Wednesday, July 24, 2013

Updates: Women With Chronic Hepatitis C Virus Infection

Filter through the many July updates on the website by clicking on the links provided below. Topics include; liver health, updated research on current or new therapies in development to treat hepatitis C, videos and more.

All Updates: Women and HCV
The natural history of hepatitis C virus infection differs between women and men. Women demonstrate a slow rate of disease progression until menopause. Older women are more likely to develop fibrosis and are less responsive than younger women to pegylated interferon and ribavirin. Women of childbearing age have higher rates of sustained virologic response, but current therapies are contraindicated during pregnancy. Vertical transmission of hepatitis C virus  occurs, but data supporting recommendations for prevention of mother-to-infant transmission are limited...
In draft guidance published today NICE recommends peginterferon alfa in combination with ribavirin as an option for treating chronic hepatitis C in children and young people.
Among pediatric patients with HCV infection the effectiveness of PEG-IFN/RBV therapy may be lower in the group with genotype-1 IL28B minor alleles than in other groups with IL28B major allele. Treatment strategy should be carefully implemented in patients with IL28B unfavorable type.

Peginterferon/ribavirin effective for children, adolescents with chronic HCV
Treatment of chronic hepatitis C with pegylated interferon and ribavirin is effective and relatively safe for children and adolescents, according to recent results. Researchers performed a systematic review and meta-analysis of eight trials assessing the use of pegylated interferon (PEG-IFN) alfa-2a or 2b with ribavirin (RBV) in patients aged 3 to 18 years with chronic HCV.

All Updates: HCV In Elderly Patients

Abstract: A pilot study of triple therapy with telaprevir, peginterferon and ribavirin for elderly patients with genotype 1 chronic hepatitis C.
Results suggest that 24-week triple therapy with telaprevir 1,500 mg seems safe and efficacious for elderly Japanese patients infected with HCV genotype 1b.....

Abstract: Various Predictors of Sustained Virologic Response in Different Age Groups of Patients With Genotype-1 Chronic Hepatitis C.
SVR rate was highest in patients younger than 45 years and lowest in patients older than 65 years even through propensity score matching analysis. As for the SVR predictors ....

All Updates: Liver Health Articles and Research

Liver Transplant Houston: Is There a Special Diet to Follow?
A common question I am asked daily is in regard to “what kind of diet do I need to be on while waiting for my liver  transplant?”. There is a great deal of misunderstanding surrounding this, that it deserves a few simple comments.

Fat in Liver, Muscle, and Blood Increases Osteoporosis Risk
A new US study has revealed that, in addition to excess stomach fat, high fat levels in the liver and blood are also dangerous. The study, which was published in "Radiology", showed that people with higher levels of fat in their liver, muscle tissue and blood also have higher amounts of fat in their bone marrow, which increases the risk for osteoporosis.

Miriam A. Bredella from the Harvard Medical School in Boston and her team used proton magnetic resonance spectroscopy (MRS) to examine 106 men and women, aged 19 to 45 years, who were obese based on body mass index measurements, but otherwise healthy.

The researchers discovered that people with more liver and muscle fat had higher levels of fat in their bone marrow, independent of body mass index, age and exercise status. HDL cholesterol, the "good" type of cholesterol, was inversely associated with bone marrow fat content. Triglyceride levels had a positive correlation with bone marrow fat.

"Obesity was once thought to be protective against bone loss. We have found that this is not true," said Bredella. "If you have a spine that's filled with fat, it's not going to be as strong."
Article Source
Study available @ Medscape

Binge eating has scarred my liver
By Claire Bates BBC Science
When actor Ricky Grover, 51, was asked to take part in a TV programme testing for three serious health conditions he had no qualms in signing up. And tests revealed Mr Grover was showing signs of two of them. A skin-prick test revealed he had Type 2 diabetes while an MRI scan showed scarring, known as fibrosis, on his liver.....

FDA Voice -Reminds Consumers to Use Acetaminophen Safely
To help avoid the risk of liver damage, make sure you understand the information provided on the medicine label or the directions given by your health care professional....

Cutting Back on Fat and Sugar (In the Diabetic Liver)
In a way, the diabetic liver is like a lot of us—too in love with fat and sugar. In type 2 diabetes, the liver floods the bloodstream with three times more glucose than does a healthy liver, while at the same time storing more and more fat that can lead to chronic liver disease, cirrhosis, and liver cancer.

Eating Raw Oysters - Vibrio Vulnificus Bacteria Lurks In Gulf Waters
Those with liver damage due to excessive drinking and individuals with liver disease, including Hepatitis C and cirrhosis, are most at risk for developing serious illness from Vibrio vulnificus

Hepatitis A and Hepatitis B Vaccine: Dr. Joe Galati Explains
Viral hepatitis most common causes of both cirrhosis and liver cancer 

All Updates: 2013-Hepatitis C Full Text Articles

Management algorithm for genotype 1 hepatitis C virus
Hepatitis C virus (HCV) infection is the most common etiology of chronic liver disease in Western countries. Morbidity and mortality due to HCV-related end-stage liver disease are increasing, just as novel therapeutics arrive with the promise of better cure rates that prevent these complications.
However, substantial barriers to successful application of these novel treatments remain, including the lack of providers with sufficient knowledge to address this epidemic. To address these deficits, this article aims to provide a general framework with algorithms to guide initial management decisions for HCV genotype 1 infection, the most commonly found genotype, based on therapies approved as of 2013.

