Friday, January 18, 2013

HCV Weekly Rewind: IFN-free Trials, The Silent Pandemic and Veterans Affected By Buffalo VA Infection Risk

Good afternoon folks,

Another Friday is upon us and its time for a quick review of the top hepatitis C headlines for the week of January 7th, including today's news in this edition of HCV Weekly Rewind.


We begin with an interferon-free trial announced yesterday by Boehringer Ingelheim, the company is headquartered in Ingelheim, Germany and based in Ridgefield, CT.

Boehringer Ingelheim has begun enrolling patients in a pivotal late-stage hepatitis C study. The companies investigational IFN-free regimen combines the compounds faldaprevir (BI 201335), a protease inhibitor administered once-daily, and BI 207127, a non-nucleoside polymerase inhibitor administered twice-daily, plus ribavirin.

"Our investigational interferon-free regimen has shown particular promise in treating patients with HCV genotype-1b so we have decided to enroll these patients in our Phase 3 trial program. Our goal is for an interferon-free future and ensuring patients are treated with the most effective treatment for them individually," said Peter Piliero, M.D., vice president, clinical development and medical affairs.


The aim of the study is to confirm efficacy and safety of treatment with 600 mg of BID BI 207127 in combination with 120 mg QD FDV and RBV for 16 or 24 weeks in target chronically infected HCV GT1b treatment naïve patients, including patients with compensated cirrhosis.

U.S. Locations

U.S. clinical trial sites: Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Michigan, Mississippi, Missouri, New Jersey, Ohio, Texas, Utah, and Virginia. International sites and additional information can be found at Contact Boehringer Ingelheim at 1-800-243-0127.

January 17, 2013 Press Release
Boehringer Ingelheim Enrolls First Patients in Pivotal Phase 3 Interferon-Free Hepatitis C Trial Program

Previous Trials:

A quick summary-Faldaprevir (BI-201335) and BI-207127

Cirrhosis SOUND-C2

In November results of the interferon-free trial called SOUND-C2 using Boehringer Ingelheim’s faldaprevir (BI-201335) and BI-207127 with ribavirin were presented at the 63rd annual meeting of the American Association for the Study of Liver Diseases (AASLD) in Boston.

Results from SOUND-C2 Sub-analysis of Patients with Compensated Liver Cirrhosis due to HCV
 Data from the SOUND-C2 study are the first data for an IFN-free regimen in HCV patients with compensated liver cirrhosis. This sub-analysis included 33 patients (nine percent of the study population) with compensated liver cirrhosis, as confirmed by either biopsy or Fibroscan. Investigators noted that data from this analysis support the continued development of this investigational IFN-free treatment regimen in Phase 3 trials for patients with compensated liver cirrhosis.

SOUND-C2 Sub-Analysis in Patients with Compensated Liver Cirrhosis
1335 QD/7127 TID/RBV
16, 28 or 40 weeks
Pooled (n=21)
1335 QD/7127 BID/RBV
28 weeks (n=9)
1335 QD/7127 TID
28 weeks (n=3)
SVR12 / 24, n (%)3 (43%)8 (57%)2 (50%)4 (80%)N/A1 (33%)
DCs due to AEs,
n (%)
6 * (29%)1 (11%) 0
DCs due to rash,
n (%)
3 * (14%)00
DCs due to
n (%)
2 (10%) 00
DCs due to vomiting,
n (%)
1 (5%) 00
*No cases of erythema multiforme, Stevens-Johnson Syndrome (SJS), toxic epidermal necrosis, or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

Comparison of SVR4, SVR12 and SVR24 Results from SOUND-C2 A comparison of results from the SOUND-C2 study shows that almost all patients (98 percent) in the study who achieved SVR4 continued to maintain undetectable virus levels and achieve SVR24. All of the patients who achieved SVR12 in the SOUND-C2 study maintained their undetectable virus levels and achieved SVR24.

