrea Aglitti, Davide Precone, Mariano Corrado, Antonio De Luna, Filomena Morisco, Silvia Camera, Alessandro Federico, Marcello Dallio, Ernesto Claar, Nicola Caporaso, Mario Masarone

doi: 10.3851/IMP3186

Full Text
PDF link provided via Henry E. Chang on Twitter.

Background: Direct Antiviral Agents (DAA) demonstrated high efficacy among HCV-infected patients in registered trials. Nevertheless, the impact of these therapies on liver stiffness measurement(LSM) and liver functionality in “real-life” is not well-known. Aim of the present study was to evaluate the SVR impact on LSM and clinical parameters of DAA-therapy on a real-life population of HCV patients with F3/F4 fibrosis
Methods: 749 HCV genotype 1-4 patients with F3/F4 hepatitis undergoing antiviral therapy, were consecutively enrolled in four centers of Hepatology of Italy. Clinical, biochemical and imaging data were collected at the baseline(T0), at the End of Therapy(EoT) and after 12 weeks(SVR12).
Results: Out of 749 patients, 69.7% was F4 and 30.3% was F3. SVR12 was reached in 97,5%. LSM significantly decreased from T0 to EoT(p<0.001) whereas it did not from EoT to SVR12(p:ns). Moreover, in F4 no significant differences were found in Child and MELD between T0, EoT and SVR12(p=ns). At the univariate analysis of clinical and liver parameters, baseline high glucose(p<0.005), type 2 diabetes(p<0.001), low ALT(p<0.001), low PLTs(p<0.005), and the presence of esophageal varices (EV)(p<0.001) were found to be associated with a lack of a significant EoT LSM improvement. At a multiple regression, ALT(p<0.05), Diabetes(p<0.005) and EV(p<0.05), were inversely associated with significant LSM reduction.

Conclusions: Virological response to DAA is associated with fibrosis regression and recovery of liver functionality and this can be detected as early as EoT. HCV eradication is associated with a rapid and significant clinical improvement that lasts overtime and seems to be negatively influenced by diabetes and EV.
Continue reading -

If you are interested in reading full text articles about the treatment and management of hepatitis C follow Henry E. Chang on Twitter.

Friday, August 11, 2017

Hepatitis C Genotype 3 Infection Pathogenesis and Treatment Horizons

Clinics in Liver Disease
August 2017 Volume 21, Issue 3

Hepatitis C Genotype 3 Infection Pathogenesis and Treatment Horizons
Haripriya Maddur, MD*, Steven L. Flamm, MD

Genotype 3 hepatitis C infection is the second most common genotype worldwide and accounts for most infections in Southeast Asia. It is a particularly ominous genotype because it has been linked to increased mortality, specifically increased late-stage liver events, accelerated development of hepatic fibrosis, and an increased risk of hepatocellular carcinoma. As new treatment regimens for hepatitis C have been emerging, treatment of genotype 3 often requires longer treatment duration with decreased response rates as compared with other genotypes.

KEY POINTS Hepatitis C genotype 3 infection is associated with increased late-stage liver events, accelerated hepatic fibrosis, and hepatocellular carcinoma.
Infection with genotype 3 infection has been linked to hepatic steatosis thought to be related to direct viral protein effect on hepatocytes.
With the advent of direct-acting antiviral therapies, infection with genotype 3 has been found to be more difficult to treat as compared with other genotypes.

Continue reading... Full Text PDF Tweeted By @Henry E Chang

Of Interest
Shortening the duration of therapy for chronic HCV
Lancet Published online August 9, 2017
Combination direct-acting antiviral therapy of 8–24 weeks is highly effective for the treatment of chronic hepatitis C infection. However, shortening the treatment duration to less than 8 weeks could potentially reduce overall treatment costs and improve adherence. Here we explore the arguments for and against the development of short-duration regimens and existing data on treatment for 6 weeks or less among patients with chronic hepatitis C virus genotype 1 infection. Additionally, we identify potential predictors of response to short-course combination therapies with direct-acting antiviral drugs that might be explored in future clinical trials.
Continue reading... Full Text PDF Tweeted By @Henry E Chang

If you are interested in reading full text articles about the treatment and management of hepatitis C  follow Henry E. Chang on Twitter.

Ibuprofen most frequent drug-induced liver injury agent in Spain

Ibuprofen most frequent drug-induced liver injury agent in Spain
Zoubek ME, et al. Clin Gastroenterol Hepatol. 2017;doi:10.1016/j.cgh.2017.07.037.
August 10, 2017
Ibuprofen is one of the most frequent causative agents listed in the Spanish and Latin-American registries of the Drug-Induced Liver Injury Network, according to a recently published study.

