Friday, February 24, 2017

The Liver Loving Diet - A Must Read For People With HCV Or Liver Disease

The Liver Loving Diet

My admiration runs deep for a small group of bloggers who spend hours in front of a computer helping those suffering with HCV. What they accomplish is astounding, why do they do it?

So that no one with this disease ever feels alone.

HCV is a progressive liver disease that can be cured, although cirrhosis is usually irreversible and can potentially lead to life threating complications.

Karen Hoyt understands this only to well, she is devoted to offering support and accurate information to people coping with the effects of liver disease. Karen writes from a patients' perspective about living with and treating hepatitis C, cirrhosis, liver cancer and liver failure on her blog, "Your Best Friends Guide To Hepatitis C."

This compassionate author, HCV advocate, and survivor, once again is doing what she does best, keeping us informed and full of hope. Karen has recently announced her new book, "The Liver Loving Diet" is available to enjoy, a book that will help you learn to eat well during all phases of liver disease. For the cost of a few cups of liver friendly coffee - this book can be yours.

Purchase is now available through PayPal, click here to learn more.

From Karen

Low Sodium, Healthy Protein Plan
After my diagnosis with Hepatitis C and liver failure, I got busy putting together a low sodium, healthy protein plan for eating.

Here at Your Best Friends Guide, you all have blown me away with requests for an easy menu plan. I love the emails pouring in from you all sitting in hospitals, grocery stores, and at home. You’ve begged for recipes. Well, it’s taken some time (2 years), but I heard you and here it is!

Drumroll please….

The Liver Loving Diet Book is a big picture peek at liver disease that helps you understand how valuable it is to eat well during treatments, cures, setbacks, cancer, and transplant. My diet played a huge role in keeping me alive and active. Now I’m handing all that power to you in one tidy package – tied up with love and priced at $4.99. I worked extra hard to give you a simple book with over 300 pages of personal stories and recipes.

Visit Karen on Facebook or follow her on Twitter

Thursday, February 23, 2017

Hepatitis C virus infection and risk of thyroid cancer: A systematic review and meta-analysis

Systematic review

Hepatitis C virus infection and risk of thyroid cancer: A systematic review and meta-analysis
Peng Wanga, 1, Zhaohai Jingb, 1, Changjiang Liua, Meihua Xua, Pei Wanga, Xiao Wanga,
Yulei Yina, Ying Cuia, Dunlin Renc, Xiaopang Raoa, ,

Received 8 August 2016, Accepted 21 January 2017, Available online 20 February 2017

Several epidemiological studies investigated the relationship between hepatitis C virus (HCV) infection and risk of thyroid cancer, but the results were not consistent. A systematic review and meta-analysis was conducted to assess the impact of HCV infection on thyroid cancer risk.

The literature was searched up to March 15, 2016 for case-control or cohort studies on the association between HCV infection and thyroid cancer risk. The summary relative risks (RR) and 95% confidence intervals (CI) were calculated.

Five studies (two case-control studies and three cohort studies) were included in the meta-analysis, with a total of 751,551 participants and 367 cases of thyroid cancer. Meta-analysis of those 5 studies found that there was no statistically significant association between HCV infection and thyroid cancer risk (summary RR = 2.09, 95%CI 0.78–5.64, p = 0.145; I2 = 81.2%). However, HCV infection was significantly associated with increased risk of thyroid cancer (summary RR = 2.86, 95%CI 1.63–5.03, p = 0.003; I2 = 24.9%) after adjusting the heterogeneity.

There is a possible association between HCV infection and increased risk of thyroid cancer, and more cohort studies are needed to validate the possible association.

RR, relative risk;
CI, confidence interval;
NOS, Newcastle Ottawa scale;
HCV, hepatitis C virus

With hep C franchises languishing, Merck’s MK-3682 goes from blockbuster to bomb

With hep C franchises languishing, Merck’s MK-3682 goes from blockbuster to bomb
by John Carroll

A little less than three years after acquiring the hepatitis C drug MK-3682 (uprifosbuvir) in its $3.85 billion buyout of Idenix, Merck’s prospects in the field have cooled dramatically, and its once great hopes for the drug have been reduced to nearly nothing.

Continue reading...