Of the patients with undetectable hepatitis C virus levels at the end of treatment (EOT), and who received the treatment per the pre-specified protocol, 15 experienced documented relapse (7 percent). Relapse occurred within 12 weeks post-treatment for 14/15 patients. One patient in the 16 week study arm relapsed between 24-48 weeks post-treatment.

It should be noted that rare late relapses have been observed following both IFN-based and IFN-free treatment. It is unclear why these patients relapsed so late in the follow up period. These results emphasize the importance of monitoring patients for at least one year following the end of treatment regardless of whether they were treated with an IFN-based or IFN-free regimen.
Continue reading...


What About SVR-4, SVR-12 and SVR-24 ?

Have you noticed at scientific meetings new terminology has evolved over the years, especially relating to sustained virologic response - SVR?  The once standardized term "SVR" was defined as being HCV RNA negative 6 months after finishing standard therapy. This endpoint used in clinical trials had low rates of relapse and has been interpreted by researchers as a 'cure'. However, now with new agents the definitions of viral responses using standard therapy or peginterferon and ribavirin have become somewhat insufficient.

That Was Then This Is Now

Tracy Swan from TAG (Treatment Action Group) recently wrote an update on the newer sustained virologic response terminology; SVR-4, SVR-12 and SVR-24, in the report SVR rates from HCV drugs currently under development are included using data from the 2012 liver meeting.

Swan warns of the importance of monitoring late relapse, using examples of late relapses in two interferon-free trials-one was SOUND-C2.

The hunger for information about cure rates from interferon-free regimens has led to earlier reporting of results; SVR-4 (undetectable HCV RNA four weeks after finishing treatment) is now commonly used. But with interferon-free regimens, SVR-4 does not always predict SVR-12, and SVR-12 does not always predict SVR-24. In fact, there have been two late relapses, between 24 and 48 weeks after treatment with an interferon-free regimen: one in Abbott’s PILOT trial [1] and one in Boehringer Ingelheim’s SOUND-C2 trial [2]. In both cases, treatment consisted of an HCV protease inhibitor, a non-nucleoside polymerase inhibitor and ribavirin. Although SVR-12 and SVR-24 are primary outcomes for interferon-free trials, monitoring for late relapse will continue. 
Read the full report entitled: Cure rates with pipeline HCV drugs: reports from AASLD.

Gilead Sciences: Sofosbuvir (GS-7977)/GS-5885 and Ribavirin

Gilead Sciences is now recruiting at some locations in the U.S.

Study Title
Safety and Efficacy of Sofosbuvir/GS-5885 Fixed-Dose Combination ± Ribavirin for the Treatment of HCV

The purpose of this study is to evaluate the safety, tolerability and antiviral efficacy of sofosbuvir/GS-5885 (fixed dose combination) with or without RBV administered for 12 or 24 weeks in treatment-experienced subjects with chronic genotype 1 HCV infection.

More Information @
In Case You Missed It

Gilead Update January 7 - Press Release:

Gilead Update - 2nd Phase 3 Study of Sofosbuvir and GS-5885 to Begin Later this Month
-- Sustained Virologic Response Achieved with Oral Regimen of Sofosbuvir, GS-5885 and Ribavirin in 9/9 Null Responder Genotype 1 Hepatitis C Patients --
-- Second Phase 3 Study Evaluating Fixed-dose Combination of Sofosbuvir and GS-5885 to Begin Later this Month --
Continue Reading....


As most of you know, last August Bristol-Myers Squibb discontinued a mid-stage study of the experimental nucleotide polymerase inhibitor BMS-986094 after heart failure was reported in one of the 30 patients enrolled in the study - several participants suffered serious complications.

On Wednesday  over at Fierce Biotech reported that Bristol-Myers will begin talks on settling claims from patients and families involved in the tragic trial, read the article here. 


CHMP post-authorisation summary of positive opinion for Pegasys  On 17 January 2013, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion recommending a variation to the terms of the marketing authorisation for the medicinal product Pegasys. The marketing authorisation holder for this medicinal product is Roche Registration Ltd. They may request a re-examination of the CHMP opinion, provided that they notify the European Medicines Agency in writing of their intention within 15 days of receipt of the opinion.