“The risk of developing ibuprofen-induced liver injury is low considering the extensive use of this drug worldwide, but should not be overlooked as it can have life-threatening consequences,” the researchers wrote.

Continue reading @ Healio

Common brand names for ibuprofen Brufen, Advil, Motrin, and Nurofen

All News At Healio

Thursday, August 10, 2017

Australia - A note of caution amidst a ‘revolution’ in hepatitis C treatment

A note of caution amidst a ‘revolution’ in hepatitis C treatment

Tens of thousands of Australians have been cured of Hepatitis C since new treatments were made universally available last year, and a report released last month said Australia is on track to eliminate hepatitis C by 2026.

But while new treatments continue to dramatically reshape the landscape, data from the Centre for Social Research in Health’s (CSRH) Annual Report of Trends in Behaviour 2017: Viral Hepatitis in Australia underscores the need for caution.

Addressing stigma in healthcare settings, engaging marginalised communities in prevention, and continuing to trial innovative models of care will all be imperative if the ‘new era’ of treatment is to fulfil its promise, the report says.

The report will be presented on 10 August at the Australasian Viral Hepatitis Elimination Conference (AVHEC) in Cairns.

The Annual Report of Trends in Behaviour presents data from a selection of the behavioural and social research conducted by the CSRH. It is designed to inform prevention, diagnosis and treatment by critiquing and questioning the assumptions that sometimes underlie research, policy and practice around viral hepatitis.

Key issues in the 2017 report on viral hepatitis include:
The need to continually innovate harm reduction programs in ways that reflect how transmission happens in the everyday
Exploring best models of care for affected communities
The impact of stigma on the capacity of affected communities to navigate treatment systems
Understanding and preventing hepatitis C transmission within heterosexual couples
Examining strategies beyond equipment distribution
Gaps in the way that hepatitis C prevention sector understands and addresses risk

Lead author Dr Joanne Bryant, Senior Research Fellow at the CSRH, said the report particularly highlighted the challenges of testing, diagnosis and care of Aboriginal people with hepatitis C.

“While we found that Aboriginal Australians living with hepatitis C were generally satisfied with their care, they were often subject to stigma and discrimination, which can create a barrier in accessing healthcare,” Dr Bryant said. “Policies and programs need to be culturally tailored to address the unique needs and experiences of Aboriginal people living with hepatitis C and their communities.”

The report found that most hepatitis C infections occur early in people’s drug using pathways but many young people had limited knowledge about the availability of sterile injecting equipment.

In a survey of 210 socially marginalised young people at risk of transitioning to injecting drug use, a third (34.3%) of participants thought they knew where to obtain sterile needles, fewer (24.3%) could correctly identify a service, and the sources most commonly identified – hospitals (27.8%) and pharmacies (25.0%) – were not specifically needle distribution services.

“These findings suggest that needle distribution policies should focus less on getting ‘at-risk’ young people to visit primary needle and syringe programs and more on improving services that they already know about, such as hospitals and pharmacies, or finding ways of bringing sterile needles to them, such as through peer distribution,” Dr Bryant said.

The report also notes that despite the majority of needle or syringe sharing occurring between sexual partners, the framing and delivery of harm reduction in Australia has little capacity to recognise intimate partnerships, including addressing the hepatitis C risks specific to them.

“Not only might more effective harm reduction strategies be achieved by moving to a practice framework that addresses the social context of injecting, including the experience of couples, the broader drug treatment and hepatitis C care sectors might also benefit from recognising the importance that partnership plays in the lives of couples who inject drugs,” Dr Bryant said.

The report also examines risks factors, attitudes and knowledge of hepatitis B, and highlights that about one third of people living with the diseases are yet to be diagnosed and only 6% have been treated.

Stigma remains a factor influencing decisions about care and treatment of people living with hepatitis. But for those diagnosed with liver cancer, the report says lack of English-language proficiency can be a barrier to accessing health services and understanding the implications of a cancer diagnosis.

“Our recommendations include a directory of Chinese-speaking medical practices and Chinese language interpretation services, the development of Cantonese and Mandarin language health promotional materials, and identifying opportunities to support family doctors and liver specialists,” Dr Bryant said.