Of Interest
MK-3682 + grazoprevir + elbasvir or MK-3682 + grazoprevir + MK-8408 There are two triplet therapies and at least one doublet regimen in development by Merck (Kenilworth, NJ) that include MK-3682 (a novel NS5b nucleotide polymerase inhibitor) with or without grazoprevir and with either elbasvir or MK-8408 (a novel NS5A inhibitor). MK-3682 was tested in 300 mg and 450 mg doses in the CREST 1 (for genotypes 1 and 2) and CREST 2 (for genotype 3) studies. The CREST 1 study showed mITT SVR24 of 91–100% for genotypes 1 (n = 93 with 46 GT1a and 47 GT1b) with either elbasvir or MK-8408 at both doses for MK-3682. However, only the MK-3682 (450 mg)/grazoprevir/MK-8408 regimen showed efficacy >90% in genotype 2 patients (n = 61). For genotype 3 patients, both the 300 mg and 450 mg doses of MK-3682 showed SVR24 rates >90% (n = 86).....

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Egypt Targets Spain, Belgium, Italy, Netherlands and the UK hepatitis C patients for medical tourism

Egypt targets hepatitis C patients for medical tourism

In mid 2016, Prime Pharma, a private Egyptian pharmaceutical company, launched Tour n’ Cure to revive therapeutic tourism in Egypt. The first target is hepatitis C patients from around the world. Countries targeted are Spain, Belgium, Italy, Netherlands and the UK.

Continue reading...

Chronic Hepatitis C Virus Infection and the Risk for Diabetes

Chronic Hepatitis C Virus Infection and the Risk for Diabetes
Does chronic hepatitis C infection increase diabetes risk?
February 23, 2017


The association between hepatitis C virus (HCV) infection and the occurrence of type II diabetes remains controversial. Prospective studies are needed to assess its causal temporality.

A cohort of 21 559 adults enrolled from seven townships in Taiwan during 1991–1992 and followed till the end of 2010. Incident diabetes over a study time period from 2000 to 2010 was ascertained through computerized linkage with the National Health Insurance database and the National Death Certification profiles. Cox's proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Antibodies against HCV (anti-HCV) were tested for all participants, and serum HCV RNA levels were measured for anti-HCV seropositives.

During 180 244 person-years of follow-up, there were 1917 incident diabetes cases recorded. The cumulative risk for diabetes was 10.9% for anti-HCV seronegatives and 16.7% for anti-HCV seropositives respectively. The HR for diabetes of anti-HCV seropositivity was 1.53 (95% CI: 1.29–1.81) compared with anti-HCV seronegatives after adjustment for risk predictors. The adjusted HRs were 1.63 (1.31–2.02) for anti-HCV seropositives with positive HCV RNA compared to anti-HCV seronegatives (P<.001).

Chronic HCV infection was associated with an increased risk for diabetes after adjustment for other risk predictors.

Discussion Only
Medscape - Full Text Article
Liver International
In this study, our data suggested that HCV infection brought significant increasing risk for the occurrence of diabetes after controlling several risk factors. Whereas the findings from NHANES were inconsistent, and their most recent report did not demonstrate an association of HCV infection with diabetes or with insulin resistance. NHANES is a large survey that consists of interviews, health examinations and laboratory data collected from a stratified, multistage probability cluster sample to obtain a nationally representative sample of the noninstitutionalized civilian US population. The first investigation using the NHANES data that evaluated the relationship between HCV infection and diabetes used the survey collected in the cycles of 1988–1994.[12] The investigators found that among individuals who were 40 years of age or older, those with HCV infection had an increased likelihood of having diabetes with the odds ratio of 3.8 (95% CI: 1.8–7.8) after controlling risk factors.[12] However, during the later study cycles (1999–2004 and 2005–2008), a statistically significant association was not found.[10] In the NHANES survey, the prevalence of obesity, insulin resistance and diabetes increased steadily over the same time period.[25] Thus, it is possible that estimates of the relationship between HCV infection and diabetes became attenuated in the presence of this epidemic of obesity and increased numbers of metabolic factors in recent decades. More recently, investigators using NHANES data have found that chronic hepatitis C patients, defined as anti-HCV seropositives with positive HCV RNA levels, had a two-fold risk for insulin resistance or diabetes,[9] suggesting that serum HCV RNA testing which enables the differentiation of past HCV infection with spontaneous clearance of HCV RNA (undetectable HCV RNA) and chronic HCV infection (detectable HCV RNA) might be important.