The extension adopted by the CHMP is to add a new strength (90 µg) to the existing product range.
The CHMP also adopted a new indication, as follows:

Paediatric patients 5 years of age and older:
Pegasys in combination with ribavirin is indicated for the treatment of chronic hepatitis C in treatment-naïve children and adolescents 5 years of age and older, who are positive for serum HCV-RNA.

When deciding to initiate treatment in childhood, it is important to consider growth inhibition induced by combination therapy. The reversibility of growth inhibition is uncertain. The decision to treat should be made on a case by case basis (see section 4.4).

Detailed conditions for the use of this product will be described in the updated summary of product characteristics (SmPC), which will be published in the revised European public assessment report (EPAR), and will be available in all official European Union languages after the variation to the marketing authorisation has been granted by the European Commission.
For information, the full indications for Pegasys will be as follows1:

Chronic hepatitis B

Pegasys is indicated for the treatment of hepatitis B envelope antigen (HBeAg)-positive or HBeAg-negativechronic hepatitis B (CHB) in adult patients with compensated liver disease and evidence of
viral replication, increased ALT and histologically verified liver inflammation and/or fibrosis (see sections 4.4 and 5.1).

Chronic hepatitis C

Adult patients
Pegasys is indicated for the treatment of chronic hepatitis C (CHC) in adult patients who are positive for serum hepatitis C virus ribonucleic acid (HCV-RNA). This includes patients with compensated cirrhosis and/or co-infected with clinically stableHIV (see section 4.4).

The optimal way to use Pegasys in patients with chronic hepatitis C is in combination with ribavirin. The combination of Pegasys and ribavirin is indicated in treatment-naïve patients and in adult patientswho have failed previous treatment with interferon alpha (pegylated or non-pegylated) alone or in combination therapy with ribavirin.

Monotherapy is indicated mainly in case of intolerance or contraindication to ribavirin.

Paediatric patients 5 years of age and older:
Pegasys in combination with ribavirin is indicated for the treatment of chronic hepatitis C in treatment-naïve children and adolescents 5 years of age and older who are positive for serum HCV-RNA.

When deciding to initiate treatment in childhood, it is important to consider growth inhibition induced by combination therapy. The reversibility of growth inhibition is uncertain. The decision to treat should be made on a case by case basis (see section 4.4).

Big Pharma

Big Pharma ranks near bottom in patient attitudes

Big Pharma has got to be thankful for for-profit health insurers. They represent the only group that patients who are taking drugs are touched by that they dislike more than makers of branded drugs.

That is according to a survey recently published in PatientView Quarterly, which surveyed 500 international, national and regional patient groups, about their opinions of different parts of the drug and devicemaking, paying and delivery process. While 72% of the participants come from Europe, Forbes contributor John LaMattina says there are lessons to be drawn for the industry. LaMattina is the former president of Pfizer R&D and now senior partner at PureTech Ventures,

Pharma ranked seventh out of 8 categories.

According to the survey, which must be purchased to get to the nitty-gritty, only 34% gave pharma a good or excellent rating. Generic drugmakers didn't do much better, with 37% of respondents having good feelings about them, while biotechs were rated favorably by 44%. Patients liked their retail pharmacists the best, at 62%. Then there was medical device companies, 50%; private healthcare services, 46%; biotechs, 44%; and not-for-profit health insurers, 39%. For-profit health insurers fell a full 10 percentage points lower than pharma at 24%.

There are number of factors that influenced patients against branded drugmakers. Not surprisingly, pricing was at the top of their list. They also found drug companies too secretive, said they do a poor job of letting them know about adverse drug event news and a third of them have issues with the industry's integrity.

The former Pfizer ($PFE) R&D exec offers up some ideas on changing such attitudes. He thinks Big Pharma should provide more transparency on payments to physicians and clinical trial data, stop pushing drugs for unapproved uses and give up television advertising.

Some individual drug companies have taken these kinds of steps, although often after intense criticism. For example, GlaxoSmithKline ($GSK) has committed to open up its data vaults and let researchers peruse years of results good and bad.