Professor Carla Treloar, Director of the CSRH, said: “Viral transmission happens in complex ways that are impacted by social context and the relationships of people at risk of acquiring viral hepatitis. Within the exciting context of new generation hepatitis C treatments, there remains the need to continually innovate harm reduction programs in ways that reflect how transmission happens in the everyday.”

The full report is available here.

Media contact: Clare Morgan, UNSW Media Office,, 02 9385 8920, 0416 127 312

The Fight Against Hepatitis C Has Not Yet Been Won - Here’s What We Have To Do

The Fight Against Hepatitis C Has Not Yet Been Won - Here’s What We Have To Do
Professor Mark Thursz
10/08/2017 14:19
After the handshakes comes the hard work. When the Government signed up to an ambitious World Health Organization target on hepatitis C virus (HCV), it was welcome news for thousands of patients, doctors and loved ones living with or affected by this life-changing infection. But for the more than 200,000 people in the UK estimated to be living with HCV, it was far from the end of the story.

Continue reading....

The risks of hepatocellular carcinoma development after HCV eradication are similar between patients treated with peg-interferon plus ribavirin and direct-acting antiviral therapy

The risks of hepatocellular carcinoma development after HCV eradication are similar between patients treated with peg-interferon plus ribavirin and direct-acting antiviral therapy
Yuko Nagaoki, Michio Imamura, Hiroshi Aikata, Kana Daijo, Yuji Teraoka, Fumi Honda, Yuki Nakamura, Masahiro Hatooka, Reona Morio, Kei Morio, Hiromi Kan, Hatsue Fujino, Tomoki Kobayashi, Kazuaki Chayama
Published: August 10, 2017

The risk of hepatocellular carcinoma (HCC) development is reduced following viral elimination by interferon therapy in chronic hepatitis C patients. However, the risk in patients treated with interferon-free direct-acting antivirals (DAAs) is unknown. We evaluated chronic hepatitis C patients who achieved viral eradication by pegylated-interferon plus ribavirin (PEG-IFN/RBV, n = 244) or daclatasvir plus asunaprevir (DCV/ASV, n = 154) therapy. None of the patients had prior history of HCC or antiviral therapy. The median observation period after the end of treatment for the PEG-IFN/RBV and DCV/ASV groups were 96 (range 10–196) and 23 (range 4–78) months, respectively. During the observation period, HCC developed in 13 (5.3%) and 7 (4.5%) patients in the PEG-IFN/RBV and DCV/ASV groups, respectively. The cumulative HCC development rate after 1-, 3- and 5-years (0.4%, 3% and 5% for the PEG-IFN/RBV group and 0.6%, 9% and 9% for the DAA group, respectively) were similar between the two groups. Propensity score matching analysis also showed no significant difference in HCC development rates between the two groups. Serum AFP levels decreased to similar levels between PEG-IFN/RBV and DCV/ASV groups following the achievement of viral eradication. The risk for HCC development following viral eradication by IFN-free DAA therapy may be similar to that in IFN-based therapy.

Discussion Only
Read Full Text Article

This study examined the cumulative incidence of HCC development after HCV eradication by PEG-IFN/RBV or DCV/ASV treatment. During the follow-up period, HCC developed in 13 out of 244 (5.3%) of the PEG-IFN/RBV group and 7 out of 154 (4.5%) of the DCV/ASV group, and the cumulative HCC development rate tended to be high in DCV/ASV groups (P = 0.053). To overcome bias due to the different distributions of covariates among patients treated with PEG-IFN/RBV or DCV/ASV, one-to-one matches were created using propensity score analysis. The cumulative HCC development rate after 1-, 3- and 5-years were 1.5%, 10% and 19% for the PEG-IFN/RBV group and 1.5%, 10% and 12% for the DCV/ASV group, respectively. Propensity score matching analysis also showed similar rates of HCC development in the two groups. Based on the results of this analysis, one can argue that the risk of HCC development after HCV eradication achieved by DCV/ASV is similar to that of IFN therapy. In the present study, HCC development risk was similar between the PEG-IFN/RBV and the DCV/ASV groups in both patients with and without advanced liver fibrosis. In contrast, Conti, et al. reported that virus eradication by DAAs treatment did not reduce occurrence of HCC development in HCV-infected cirrhosis patients [29]. Further analysis is needed to clarify the relationship between HCC development risk after HCV eradication by DAAs treatment and liver fibrosis.

