Sunday, November 6, 2016

HCV Reading: AASLD Key Abstracts Reviewed By Pacific Hepatitis C Network

HCV Weekend Reading: Week In Review
Hello everyone, here is a look back at last weeks publications, headlines, and hot topics including today's news with updates as the day progresses.

What's New
This month Pacific Hepatitis C Network (PHCN) just started a news in review newsletter. Don't miss a two part blog post summarizing key HCV abstracts that will be presented at next weeks American Association for the Study of Liver Diseases 67th annual meeting. Next read through Hep C Tip News, with information about the latest drugs to treat hepatitis C. Finally stay updated by joining Pacific Hepatitis C Network's mailing list.

AASLD 2016 Updates On This Blog
AASLD 2016 Conference Updates

Digest Of News
In addition review important HCV headlines in the latest edition of The Weekly Bull online over at HepCBC.

Follow the links provided further down this post to review highlights from both Canadian publications.

Health Review - A User's Guide to the Common Cold
Johns Hopkins Fall/Winter 2016 Health Review is out, with expert advice on how to survive the flu and cold season; A User's Guide to the Common Cold. Another article of interest; Understanding Inflammation about chronic inflammation and its effects on the body is featured in the Spring/Summer 2016 issue.

In Case You Missed It
The November index of HCV newsletters was recently updated to include three new publications, begin here.

Hot Topic - In Today's News
Nov 6
Buyers clubs for cheaper drugs help fight hepatitis and HIV
A Indian-made course of treatment for the liver-destroying disease hepatitis C, meanwhile, can be had for around 1,000 pounds against a list price for branded drugs of around 35,000.Gilead is also a leading producer of patented hepatitis C drugs, along with Merck and AbbVie.

Published Nov 2
Watch - An Introduction to Access to Generic Hepatitis C Medicines
Following the success of the first two webinars in the Knowledge for Change series covering access to diagnostics and medicines, we were pleased to deliver the next in the series, ‘An Introduction to Accessing Generic Hepatitis C Medicines’ on 1 November. The webinar explored the generics landscape for hepatitis C with discussions on legalities, quality and performance of generics medicines as well as providing examples of how people across the globe are accessing them.

Todays' News
Nov 7
Bayer applies for Regorafenib authorization to treat liver cancer
German drugmaker Bayer on Monday said it submitted an application to have its cancer drug Regorafenib approved for the second-line treatment of liver cancer patients following successful clinical trials.

Nov 6
Lawmakers Hear From Organ Harvesting Investigators
In 2006 international human rights lawyer David Matas and former Crown attorney and cabinet minister David Kilgour first released an initial investigative report into allegations of live organ harvesting in China; Kilgour-Matas Report. Read their latest report, released in June, at a House of Commons hearing on Nov. 3, along with other articles on recent advocacy efforts and government solutions.

Cairns leads regional Queensland in roll out of new hepatitis C drug
“In Australia there’s about 250,000 people with hepatitis C and we think, since the medication has become available on March 1, we’ve treated nearly 40,000 people Australia-wide.”

NM aims to control hepatitis C costs

Albuquerque Journal
Last year, the New Mexico Medicaid program spent $36.5 million for hepatitis

Recent News and Research
Nov 7
​All Genotypes​
Concise review: Interferon-free treatment of hepatitis C virus-associated cirrhosis and liver graft infection
Chronic hepatitis C is a major reason for development of cirrhosis and a leading cause for liver transplantation. The development of direct-acting antiviral agents (DAA) offered new therapeutic options for patients with advanced cirrhosis and liver graft recipients. This review gives a high topical summary of most current therapeutic options of DAA-based antiviral therapy in patients with hepatitis C virus associated cirrhosis before and after liver transplantation.