But there are other signs of disaffection with the lack of transparency in the industry. Just this week, the AARP, AFL-CIO, and 17 other healthcare advocacy groups issued a letter to the Office of Management and Budget, urging the Obama administration to roll out regulations for the Physician Payments Sunshine Act. That is the legislation that mandated disclosure of financial ties between industry and doctors. The regulations to implement the act are 15 months overdue. Some doctors wrote a similar letter. Of course, this delay is not the industry's doing.
Source- Fierce Biotech
- read the Forbes piece
- here's a link to the report

Related Articles:
Will GlaxoSmithKline's transparency pledge force pharma rivals to open up?
AARP, AFL-CIO and prominent docs to White House: Get us the sunshine rules, stat
Should doc-payment rules require more info?
Senate mulls bill to keep pharma documents unsealed
Pfizer to report doctor payments


Harmful Cells May Have A Role To Play In Liver Repair

Liver damage could be repaired by the same cells that harm the organ in the first place, a study suggests.

The cells - called macrophages - cause tissue to become scarred, which can lead to cirrhosis of the liver.

University scientists have now found that the macrophages also have a role in breaking down and getting rid of damaged tissue so that the normal liver structure and function is restored.

Macrophages are found throughout the body and help fight infection by breaking down bacteria.

They also regulate inflammation in cells, which can cause scarring in tissue and help to seal wounds.

Researchers are identifying what triggers the cells to change their function in the liver, with a view to developing a drug that switches the cells to repair mode.

Liver cirrhosis

Liver cirrhosis occurs as a result of long-term damage that can be brought on by infection, excess alcohol consumption or obesity.

The condition, which is increasing rapidly, currently ranks as the 5th most common cause of death leading to around 1,000 deaths in the UK each year, with 700 people needing a transplant to survive.

We have shown that the very cells that provoke scarring to the liver can also help the liver to heal by getting rid of damaged tissue. While scarring of the skin, for instance, following a cut is important to help the skin heal when the liver becomes scarred this can affect how it works, preventing toxins in the bodies from being broken down properly.

Prakash Ramachandran

Medical Research Council Centre for Inflammation Research at the University


The study, which has been published in PNAS, looked at the role of macrophages in liver tissue in mice.

The research was funded by the Medical Research Council, the Wellcome Trust, the Academy of Medical Sciences, the Health Foundation, Royal College of Surgeons of Edinburgh, British Heart Foundation and Sir Jules Thorn Trust.

January Pubmed Literature Review

Monthly Pubmed Review of the most relevant research on hepatitis C


Clinical Trials, Cohort Studies, Pilot Studies
Basic and Applied Science, Pre-Clinical Studies
HIV/HCV Coinfection
Complementary and Alternative Medicine
Epidemiology, Diagnostics, and Miscellaneous Works
Liver Cancer

January Abstracts Available @ CAP Hepatitis C Literature Review

Raising Awareness

Silent Pandemic: Tackling Hepatitis C

A report published this week by the Economist Intelligence Unit in London titled "The Silent Pandemic: Tackling Hepatitis C with Policy Innovation", warns hepatitis C has become a ''silent pandemic''' that kills 350,000 people each year.

"The report highlights that worldwide, despite the significant burden of HCV, governments have failed to get a grip on the scale and impact of the disease," said Charles Gore, President of The World Hepatitis Alliance. "In both developed and developing countries, the true human and economic cost of HCV will continue to rise unless policy makers confront this urgent public health issue now."
Hepatitis C disease backgrounder

HCV Transmission In A Clinical Setting

Veterans exposed to HCV, HBV and HIV at Buffalo VA Medical Center

700 patients over a two-year period may have been exposed to hepatitis B, hepatitis C or HIV through the reuse of insulin pens at the Buffalo VA Medical Center.

