Saturday, May 26, 2012

May 26 Weekend Reading-Relevant Hepatitis C Research and News

Girl Reading  by Pablo Picasso

Most weekends this blog offers up a few substantial links to relevant HCV information, click here for previous "Weekend Reading" articles. Hepatitis C New Drug Research And Liver Health has an article database which includes full-text and abstracts on hepatitis C.  View the RSS feed for this weekend of updates.

Meeting Coverage In The News

EASL 2012

EASL: Telaprevir 100% Effective for IL28B CC, Adding VX-222 Overcomes Unfavorable Genes
23 May 2012

Written by Liz Highleyman

Adding telaprevir (Incivek) to pegylated interferon and ribavirin cured all hepatitis C patients with the favorable IL28B gene pattern, researchers reported at the 47th International Liver Congress (EASL 2012) last month in Barcelona. Another study found that adding the experimental HCV protease inhibitor VX-222 raised cure rates even for those with unfavorable IL28B patterns.
DDW, the annual meeting of the American Gastroenterological Association (AGA) Institute, is jointly sponsored by the American Association for the Study of Liver Diseases, the AGA, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract.

Increased mortality observed in patients with HCV and diabetes
May 23, 2012

Those with both hepatitis C and diabetes had a higher mortality rate when compared with those who had either condition alone, according to research presented during Digestive Disease Week 2012.
When we observed the rates for patients who had both hepatitis C and diabetes, we saw that the mortality rate was significantly increased — at least three times the amount of patients died in the group with both hepatitis C and diabetes compared with patients who had neither condition,”

Meira Abramowitz, MD, of the division of internal medicine at SUNY Downstate Medical Center in Brooklyn, N.Y., told Infectious Disease News.

Abramowitz and colleagues conducted a retrospective chart review of patients treated at the VA New York Harbor Healthcare System from 2002 to 2003. Mortality data were collected from 2011.
Patients with HCV were identified from a registry of more than 6,000 patients with HCV. These patients were age-matched with other patients without HCV from the VA system, some of whom had diabetes.

The final cohort included 1,846 patients, of whom 18.8% had neither HCV nor diabetes and 12.8% had both. Of the 579 patients with diabetes, 31.3% died vs. 20.6% of the 1,213 patients without diabetes. Of the 1,141 patients with HCV, 24.5% died vs. 24.1% of the 692 patients without HCV.

Of the 237 patients with both HCV and diabetes, 36.3% died vs. 20.8% of the 867 patients with HCV alone, 27.8% of the 342 patients with diabetes alone and 20.2% of the 346 patients with neither disease. The OR for mortality in patients with diabetes vs. patients without diabetes was 1.7 (95% CI, 1.3-2.24). This increased to 1.89 when the researchers compared patients with both HCV and diabetes to patients with neither disease (95% CI, 1.45-2.46).

“We are not entirely sure why this mortality increase took place because both of these conditions have their own individual complications,” Abramowitz said. “Hepatitis C can develop into hepatocellular carcinoma and hepatic encephalopathy, while diabetes can progress into diabetic nephropathy and diabetic neuropathy with accompanying cardiovascular complications.”
  • Abramowitz M. #MO1905. Presented at: Digestive Disease Week 2012 Annual Meeting; May 19-22; San Diego.
  • Dr. Abramowitz reports no relevant financial disclosures.


View Additional DDW articles..............


ISSUE: MAY 2012 | VOLUME: 63:5

Update on the Diagnosis and Treatment of Hepatitis C

by Arun B. Jesudian, MD and Ira M. Jacobson, MD

Hepatitis C virus (HCV) infection is a national and global public health concern, affecting up to 4 million individuals in the United States and 200 million individuals worldwide. Despite a declining incidence of new HCV infections in the United States, the prevalence of advanced liver disease secondary to chronic HCV infection, including cirrhosis and hepatocellular carcinoma, is expected to rise in the coming years.

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NICE Bites is a monthly bulletin which summarises key prescribing points from NICE guidance. This edition includes two topics; Anaphylaxis and Hepatis C – technology appraisals.

Healthy You

Oregon State University

Like curry? New biological role identified for compound used in ancient medicine

CORVALLIS, Ore. – Scientists have just identified a new reason why some curry dishes, made with spices humans have used for thousands of years, might be good for you.

New research at Oregon State University has discovered that curcumin, a compound found in the cooking spice turmeric, can cause a modest but measurable increase in levels of a protein that's known to be important in the "innate" immune system, helping to prevent infection in humans and other animals.

This cathelicidin antimicrobial peptide, or CAMP, is part of what helps our immune system fight off various bacteria, viruses or fungi even though they hadn't been encountered before.
Prior to this, it was known that CAMP levels were increased by vitamin D. Discovery of an alternative mechanism to influence or raise CAMP levels is of scientific interest and could open new research avenues in nutrition and pharmacology, scientists said.

Turmeric is a flavorful, orange-yellow spice and an important ingredient in many curries, commonly found in Indian, South Asian and Middle Eastern cuisine. It has also been used for 2,500 years as a medicinal compound in the Ayurvedic system of medicine in India – not to mention being part of some religious and wedding ceremonies. In India, turmeric is treated with reverence.