Nov 4
Shorter Hep C Regimens Hot Topic at the Liver Meeting
Medscape-40 minutes ago
BOSTON — Shortening the length of curative regimens for hepatitis C treatment will be one of the hot topics here at The Liver Meeting 2016. One study likely to ...
Reported by Jules Levin
IDWeek Oct 26-30
New Orleans 2016

Sofosbuvir/Velpatasvir Plus Voxilaprevir for 6, 8, or 12 Weeks in Genotype 1-6 HCV-infected Patients: An Integrated Analysis of Safety and Efficacy from Two Phase 2 Studies

Safe and effective sofosbuvir-based therapy in patients with mental health disease on hepatitis C virus treatment
The prevalence of mental health disease (MHD) among patients with chronic hepatitis C virus (HCV) can be high. However, patients with MHD may be marginalized with respect to HCV therapy and MHD is one of the most frequently cited reason for exclusion from HCV therapy. HCV therapy has evolved from interferon-based to directly acting antiviral (DAA)-based therapy with excellent tolerability and efficacy. Our study found that baseline MHD did not impact efficacy nor treatment adherence to sofosbuvir-based therapy. Furthermore, we found that Becks Depression Inventory scores improved with sofosbuvir-based therapy, suggesting that HCV treatment with the newer DAA therapies may have additional mental health benefits.​

Alcohol use disorder and its impact on chronic hepatitis C virus and human immunodeficiency virus infections
Alcohol use disorder (AUD) and hepatitis C virus (HCV) infection frequently co-occur. AUD is associated with greater exposure to HCV infection, increased HCV infection persistence, and more extensive liver damage due to interactions between AUD and HCV on immune responses, cytotoxicity, and oxidative stress. Although AUD and HCV infection are associated with increased morbidity and mortality, HCV antiviral therapy is less commonly prescribed in individuals with both conditions. AUD is also common in human immunodeficiency virus (HIV) infection, which negatively impacts proper HIV care and adherence to antiretroviral therapy, and liver disease​...

Prevention of Progression to Cirrhosis in Hepatitis C With Fibrosis
Are direct-acting anti-virals cost-effective treatment for patients with HCV infection with liver fibrosis who are at high risk of progression to cirrhosis?

Evidence shows value of treating all stages of chronic HCV
Evidence from 38 studies, involving 73,861 patients, showed a significant mortality benefit of achieving SVR in patients with all stages of fibrosis. Long-term studies with follow-ups of five to 12 years suggested that, particularly among non-cirrhotic patients, there was a significant decrease in mortality in SVR versus non-SVR groups.

MRE, MRI-PDFF best other techniques for detection of fibrosis, steatosis
Recent findings show magnetic resonance elastography was more accurate for detecting liver fibrosis vs. transient elastography, and MRI-based proton density fat fraction was more accurate than controlled attenuation parameter for detecting steatosis, in patients with biopsy-proven nonalcoholic fatty liver disease.​

Biopsy Not Needed to Track Impact of Direct-Acting Antivirals
Noninvasive technology can accurately measure liver stiffness and track progress in liver disease cure.

News In Review
The Pacific Hepatitis C Network
The Pacific Hepatitis C Network’s mission is to strengthen the capacity of individuals and organizations throughout British Columbia to prevent HCV infections and improve the health and treatment outcomes of people with HCV.

One of its projects is the Hepatitis C Treatment Information Project your web-based hepatitis C treatment information toolkit for entering into that world and building your understanding about hep C treatment.

The Pacific Hepatitis C Network‘s News in Review Newsletter
November 5, 2016
Welcome to the Pacific Hepatitis C Network (PHCN)‘s very first hepatitis C news in review newsletter. This is where we review all of the major issues and events around hepatitis C and hep C treatments. It is an email that includes links to all of our recent blog posts—including the blog post about the big news surrounding the hep C treatment Epclusa (generic name: sofosbuvir/velpatasvir).

Epclusa (generic name: sofosbuvir/velpatasvir), developed by Gilead Sciences Canada, Inc., just passed its Common Drug Review with the release of the Canadian Drug Expert Committee (CDEC) Final Recommendation. Click here to read more about their recommendation sent to the provinces and territories to help them decide on whether or not to cover the treatment and how to cover it.

In October, Daryl Luster wrote two blog posts for the Pacific Hepatitis C Network. Daryl is a hep C advocate who is PHCN’s president, a member of the Executive Steering Committee for Action Hepatitis Canada (AHC), a counselor for the Help-4-Hep helpline, and the administrator of multiple peer support groups. In 2010, Daryl was cured of hep C while participating in a clinical trial. The two blog posts he wrote were:

DAAs: Long Term Effects
AHC BC Regional Meeting: October 18-19

The Liver Meeting 2016, the American Association for the Study of Liver Diseases (AASLD)‘s 67th annual meeting, will be held in a week. Last year’s meeting drew more than 9,500 international hepatologists and hepatology health professionals to San Francisco to discuss the latest treatments and research for liver diseases. This year, Boston, Massachusetts, will be hosting the meeting and, as always, the meeting promises to be exciting.

