Hepatitis C News; Sunday Roundup :Boceprevir/Telaprevir Dosing Regimens And Side Effects

HCV Advocates newsletter has lots of encouraging information this month.
Check out the "Snapshots" section and read highlights from the EASL covering; BMS-790052 and BMS-650032 , Alisporivir (DEB025), Danoprevir Plus Low-dose Ritonavir (DNV/R), Mericitabine (RG7128) and more.

In This May Issue:

EASL 2011: Cure without Interferon/Ribavirin
Alan Franciscus, Editor-in-Chief
Hepatitis C and Bleeding Disorders
CD Mazoff, PhD

HCV Snapshots from EASL 2011
Lucinda K. Porter, RN and Alan Franciscus, Editor-in-Chief

HealthWise: Special Report of the 2011 EASL Meeting
Lucinda K. Porter, RN
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Liver Health Today
Click here to view the current issue of Liver Health Today Digitally!
*Takes just a moment to download
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Great HCV Blogs;
If you are starting treatment you'll find these two blogs very beneficial.
What goes around comes around and Ian Quill : My World.
Both links can also be found on the sidebar of this blog under ;

Other HCV Sites:
These links will take you to the premier Hepatitis C sites and keep you informed with breaking news, clinical studies, new drugs, podcasts, newsletters, support, personal experiences, chat rooms, forums and more.

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Over at the AIDS Beacon is a two part series on telaprevir and boceprevir;

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This article is first in a two-part series that will discuss the benefits and drawbacks of two drugs, boceprevir and telaprevir, which are being developed for hepatitis C. Part 1 discusses the efficacy of the two drugs in clinical trials. Part 2 will discuss the complications and side effects for each drug.

New Drugs For Hepatitis C: Part 1 – Boceprevir And Telaprevir Provide Higher Cure Rates

New Drugs For Hepatitis C: Part 2 – Boceprevir And Telaprevir Dosing Regimens And Side Effects

On the website is a new two part video from Melissa Palmer, M.D. on Telaprevir (Vertex Pharmaceuticals) & Boceprevir (Merck), the new protease inhibitor treatments for hepatitis C (HCV).
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Fatty Liver - NASH and Liver Cancer Risk From;  Internal Medicine News Digital Network

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Liver Cancer Risk Characterized in NASH Patients

May 01 2011

By: MARY ANN MOON,

It has not yet been definitively established that nonalcoholic steatohepatitis can progress to hepatocellular carcinoma, but the evidence is mounting, Dr. Kohichiroh Yasui and colleagues reported in the May issue of Clinical Gastroenterology and Hepatology.

Case reports and case series, retrospective studies, and prospective studies have all suggested such a link, but most have examined only a small number of cases and have had limited duration of follow-up. Therefore, the incidence of hepatocellular carcinoma (HCC) among patients with nonalcoholic steatohepatitis (NASH), and the risk factors that may predispose patients with NASH to progress to HCC, are not yet clear.

Dr. Yasui and associates performed a cross-sectional study to characterize the features of NASH in 87 Japanese patients who went on to develop HCC. The investigators used data collected by the Japan NASH Study Group, which was begun in 2008 by the Ministry of Health, Labour, and Welfare of Japan to support research in liver disease.

Most of the study subjects were found to have HCC as they were being screened for the disease while attending one of 15 hepatology centers for evaluation of NASH. The screening included ultrasound and/or CT scanning of the liver and testing of serum alpha-fetoprotein levels.

These subjects reported negligible alcohol consumption and had no other liver disease to account for their NASH. There were 54 men and 33 women, with a median age of 72 years. The degree of steatosis was generally mild, as expected: grade 1 (5%-33%) in 60 patients, grade 2 (34%-66%) in 19 patients, and grade 3 (more than 66%) in 7 patients.

One patient who showed less than 5% steatosis was diagnosed as having "burn-out" NASH, meaning that steatosis had been more severe earlier in the course of the disease but had disappeared as NASH progressed to cirrhosis. A previous liver biopsy had been performed in this patient before the development of HCC, and it had demonstrated the typical histologic features of NASH.