A recent study showed a high rate and unexpected pattern of HCC recurrence after HCV eradication by IFN-free DAA therapy in patients with HCV-related HCC [30]. Although the mechanism underlying this unexpected early HCC recurrence is unknown, it is possible that HCV eradication by DAA therapy could enhance HCC development or recurrence in patients who have elevated risk for HCC. However, the present study showed no evidence for an increase in HCC development following achievement of HCV eradication by DAA therapy.

The present study has several limitations. First, the observation period was relatively short in the DCV/ASV group; the median observation period was only 23 months in this group compared with 96 months in the PEG-IFN/RBV group. Furthermore, only 7 patients developed HCC in DCV/ASV group. This short observation period and the small number of patients who developed HCC might underlie the lack of significance between the two groups.

Second, patients who were treated with PEG-IFN/RBV and those treated with DCV/ASV differ with respect to many host and viral factors that potentially affect HCC development. Although propensity score analysis showed a similar HCC development risk between the two groups, the propensity score matching may not completely compensate for these differences among the patient populations. Large-scale, long-term follow-up studies that include patients treated with other DAA regimens, such as sofosbuvir plus ledipasvir, ombitasvir/paritaprevir/ritonavir, and elbasvir plus grazoprevir, should be performed.

Previous studies have shown that advanced liver fibrosis, male gender, older age, high AFP levels, greater alcohol intake, complications from diabetes mellitus, and obesity were risk factors for HCC development after HCV eradication by IFN treatment [17,18, 3134]. The present study showed that male gender and AFP levels ≥10 ng/mL were associated with HCC development after HCV eradication by DCV/ASV therapy; however, no factor was identified for independent risk for HCC development. The small number of patients who developed HCC might be associated with the absence of independent factors. AFP is a surrogate marker for risk of HCC development. Previous reports showed that AFP levels after the completion of IFN treatment were useful predictors for HCC development in chronic hepatitis C patients who achieved viral eradication [10, 34]. In the present study, serum AFP levels decreased to similar levels following achievement of SVR both in the PEG-IFN/RBV and the DCV/ASV groups, suggesting the possibility of reduced potential for HCC development. Future analysis to identify predictors for HCC development after HCV eradication to examine whether AFP levels could be a surrogate marker for HCC development in patients who achieved SVR by IFN-free DAA therapy using a larger number of patients is needed.

Previous studies showed that IL28B and DEPDC5 genotypes were strongly associated with IFN treatment response and HCC development in chronic hepatitis C patients, respectively [2123]. However, the present study showed that IL28B and DEPDC5 genotypes were not independent risk factors for HCC after HCV eradication. Recent genome-wide association study identified the association between the SNP rs17047200 in the TLL1 locus and HCC development after HCV eradication in patients treated with IFN-based treatments [35]. Future analysis is expected to identify SNPs associated with HCC development after HCV eradication, particularly in patients treated with DAAs.

In conclusion, we demonstrated that the risk of HCC development in patients infected with HCV genotype 1 after achieving viral eradication with DAA therapy is similar to that for PEG-IFN/RBV therapy.

Watch ASCEND Documentary: Patients, Providers, and Hepatitis C

The ASCEND Documentary - An inside view of Hepatitis C treatment in an urban community health care setting

The ASCEND study has been published in the Annals of internal medicine: Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial.

Full Text 
Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers
A Nonrandomized Clinical Trial
Sarah Kattakuzhy, MD; Chloe Gross, RN; Benjamin Emmanuel, MPH; Gebeyehu Teferi, MD; Veronica Jenkins, MD; Rachel Silk, RN, MPH; Elizabeth Akoth, RN, MS; Aurielle Thomas, BA; Charisse Ahmed, BS; Michelle Espinosa; Angie Price, CRNP; Elana Rosenthal, MD; Lydia Tang, MD; Eleanor Wilson, MD, MS; Soren Bentzen, PhD; Henry Masur, MD; Shyam Kottilil, MD, PhD; and the ASCEND Providers*
Full text PDF tweeted via @HenryEChang

Follow On Twitter
I highly suggest you follow Henry E. Chang on Twitter if you are interested in reading full text articles about the treatment and management of hepatitis C.

Aug 10, 2017 Provided by NATAP 
Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial - ASCEND Study - (08/10/17)

Follow On Twitter @JulesLevin1      

Aug 10, 2017
Provided by - InstHumanVirology

Wednesday, August 9, 2017

Focus on primary care before we run out of hep C patients, says Ed Gane

Regular news from the New Zealand Doctor newsroom

Focus on primary care before we run out of hep C patients, says Ed Gane
Cliff Taylor
But the flow of easy-to-reach patients, treated mainly in hospital clinics, is coming to an end. The pressing need is to engage with the 48,000 patients believed to be in the community, he says.