Finally, the most recent report from NHANES, using data from the 1999 through 2010 surveys failed to find an association between HCV infection and diabetes.[11] However, they did find a positive relationship between insulin resistance and elevated liver enzymes.[11] The elevated serum liver enzyme levels may be as result of either HCV infection or other conditions such as metabolic syndrome or steatohepatitis. It is difficult to disentangle the association of these factors and diabetes by cross-sectional study design in which participants were tested for their serum levels of liver enzymes and diabetes at the same time. Compared with the participants in NHANES, the participants in our study had lower educational levels, lower BMI and a lower percentage of cigarette smoking and alcohol drinking habits than the participants in NHANES. In other words, our study population seemed to have relatively fewer metabolic risk factors for diabetes. The major risk factor for HCV infection was illicit drug use in NHANES, whereas iatrogenic factors were the main transmission route for HCV infection in our population.[17,26] Thus, differences in the findings from our study from those in the NHANES study might be caused by differences in the characteristics of the study populations as well as in the study design.

Comparing to anti-HCV seronegatives, the adjusted HR was 1.39 for anti-HCV seropositives with seronegative HCV RNA, and 1.63 for anti-HCV seropositives with seropositive HCV RNA respectively. It showed a trend effect on the risk of diabetes for patients who had replication of HCV. Whereas, among anti-HCV seropositives, the risk of diabetes was only increased slightly when comparing to HCV RNA seronegatives and RNA seropositives, suggesting that the lipid profiles may be altered once individuals infected by HCV. However, the mechanisms still need to be further evaluated. Our study suggested that HCV infection has a major public health impact, not only for hepatic diseases but also for extrahepatic diseases.

Our cohort is recognized as a natural history cohort because most of the participants did not have the experience of antiviral treatment as a result of its high cost and adverse effects. Until October 2003, only patients with abnormal ALT levels (>82 U/L) and moderate fibrosis proven by liver biopsy could be reimbursed for treatment by the National Health Insurance. However, there are still huge gaps of self-awareness, referral and linking to care.[27] Although it is an important clue to compare the patients with or without antiviral treatment for further clarification of the associations between HCV infection and diabetes in the future.

In addition, we identified diabetes cases through a computerized data linkage with the National Health Insurance database, which provided coverage for 96% of the total population for Taiwan (23 million) in 2000, 98% in 2005 and 99.6% in 2009.[22] A limitation of our study is that we enrolled the participants and collected the questionnaires and blood samples during 1991–1992, whereas the index date for the linkage with the National Health Insurance database for the study described in this study was January 1, 2000 when the claims data were released. Life style and biochemical markers in the REVEAL-HCV enrolees might have changed over the period 1991–1992 to 2000. In particular, there might have been new infection with HCV during the 10 years of follow-up. However, establishing the incidence of HCV is very difficult because most infections are initially asymptomatic. In Taiwan the incidence of transfusion-associated hepatitis decreased as a result of the effectiveness of a series of donor screening intervention.[28] Also the presence of such cases would result in an underestimate of the effects of HCV on the incidence of diabetes. In this study, we defined the patients with diabetes with the stringent criteria: patients with at least one hospital admission code with diabetes diagnosis or with three or more outpatient visits code for diabetes,[21,22] which made the findings conservatively.

During the long-term follow-up, BMI may change when individuals change their life style, it is important to consider the follow-up changes on anthropometrical parameters. In our study, the anti-HCV seropositives were asked and invited for regular health examinations every 6–12 months. We obtained BMI data during their follow-up, and it showed similar results in the four models of multivariate analyses. The stratification analysis showed that chronic HCV infection may increase the risk for diabetes by comparing anti-HCV seronegatives. The changes in BMI during follow-up of each person were highly correlated (r=.84, P<.0001), and the correlation was even higher after grouping by <23 and ≥23 (r=.98, P<.0001). Another limitation of our study is that we did not measure blood glucose in our study. Thus, data of blood glucose are not available. However, serum level of triglycerides is highly correlated with blood glucose. We included triglyceride levels as an alternative marker for glucose levels in the analyses.