This case serves as a reminder that many instances of NASH-associated hepatocellular carcinoma may be missed because of this disappearance of the tell-tale sign of steatosis, the investigators noted.

In 49 patients, liver cancer was verified on hepatic resection, and in 21 it was verified by ultrasound-guided tumor biopsy. In the remaining 17 patients, it was diagnosed via dynamic CT or MRI. Noncancerous liver tissue was collected from all 87 patients so that background liver tissue at the time of cancer diagnosis could be assessed.

The necroinflammatory grade was mild in 31 patients, moderate in 45, and severe in 11. The degree of fibrosis was stage 1 in 10 patients, stage 2 in 15, stage 3 in 18, and stage 4 (that is, cirrhosis) in 44.

"Interestingly, male patients developed hepatocellular

The median tumor size was 3 cm in diameter, which is equal to or smaller than the typical size reported in the literature. Three-fourths of the patients had only one tumor. It is likely that malignancies were small and singular in these study subjects because in most cases the cancer was discovered relatively early, during screening.

Men with NASH had higher rates of liver cancer than did women, at a ratio approaching 2:1. The reasons for this sex-related difference may lie in differences in exposure to risk factors. "Men are more likely than women to be infected with hepatitis B and C viruses, consume alcohol, smoke cigarettes, and have increased iron stores," Dr. Yasui and colleagues said. In addition, androgens are thought to play a role in the development of HCC.

"Consistent with the literature, more than half of our patients displayed obesity, diabetes, and hypertension. Obesity constitutes a significant risk factor for cancer mortality in general and is an increasingly recognized risk factor for hepatocellular carcinoma in particular," they noted.

The exact mechanism by which NASH might predispose patients to liver cancer is not yet known. "Further prospective studies with a longer follow-up time and larger cohorts are needed to determine the causal association of NASH with hepatocellular carcinoma," the investigators added.

This study was supported by the Ministry of Health, Labour, and Welfare of Japan. No conflicts of interest were reported.

Off The Cuff

Every Sunday I start out my morning by reading a list of  articles @ Grand Rounds .

What is Grand Rounds?

Grand Rounds is the the weekly rotating carnival of the best of the medical blogosphere.

Grand Rounds is hosted each week, by a doctor, nurse, patient or healthcare professional with a blog. The host of Grand Rounds introduces and compiles links to a week of noteworthy posts about medicine.

This weeks host is; Dispatch From Second Base.

About The Author

I’m a breast cancer survivor and writer living in Nebraska with my husband Bruce. My day job is media relations and I read and write poetry to feed my head. I love Nebraska Cornhusker football, baseball and volleyball and light bulb jokes.

Welcome to Grand Rounds! First, a quick shout-out to Nick Genes, an emergency medicine physician who blogs at blogborygmi (possibly the best blog name ever) and is one of the founders of Grand Rounds. I had no plans to host GR a second time until I saw Nick’s APB for April hosts. I had forgotten how much fun this was until the posts started coming in. So thanks, Nick.

The theme this time is what gives your life or work meaning. One of the loveliest, most contemplative posts I’ve seen on this topic is Nourishing Healthy Seeds from Deb Thomas, who blogs at Debbie’s Cancer Blog. Another one I loved comes from psychiatrist Greg Smith. He has become one of my favorite bloggers and The Day The Music Died is one of many reasons why. He captures music’s power to heal and bring us together during times of profound sadness.

Psychiatrists are famous for answering questions with a question, such as ”What do you think it means?” But in all seriousness, the good doctors at ShrinkRap want to know what meaning we ascribe to psychiatry. Here’s the survey..... Read All Contributions Presented at this weeks grand rounds...