Treatment rate plateauing 
Until March, between 150 and 200 patients were being treated each month, but the number is now about 105.

“We wouldn’t expect that to be happening so soon,” Professor Gane says. “We would have expected it to remain high, or increase.”

Continue reading...

Tuesday, August 8, 2017

What is the Best Management Strategy for Patients With NAFLD?

08/08/2017 | News release | Distributed by Public on 08/08/2017 06:57

AGA - American Gastroenterological Association

What is the Best Management Strategy for Patients With NAFLD?
Management of patients with non-alcoholic fatty liver disease (NAFLD) requires combined efforts of general practitioners, hepatologists, and other experts, Herbert Tilg explains in a Mentoring, Education, and Training Corner article in the August issue of Gastroenterology.

NAFLD has become the most common liver disease worldwide. It ranges from simple steatosis in the absence of inflammation to nonalcoholic steatohepatitis (NASH), liver cirrhosis, and hepatocellular carcinoma. The prevalence is as high as 30% in the United States and parts of Asia, and rates are along with those of obesity and type 2 diabetes. More than 10% of patients with NAFLD are believed to have nonalcoholic steatohepatitis (NASH).

What is the best way to identify and manage these patients?

Tilg explains when to suspect that a patient has NAFLD, and provides an algorithm for diagnosis. He states that assessment of fibrosis is the most important task in the management of patients with NAFLD.

The NAFLD fibrosis score, fibrosis 4 calculator, enhanced liver fibrosis test, and FibroTest can be used to identify patients with advanced fibrosis, and results associate with cardiovascular and liver-related mortality. Tilg writes that although transient elastography is the most common technique used to define fibrosis stage of patients with NAFLD, it has limitations in evaluation of the very obese population and inter-investigator reliability. Tilg states that magnetic resonance elastography is now the most accurate method to assess stage of fibrosis.

Tilg explains that a definite diagnosis of NASH is important because inflammation and/or fibrosis dictate the long-term prognosis of this disease, which might ultimately require liver transplantation. Whereas liver-related long-term complications develop in patients with definite NASH, NAFLD has in general a high rate of extra-hepatic complications, including cardiovascular complications, chronic kidney disease, diabetes, and cancer.

Although there is no established treatment for NASH, therapeutic strategies are in development.

Lifestyle changes, such as weight reduction, reduce features of NAFLD. NASH disappeared in 85% of patients who underwent bariatric surgery, and fibrosis was reduced in more than 30% of patients. Diets high in protein (either animal or plant) significantly reduced liver fat in patients with diabetes and NAFLD, independently of body weight, and reduced markers of insulin resistance and hepatic necroinflammation. The diets appear to mediate these changes via lipolytic and lipogenic pathways in adipose tissue. Tilg also reviews the evidence that exercise reduces liver fat.

Tilg explains developments in pharmacotherapy for NAFLD, stating that although no drugs have been approved for treatment of NAFLD, agents such as thiazolidinediones (PPAR-gamma agonists), which reduce liver fat content, have shown effects in patients with NASH. Tilg remarks on results of trials with vitamin E, glucagon-like peptide-1 agonists, liraglutide, and an agonist of PPARs-alpha and -delta. He also discusses trials underway to target metabolic pathways, oxidative stress and inflammation, gut microbiota, and fibrosis (see figure).

Tilg explains the importance of following patients for liver complicationssuch as hepatocellular carcinoma (HCC) as well as extrahepatic and systemic complications. Patients with a diagnosis of NAFLD require life-long monitoring for cardiovascular disorders, chronic kidney disease, diabetes, and non-liver malignancies such as colon neoplasias.

Tilg concludes that NAFLD is a syndrome with many features, so it is essential for physicians to consider patients in a holistic manner. It is important to search for signs of arterial hypertension, diabetes, and sleep apnea. Only a broad awareness in the medical community can lead to proper diagnosis and effective management and treatment.

Monday, August 7, 2017

New study generates more accurate estimates of state opioid and heroin fatalities

New study generates more accurate estimates of state opioid and heroin fatalities

Developing a statistical model to fill in the blanks on death certificates presented in the American Journal of Preventive Medicine

Image - Reported and corrected 2014 overdose death rates (per 100,000). view more 


Ann Arbor, MI, Aug. 7, 2017 - Although opioid and heroin deaths have been rising dramatically in the U.S., the magnitude of the epidemic varies from state to state, as does the relative proportion of opioid vs heroin poisonings. Further complicating the picture is that up to one-quarter of all death certificates fail to note the specific drug responsible for the fatality, complicating efforts to target enforcement and treatment programs at both state and federal levels. A new study in the American Journal of Preventive Medicine presents a correction procedure to refine this data, which results in significant shifts in state-by-state mortality rates. This truer picture helps to remove an important barrier to formulating effective policies to address this serious drug epidemic.