In a previous study, anti-HCV seropositives had increased mortality from diabetes (106.1 per 100 000 person-years) than anti-HCV seronegatives (60.8 per 100 000 person-years).[5] These results are consistent with the results from a database study of deaths in patients with diagnosed chronic hepatitis C infection which showed a 1.77 times increased risk of death from diabetes compared to the general population in the USA.[29] Although the evidence from these two studies of mortality provided an indication of a relationship between HCV and diabetes, it could not determine whether the infection increased the risk for the incidence of diabetes or worsened the prognosis for those with diabetes. The current longitudinal study has estimated the incidence of diabetes in those with and without anti-HCV seropositivity. Although data on steatosis in our study were lacking, we stratified by surrogate measures for steatosis including BMI, ALT and triglycerides.

In conclusion, our data suggested that HCV infection has increased risk for the occurrence of diabetes after controlling other risk factors. Chronic hepatitis C patients may benefit from antiviral treatment to decrease their risks for diabetes. More affordable prices of the effective drugs are required to increase the accessibility for the patients in need.
Continue to Full Text Article

Wednesday, February 22, 2017

Ontario Becomes First Province To List EPCLUSA™ On Public Drug Plan To Treat All Six Genotypes Of Chronic Hepatitis C Infection

Feb. 22, 2017
Ontario Becomes First Province To List EPCLUSA™ On Public Drug Plan To Treat All Six Genotypes Of Chronic Hepatitis C Infection

-- Ontario Also Broadens Access for Patients
with Less Advanced Disease with Co-Factors --

MISSISSAUGA, ON, Feb. 22, 2017 /CNW/ - Gilead Sciences Canada, Inc. (Gilead Canada) today announced, effective February 28th, 2017, Ontario will provide public access to EPCLUSA™ (sofosbuvir/velpatasvir) tablets, the first once-daily, pan-genotypic single tablet regimen for the treatment of adults with genotype 1-6 chronic hepatitis C virus (HCV) infection. This listing will support patients to access curative therapy, and will advance Canada's efforts to achieving its World Health Organization commitment to eliminate hepatitis C by 2030.

EPCLUSA, one tablet taken daily for 12 weeks, is for use in adult patients without cirrhosis or with compensated cirrhosis, and in combination with ribavirin (RBV) for those with decompensated cirrhosis. It is also the first single tablet regimen approved for the treatment of patients with genotypes 2 and 3, without the need for RBV.

The approval of EPCLUSA was supported by data from four international Phase 3 studies, ASTRAL-1, ASTRAL-2, ASTRAL-3 and ASTRAL-4. Of the 1,035 patients with compensated disease treated with EPCLUSA for 12 weeks in the ASTRAL-1, ASTRAL-2 and ASTRAL-3 studies, 1,015 (98 per cent) achieved SVR12 (sustained virologic response 12 weeks after the end of treatment). In ASTRAL-4, patients with decompensated cirrhosis receiving EPCLUSA with RBV for 12 weeks achieved a high SVR12 rate (94 per cent) compared to those who received EPCLUSA for 12 weeks or 24 weeks without RBV (83 per cent and 86 per cent, respectively). The most common adverse events in the four ASTRAL studies were headache, fatigue and nausea, and were comparable in incidence to the placebo group included in ASTRAL-1.

The Ontario listing follows the completion of a recent agreement between the pan-Canadian Pharmaceutical Alliance (pCPA) with member provincial, territorial and federal drug plans to fund this innovative therapy for patients. In addition, aligned with the pCPA agreement, Ontario will expand access to include patients with less advanced disease (fibrosis scores of F0 or F1) if they have been diagnosed with certain co-existing factors. All HCV patients with fibrosis scores of F2 or higher also remain eligible for reimbursement.

For more information on the expanded access criteria:

"We now have the ability to cure the majority of patients with chronic HCV with a simple, safe and effective 12-week treatment, regardless of genotype or patient history," said Dr. Curtis Cooper, Associate Professor of Medicine, University of Ottawa, and Director, The Ottawa Hospital and Regional Hepatitis Program. "Broader access to EPCLUSA, particularly at the earlier stage of the disease, means that we can move more quickly to help patients achieve a cure and improve their quality of life, while saving valuable funds associated with the significant long-term burden of illness and costs to the healthcare system."

In Ontario, the Public Health Agency of Canada estimates that more than 102,000 people are living with chronic HCV. In Canada, it is estimated that 250,000 Canadians are living with chronic HCV, with thousands of new cases diagnosed each year. There are six genotypes of hepatitis C. Genotype 1 infection is the most prevalent genotype in Canada representing 64.1 per cent of infected individuals. Genotypes 2 and 3 account for approximately 14.1 per cent and 20.2 per cent of infections in Canada, whereas genotypes 4, 5, and 6 are less prevalent in Canada (0.3 per cent).