Excerpt From Olean Times Herald;

Some local veterans affected by Buffalo VA infection risk
"Letters were sent out to veterans who were admitted to the Buffalo VA Hospital between Oct. 19, 2010, and Nov. 1, 2012. The reuse of the insulin pens was disclosed to members of Congress last week, and Rep. Chris Collins, R-Clarence, disclosed the VA infection risk on Saturday. The VA discovered the improper reuse of the insulin pens in November."
Continue reading...

The Buffalo News Reports:

FDA warned in 2009 not to reuse insulin pens

WASHINGTON – The Food and Drug Administration warned hospitals nationwide against reusing insulin pens on multiple patients in March 2009, 19 months before the Buffalo VA Medical Center began a practice that could have prompted its nurses to do that very thing.
What’s more, the hospital continued running the risk of spreading deadly viruses through those insulin pens for more than two years until last Nov. 1, despite a January 2012 alert from the Centers for Disease Control and Prevention reiterating the FDA’s earlier warning.
Continue reading....

ARIZONA: Hepatitis C Lawsuit Filed Against Bullhead City Clinic

A Mohave County resident is suing the Ear & Sinus Center of the Southwest in Bullhead City, Ariz., after allegedly contracting hepatitis C while having a voice box nodule examined with an endoscope in January 2012. On November 30, 2012, the clinic sent the patient a letter stating that the equipment used in the procedure may not have been sterilized properly. The clinic suggested that the patient get tested for a variety of diseases. The patient filed a lawsuit in Maricopa Superior Court on December 27, 2012, after testing positive for hepatitis C. The patient claims that the equipment used for the procedure was not properly sterilized. Robert Mosier of the law firm Hodes, Milman, Liebeck, and Mosier is representing the patient. The latest inspection report for the clinic on the Arizona Department of Health’s website is dated October 29, 2012, and shows no violations. Mosier states, "What we want to know is why did it take the clinic until November [2012] to notify [the patient] of the problem? How many other patients were put at risk and why were procedures not followed?" Mosier’s office has not yet heard back from Ear & Sinus Center of the Southwest.

Second Hepatitis C case diagnosed at BHC clinic
A second person treated at the Ear & Sinus Center of the Southwest in Bullhead City has tested positive for Hepatitis C. Las Vegas attorney Gerald Gillock said his client was treated at least nine times at the clinic, including several procedures with an endoscope. An endoscope is a flexible tube with a camera and sometimes surgical instruments that doctors can use to check out the insides of the sinuses, throat, windpipe and colon. In November, The clinic sent letters to its patients saying that its staff may not have followed proper sterilization procedures for its endoscopes and recommending tests for a variety of diseases, including Hepatitis C. Gillock is fairly certain his client's infection came from the clinic.
 Continue reading...

Exeter hepatitis C outbreak malpractice cases hit court today
David Kwiatkowski, whom prosecutors have called a "serial infector," is charged with stealing painkillers from Exeter Hospital and replacing them with saline-filled syringes tainted with his own blood. He pleaded not guilty earlier this month to 14 federal drug charges and has been in jail since his arrest in July.
Continue reading..

Health Care-Related Exposure Linked to HCV, HBV Infection in Older Adults
Researcher Joseph Perz reported that older patients who received healthcare had increased risk of becoming infected with hepatitis C or hepatitis B. Patients' behavioral risks -- being in jail, using "non-injected illicit drugs," or having sex with hepatitis-infected partners or with multiple partners -- had no relation to this increased risk. The study included 48 hepatitis-infected patients ages 55 and older who showed hepatitis symptoms within six months of exposure to healthcare settings.
Continue reading @ The

HCV Transmission

Online tattoo and piercing kits could be spreading Hepatitis C
"We do know that tattooing is incredibly popular, becoming more so, body piercing is very popular and there are now online kits.
"So you've got this situation where people are getting involved in tattooing parties and body piercing parties among themselves.
"They're doing some good stuff but they don't have the knowledge or the equipment to sterilise the equipment."
Tattoo and body piercing kits are widely available online for about $100 or less. Many of them are advertised as being "for beginners".
Continue reading...

