Thursday, August 14, 2014

August Hepatitis Newsletters;The good, the bad and the ugly of the new treatments for hepatitis C virus

Hepatitis C Newsletters

Welcome to this months edition of Hepatitis Newsletters, published by advocacy groups devoted to increasing awareness and information about viral hepatitis.

Sit back and enjoy a review of July and August news with articles covering everything from Milk Thistle, conditions outside the liver, to new drugs to treat hepatitis C.

We begin with this months issue of "Annals of Hepatogly" with an article addressing the cost of new HCV therapies.

The good, the bad and the ugly of the new treatments for hepatitis C virus
September - October, 2014
Vol. 13 Issue 5

The good, the bad and the ugly of the new treatments for hepatitis C virus
The cost of new hepatitis C treatments
Karen V. Silva-Vidal, Nahum Méndez-Sánchez. Liver Research Unit ...

Reducing the cost of new hepatitis C drugs
An index of current articles expressing concerns about the pricing of Gilead's Sovaldi.

In case you missed it, this week a new section was added to AASLD/IDSA Hepatitis C guidelines; When and in Whom to Initiate HCV Therapy.

The American Association for the Study of Liver Disease (AASLD) and the Infectious Diseases Society of America (IDSA), in collaboration with the International Antiviral Society-USA (IAS-USA), today released the latest section of their website,, which assists clinicians treating patients with hepatitis C virus (HCV). The new section is titled, "When and in Whom to Initiate HCV Therapy.

With the addition of the new section, now offers clinicians information on how to prioritize treatment for those patients who will derive the most benefit or will have the greatest impact on limiting further HCV transmission. Highest priority should be given to patients with advanced fibrosis with compensated cirrhosis and liver transplant recipients and high priority given to patients at high risk for liver-related complications and severe extra-hepatic HCV complications. The guidance provides further detailed information on additional conditions that warrant prioritization of treatment.
Continue reading...

Article published in MedPageToday

Guidelines: Treat Sickest HCV Patients First

Published: Aug 11, 2014

Patients with less advanced fibrosis but other life-threatening complications, such as cryoglobulinemia, should also be at the head of the list for new direct-acting treatment regimens, Jensen told MedPage Today during a teleconference on the new guidelines.

The societies launched their guidelines in January to help physicians cope with an expected demand for treatment as new regimens reach the clinic.

Unusually, the guidelines are online and under constant revision, making them a "living document" that can cope with a rapidly changing field, according to Michael Saag, MD, of the University of Alabama at Birmingham, the guidelines co-chair for IAS-USA.

The latest addition, reporters were told, is a section on when -- and in which patients -- to initiate therapy.

An estimated 3 million to 4 million Americans have chronic HCV and about half are not aware of it. Many will develop advanced liver disease or liver cancer.

The advent of the novel direct-acting agents -- the first were approved in 2011 -- offers the possibility of eradicating the disease in a "very high percentage" of patients, Jensen said.

The guidelines argue that all patients with chronic HCV could benefit from treatment -- but some need it more urgently than others, he added. Not all patients "can receive treatment immediately upon the approval of new agents," he said. "From a clinical perspective, we are most concerned with those with severe liver disease," he said. The guidelines do not directly address the issue of the cost of the some of the new agents, which has raised concern about the impact on the healthcare system if many thousands of patients seek therapy.

"We hope that the cost issues will be sorted out in another venue," Jensen said, "but it's really patient-directed care that we're concerned about."

"We understand that the system is struggling because these medications are expensive," Saag added, "and we need to provide some at least indirect guidance on who has the highest priority."

The CDC is currently recommending that all Americans born from 1945 to 1965 be tested at least once for HCV, since studies suggest that about 2 million of them have the virus.

One goal of the guidelines is to create a larger clinical workforce capable of treating patients with HCV, especially if that testing takes hold and a large number of people suddenly begin demanding treatment.

"There aren't enough hepatologists in the United States to see all these patients," Saag said. "These guidelines will be able to help educate not only those who are very expert in the field about new and emerging treatment trends, but also to educate those who are perhaps new to the treatment of hepatitis C."

Bloggers Corner

Lucinda K. Porter, RN
Hepatitis C and Milk Thistle
A patient wrote to me this week, asking what I thought of a particular protocol purporting to cure hepatitis C. The protocol uses a variety of herbs, mostly milk thistle. I told her that I don’t believe that herbs can cure hepatitis C. I think that when used appropriately, herbs may help a variety of ailments, but when it comes to curing hepatitis C, we haven’t yet found an herbal path..