"Canada, and other countries, have committed to eliminating hepatitis C by 2030, and to accomplish this goal we need to significantly increase treatment rates," said Dr. Morris Sherman, Chairperson, Canadian Liver Foundation and hepatologist at Toronto General Hospital. "Treatment regimens are getting shorter, simpler and more widely effective across genotypes meaning that treatment is now easier for both patients and physicians to manage.

"Currently, an estimated 44 per cent still remain undiagnosed, so increasing treatment rates also means improving screening and diagnosis, which is why the Canadian Liver Foundation recommends that all Canadians born between 1945-1975 receive a one-time test for hepatitis C," added Dr. Sherman. "Treatment should be an option for everyone, but the cost of treatment has been an obstacle. We're glad to see that the pCPA and the provinces are taking steps to make these treatments accessible regardless of where someone lives or their ability to pay."

"Gilead Canada is pleased that the pCPA and the Ontario Ministry of Health and Long-Term Care are recognizing the innovation and clinical value of EPCLUSA for the treatment of all genotypes of hepatitis C in a single tablet regimen," said Kennet Brysting, General Manager, Gilead Canada. "Broader treatment access for patients will potentially have a profound impact on disease elimination efforts in Canada, and supporting such efforts is a key priority for our company. We will continue to work closely with all jurisdictions to bring this simple and cost-effective curative treatment to all eligible patients, regardless of their genotype or stage of fibrosis."

Feb. 22, 2017
Ontario and British Columbia expand treatment access to chronic hepatitis C (CHC) patients
Effective February 28, Ontario will become the first province to reimburse ZEPATIER®  (elbasvir/grazoprevir), a simple one pill, once daily, 12 week no ribavirin regimen for most patients, and will be followed by British Columbia on March 21

  • In addition to patients with liver fibrosis stage F2+, patients with liver fibrosis stage F0 and F1 with poor prognostic factors, who had no public access to a potential cure under existing public plans, are now eligible for treatment
  • Patients with CHC genotypes 1 and 4, with chronic kidney disease (CKD) and intraveinous drug users - representing the highest number of new cases1 - will have access to treatment

  • KIRKLAND, QC, Feb. 22, 2017 /CNW Telbec/ - An estimated 185,000 people in Ontario and
    British Columbia have hepatitis C, a chronic liver disease that, if left untreated, can lead to cirrhosis, liver cancer and liver transplants.2 Merck Canada Inc. today announced that the Government of Ontario and of British Columbia are strengthening their commitment in the global fight against hepatitis C by becoming the first provinces to reimburse ZEPATIER® (elbasvir/grazoprevir). Zepatier is indicated in the treatment of chronic hepatitis C genotypes 1, 3 or 4 infections in adults patients.3 The product monograph with detailed product indication is available online by clicking here.
    "We're pleased to have worked with the pan-Canadian Pharmaceutical Alliance (pCPA) and participating jurisdictions to provide access to Zepatier to patients who need it, including those at higher risk," says Chirfi Guindo, President and Managing Director, Merck Canada Inc. "Hepatitis C is a curable disease, and today's announcement brings us one step closer to eradicating the virus in Canada."

    For the first time special populations, including hepatitis C patients with fibrosis stage F0 and F1 who are co-infected with human immunodeficiency virus (HIV) or hepatitis B virus or who have chronic kidney disease (CKD), will be eligible for treatment as of February 28th under the Ontario Drug Benefit Program (ODB), and as of March 21st under B.C.'s PharmaCare program.

    "The publicly funded availability of Zepatier in Canada for hepatitis C treatment represents a major milestone in the access to care for patients; not only those patients with advanced liver damage or cirrhosis have access to treatment but now those who may progress to more serious liver damage in the future can be cured. The dedication of Merck to addressing clinical studies in targeted and specific populations in need such as those with cirrhosis, advanced kidney disease and those who inject drugs, allow all treaters to use this treatment regimen to cure their patients safely," said Dr. Sergio Borgia, Medical Director and Corporate Division Head of the Infectious Disease Program at William Osler Health System.