On a national basis, these corrected mortality rates were 24% higher for opioids and 22% higher for heroin. For opioids, uncorrected mortality growth rates were considerably underreported in Pennsylvania, Indiana, New Jersey, and Arizona, but dramatically overestimated in South Carolina, New Mexico, Ohio, Connecticut, Florida, and Kentucky. Increases in heroin death rates were understated in most states, and by a significant margin in Pennsylvania, Indiana, New Jersey, Louisiana, and Alabama.

According to author Christopher J. Ruhm, PhD, Frank Batten School of Leadership and Public Policy, University of Virginia, Charlottesville, Virginia, "A crucial step to developing policy to combat the fatal drug epidemic is to have a clear understanding of geographic differences in heroin- and opioid-related mortality rates. The information obtained directly from death certificates understates these rates because the drugs involved in the deaths are often not specified."

This study develops correction methods to provide more accurate information. The corrected estimates often differ considerably from reported rates. To provide an example, in 2014, the opioid and heroin death rates based on death certificate reports in Pennsylvania were 8.5 and 3.9 per 100,000, respectively, but a drug category was specified in only half of fatal overdose cases in that year. Correcting for this understatement yields estimated actual opioid and heroin overdose deaths of 17.8 and 8.1 per 100,000.

Counts of drug deaths of U.S. residents were obtained from the 2008 and 2014 Centers for Disease Control and Prevention Multiple Cause of Death (MCOD) files. The MCOD data provide information from death certificates on a single underlying cause of death, up to 20 additional causes, and also provided age, race/ethnicity, gender, year, weekday, and place of death. The death certificate may also list one or more drugs involved as immediate or contributory causes of death, included separately as ICD-10 T-codes. T-codes 40.0-40.4 and 40.6 indicate the involvement of opioids and T-code 40.1 refers to heroin.

There were 36,450 fatal overdoses nationwide to U.S. residents in 2008 and 47,055 in 2014. However, for about half the overdose fatalities, unspecified drugs were mentioned, and in one-fifth to one-quarter of the cases, this was the only drug-related designation included. To develop corrected rates, information from death certificate reports where at least one specific drug category was identified were used to impute drug involvement for cases where drug involvement categories were left unspecified. These corrections were then applied on a state-by-state basis to produce opioid- and heroin-specific death rates.

Dr. Ruhm notes that these corrections have a substantial influence on state mortality rankings. "For instance, Pennsylvania had the 32nd highest reported opioid mortality rate and the 20th highest reported heroin death rate, but ranked seventh and fourth based on corrected rates. Similarly, Indiana's rankings moved from 36th and 29th to 15th and 19th, respectively, and Louisiana's from 40th and 31st to 21st and 20th, respectively. There were 19 states whose corrected and reported opioid rankings differed by at least five places and eight states where this occurred for heroin."

Understanding the inaccuracies resulting from the lack of specificity of drug involvement on death certificates is particularly important because federal policies often target states believed to have especially severe opioid or heroin problems. "More fundamentally, geographic disparities in drug poisoning deaths are substantial and a correct assessment of them is almost certainly a prerequisite for designing policies to address the fatal drug epidemic," concludes Dr. Ruhm.

Sunday, August 6, 2017

August Newsletters Vosevi and Mavyret: Have We Reached the End of HCV Drug Development?

Vosevi and Mavyret
Like a kind man once said "It's a Beautiful Day in This Neighborhood." 

Welcome folks, the HCV community had some great news on Aug 3 when AbbVie's Mavyret (glecaprevir/pibrentasvir) was FDA approved and also in July when Gilead announced the FDA approval of Vosevi (Sofosbuvir/Velpatasvir/Voxilaprevir.) In addition the EMA granted marketing authorization for both Vosevi and Mavyret, in July as well.

Mavyret & Vosevi: News & Updates
You know what I love, a well organized list of noteworthy articles about Mavyret and Vosevi. Sit back, get comfortable, even grab a pair of slippers, before clicking on the above mentioned links.