Watching the world get better

August Newsletters 

Project Inform believes it is possible to create the first generation free of HIV and hepatitis C within the next decade. To achieve that dream, we focus our work in four areas: drug development, bio-medical prevention, education and health care access.

Project Inform launches new provider toolkit for screening hepatitis C in people living with HIV
This month, Project Inform launched “A Toolkit for Screening, Counseling and Patient Education: Hepatitis C Infection and People Living with HIV,” which includes materials for medical providers and other health care staff as well as patient fact sheets.

It is estimated that at least 300,000 people or 25% of those living with HIV are also infected with hepatitis C. HCV-related liver disease is the leading non-AIDS cause of death in HIV-infected patients, and HCV disease progression is more rapid in this group, making detection of both acute and chronic hepatitis C extremely important in clinical practice.

To request a free copy of the toolkit, fill out the order form here, or email Andrew Reynolds, Hepatitis C Education Manager, at

Project Inform can help clients and patients living with co-infection, or who are at risk of HCV infection, with additional educational materials and services. Our three-booklet Health and Wellness series for patients living with HIV and HCV is one resource. You can order sets here.

Additionally, providers can direct patients to the national hepatitis C helpline, HELP-4-HEP at 1-877-Help-4-Hep (877-435-7443). Trained counselors and health educators are available to talk with your patients Monday-Friday, 9am to 7pm EST. You can also order HELP-4-HEP posters, brochures and tear pads here.

Project Inform’s wrap-up from World Hepatitis Day 2014
In honor of World Hepatitis Day, which is observed on July 28 every year and is one of only four disease-specific days recognized by the World Health Organization (the others being tuberculosis, malaria, and HIV), Project Inform participated in two events in Washington, DC. The first…

Help Lines
HELP-4-HEP (hepatitis C helpline)
Toll-free at 1-877-435-7443 Monday–Friday, 9am–7pm (Eastern Time). 
Learn more.

HIV Health InfoLine
Toll-free at 1-800-822-7422 Monday–Friday, 10am–4pm (Pacific Time), call-back service only. English only. 

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The HCV Advocate newsletter is a valuable resource designed to provide the hepatitis C community with monthly updates on events, clinical research, and education. 

HCV Advocate News & Pipeline Blog
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HCV Advocate Newsletter

August Newsletter

In This Issue:

Alan Franciscus, Editor-in-Chief
This month Alan discusses Daklinza and Sunpreva from BMS, AbbVie's 3D, the Olysio/Sovaldi combination and the side effects of some of these new medications. 

Lucinda K. Porter, RN
Lucinda reviews studies on genotype 3, cirrhosis and cancer; HCV and end-stage kidney disease; alternatives to liver biopsy, and testing policy. 

Lucinda K. Porter, RN
This month Lucinda talks about hepatic encephalopathy, and what happens when liver disease hijacks the brain.

Alan Franciscus, Editor-in-Chief
This month Alan talks about extrahepatic manifestations of hepatitis C, such as vasculitis, glomerulonephritis, cryoglobulinemia and non-Hodgkin lymphoma and the need for physician awareness of these conditions—especially now that the new treatments are becoming available.

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Connect With HCV Advocate
Hep is an award-winning print and online brand for people living with and affected by viral hepatitis. Offering unparalleled editorial excellence since 2010, Hep and are the go-to source for educational and social support for people living with hepatitis.

August News

August 13, 2014
When Positive Hep C Tests Go Unconfirmed, Care Can Go Awry
In the event that individuals receive an unconfirmed positive test for hep C, they are subject to cracks in the health care system and potentially unnecessary care.

August 11, 2014
New Clinical Guidelines Prioritize Care Among Hep C Patients
Two clinical groups have issued new hepatitis C treatment guidelines that instructs clinicians on how to prioritize care among patients seeking a cure.

August 06, 2014
Donors Only Reaching 7% of Global Harm Reduction Needs
Major international donors are only spending 7 percent of the estimated funding needed to support harm reduction for injection drug users worldwide.

Program for Drug-Using Couples Lowers Hep C and Risky Sex Rates
An intervention for couples who use drugs lowers their risk of contracting hepatitis C virus as well as raises their rate of condom use.

August 04, 2014
Olysio-Sovaldi Cures High Rates of Hepatitis C Genotype 1
Twelve weeks of Olysio (simeprevir) and Sovaldi (sofosbuvir) cures high rates of genotype 1 of hepatitis C without the need for ribavirin.