    These provincial public funding announcements follow the World Health Organization's (WHO) adoption of  the first global health strategy on viral hepatitis, which includes a goal of 30% reduction in new cases of hepatitis B and C by 2020 and a 10% reduction in mortality, as well as increased access to treatment for hepatitis B and C.4 In June 2016, the Government of Canada announced its commitment in the global fight against viral hepatitis with the adoption of the Global Strategy on Viral Hepatitis. It has for objective to eliminate hepatitis B and C by 2030.5

    Feb. 22, 2017
    More patients to benefit from hepatitis C treatments
    Thousands of British Columbians living with hepatitis C will have better access to treatment as a result of successful negotiations brokered by the pan-Canadian Pharmaceutical Alliance (pCPA).
    “This agreement changes the landscape for hepatitis C patients living in B.C.,” said Health Minister Terry Lake. “Not only are there four new treatment options for what is now a curable virus, but the savings that were negotiated will allow us to cover treatment options for all hepatitis C patients – rather than just those in more advanced stages of the disease.”
    British Columbia and Ontario co-led the negotiations with the drug manufacturers on behalf of the pCPA. The alliance helps provinces and territories leverage their collective buying power and negotiate better prices for new drugs.....

    Daklinza (daclatasvir) – new
    Epclusa (sofosbuvir/velpatasvir) – new
    Harvoni (ledipasvir/sofosbuvir)
    Sovaldi (sofosbuvir)
    Sunvepra (asunaprevir) – new
    Zepatier (elbasvir/grazoprevir) – new

    Continue Reading...

    Deal reduces price of life-saving hepatitis C drugs for Canadians

    More patients to benefit from hepatitis C treatments
    Thousands of British Columbians living with hepatitis C will have better access to treatment as a result of successful negotiations brokered by the pan-Canadian Pharmaceutical Alliance (pCPA).
    “This agreement changes the landscape for hepatitis C patients living in B.C.,” said Health Minister Terry Lake. “Not only are there four new treatment options for what is now a curable virus, but the savings that were negotiated will allow us to cover treatment options for all hepatitis C patients – rather than just those in more advanced stages of the disease.”
    British Columbia and Ontario co-led the negotiations with the drug manufacturers on behalf of the pCPA. The alliance helps provinces and territories leverage their collective buying power and negotiate better prices for new drugs.

    The collaborative effort resulted in a significant cost savings to drug plans for participating provinces and territories. The agreement also allows access to treatment for all eligible patients in a fiscally sustainable manner. Prices and terms for this negotiation are confidential.
    The list cost to the health system for hepatitis C treatment has ranged from $45,000 to over $100,000 per patient, depending on the drug and disease progression.
    Agreements with the pCPA were reached with Gilead Sciences Canada, Merck Canada, and Bristol-Myers Squibb Canada to provide several hepatitis C drugs at an improved cost:
    • Daklinza (daclatasvir) – new
    • Epclusa (sofosbuvir/velpatasvir) – new
    • Harvoni (ledipasvir/sofosbuvir)
    • Sovaldi (sofosbuvir)
    • Sunvepra (asunaprevir) – new
    • Zepatier (elbasvir/grazoprevir) – new
    PharmaCare is expanding the criteria in March 2017 to provide coverage to more patients living with hepatitis C. Physicians can apply for coverage of the new drugs on behalf of their patients on or around March 21, 2017. Starting in 2018-19, PharmaCare will provide coverage for any British Columbian living with chronic hepatitis C, regardless of the type or severity of their disease.
    Up to 75,000 British Columbians are estimated to be living with hepatitis C. Approximately 24% of those exposed to the virus are able to clear it on their own. However, when left untreated, it can cause serious complications such as liver failure and liver cancer. The new modern hepatitis C therapies are highly effective, with the ability to clear the virus at rates over 95%.
    If untreated, hepatitis C virus infection can be a life-threatening communicable disease. Risk and harm reduction practices are strongly encouraged for those who may be at higher risk for re-acquiring the virus after successful treatment, including people who inject drugs, men who have sex with men, and commercial sex workers.
    Hepatitis C is the most-frequent cause of premature death among reportable infectious diseases in North America, and has become the most-frequent cause of premature death among people living with both hepatitis C and HIV.