Association of tattooing and hepatitis C virus infection: A multicenter case-control study

Carney K, Dhalla S, Aytaman A, Tenner CT, Francois F.
Source NYU Langone Medical Center, New York, NY.

Although injection drug use (IDU) and blood transfusions prior to 1992 are well-accepted risk factors for hepatitis C virus (HCV) infection, many prior studies that have evaluated tattooing as a risk factor for HCV infection did not control for a history of IDU or transfusion prior to 1992.

In this large, multicenter case-control study we analyzed demographic and HCV risk factor exposure history data from 3,871 patients, including 1,930 with chronic HCV infection (HCV RNA positive) and 1,941 HCV negative (HCV antibody negative) controls.

Crude and fully adjusted odds ratios of tattoo exposure by multivariate logistic regression in HCV infected versus controls were determined. As expected, injection drug use (65.9% vs. 17.8%, p < 0.001), blood transfusions prior to 1992 (22.3% vs. 11.1%, p < 0.001), and history of having one or more tattoos (OR = 3.81; 95% CI 3.23 - 4.49, p<0.001) were more common in HCV-infected patients than in control subjects.

After excluding all patients with a history of ever injecting drugs and those who had a blood transfusion prior to 1992, a total of 1,886 subjects remained for analysis (465 HCV positive and 1,421 controls).

Among these individuals without traditional risk factors, HCV positive patients remained significantly more likely to have a history of one or more tattoos after adjustment for age, sex, and race/ethnicity (OR = 5.17; 95% CI 3.75 - 7.11, p<0.001).

Conclusion: Tattooing is associated with HCV infection, even among those without traditional HCV risk factors such as injection drug use and blood transfusion prior to 1992. (HEPATOLOGY 2013.).
Hepatology. 2013 Jan 12. doi: 10.1002/hep.26245.

New Research into survival of HCV outside of the syringe

Juliane Doerrbecker from the Medical School of Hannover and Helmholtz Centre for Infection Research and colleagues in Germany looked at the risk of HCV transmission associated with water used to dilute drugs, water containers, and filters (such as cotton).

Experiments were designed to replicate the practices of people who inject drugs, with routinely used injection equipment.

Viral stability in water was assessed by adding HCV to 100 mL of bottled water and letting it stand for several days at room temperature. Stability in containers was determined by filling aluminum, glass, and plastic containers with water, adding HCV, emptying the water, and refilling the container with new water. Transmission associated with filters was determined by drawing virus through a filter, wrapping it in foil, and incubating it to release viral particles....

Continue reading @


National cancer forecast: 1.66 million new cases in 2013
More than 1.66 million new cases of cancer will be diagnosed in 2013, while more than 580,000 Americans are expected to die of the disease, according to the annual statistics report of the American Cancer Society.
Although cancer rates are declining for most types of cancer, they are increasing among both sexes for melanoma of the skin and cancers of the liver, thyroid and pancreas.
Continue reading....

Medical Journals

Coming Soon....

New Issue of CLD to Explore Current Issues in HCC

Clinical Liver Disease, an online learning resource from AASLD, is pleased to announce an issue devoted to the important topic of Current Issues in Hepatocellular Carcinoma. Guest Editor Jorge A. Marrero, MD, MS, Professor of Medicine, Chief of Clinical Hepatology, Medical Director of Liver Transplantation, UT Southwestern Medical Center, assembled a team of experts from leading centers to address:
Molecular Epidemiology of HCC
Risk factors for HCC
Natural History and Staging for HCC
Current Issues and Future Trends in Surveillance for HCC
Radiologic Diagnosis of HCC
Pathologic Diagnosis of HCC
Systemic targeted therapy beyond sorafenib
What primary care providers need to know about HCC
And More.....

Using a blended content delivery format incorporating audio, video, text, and other interactive learning activities, CLD lets you learn at your own pace, in the location of your choice. Access is free, and CME credit is available.
Source - AASLD

This Week

Journal of Hepatology

Early hepatocellular carcinoma – Is there such a thing as too early?