To celebrate the meeting and all of the amazing discoveries that will be presented, the Hepatitis C Treatment Information Project wrote the following blog posts summarizing and highlighting some of what will be presented about hep C treatments:

The Liver Meeting 2016 Hep C Abstract Highlights (Part1)
The Liver Meeting 2016 Hep C Abstract Highlights (Part2)
Live Stream Sessions from The Liver Meeting 2016

The Basics Series by the Hepatitis C Treatment Information Project is a series of blog posts about the very basics about hep C and hep C treatments. So far, the series has five issues, entitled the following:
Hepatitis C Genotypes: The Basics
Pan-Genotypic Hepatitis C Treatments: The Basics
To treat or to wait? That may be the question with hep C treatment.
Treatments Covered by BC PharmaCare for Hep C Genotypes 1a/1b
Treatments Covered by BC PharmaCare for Hep C Genotypes 2-6

For more information about the topics in this newsletter, please click on the links, visit PHCN’s Hepatitis C Treatment Information Project, or email us.

HepCBC is a non-profit organization run by and for people infected and affected by hepatitis C. Our mission is to provide education, prevention and support to those living with HCV.

Weekly Bull
Friday, November-4-16 
News in Brief

Pan-Genotypic Hep C Drug Epclusa™ Recommended for PharmaCare Coverage by CADTH
November 4, 2016
Epclusa™, a Direct-Acting-Antiviral combo for ALL GENOTYPES of Chronic Hepatitis C, received approval from CADTH on October 28, 2016. This combo of (generics) sofosbuvir and velpatasvir, from Gilead Sciences, was recommended by CADTH’s Canadian Drug Expert Committtee (CDEC) for reimbursement by provincial and territorial PharmaCares.

BC Ministry of Health’s Refusal to Reimburse Critical Drug “Zaxine™” for Hepatic Encephalopathy
November 4, 2016
BC Ministry of Health sent a puzzling reply to HepCBC’s request for reimbursement of hepatic encephalopathy drug rifaximin (Zaxine™). BC is the only province/territory which does not cover it; many of BC’s End Stage Liver Disease (ESLD) patients are suffering from preventable brain damage because of this. This drug has been shown to be of great benefit to patients suffering from ESLD, either in combination with lactulose, or instead of lactulose in cases where lactulose does not work. Nevertheless, BC is still refusing to cover it.

Who sets the maximum price allowed for patent medicines in Canada, including hep C treatments?
November 4, 2016
The “Patented Medicine Prices Review Board” (PMPRB) does! PMPRB asked patient groups for feedback on proposed changes to PMPRB’s mandate. In our submission, HepCBC asked for maximum pricing to reflect “prevalence” of a disease (how many people have it), because the more treatments you can sell, the more you can lower your price and still make the same or better profit. We advocated for pricing which is more in line with European rather than American prices. We also advocated for an “Equitable Profit Margin”. We said it is not so important to patients if Research and Development is done in Canada as long as clinical trials are conducted here. Read HepCBC’s full (8 page) submission:

These researchers think they have a solution to the global crisis in drug prices
November 4, 2016
Jerome Zeldis remembers exactly how he felt when he heard about the $84,000 price tag on a powerful new hepatitis C treatment three years ago. “I was somewhere between annoyed and outraged,” recalled Zeldis, the former chief medical officer of the biotech juggernaut Celgene. So he has started Trek Therapeutics as a public benefit corporation – a relatively new type of corporate structure that places public welfare on equal footing with profit.

DAA Combination Treatment Fast and Effective for Hepatitis C
November 3, 2016
Sofosbuvir, velpatasvir, and voxilaprevir for 8 weeks does the trick across all genotypes, treatment experienced, DAA relapse or cirrhosis! Two phase 2 studies of combination direct-acting antiviral agent (DAA) treatments were published recently in Gastroenterology. They were accompanied by an editorial simply titled “Hepatitis C Therapy: Game Over!”