The newest findings were made by researchers in the Linus Pauling Institute at OSU and published today in the Journal of Nutritional Biochemistry, in collaboration with scientists from the University of Copenhagen in Denmark. The work was supported by the National Institutes of Health.

"This research points to a new avenue for regulating CAMP gene expression," said Adrian Gombart, an associate professor of biochemistry and biophysics in the Linus Pauling Institute. "It's interesting and somewhat surprising that curcumin can do that, and could provide another tool to develop medical therapies."

The impact of curcumin in this role is not nearly as potent as that of vitamin D, Gombart said, but could nonetheless have physiologic value. Curcumin has also been studied for its anti-inflammatory and antioxidant properties.

"Curcumin, as part of turmeric, is generally consumed in the diet at fairly low levels," Gombart said. "However, it's possible that sustained consumption over time may be healthy and help protect against infection, especially in the stomach and intestinal tract."

In this study, Chunxiao Guo, a graduate student, and Gombart looked at the potential of both curcumin and omega-3 fatty acids to increase expression of the CAMP gene. They found no particular value with the omega-3 fatty acids for this purpose, but curcumin did have a clear effect. It caused levels of CAMP to almost triple.

There has been intense scientific interest in the vitamin D receptor in recent years because of potential therapeutic benefits in treating infection, cancer, psoriasis and other diseases, the researchers noted in their report. An alternative way to elicit a related biological response could be significant and merits additional research, they said.

The CAMP peptide is the only known antimicrobial peptide of its type in humans, researchers said. It appears to have the ability to kill a broad range of bacteria, including those that cause tuberculosis and protect against the development of sepsis.

Is coffee good for the liver?
ISIC the Institute for Scientific Information on Coffee©
14th May 2012

Questions patients ask

Q: Is coffee good for the liver?
A: Research suggests that regular, moderate coffee consumption can lower people’s risk of developing a range of liver diseases – including cancer, fibrosis (scar tissue that builds up within the liver) and cirrhosis (the result of a long-term build up of scar tissue within the liver).

Q: How many cups of coffee do I need to drink to see a benefit?
A: It is too early to make specific recommendations concerning the levels of coffee intake that may be beneficial for liver function. Research suggests that regular, moderate coffee consumption may be beneficial

1,2. However certain patients with specific conditions may need to limit their caffeine consumption. For example, pregnant women are advised to limit their caffeine intake to 200-300mg per day – the equivalent amount found in 2-3 regular cups of coffee.

Q: Are the benefits of coffee down to caffeine?
A: While research has suggested that caffeine may slow down the progression of liver fibrosis, alcoholic cirrhosis and liver cancer

3,4,5, the extent to which caffeine is implicated in the reduced risk of developing these diseases remains unclear. Research also suggests that other coffee constituents, including cafestol and kahweol6 (naturally occurring compounds found in the oily part of coffee), and antioxidants may have a beneficial effect on liver function.

Q: Is decaffeinated coffee as good as regular coffee?
A: Research suggests that caffeine might play a role in the relationship between coffee drinking and lower risk of liver disease; however, currently there are no published studies specifically investigating the effects of decaffeinated coffee on liver function.

Q: If I’m a coffee drinker, can I drink more alcohol without increasing my risk of liver disease?
A: No. All medical advice makes clear that excessive alcohol consumption is detrimental to health. Adults, who choose to consume alcohol, should be aware of the recommended advice for safe consumption. While scientific research suggests that coffee drinking may have a beneficial effect on liver function, the risks associated with excessive alcohol consumption are not counter balanced by coffee consumption.

Q: I’ve heard that the effects of alcohol on the liver can be different for women than for men. Is the same true for coffee?
A: Generally, the effect of coffee drinking does not differ between the sexes; however, some groups, such as pregnant women, smokers, or women taking hormone replacement therapy do metabolise caffeine at a different rate to those in the general population. Pregnant women are advised to limit their caffeine intake to 200-300mg per day – the equivalent amount found in 2-3 regular cups of coffee.

Q: Do all types of coffee have the same effect?
A: Studies investigating the relationship between coffee and liver function have demonstrated beneficial effects in various types of coffee preparation, including filtered, instant and espresso coffee.

Q: Is it safe for individuals with liver disease to drink coffee?
A: Yes, there is no evidence to suggest that moderate coffee drinking poses any dangers for individuals with liver disease. In fact, some studies suggest coffee may slow down the progression of liver disease in some patients.

Q: Does coffee have any benefits for individuals with liver disease?
A: Research has shown that individuals with liver disease who regularly drink moderate amounts of coffee tend to display a milder progression of the disease7,8.
 Source and References

May 24
Think you eat a nutritious diet but still find yourself battling sugar cravings, feeling fatigued and struggling to lose weight? Then carve out time today to watch this talk by Stanford internist Nicole Peoples, DO. In this video lecture, she explains what happens once food enters your system, how your body responds to it and why the food choices you’re making could be contributing to these and other symptoms.

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