Annals of Internal Medicine

Screening for Hepatitis C Virus Infection in Adults: A Systematic Review for the U.S. Preventive Services Task Force

Comparative Effectiveness of Antiviral Treatment for Hepatitis C Virus Infection in Adults: A Systematic Review

Reducing Risk for Mother-to-Infant Transmission of Hepatitis C Virus: A Systematic Review for the U.S. Preventive Services Task Force

A Few Of My Favorite Peer Reviewed Medical Journals

The Lancet
You are able to search for articles on hepatitis C and are able to view the abstracts free of charge; full text articles can be viewed for a fee.

The New England Journal of Medicine
Many abstracts and full text articles to view without a fee.
Specialties & Topics ;
Infectious Disease

The World Journal of Gastroenterology
Abstracts, and full text articles to view, again without a fee.

For Your Viewing Pleasure

Catching Hepatitis Before It's Too Late - Medical Minute

Hepatitis C is a silent killer that can stay dormant inside the body for decades without showing any symptoms. In Paula's case it was more than 30 years.

Source - AveraMcKennan

Medscape's Predictions for 2013

In this slideshow Medscape editors and advisors looked at the clinical and policy healthcare news in 2012 and have offered their predictions on how key events will play out this year.

One prediction - More hep C treatments

There is an "avalanche" of new drugs in the pipeline to treat hepatitis C. Unlike HIV and HBV, HCV can be cured, and the new drugs will make that possible for most.
View the slideshow @ Medscape

*Free registration required - I know, I hate that too. If its free why do we have to register?

For Your Listening Pleasure

As Hepatitis C Sneaks Up On Baby Boomers, Treatment Options Grow

@ NPR discusses new hepatitis C treatments, listen to the program here or view the transcript here.

Hepatitis C Newsletters And Blogs

Just published

HepCBC’s MONTHLY NEWSLETTER, the hepc.bull, has been “Canada’s hepatitis C journal” since the late 1990′s and has been published nonstop since 2001.

It contains the latest research results, government policy changes, activities and campaigns you can get involved in, articles by patients and caregivers, and a list of support groups plus other useful links.

January, 2013
Download - hepc.bull -- 01 2013

In This Issue
Hep C in the News
Rob’s Story 
HCV Around the World
If it Itches... 
HCV on the Internet
Michael’s Story

SIGN UP for free EMAIL hepc.bull and occasional email notices from HepCBC. Confidential.

New From The Hepatitis C Trust

The updates from The Hepatitis C Trust aim to bring you regular information on the work we are doing each month.
Download - Jan 15 2013 Issue (762kb)

Gastroenterology & Endoscopy News - January Issue

Articles from the January issue of Gastroenterology & Endoscopy News are now online.

FDA Adds Boxed Warning for Serious Skin Reactions to Telaprevir
Serious skin reactions, some fatal, have been reported with the use of telaprevir, an HCV protease inhibitor, used in combination with peginterferon alfa and ribavirin, according to an FDA drug safety communication issued on Dec. 19. Some patients died when they continued to receive the combination therapy after developing a progressive skin rash and systemic symptoms.

Click here to read all the top stories from this month’s issue.


Boceprevir/Victrelis Treatment diary
I have had Hepatitis C since 2000, sub type 1a/b. I was treated using PegInterferon and Ribavirin in 2007 but didn't make the 2log drop in virus levels, so the treatment was stopped after 12 weeks. After recovering from the treatment I did feel better though. Generally my virus levels have been quite low - e.g. 12 months ago, 124,000.

Entry Jan 18 2013:
Treatment starts on Friday 1 March. The letter from the hospital arrived on Wednesday. 
I've told my boss, and he's being supportive. He didn't say much, just, "thanks for letting me know".
Continue reading...

Defeating Hep C

1987 - Houston TX:Contracted HCV genotype 1a via blood transfusion during chemotherapy treatment for leukemia at age 12 (acute myelocytic leukemia).