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Liver Lowdown is the monthly general interest e-newsletter of the American Liver Foundation.

July/August 2014 Edition - Not Yet Published....
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The hepc.bull, has been “Canada’s hepatitis C journal” since the late 1990′s and has been published nonstop since 2001. The monthly newsletter 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.

August Newsletter

In This Issue
RX&D Rebuttal /Review 2 New Drug
Co-infection: Bob’s Story / Hep C News 
RhoGAM/ Marathon News / Percuro 2
What is a Fibroscan? 

Stay Connected

The New York City Hepatitis C Task Force is a city-wide network of service providers and advocates concerned with hepatitis C and related issues. The groups come together to learn, share information and resources, network, and identify hepatitis C related needs in the community. Committees form to work on projects in order to meet needs identified by the community. 

NYC Viral Hepatitis Monthly E-Newsletter

August Newsletter

In this Newsletter

New Provider Resources
Updated City Health Information (CHI): Diagnosing and Managing Hep C: Clinical guidance for medical providers.

Updated Hep C Dear Colleague Letter from the NYC Commissioner of Health.New Video PSA | Protect Your Family: Get Tested for Hepatitis B. 30 sec in English, CantoneseMandarin, Korean & Vietnamese.

Hep C: Get Tested, Get Cured! 32 second video illustrating the risks of Hep C, and the importance of testing and treatment. Share widely!

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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. 

Current Issue (Vol. 8 No. 8 August 2014): Download PDF Or View Interactive Issue

In This Issue
Fewer than 10% of HCV patients finish treatment
Sofosbuvir achieves SVR12 in patients with HCV + HIV
Interferon-free regimens yield 96%-100% SVRs
Everolimus fails to improve HCC survival

Stay connected

Hep C Connections - Website
Our mission is to educate the general public about hepatitis C and to provide resources and support for those affected by the virus. Hep C Connection offers a helpline to answer your questions regarding hepatitis C (HCV). You can expect respect, patience & understanding, in clear, jargon-free language from our staff & volunteers. Call 1-800-522-HEPC (4372) today!

In This Issue
Support Groups
Upcoming Events
Articles of Interest
Financial Resources
Featured Clinical Trials

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Welcome to the new HCV Action website, the home of the UK’s hepatitis C professional community. Browse our tailored resource libraries, view our case study map or find out more information, here.

The HCV Action network brings together health professionals from across the patient pathway, including GPs, specialist nurses, clinicians, drug action teams, public health practitioners, prison healthcare staff and commissioners. We provide resources for commissioners, medical and drug services professionals, promoting good practice in HCV care across the UK.Visit their new website, here. 

News Updates
South Asian community: get advice on hep C at the Birmingham Mela
Scottish study: hepatitis C in the gay community

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Hepatitis Foundation International 
The Hepatitis Foundation International is dedicated to liver health and the prevention of liver related diseases. We inform and educate by making available reliable and up-to-date facts. We want you to make well-informed decisions for yourself and your loved ones' health and well-being. We are proud to present this website as your personal Internet gateway to hepatitis information and liver care.

In This Issue Of Health-e Bytes
HFI In The Know

Health Observances
Advocacy Alert
World Hepatitis Day

HFI Launches Patient Registry
Grand Rounds
Science, Research and Medical Updates

Hepatitis Highlights 
By Regions (WHO) 
Helping Hands

HFI’s Fundraising Appeal Activities
There's An App for That 
Health Information for your Mobile Phone and Tablets

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Of Interest

A monthly newsletter from the National Institutes of Health, part of the U.S. Department of Health and Human Services

Scientists detail urgent research agenda to better understand, address chronic disease toll
Health care systems that keep HIV patients from dying early in low- and middle-income nations need urgently to be repurposed to treat the chronic diseases that many of these patients now have, experts say.

Featured In The August Issue

Illustration of a patient being treated in a hospital room.Surviving Sepsis
Taming a Deadly Immune Response

Many people have never heard of sepsis, but it’s one of the top 10 causes of disease-related death in the U.S.

Read more about sepsis.

Can You Recognize a Heart Attack or Stroke?
What To Do When Every Moment CountsIllustration of a woman steadying herself against a wall while a concerned passerby makes a call for help.

How would you react to a medical emergency? When it comes to life-threatening conditions like heart attack or stroke, every minute counts. 

