Saturday, December 17, 2011

HCV News Ticker; Risk factors for hepatocellular carcinoma with hepatitis B or C

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In The News

Risk factors for hepatocellular carcinoma with hepatitis B or C

The latest issue of the Journal of Gastroenterology & Hepatology identifies risk factors for hepatocellular carcinoma in a cohort infected with hepatitis B or C.

The incidence of hepatocellular carcinoma has increased in Australia in recent decades, a large and growing proportion of which occurs among a population chronically infected with hepatitis B virus or hepatitis C virus.

However, risk factors for hepatocellular carcinoma among these high-risk groups require further characterization.

Professor Greg Dore and colleagues from Australia conducted a population-based cohort study using hepatitis B virus or hepatitis C virus cases notified to the New South Wales Health Department between 2000 and 2007.

These were linked to cause of death data, HIV/AIDS notifications, and hospital records.

Hazard ratios for males were 2 to 3 times those of females
Journal of Gastroenterology & Hepatology
Proportional hazards regression was used to identify significant risk factors for developing hepatocellular carcinoma.

The team noted that a total of 242 and 339 hepatocellular carcinoma cases were linked to hepatitis B virus or hepatitis C virus notifications, respectively.

For both hepatitis B virus or hepatitis C virus groups, being male and increasing age were significantly associated with risk of hepatocellular carcinoma.

The research team observed that increasing comorbidity score indicated high risk, while living outside urban areas was associated with lower risk.

Hazard ratios for males were 2 to 3 times those of females.

For both hepatitis B virus or hepatitis C virus groups, the team found that cirrhosis, alcoholic liver disease, and the interaction between the 2 were associated with significantly and considerably elevated risk.

Professor Dore's team concluded, "This large population-based study confirms known risk factors for hepatocellular carcinoma."

"The association with older age highlights the potential impact of hepatitis B virus or hepatitis C virus screening of at-risk groups and early clinical assessment."

"Additional research is required to evaluate the impact of improving antiviral therapy on hepatocellular carcinoma risk."
J Gastroenterol Hepatol 2011: 26(12): 1757–1764
15 December 2011


Safety (Still) Trumps Acquisitions in Hep C


The euphoria over Gilead Sciences' (Nasdaq: GILD ) acquisition of Pharmasset (Nasdaq: VRUS ) and Roche's purchase of Anadys Pharmaceuticals seems to have caused memory loss in investors.

But they got a reminder of reality today, when Pharmasset announced it was discontinuing all treatment arms in one of its phase 2b trials that contain the drug PSI-938. The drug candidate caused laboratory abnormalities in tests associated with liver function...



Clinical Care Options Launches CCO Hepatology inPractice™, Adding a Third Specialty to its Comprehensive Online Resource

/PRNewswire/ -- Clinical Care Options (CCO), a leader in the development of innovative online, print, and live medical education programs and medical education technologies for healthcare professionals, is proud to announce the launch of CCO Hepatology inPractice™, the third specialty area for the free, online point-of-care resource for clinicians that provides critical information for the management of viral hepatitis. CCO HIV inPractice™ and CCO Oncology inPractice™, now used around the world, are available at inPractice.com.

CCO Hepatology inPractice™, authored by 14 world-renowned experts and led by Editors in Chief Nezam H. Afdhal, MD, FRCPI, of Harvard University; Norah Terrault, MD, MPH, of the University of California, San Francisco; and Stefan Zeuzem, MD, of JW Goethe University Hospital, provides a single easy-to-use search interface. Performing a search on Hepatology inPractice initially allows the busy clinician direct access to the first 10 original, expert-authored chapters designed specifically for point-of-care use, integrated with drug information, treatment guidelines, conference coverage, PubMed abstracts, and ClinicalTrials.gov.

"In the fast-changing field of viral hepatitis, this innovative point-of-care resource combining regularly updated content and the ability to simultaneously search multiple key reference sources is an essential tool to enable clinicians to provide the very best patient care," commented Dr. Terrault. Drs. Afdhal, Terrault, and Zeuzem will continue to oversee regular updates to this dynamic program ensuring that the original textbook chapters remain current as best practices in hepatitis care are updated.

