Wednesday, January 8, 2014

Hepatitis C Updates- Liver Health, Genotypes, Coffee and Alternative Treatments


2014 Blog And Website Updates

Healthy You

Healthy Liver - Healthy Digestion
A quick glance at diet and liver health with a focus on digestion, including a somewhat familiar disorder called Functional Dyspepsia (FD). The medical term simply means - bad digestion, the symptoms vary, but are frequently described as a full or bloated feeling after eating

Coffee Consumption and Liver Disease
A collection of research articles suggesting the connection between coffee consumption and the liver.

Liver Health News and Research
A collection of  latest research, news and health tips about viral hepatitis and liver health.

Baby Boomers and the Hepatitis C Boom
As it turned out, the prevalence was much, much higher than anyone at UAB had expected. After screening 40 baby-boomer patients that first day, 6 results were antibody positive for hepatitis C, a blood-borne viral disease that attacks the liver but remains dormant in the body for decades before symptoms appear, typically in the form of cirrhosis, liver disease, or liver cancer.

Stem Cell News and Research
Current research and sometimes hype on the promise of using stem cell therapy to regenerate the liver 

In The Pipeline
 
Triple-antiviral therapy achieves 94% response without interferon, ribavirin
By: MICHELE G. SULLIVAN, Internal Medicine News Digital Network
Both a 12-week and a 24-week regimen of three oral antiviral drugs achieved sustained viral remissions at 12 weeks in up to 94% of treatment-naive patients with genotype 1 hepatitis C virus infections....

Hepatitis C: Vertex Announces VX-135 with Daclatasvir (SVR4) Data
(VX-135) is still on partial clinical hold by the FDA in the U.S. -  
Vertex’s VX-135 partial hold

Bristol-Myers Daclatasvir Hepatitis C Treatment to Get Faster Review by the European Medicines Agency
"The application seeks the approval of daclatasvir for use in combination with other agents, including sofosbuvir, for the treatment of chronic hepatitis C."

HCV Newsletters 

2014 Hepatitis Newsletters
***Just updated
Welcome to 2014 folks, where did the year go? Once again we have an array of informative newsletters put together by incredible people completely devoted to HCV awareness and education. 

Worth A Click

Hepatitis C: Cure or Remission?
Every expert I know, including several presidents of the American Association for the Study of Liver Diseases are calling hepatitis C a curable disease.

People With HCV Die Decades Earlier Then Persons Without The Disease
Hepatitis was listed as a cause of death for more than 18,000 people in 2010 in the United States, and the deaths occurred 22 to 23 years earlier than in patients not listing such infections as a cause of death, a study determined.

How to Prepare for Hep C Triple Therapy
In Preparing for Hep C Triple Therapy you need understanding of treatment side effects and how to deal with them effectively. Learn helpful tools and tips that have worked for other Hep C patients in their treatment experience
Part 1
Part 2

HCV Genotypes 

Genotype 4, 5 and 6
Review article: the epidemiology and therapy of chronic hepatitis C genotypes 4, 5 and 6
The current standard-of-care therapy for HCV genotypes 4, 5 and 6 is pegylated interferon and ribavirin for 48 weeks. A shorter course with 24 weeks of therapy may be considered for patients with genotype 6. Newer and much more effective therapies may be forthcoming in the next few years.

HCV F1/F2 Treat Now Or Wait?
Discusses treating genotype 1-6

Optimizing treatment for HCV genotype 4: PEG-IFN alfa 2a vs. PEG-IFN alfa 2b; the debate continues
Hepatitis C virus (HCV) remains one of the leading causes of morbidity and mortality worldwide. Combined therapy with pegylated interferon (PEG-IFN) and ribavirin is the current standard of care treatment for HCV genotype 4. Two types of PEG-IFN are commercially available. The limited number of trials that were conducted for HCV genotype 4 and the few head to head comparisons make it impossible to know which is the best option? In this article we review all available PEG-IFN trials performed worldwide for HCV genotype 4 since 2004. Unless another molecule is developed as a standalone for the treatment of HCV, PEG-IFN will continue to be a source of debate. 

Genotype 3
Treatment of hepatitis C virus genotype 3-infection
Interesting results have been reported in genotype 1- patients without cirrhosis who received quadruple or quintuple combination ABT-450 boosted by Ritonavir, the ABT-267 NS5A inhibitor, in association or not with the NS5B non-nucleos(t)idic polymerase inhibitor ABT-333 and RBV for 8 to 12 weeks. The SVR12 rates were from 87 to 97% in naïve patients and 93% in experienced non-responders, including 100% in subtype 1b patients [37]. Trials have begun with these combinations in genotypes 2- and 3- patients. Similarly, a combination of Daclatasvir, Asunaprevir and a non-nucleosidic polymerase inhibitor (BMS-791325) resulted in a SVR in 95 to 100% of naïve genotype 1 patients. Trials in genotypes 2 and 3 are ongoing [38].... 

Genotype 2
How to optimize current treatment of genotype 2 hepatitis C virus infection
The standard of care (SOC) for hepatitis C virus (HCV) genotype 2 is pegylated interferon (PEG-IFN) plus ribavirin (RBV). Even though most patients can be cured with this therapy after 24 weeks, tailoring treatment can improve its safety and efficacy in special populations. Thus, shortening treatment together with a weight-based RBV dosing approach has been considered satisfactory in patients with positive predictors of response. With the development of the direct antiviral agents (DAAs), shorter, better tolerated and more efficient treatments for HCV genotype 2 will become available, including interferon-free regimens. Until these new treatments are released, the decision to treat patients with HCV genotype 2 with currently approved drugs or to wait for future options must be made, taking into account the stage of fibrosis. 

Genotype 1
Is there still a role for PEG IFN+RBV therapy in patients with HCV genotype 1? (pages 11–12)
Boceprevir and telaprevir-based triple therapy is now the standard of care for the treatment of genotype 1 patients. However, dual therapy with pegylated interferon and ribavirin should be discussed in treatment-naïve patients with good predictors of response. A recent published trial has shown in non-cirrhotic patients with low viral load at baseline, similar efficacy of a 24-week course of dual therapy vs a 24-week course of boceprevir-based triple therapy in case of rapid virological response. Accordingly, addition of protease inhibitor should be discussed after 4 weeks of dual therapy in this easy-to-treat population.

Alternative Treatments For HCV
Review article: management of chronic hepatitis C in patients with contraindications to anti-viral therapy
Therapeutic strategies and lifestyle interventions that can be used to improve liver damage in patients with chronic hepatitis C who cannot receive or refuse interferon-based treatments.


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