Thank You
Thank you to all the good people who put out these informative newsletters and well written blogs each month. A special thank you to Don, for always tweeting about this blog, follow my handsome friend on Twitter @dcrocock, on Facebook, here.

Newsletters & Blogs
This index of August newsletters offer health tips and important information about both newly approved direct-acting antivirals, as do the following patient friendly blogs.

HIV and ID Observations
NEJM Journal Watch - An ongoing dialogue on HIV/AIDS, infectious diseases, all matters medical, and some not so medical.

Have We Reached the End of HCV Drug Development?
Paul E. Sax, MD
Two new HCV regimens gained FDA approval recently, bringing us closer to the end of this extraordinary phase of drug development.
Think about it — has ever been a more spectacularly rapid improvement in treatment of anything? If so, please let me know what that is. Remember, as recently as early 2013, highly toxic interferon-based therapy (with ribavirin and telaprevir or boceprevir) was still standard-of-care.
Begin here...

Médecins Sans Frontières/ Doctors Without Borders (MSF)
Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organisation. We offer assistance to people based on need, irrespective of race, religion, gender or political affiliation. Our actions are guided by medical ethics and the principles of neutrality and impartiality.

Fighting Hepatitis in Cambodia: The mid-point

At the half-way point of her assignment in Cambodia, Theresa reflects on what she's accomplished, and what she's learned about life as a doctor with...
Continue reading....

World Hepatitis Day

"Do I sound proud of our clinic? Well, that’s because I am proud. Every day we walk through a crowd of anxious patients to get to the clinic, and every day we confront apparently insurmountable obstacles, and yet every day we are getting people treated for hepatitis C."
Continue reading....

HEP - News & Blog Updates
Hep is an award-winning print and online brand for people living with and affected by viral hepatitis. Offering unparalleled editorial excellence since 2010, Hep and Hep Magazine are the go-to source for educational and social support for people living with hepatitis.

Treatment News
FDA OKs AbbVie’s Mavyret for All Hepatitis C Genotypes
For first-timers to treatment with all genotypes and no cirrhosis, eight weeks of Maryvet is recommended; for those who have compensated cirrhosis, defined as Child-Pugh A, 12 weeks is recommended.

Hep C Cure Impact Greatest on Those With Advanced Fibrosis
A look at a large cohort of Canadians with HIV and hepatitis C also examined modifiable factors associated with a reduced risk of death.
Begin here....

Blog Updates
Vosevi: The Newest Hepatitis C Treatment on the Block
By Lucinda K. Porter, RN
Gilead Sciences’ Vosevi is one pill containing three drugs. All are direct-acting antivirals (DAAs) which means they directly interfere with hepatitis C virus replication. One drug, sofosbuvir (brand name Sovaldi), has been on the market since late 2013. It is a polymerase inhibitor. The second drug is velpatasvir, an NS5A inhibitor.

FDA Approves New Hepatitis C Treatment Vosevi for All Genotypes
By Connie M. Welch
Vosevi is a once a day, fixed dose combination pill to be taken at a scheduled time each day. Vosevi is recommended to take with food. If you need to take an antacid medicine that contains aluminum or magnesium, take it either four hours before or four hours after you take your dose of Vosevi.
Continue reading....

The National Viral Hepatitis Roundtable NVHR
The National Viral Hepatitis Roundtable is a broad coalition working to fight, and ultimately end, the hepatitis B and hepatitis C epidemics. We seek an aggressive response from policymakers, public health officials, medical and health care providers, the media, and the general public through our advocacy, education, and technical assistance.

NVHR’s More than Tested Cured, Project Empowers Drug Users to Take Control of Their Health
The More than Tested, Cured project is a partnership between the National Viral Hepatitis Roundtable (NVHR), the Atlanta Harm Reduction Coalition (AHRC), the People’s Harm Reduction Alliance (PHRA) and the Urban Survivors Union (USU). These groups are working together to improve access to hepatitis C care faced by individuals who use drugs nationwide.

To view a list of all bloggers at HEP, please click here.

At we empower patients and caregivers to take control of Hepatitis C by providing a platform to learn, educate, and connect with peers and healthcare professionals

Childhood and Hepatitis C
By Karen Hoyt
Hep C Treatment Approved for Children Finally a cure for kids! For those youngsters with hep C, the FDA gave out good news. Two of the drugs that have been used for...
Continue reading...

Tips and Life Hacks for Navigating Hepatitis C
Being diagnosed with hepatitis C and then navigating its symptoms and treatment can be overwhelming, daunting, and stressful. For those in the community trying to manage hepatitis C, tips and certain life..