Steven Tyler: "I Probably Would Have Been Dead Several Times Over"

On top of the world again after charming American Idol fans with his warm and wacky ways, Aerosmith rocker Steven Tyler, 63, opens up to PEOPLE magazine in this week's issue about his four kids, eight rehabs, and stunning comeback. What makes Tyler's resurgence all the more triumphant is the rough road he took to get here. "Left up to my own devices," says the singer, "I probably would have been dead several times over."

A rock star with drug problems is nothing new, but Tyler wants everyone to know he wasn't just another junkie. He has had a slew of health problems including a torn ACL in his knee, a broken blood vessel in his throat, a false brain tumor diagnosis, and, worst of all, hepatitis C and the grueling year of treatment he had around 2005. What really could have killed him were the post-surgery pain medications that led him to relapse after varying stints of sobriety (including a stretch of 12 years).

Religious Activity Does Not Lower Blood Pressure
Contrary to some earlier studies, a Loyola University Health System study has found that religious activity does not help protect against high blood pressure.

Healthy You

Have a Clean, Green Spring

Released: 4/29/2011 11:35 AM EDT
Source: Vanderbilt University

Newswise — NASHVILLE, Tenn. - Now that spring is underway and the weather is warmer, thoughts turn to freshening up your surroundings. Spring cleaning is a time-honored tradition, and can result in simplifying and organizing your home and/or office without impacting the environment by following some simple strategies.
“Spring cleaning is a great time to think about your environmental impact and strategies,” said Kendra Abkowitz of the Vanderbilt University Sustainability and Environmental Management Office. “Start a recycling program, switch to a greener cleaner or donate gently used items to a charitable organization.”
• Use old T-shirts, sheets and other clothing items as dusting and cleaning rags or sponges and cloth towels made of natural fibers instead of paper towels. You can even wash and reuse them several times. If you must use paper towels, try using those that are processed chlorine-free (PCF) and contain high levels of post-consumer recycled content. Check out the National Resources Defense Council’s Shoppers Guide to Home Tissue Products for more information on specific products meeting these criteria.
• Consider using less-toxic and more environmentally friendly cleaning products, such as those that have received Green Seal Certification and those available from Seventh Generation , Mrs. Meyer’s, Method or Clorox Green Works, many of which can be purchased at common retailers including Target, Walmart and Kroger.
You can even make your own cleaners using household items such as baking soda, lemon juice, vinegar, and club soda. Visit Care2’s How to Make Your Own Non-Toxic Cleaning Kit for more information. In most cases, environmentally-friendly cleaners work just as well as their commercial counterparts.

• Reduce some of the clutter in your life through re-using and recycling. List usable items that you no longer want for sale in your local classifieds or on Craigslist. Or give away usable, unwanted items instead of disposing of them in landfills through FreeCycle or to charitable organizations such as Goodwill and the Salvation Army.
To find recycling information about your community, visit Earth911.
Don’t forget to dispose of hazardous materials properly. The U.S. Environmental Protection Agency has information about hazardous waste disposal. http://www.epa.gov/osw/conserve/materials/hhw.htm.
Other quick tips:
• Go paperless and enroll in online banking and billing, subscribe to newsletters and magazines electronically, utilize e-books and print out fewer items. Visit SustainVU’s Paper Reduction Page for a more extensive list of ideas for reducing the amount of paper you generate and consume at home and in the office.
• Only buy what you need, opt for items that are reusable rather than single-use or disposable, or consider renting or sharing infrequently used products, such as checking out books and other resources through libraries.
• Naturally clean indoor air by obtaining houseplants, such as Boston ferns, English ivy, rubber plants and peace lilies, which help to clean the air.
• Use natural alternative to mothballs by wrapping cinnamon sticks, bay leaves, or whole cloves in cheesecloth.
For more information about Vanderbilt’s sustainability program, visit the SustainVU website, become a fan of SEMO’s SustainVU Facebook page, or contact VU’s Sustainability and Environmental Management Office at SustainVU@vanderbilt.edu. For more information about Vanderbilt University, visit news.vanderbilt.edu.
-VU-