What Are the Out of Pocket Costs for Harvoni, Viekira Pak and Epclusa under Medicare Part D?
November 3, 2016
We often get asked this question by American visitors to our site, and we hope this page will help provide the answers you need. Not all drugs are covered by Medicaid but there are “coupons” that you can use. The information is from GoodRX. This is for the USA only.

Vietnam vets urged to receive hepatitis C testing
November 2, 2016
American Legion Post 1619 is working on a statewide awareness campaign and urging all Vietnam-era veterans to get tested for hepatitis C. Two free clinics are scheduled for Nov. 4 and 5 in Morrisonville. MORRISONVILLE NY — The boot camp ritual was robotic in its precision. Soldiers lined up for their vaccination shots. Needles were outdated, “jet guns” were in, and soldiers received high pressure blasts of an 18-drug cocktail before being shipped off.

Acute hepatitis after heavy energy drink use ‘a warning to the consumer,’ liver specialist says
November 1, 2016
Construction worker relied on 4 to 5 bottles a day to get through his shift A construction worker who consumed an excessive amount of energy drinks developed a rare case of acute hepatitis, say doctors who want patients to know about the potential risks to the liver from such over-consumption.

HCV reinfection common in MSM with HIV
November 1, 2016
In a retrospective study, researchers found that hepatitis C virus reinfection is common among HIV-positive men who have sex with men after successful treatment and spontaneous clearance. “A subsequent high incidence of HCV reinfection has been reported regionally in men who both clear the infection spontaneously or who respond to treatment.

Recurrent viremia infrequent in hepatitis C
November 1, 2016
The prevalence of recurrent viremia was low among patients with hepatitis C who achieved sustained virologic response, data from a recently published study demonstrate. Among those patients who did experience late recurrent viremia, most had HCV reinfection. (HCV reinfection common in MSM with HIV).

Two genes linked to increase in immunity to hepatitis C after childbirth, study shows
October 31, 2016
Alternative forms of two genes are associated with a boost in immunity to hepatitis C after childbirth, a study led by a Nationwide Children’s Hospital physician-researcher shows. At three months postpartum, the number of viruses circulating in the blood declined sharply in most women who carried particular versions of IFNL3 and HLA-DPB1 genes. Mothers lacking these gene variants experienced little change in viral levels after delivery.

Tampa Bay woman with Hepatitis C reduces co-pay for treatments with coupon
October 31, 2016
PASADENA, FL (WFLA) — The FDA has approved several new cures for people fighting chronic diseases, but the problem is, many people can’t afford the drugs and insurance companies will cover only the sickest patients. That includes a drug now on the market for people with Hepatitis C called Harvoni — a pill that patients take for 8 to 12 weeks. Wendy Latorre, of Pasadena, says when she heard about the drugs she was extremely hopeful. “And then she found out the cost!

Dating after Hepatitis C: Hope on the horizon for the 1 in 30 boomers estimated to be infected
October 30, 2016
Baby boomers are 6 times more likely to be infected than other adults. We need to talk about testing and treatment. Recently I went on a first date — a stroll in a city park — that went rather well. We had so much in common, from a love of reading to a history of youthful troublemaking. If I wasn’t convinced already he was someone I could relate to, my new friend shared that he’d been cured of Hepatitis C. I could hardly believe it.

Why all those discarded needles are signs of progress for HIV, Hep C in Southern Interior
October 29, 2016
THOMPSON-OKANAGAN – Nearly 400 new Hepatitis C cases and as many as 15 HIV cases were recorded by Interior Health last year, and most were caused by injection drug use. The numbers may seem surprisingly high, but are average compared to recent years, according to senior medical health officer Dr. Trevor Corneil, who says they’ve actually been on an overall downward trend over the past 15 years with the advent of harm reduction strategies.

Generic hepatitis C drugs purchased online achieve high cure rates
October 28, 2016
Use of generic versions of direct-acting antivirals resulted in very high cure rates for people who obtained the products through three buyers’ clubs, indicating that the generic products are effective, according to three presentations at the International Congress on Drug Therapy in HIV Infection (HIV Glasgow) this week. People who purchased the drugs were cured of hepatitis C at a cost of around $700-$900 in South-East Asia and Eastern Europe.

I have a little news of my own, I just found out my son is getting married! Enjoy the rest of your weekend folks.


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