Patients with hepatitis C infection and normal liver function: an evaluation of cognitive function

Direct-Acting Antivirals for the Treatment of Chronic Hepatitis C: Open Issues and Future Perspectives

Of Interest
Management of Treatment-Naïve Genotypes 2 and 3 HCV Infection

Advanced fibrosis is not a negative pretreatment predictive factor for genotype 2 or 3 chronic hepatitis C patients

Aust Fam Physician - Hepatitis C - An update

Durability of SVR in HCV patients treated with peg/riba and a direct-acting anti-viral
To evaluate the long-term durability of viral eradication in patients treated with triple therapy, including direct-acting anti-virals.


All Updates: Chronic hepatitis C: Treat or wait?

Not Waiting for New Hepatitis C Treatment
by Lucinda Porter, RN on July 18, 2013 With new hepatitis C medications in the pipeline, I’ve heard people wonder if everyone should wait, or if there are reasons why patients might want to start treatment now. Here are some reasons why patients are starting treatment now, rather than waiting .....

Video Vignettes -Current Outlook On Hepatitis C Treatment
With rapid advancements in the field and new agents offering potential improvements in outcomes, shorter treatment durations, and unique adverse event profiles, clinicians must stay informed of the evolving data in order to counsel patients appropriately--in particular, those who may wish to discuss the benefits and risks of initiating therapy now vs delaying treatment. This program will consist of a series of four video vignettes presenting interviews with clinical experts who will explore some of the most pressing issues in the management of patients with HCV.

Janssen’s Simeprevir: Hep C Patients Hope It Is Worth the Wait
Simeprevir, a protease inhibitor developed by Janssen and Medivir, is 1 of the prospective agents that has been creating a stir in the HCV community The FDA recently granted the drug priority review, which may accelerate its journey to market and help close the treatment gap for patients in need. Janssen is seeking approval for simeprevir administered once daily along with pegylated interferon and ribavirin to treat adult patients with genotype 1 chronic
HCV with compensated liver disease.


All Updates: Interferon Free Combinations

Interferon-free Regimen for Hepatitis C Advances
The direct-acting antiviral combination, manufactured by AbbVie Pharmaceuticals, consists of the proteaseinhibitor ABT-450, the non-nucleoside NS5B polymerase inhibitor ABT-333, and the novel NS5A inhibitorABT-267. When used in combination with ribavirin, it reportedly produces sustained virologic response ratesof up to 99% in patients with hepatitis C.

Treatment Action Group 2013 Pipeline Report
"An impressive 26  new HCV drugs are being studied in phases II/III in at least28 interferon-free regimens, which are bringing the potential of  faster, all-oral HCVcures rapidly toward approval for the world’s 185 million people living with  HCV"

A brighter future in the fight against hepatitis  An interferon-free therapy for hepatitis C may also soon exist. In April, a triple combination of direct-acting antivirals without interferon showed efficacy in treatment-naive individuals and in nonresponders to standard of care


All Updates: 2013 Stem Cell News and Research

Perspectives on human micro-liver-like structures made from iPS cells

A Science First: Japanese researchers grow human liver using stem cells

Don’t market stem-cell products ahead of proof


All Updates: HCV Triple-therapy Side Effects

Renal impairment is frequent in chronic hepatitis C patients  under triple therapy with telaprevir or boceprevir

Health-related QOL poorer during early HCV treatment with addition of telaprevir


All Updates: Drug To Drug Interactions in Triple Therapy 

There were several presentations in Wednesday’s session on drug interactions with new HCV agents in development and one survey on drug interactions with the currently licensed DAAs, boceprevir and telaprevir.
A  review of data from clinical trials indicated that the anti-HCV protease inhibitors telaprevir (Incivek or Incivo) and boceprevir  (Victrelis) did not add to the psychiatric adverse-event profile of  existing HCV therapy. However, the investigators identified several significant interactions between the protease inhibitors and a number of antidepressants, benzodiazepines, anticonvulsants and antipsychotics. 

Drug interactions may compromise response to boceprevir and telaprevir
Concurrent use of drugs that alter concentrations of boceprevir (Victrelis) or telaprevir (Incivek or Incivo) in the body may contribute to poor response to interferon-based triple therapy for chronic hepatitis C virus (HCV), according to study findings presented at the Digestive Disease Week meeting (DDW 2013) last month in Orlando.

Few Quick Links - News Updates
News/Incivek (Telaprevir)
News/Victrelis (Boceprevir)
Sofosbuvir (GS-7977 and PSI-7977)
News/Liver Cancer

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