    Quick Facts:
    • Hepatitis C is a serious, communicable disease that is spread through direct contact with the blood of a person living with the virus. Symptoms may include fatigue, jaundice, abdominal pain and joint pain. In some people, it can cause liver damage (cirrhosis) or liver cancer.
    • Up to 75,000 people are estimated to be living with hepatitis C in British Columbia. However, many people with the virus have no symptoms. About one-quarter of people living with hepatitis C do not know they have it.
    • About one-quarter of people with hepatitis C do not need treatment, as their body fights off the infection.
    • Once someone is successfully treated and cured of hepatitis C infection, they are no longer able to pass the disease on to others.
    • Currently, there is no vaccine to prevent hepatitis C infection.
    • From March 2015 to December 2016, PharmaCare coverage was provided to about 3,800 people in B.C. for medication used to treat chronic hepatitis C.
    Learn More:
    For more information on the pan-Canadian Pharmaceutical Alliance:
    For more information about B.C.’s PharmaCare program:

    Deal reduces price of life-saving hepatitis C drugs for Canadians
    Kelly Grant - HEALTH REPORTER
    Tens of thousands of Canadian patients with mild versions of chronic hepatitis C could soon receive public funding for medications that cure the infection now that the provinces have sealed a deal with three pharmaceutical companies to reduce the cost of the ultra-expensive drugs.

    The pan-Canadian Pharmaceutical Alliance (pCPA), which negotiates prices on behalf of the provincial and territorial public drug programs, announced on Tuesday that it had reached an agreement with the makers of six breakthrough hepatitis C medications, including the best-known drugs in the class, Harvoni and Sovaldi.

    Shortly after the pCPA confirmed the deal, the British Columbia government declared that its PharmaCare program would begin covering the drugs for patients with chronic hepatitis C, regardless of the type or severity, beginning in 2018.

    HCV Genotype 1 No Longer a Treatment Bugbear

    AGA Reading Room

    HCV Genotype 1 No Longer a Treatment Bugbear
    by Pippa Wysong
    Contributing Writer, MedPage Today

    Hepatitis C (HCV) genotype 1 is now the HCV subtype most easily treated with direct-acting agents (DAAs), and cure rates approach 100%. Since genotype 1 infection is the most common subtype, affecting approximately 75% of HCV-infected patients worldwide, and was traditionally harder to treat, scientists directed efforts to develop DAAs effective against genotype 1. There are now multiple DAA regimens available for patients with genotype 1 HCV infection. Clinicians need to consider subtype (genotype 1a versus 1b), insurance factors, and patient factors such as the presence or absence of cirrhosis and the presence of resistant variants when deciding on which regimen to pick. In some situations, specific resistance testing should be done prior to initiating treatment in order to determine the efficacy of the chosen regimen.

    Treating patients with genotype 1 hepatitis C (HCV) can be rewarding because of a simple fact: modern direct-acting agents (DAAs) have a nearly 100 percent cure rate. Yet only four years ago, genotype 1 was considered the most difficult-to-treat type of HCV.
    Back then, interferon regimens were used, and cure rates for genotype 1 hovered around 50 percent, while genotypes 2 and 3 were considered better treatment successes stories.

    Continue reading..

    Genetic variant linked to risk of liver cancer after hep C eradication

    Related - Genome-wide Association Study Identifies TLL1 Variant Associated With Development of Hepatocellular Carcinoma After Eradication of Hepatitis C Virus Infection
    Download PDF.

    Genetic variant linked to risk of liver cancer after hep C eradication
    By Will Boggs MD
    NEW YORK (Reuters Health) – A single nucleotide polymorphism (SNP) in the tolloid-like 1 (TLL1) gene is associated with the development of hepatocellular carcinoma (HCC) after eradication of hepatitis C virus (HCV) infection, researchers from Japan report.

    “When we constructed different models for predicting HCC in patients with mild as opposed to advanced hepatic fibrosis by combining this TLL1 variant with other distinct risk factors, these proposed models including TLL1 variant could be useful for predicting the occurrence of HCC after achieving sustained virological response (SVR) in the clinical practice,” Dr. Yasuhito Tanaka from Nagoya City University Graduate School of Medical Sciences told Reuters Health by email.

    Even after SVR, as many as 2% of patients develop HCC within three years and as many as 8.8% develop HCC within five years, Dr. Tanaka and colleagues write in Gastroenterology, online February 3.

    Continue reading...

    Of Interest
    Liver Cancer After Treatment For Hepatitis C
    ​Research demonstrates that while SVR markedly reduced liver-related complications and liver cancer, some long-term risk for liver cancer remained in those who were cured of Hepatitis C. But after direct-acting antiviral therapy does the risk of developing liver cancer increase?