2012 - Gilbert AZ:
Began triple therapy as a patient at Mayo Clinic:
(1) Pegasys/peginterferon alfa-2a,
(2) ribavirin,
(3) Incivek/telaprevir

Entry Dec 10 2012
38 Weeks - How are you?
That's the question I get asked the most these days. My answer? "The same." This response may sound stand off-ish, but it's actually quite accurate - and honest.
"The same" is not a bad thing.
So...what do I mean when I say it?
"The same" means that the effect of this treatment remains unpredictable. It means that I can have a good day or a bad day and not know which is coming. It means that I am exhausted no matter how much sleep I get. It means that sometimes I am forgetful. It means that sometimes I am slow to respond. I end up remembering and I end up responding, but my "processor" is "congested" (with drugs) so the response isn't always immediate.

AL D. Rodriguez Liver Foundation

LiverTox: Liver and Drug Research Made Easy

Entry Jan 14
The liver is central in processing anything and everything we take in – from our favorite breakfast cereal, vitamins and medications, to our late night snack of chocolate and wine. For many people, caring for the liver may not come easily with all the medications they must take. But just how dangerous are drugs to the liver? Using a new database, finding out the specific effects of a pharmaceutical drug to the liver is now just a few mouse clicks away. 
This month of October, the National Institute of Health (NHI) proudly introduced LiverTox, a free pharmaceutical database that provides accurate and updated information on a wide range of drugs including prescription and non-prescription medicines, herbal products and dietary supplements. It provides a thorough report on a particular drug, including its chemical structure, manufacturer information, and related case studies.....
Continue reading....

Best of Medical Blogs - weekly review and blog carnival

The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds
Check it out here....

New Websites

Hep C Redefined

Boehringer Ingelheim recently launched a website,, to help improve the lives of people with hepatitis C virus (HCV) infection. Created in collaboration with HCV community advocates and health care providers, the portal offers a range of interactive resources that can be shared via social media channels, embedded on other websites or viewed on various smart devices...Read More..

Hepatitis C News

A new website, aimed at providing practical advice and support to people living with hepatitis C 

Healthy You And The Flu

How Can I Prevent The Spread Of Flu

Flu season 'bad one for the elderly,' CDC says
Flu hospitalizations among the elderly rose sharply last week, prompting federal officials to take unusual steps to make more flu medicines available and to urge wider use of them as soon as symptoms appear.... 
So far, half of confirmed flu cases are in people 65 and older. Lab-confirmed flu hospitalizations totaled 19 for every 100,000 in the population, but 82 per 100,000 among those 65 and older, "which is really quite a high rate," Frieden said.
Continue reading...

Of Interest

Video Animation on How a Flu Virus Works

This year’s flu, called H3N2, is affecting many people this season and this three minute video with NPR’s Robert Krulwich and medical animator David Bolinsky explains how a flu virus can trick a single cell into making a million more viruses.

A lot of you have had it by now, or are having it or are about to be exposed. This year’s flu is called “H3N2″ and this week it’s doing big business in about 47 states, Chicago and New York. If you’ve had a flu shot and if you wash your hands several times a day for 20 seconds, (which is the time it takes to hum “Happy Birthday to You” two times through) you might reduce your odds of getting sick.

But your biggest ally is your immune system. It’s hard, during flu season, to avoid inhaling a virus or two (or three, or 10,000), but that doesn’t mean they’re going to take you over. You have an army of defenders in you, ready to take them on.
The above video shows what the battle looks like, deep down in your cells. This is the happy version — when you win.

Source: Robert Krulwich, NPR/read more here.

Off The Cuff

Get Smarter: A Powerful Brain-Boosting Supplement You've Never Heard Of

An article written by Melanie Haiken on the supplement phosphatidylcholine, points to potential research that it may improve brain health, check it out @ Forbes. The author writes;
Doctors often recommend phosphatidylcholine (PC) to people living with hepatitis C for its liver-protective benefits, particularly in conjunction with interferon therapy. By protecting the cells that line the digestive tract and reducing inflammation, PC may also ease conditions such as ulcerative colitis and IBS.
Read the in-depth article here.


Enjoy a video by the one and only ZDoggMD

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