View all blog updates, here.

United States
HCV Advocate
The HCV Advocate newsletter is a valuable resource designed to provide the hepatitis C community with monthly updates on events, clinical research, and education.

In The Spotlight
The most important steps that people can take are to learn as much as they can about hepatitis C and work with their medical provider to stay as healthy as possible—and that should include seeking HCV treatment now. This Guide is meant to help you understand hepatitis C and provide some strategies to become healthier and live longer.
Download PDF

HCV Advocate - August Newsletter
At the top of the list is that a new combination of hepatitis C medications was approved by the Food and Drug Administration (FDA) to re-treat people who have not been cured with a previous course of certain direct-acting antiviral medications. Alan Franciscus includes HCV Drugs that offers a short overview of the FDA approval of Vosevi listed above. There is also a comprehensive overview of Vosevi that can be found on our Hep C Medications Blog. Lucinda K. Porter provides valuable information about moving on after being cured of hepatitis C and provides opinions from some of the leading experts on liver disease.

The New York City Hepatitis C Task Force
The New York City Hepatitis C Task Force is a city-wide network of service providers and advocates concerned with hepatitis C and related issues. The groups come together to learn, share information and resources, network, and identify hepatitis C related needs in the community. Committees form to work on projects in order to meet needs identified by the community.

August 2017 Hep Free NYC Newsletter
The NYS Department of Health has developed and released a guidelines on screening, diagnosis, and treatment of chronic Hep C infection for primary care providers.
Read the guideline here, newsletter, here.

Newsletter Archive

GI & Hepatology News
Over 17,000 gastroenterologists and hepatologists rely on GI & Hepatology News every month to cover the world of medicine with breaking news, on-site medical meeting coverage, and expert perspectives both in print and online. The official newspaper of the AGA Institute was launched in partnership with IMNG in January 2007.

August 2017
Under Liver Disease
Liver disease doubles risk of colorectal cancer
View all newsletters, here.

Weekly Bull
HepCBC is a non-profit organization run by and for people infected and affected by hepatitis C. Our mission is to provide education, prevention and support to those living with HCV.

Friday, August-4-17

All Issues: Weekly Bull

British Liver Trust
The British Liver Trust is the leading UK liver disease charity for adults – we provide information and support; increase awareness of how liver disease can be prevented and promote early diagnosis; fund and champion research and campaign for better services.
The Trust has worked with The National Institute for Health and Care Excellence (NICE) in the development of the new quality standard on liver disease, published on 30 June 2017.  This quality standard covers identifying, assessing and managing chronic liver disease in children, young people and adults, and cirrhosis in young people and adults.
Begin here..

Hepatitis C Coalition
The Hepatitis C Coalition is a group of leading clinicians, patient organisations, professional groups, industry and other interested parties committed to the reduction of morbidity and mortality associated with hepatitis C and its eventual elimination.

New Zealand
The Hepatitis Foundation of New Zealand
The Hepatitis Foundation is a not-for-profit organisation which provides care for people living with hepatitis B. The Foundation provides a long-term follow-up programme for people living with chronic hepatitis B. This Programme provided Hepatitis B patients with ongoing monitoring and follow-up to help improve health outcomes.

August Updates
A leading liver specialist at Auckland Hospital is calling for Pharmac to expand funding for treatment of Hepatitis C to reduce deaths linked to the deadly disease.
Begin here...

A Little Doctor Humor From SERMO physicians & World Hepatitis Day 
The SERMO Community Blog provides a window into the important, and oftentimes entertaining, content being shared by SERMO physicians.

<--- Who is the stock image doctor?
A few one-liners:
“Patient: ‘You don’t look like you did on the website. I thought I would have a good looking doctor.’  – Neurology

“Why do pretend docs always fold their arms?” – Psychiatry

He is the father of the kids whose picture comes in your newly purchased picture frame.” – Pathology

World Hepatitis Day
In a poll gauging 5,000+ global physicians, SERMO asked doctors if they thought hepatitis B and/or C could be wiped out by 2030. While 52% of physicians did not think that hepatitis B or C can be cured by 2030, 28% felt confident that both could be eliminated. 11% thought that only hepatitis C could be eliminated, and 9% of physicians thought only hepatitis B could be eliminated.
Continue reading this article or check out the blog, here.

Just So You Know
I highly suggest you follow Henry E. Chang on Twitter if you are interested in reading full text articles about the treatment and management of hepatitis C.