Friday, April 12, 2013

Hepatitis C Newsletter: A LIVING MIRACLE



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.

SIGN UP for free EMAIL hepc.bull and occasional email notices from HepCBC. Confidential.
 
 
Issue Highlights
 
A LIVING MIRACLE
Back in 1992, JAK was diagnosed with the Hep C virus. She tried different variations of “the chemo from hell,” as she would call it. “After the third round, I was done,” she reported. None of the treatments had worked.

AUTOIMMUNE DISEASE; HEP C
What do cryoglobulinemia, lymphoma, thyroid disease, rheumatoid arthritis, Sjögren’s syndrome and lichen planus have in common?

CHERYL’S JOURNEY THROUGH BC: Part 2
(Summary of Part 1, published in the March,2013 hepc.bull: Cheryl Reitz, HepCBC Volunteer, recently took a bus trip to visit old friends in Northern and Interior BC. She took with her a suitcase of hepatitis C pamphlets and 12 pamphlet holders, and distributed them in Friendship Centres, nursing stations, AIDS and community organizations, etc. She started in Smithers, then went toTerrace.
Details of her trip continue here...
 
 
In case you missed it
 
 
In This Issue:
Snapshots: CROI Conference 2013
Lucinda K. Porter, RN

HCV and Tattoos
Alan Franciscus, Editor-in-Chief

HealthWise: - Hepatitis C: How to Talk to Us
Lucinda K. Porter, RN


New Treatments Ahead for HIV/HCV Coinfection
Liz Highleyman


Alcohol Use and Hepatitis C
Alan Franciscus, Editor-in-Chief
 
 
GI & Hepatology News is the official newspaper of the AGA Institute and provides the gastroenterologist with timely and relevant news and commentary about clinical developments and about the impact of health-care policy. The newspaper is led by an internationally renowned board of editors.

View Current Issue

(VOL. 7 NO. 5 APRIL 2013):
PDF | Interactive Version

 Issue Highlights

Interferon-free HCV regimen cured all genotype 1 patients
Included: sofosbuvir, ledipasvir, ribavirin..

BY PATRICE WENDLING IMNG
Medical News ATLANTA –
Adding ledipasvir to sofosbuvir and ribavirin produced sustained virological responses 12 weeks after therapy in 100% of treatment-naive and prior nonresponder patients with chronic hepatitis C genotype 1 in the ELECTRON trial. “Certainly adding a second direct-acting antiviral agent, ledipasvir, increases the efficacy of sofosbuvir plus ribavirin,” Dr. Edward Gane said at the Conference on Retroviruses and Opportunistic Infections. Three-quarters of the roughly 170 million people infected with hepatitis C virus (HCV) worldwide have genotype 1, the most difficult strain to treat. Current treatment includes triple therapy with a protease inhibitor plus peginterferon and ribavirin for 24-48 weeks, but PIbased therapy is limited by complex dosing regimens, the potential for resistance, and lower responses in prior nonresponders, explained Dr. Gane of Auckland Clinical Studies in New Zealand. The investigators hypothesized that combining two direct-acting antivirals with a different mechanism would enhance response.......  
Ledipasvir and sofosbuvir have been combined into a single fixeddose tablet and it is being evaluated in phase III studies in patients with cirrhosis and to determine whether there is a need for ribavirin, he said. Additional studies are also underway to explore shorter durations of therapy. The ELECTRON trial was sponsored by Gilead Sciences. Dr. Gane reported ties with Gilead, Janssen- Cilag, Novartis, Pharmasset, Roche and Vertex...............

 P E R S P E C T I V E
An ‘apocalypse moment’ for HCV?
Current therapeutic approaches to treatment of chronic HCV genotype 1 are limited by troublesome side effects, long courses of therapy, drug-drug interactions, and regimens that include pegylated interferon (administered by injection) and a protease inhibitor (administered thrice daily with food). Many patients are ineligible for therapy because of contraindications to the medications.
Furthermore, the current regimens do not have high efficacy in null responders. This has provided the impetus to develop all-oral regimens with better efficacy, improved side-effect profiles, and shorter courses of therapy.
These results of the phase II ELECTRON trial arm testing the all-oral regimen of sofosbuvir (NS5b polymerase inhibitor), ledipasvir (NS5a inhibitor), and weight based ribavirin in patients with chronic HCV genotype 1 (without cirrhosis) add to the recent number of stunning reports describing all oral treatment regimens for chronic HCV.
Such therapeutic approaches offer the promise of tolerable regimens that have outstanding efficacy and may have few or no contraindications to therapy.
It is unclear if patients with cirrhosis will respond as well as noncirrhotic patients did in ELECTRON and whether or not ribavirin is needed; phase III trials are currently underway to address these issues. If the phase II results are replicated in these phase III trials and if the medications are available to all patients who have chronic HCV genotype 1, this type of a regimen could represent the “apocalypse moment” for HCV, when the most common type of HCV worldwide (genotype 1) is largely eliminated.

Steven L. Flamm, M.D., is chief of transplant hepatology and is professor of medicine in the division of gastroenterology and hepatology at Northwestern University Feinberg School of Medicine, Chicago. He disclosed receiving research support from Gilead and serving as an advisor to the company......

Everolimus approved for liver transplant indication
Food and Drug Administration approval of the immunosuppressant drug everolimus has been expanded to include prophylaxis of organ rejection in adults undergoing a liver transplant....

Alpha-fetoprotein useful marker in HCC
Changes in serum alpha-fetoprotein levels over time correlated with the development of hepatocellular carcinoma in hepatitis C patients, wrote Dr. Elliot Lee and his colleagues in the April issue of Clinical Gastroenterology and Hepatology.......
 

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