Healthy You

Hepatitis C - Understanding The Liver, and Cirrhosis
Watch a few innovative videos offering a better understanding of HCV, how the liver works, possible disease complications, and a quick look at treatment, brought to you by Armando Hasudungan and Joe Galati, M.D.

This morning from NPR

Just So You Know

"HCV Next" Is In The News

Published August 11, 2014

University at Buffalo experts in the Division of Gastroenterology, Hepatology and Nutrition are contributing co-authors to HCV Next, the first multidisciplinary publication focused exclusively on the hepatitis C virus.

In Case You Missed It.....
Millennials, Drugs and HCV
HCV Next, July/August 2014

Available in print and on the website, the magazine offers context and perspective on the latest research developments. It is designed to inform and educate an estimated 10,000 specialty and general physicians who diagnose and treat HCV.

Content also helps patients understand the disease and new treatment options that may be available to them.

Collaboration, Communication Among Specialists is Key

“With the rapid pace of drug development in HCV as well as the development of regional centers of excellence in hepatology — such as we have recently established here at UB within clinics — there is a tremendous need for rapid dissemination of new information for physicians of all specialties,” notes Andrew H. Talal, MD, MPH, professor of medicine and a member of the HCV Next editorial board.

“HCV Next is attempting to fill that void.”

“Contributing to this publication offers an excellent opportunity to promote the faculty and trainees here at UB on the national stage as leaders in the field,” he adds.

“It also helps establish UB as a leader in the eyes of the pharmaceutical industry, which can help attract clinical trials, allowing us to offer cutting-edge therapies to patients before they are widely available.”

In a May/June 2014 HCV Next interview, co-chief medical editor Ira M. Jacobson, MD, emphasized the importance of collaboration and open communication among liver and infectious disease doctors and addiction medicine specialists to address the multiple needs of patients.

Jacobson, the medical director of the Center for the Study of Hepatitis C in New York City, notes that Talal has led efforts to create physical spaces where patients are seen by multidisciplinary specialists.

At Buffalo General Medical Center, for example, “our liver clinic involves gastrointestinal fellows, pharmacists, internists, hepatologists and addiction medicine specialists who all see patients with various forms of liver disease,” says Talal. “We also have research nurses who consult with potential subjects for clinical trials.”

UB Items Discuss Pregnancy, Abnormal Proteins

In addition to Talal, HCV Next co-authors have included the following UB faculty members and physician-trainees in the gastroenterology, hepatology and nutrition fellowship program:
Manoj Kumar, MD, MPH, clinical assistant professor
Thomas C. Mahl, MD, clinical professor and interim chief of the division
Anthony D. Martinez, MD, clinical associate professor
Alia Hasham, MD, fellow
Sandeep T. Samuel, MD, fellow

Talal, Kumar and Hasham co-authored the patient profile, “The Challenge of Pregnancy in HCV Infection,” in the magazine’s premiere January/February 2014 issue.

“Since pregnancy modifies host-virus interactions, it is crucial to understand clinical manifestations of the infection and its effect on the overall magnitude of the disease, its diagnosis and management,” notes Talal.

“Physicians also should understand the effect of pregnancy on HCV immunity and appreciate the factors that influence mother-to-child viral transmission.”

Samuel, Talal and Martinez co-authored “Current Concepts on the Patient With HCV and Cryoglobulinemia,” a patient profile in the March/April issue. The article discusses current best practices for treating HCV patients with abnormal blood proteins.

Hasham and Mahl collaborated on “The Patient With NAFLD and Chronic HCV” for the July/August issue. This patient profile discusses diagnosis and care for HCV patients with non-alcoholic fatty liver disease.

Need for HCV Information Will Likely Grow

According to the World Health Organization, more than 150 million people carry the virus and more than 350,000 people die every year from HCV-related liver disease.

The need for HCV information will likely grow, as newly approved treatments are adopted and evolve.

In addition, more people are expected to be diagnosed with the infection, as new U.S. Centers for Disease Control and Prevention guidelines call for screening all people born between 1945 and 1965. A New York State law now requires health care providers to offer HCV screening to patients in this age group.

Magazine Published 6 Times Each Year

HCV Next is published every other month by the New Jersey-based SLACK Incorporated, publisher of Infectious Disease News.

Topics include diagnostics, practice management issues, drug interactions and the treatment of patients with comorbidities.

Stay healthy and happy, until next time.

Always Tina 

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