"We are delighted to release CCO Hepatology inPractice™ to our users today. Our HIV and Oncology inPractice™ resources have been used by more than 50,000 clinicians needing access to the latest and highest-quality management information over the course of the last 2 years," said Jeffrey L. Drezner, MD, PhD, CCO's Chief Executive Officer and Founder. "The addition of Hepatology inPractice™ underscores our ongoing commitment to improving patient care across the spectrum of healthcare."

CCO Hepatology inPractice™ is certified for point-of-care CME credit by USF Health and users will be able to earn point-of-care CME for searching this comprehensive reference. All CCO inPractice™ users also receive personalized recommendations for complementary CCO continuing education activities and access links to other resources and interactive tools. The program is supported by independent medical education grants provided by multiple commercial supporters.

For more information about CCO inPractice™, visit inPractice.com.

About Clinical Care Options Clinical Care Options, a leader in the development of innovative, interactive, online medical education programs and proprietary medical education technologies for healthcare professionals, creates and publishes original continuing medical education and information resources that are designed specifically for healthcare providers in the areas of HIV, hepatology/gastroenterology, and oncology. CCO's educational programs are developed not only to provide the latest scientific information but also to support the understanding, confidence, application, and competence of healthcare professional learners. In addition to the latest point-of-care resource, inPractice, CCO provides a spectrum of live and online educational programs and formats. For more information about the company and its programs, visit clinicaloptions.com.

SOURCE Clinical Care Options


Presumed Consent Wouldn't Boost U.S. Organ Donation: Study

European countries with 'opt-out' donation don't have higher rates, researchers say

FRIDAY, Dec. 16 (HealthDay News) -- It's not likely that a policy of presumed consent would solve the shortage of transplant organs in the United States, according to a new study.

Under such a system, doctors would presume a person's willingness to donate their organs after death unless they explicitly forbid it while they're alive. Those in favor of this type of opt-out system say it would help ease the organ shortage in the United States.

Most people support organ donation but never formally record their wishes and an presumed consent system might ease the burden of decision-making on grieving families, according to proponents.

In the United States, thousands of people die each year waiting for organs and many viable organs are never made available for donation, according to background information in a Johns Hopkins news release.

In this study, Hopkins researchers interviewed transplant experts in 13 European countries with presumed consent legislation. Despite those laws, the process of organ donation did not differ dramatically from the process in countries, such as the United States, which require explicit consent.

The study also found that the United States ranks third among the nations surveyed in rates of organ donation after death. The U.S. rate is 26.3 deceased donors per million population, compared with 34.1 in Spain and 26.7 in Portugal.

The findings appear online in the journal Transplantation.

"Opt-out is not the magic bullet; it will not be the magic answer we have been looking for," study leader Dr. Dorry Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine, said in the release.

"With opt-out the perception becomes, we will take your organs unless you take the time to fill out a form. That's a dangerous perception to have. We only want to use donated organs from people who intended to donate," he said.

More information

The U.S. Department of Health and Human Services has more about organ donation.

-- Robert Preidt

SOURCE: Johns Hopkins Medicine, news release, Nov. 29, 2011

Last Updated: Dec. 16, 2011


More Doctors Going the Alternative Route


(Chicago Tribune, December 14, 2011)
"While doctors are schooled in traditional Western medicine, a growing number…are turning to complementary and alternative medicine to stay healthy, then integrating the techniques into their medical practices…Alternative therapy also includes herb therapy, deep breathing, massage and yoga. Complementary and alternative medicine, or CAM, combines the methods with traditional medicine…A study published in the online version of Health Services Research in August found that 76 percent of health care workers and 83 percent of doctors and nurses used CAM, compared with 63 percent of the general population. The study used data from the 2007 Alternative Health Supplement of the National Health Interview Survey, which is part of the federal Centers for Disease Control and Prevention. Other studies have found more nurses than doctors using CAM, according to the article."

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