Wednesday, November 6, 2013

Hepatitis C, stigma and cure

Hepatitis C, stigma and cure 
Hello Folks,
Being diagnosed with hepatitis C is overwhelming enough, the negative stigma associated with the disease is nothing short of debilitating. Sadly, our culture is a culture of blame, particularly surrounding drug use, the biggest stigma linked to the virus.

Additional psychological distress caused by living with a stigmatized disease can get in the way of initial HCV testing, an important first step toward ensuring optimal care to avoid possible liver damage. Only after knowing your hepatitis C status can steps be taken to seek out life-saving treatments.

Hepatitis C, stigma and cure

Recently, an article titled "Hepatitis C, stigma and cure" published in the October issue of  World J Gastroenterol, looked at the social stigma attached to HCV, consequences of living with the chronic infection, and new drugs to treat the virus.
The global hepatitis C epidemic is estimated to include 130–170 million people worldwide. In the United States an estimated 2.7–3.9 million people are living with the virus, more than 2 million of these people are baby boomers, with around 75 percent unaware they are infected - because they haven't been tested. In a year, 80,000 new infections will occur and close to 15,000 Americans will die from the disease.
New Drugs
The disease is curable, especially with so many new drugs making their way to FDA approval. I assume that if you're reading this post then you probably already know recently the Antiviral Drugs Advisory Committee reviewed two new agents.
Gilead's Sofosbuvir, a nucleotide analog NS5B polymerase inhibitor was reviewed on October 25 and Johnson & Johnson's Simeprevir a protease inhibitor on October 24. The committee recommend the approval of Simeprevir, in combination with pegylated interferon and ribavirin for the treatment of adult genotype 1 patients with compensated liver disease, including cirrhosis. As for sofosbuvir, the panel voted unanimously in support of approving the drug in combination with just ribavirin for treating adult HCV genotypes 2/3 and in combination with pegylated interferon/ribavirin for genotype 1 and 4 treatment-naive patients. For detailed information please download the FDA review package for sofosbuvir and simeprevir.
The FDA does not have to follow the advice of its panels, but most often will. The U.S. health regulators are scheduled to decide whether to approve sofosbuvir by Dec. 8, and simeprevir by Nov. 27.
With interferon-free therapies so close to FDA approval and so many in clinical trials the promise of treating hepatitis C without interferon is becoming a reality. According to new data from this months AASLD meeting in Washington, new agents have been shown in clinical trials to shorten treatment duration, lower toxicity and improve efficacy.
Interferon-Free Genotype 1
This week published online in "The Lancet" researchers suggest that the fixed-dose combination of sofosbuvir-ledipasvir alone or with ribavirin has the potential to cure most patients with genotype-1 HCV including those with compensated cirrhosis or who have previously failed treatment with protease inhibitors.
The Links 
AASLD - Updates
Check Out - Interferon Free Combinations
AASLD Website
Browse Abstracts

AASLD Coverage
Commentary/Abstracts/Videos @ Healio
Capsule Summaries, review by experts and slides @ Clinical Care Options CCO
CME/CE with commentary by Michael Smith @ MedPage Today
Commentary/Abstracts with coverage by Liz Highleyman @
Slides/Abstracts @ NATAP

1 comment: