Tuesday, April 4, 2017

Hepatitis C Blog, Journal and Newsletter Update For April 2017

April Updates
I love April, Easter is just around the corner, a favorite holiday for all the little people in our family. Living here in Michigan I sure do look forward to spring, although it seems to be starting off slow this year.

In any event thanks for stopping by, welcome to this month's collection of blog, journal and newsletter updates.

In The News
The hepatitis market is experiencing a revolution due to new types of treatments, and patients are benefitting. Where are we with this global disease?

Pharmacists can help optimize care in patients with hepatitis C virus
Drug-drug interactions (DDIs) are common in patients taking hepatitis C virus (HCV) medications, and the involvement of a clinical pharmacist could benefit the interdisciplinary hepatology team, researchers reported in the World Journal of Gastroenterology

Revived GOP health care talks could hurt those with pre-existing conditions
They could also opt not to cover the treatments needed by patients with costly illnesses, such as cancer, diabetes and hepatitis C. That would work out well for ...
SAN FRANCISCO (CN) — A Chicagoland pharmaceutical company claims in court that Swiss drug giant Novartis “has sought to patent the hepatitis C virus, itself,” so that anyone who tries to study or cure the disease must license the Novartis patents.

Statin use significantly decreased decompensation in patients with HBV- and HCV-related cirrhosis, with a borderline effect observed in patients with alcoholic…
On 31 March 2017, WHO for the first time prequalified a generic active pharmaceutical ingredient (API) for hepatitis C – sofosbuvir. Sofosbuvir is an essential ingredient for new, highly effective medicines to treat hepatitis C called direct active antivirals (DAAs). The prequalified product’s manufacturer is Mylan Laboratories Ltd - INDIA

Blog Updates

hepCoalition.org is conceived as a tool to support the development of a global advocacy movement on access to hepatitis C diagnostics, treatment and support for people living with a high risk for HCV in low- and middle-income countries, and particularly for people who use drugs and people living with HIV/HCV.
hepCoalition.org is developed by M├ędecins du Monde and Treatment Action Group.

The HepC Pill Bill An insight into the availability, pricing and accessibility of HCV treatment

By Mrinalini Anand
4 April 2017
Introduction to Direct Acting Antivirals

Hepatitis C treatment has remarkably evolved over the years. The previously known standard HCV regimen consisted of a course of pegylated interferon injections and ribavirin tablets, which all in all were expensive, toxic, and needed 24 to 28 weeks to act. With the advent of new Direct Acting Antivirals (DAAs) in 2011, HCV regimens changed significantly. Sofosbuvir became the first drug to be approved for the new generation HCV treatment. DAAs have an edge over the previous medications, in the aspects of, being better tolerated and being more efficient in a shorter duration (90% cure rates after the first 12 weeks of treatment).

(TAG) Treatment Action Group
Treatment Action Group (TAG) is an independent, activist and community-based research and policy think tank fighting for better treatment, prevention, a vaccine, and a cure for HIV, tuberculosis, and hepatitis C virus.

With every major election, particularly one that secures or fortifies Republican control of the White House, Senate, or House of Representatives, a certain amount of worry and strategy realignment is to be expected from public health activists and civil society. Following one of the biggest upsets in political history, in which Donald Trump rode a wave of populist and nationalist sentiments to become the 45th president of the United States and all but guaranteed a right-wing trifecta, the concern among health justice leaders has been unprecedented....
Continue reading TAGline April 2017 FINAL.pdf

At HepatitisC.net we empower patients and caregivers to take control of Hepatitis C by providing a platform to learn, educate, and connect with peers and healthcare professionals.

Seven Years Hep C Free
By Daryl Luster - March 30, 2017
I am now seven years hep C free, and I thought I might take this opportunity to look back. It has been a short seven years, or at least it feels that...

Vietnam Vet Killed by Hepatitis C Added to D.C. Memorial
By Jenelle Marie Davis - March 29, 2017
The History In the United States, the Vietnam War was considered very controversial while it was occurring. However, since the creation of the Vietnam Veterans Memorial to soldiers who died in that...

Injection Drug Users Do Very Well on Sovaldi-Based Hep C Treatment
By Jenelle Marie Davis - March 28, 2017
Hepatitis C and Injection Drug Users Although hepatitis C can be contracted in numerous ways, the most common method of transmission is through the use of an infected needle. This sometimes occurs...

The Fine Line 7: Friends, Pain, and Tissues
By Rick Nash - March 27, 2017
The Fine Line is a series of stories from Rick. Check out part 1, part 2, part 3, part 4, part 5, & part 6! Fighting Through the Pain Pain medications, like...

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HEP - Blog Updates
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 Hep Magazine are the go-to source for educational and social support for people living with hepatitis.

Greg Jefferys
The Rapid Healing of Hep C with Direct Acting Antivirals
One of the amazing things about treating Hep C with the new DAAs is just how fast they work on getting rid of the Hepatitis C virus.

Hepatitis C Genotype 3

I have written a couple of times about the length of time for a Hepatitis C treatment, mostly about doing 12 weeks instead of 8 weeks when treating Genotype 1 with Harvoni, just to err on the side of caution. However, whilst the length of treatment for for genotype 3 with Sofosbuvir + Daclatasvir should ideally be 24 weeks, many doctors still tell patients that they should only consider 12 weeks.

Lucinda K. Porter, RN
Living Donation Liver Transplantation
Cirrhosis is the most common reason for liver transplantation in the United States. For decades, chronic hepatitis C virus (HCV) infection was the main cause of cirrhosis in the U.S., but non-alcoholic fatty liver disease (NAFLD) is quickly catching up.

Hepatitis C Treatment and Racial Differences
Until recently, medical literature has reported fairly evenly distributed SVR rates. However, a recent article in Hepatology (February 2017) found that there is a difference in response rates between Blacks and non-Blacks, even when DAAs are used.

Stay Updated
The latest from Hep bloggers.

Hepatitis B Foundation
The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure for hepatitis B and helping to improve the lives of those affected worldwide through research, education and patient advocacy. Our monthly electronic newsletter, provides research updates, healthy liver tips, information on public health initiatives, and other HBF news.

Like Hepatitis B, Addiction Is a Chronic Disease That Needs Treatment Without Judgement
By Christine KukkaAddiction is a chronic disease, like hepatitis B, type II diabetes, cancer and heart disease. These diseases all run in families, are influenced by environment and behavior, and are notoriously difficult to treat.

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MD Whistleblower
Michael Kirsch, M.D.
I am a full time practicing physician and writer. I write about the joys and challenges of medical practice including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When I'm not writing, I'm performing colonoscopies.

Is My Doctor Up to Date?
Professional training and development are critical. Police officers, educators, orthodontists, painters, chief executives, musicians and chefs all need ongoing training to remain current. Job requirements evolve, and we must adapt. An accountant who hasn’t kept up with new or anticipated tax law changes might not account for much when computing your tax obligation or refund.

The mission of HealthNewsReview.org is to improve the public dialogue about health care by helping consumers critically analyze claims about health care interventions and by promoting the principles of shared decision-making reinforced by accurate, balanced and complete information about the tradeoffs involved in health care decisions. HealthNewsReview.org evaluates health care journalism, advertising, marketing, public relations and other messages that may influence consumers and provides criteria that consumers can use to evaluate these messages themselves. Improving the quality and flow of health care news and information to consumers can be a significant step towards meaningful health care reform.

No evidence given for claim that statins are beneficial for patients with chronic liver disease.
This release from the American Physiological Society summarizes a review of 50 studies on the
effects of statins on liver function.

I’ll admit this is predictable, but I can’t resist: It’s a tale of two news releases. Released on the same day, about the same study, but with very different headlines. 


The Hepatitis C Mentor and Support Group (HCMSG)
The Hepatitis C Mentor and Support Group (HCMSG) was founded to address the lack of awareness, support, and services for people living with Hepatitis C (including patients co-infected with other conditions such as HIV/AIDS and Hepatitis B), and patients in need of or living with liver transplants. To address these needs, we provide resources and services to foster the development and operation of successful support groups for Hepatitis C and co-infected patients. These services are provided to prospective and current support group facilitators FREE OF CHARGE. In the future, we will also provide one-on-one mentoring services to Hepatitis C and liver transplant patients.

Resisting the Coming Austerity: Medicaid in the Crosshairs
The 2016 election is in large part a story of the failure of existing health policy to adequately address a health crisis among the working class. The largest voter margins in favor of Trump comprise many people in poor health. This includes the opioid overdose epidemic currently occurring among predominantly white, suburban, and rural communities battered by deindustrialization and dimmed economic prospects. Affordable Care Act (ACA) repeal and replace legislation, presently defeated with the fall of the American Health Care Act (AHCA) but still an ambition of the White House administration and Republican Congress, threatened to make a bad situation worse.

New drug breakthrough can cure hep C in kids
A new cure for hepatitis C in children and adolescents is on the way, promising to help some of the silent victims of a nationwide heroin epidemic. A Cincinnati Children's Hospital Medical Center doctor who helped lead the research for the drug combination says the new medication regiment brings hope for all children with the disease.

Visit - HCMSG Blog

AGA Journals - Blog
Dr. Kristine Novak is the science editor for Gastroenterology and Clinical Gastroenterology and Hepatology. She has worked as an editor at biomedical research journals and as a science writer for 15 years, covering advances in gastroenterology, hepatology, cancer, immunology, biotechnology, molecular genetics, and clinical trials. She has a PhD in cell biology and an interest in all areas of medical research.

A review article in the March issue of Gastroenterology discusses different hypotheses about the cells responsible for liver tumorigenesis. The article also reviews the different classes of liver tumors, based on the molecular features, and how these affect patient prognosis. Daniela Sia et al describe the distinct molecular and clinical features of hepatocellular

Just For Fun Or Not

Brian C. Joondeph, MD | Physician | April 4, 2017
I’m only human. We have our good days and bad days just like anyone else. We try to always have a smile on our faces, be upbeat and cheerful. But we, too, are affected by life’s challenges — work, family, finances, health, and so on. Don’t be too quick to judge and criticize!

Hot Topics

American Gastroenterological Association
AGA Reading Room - Medpage Today

Latest Articles
New HCV Tx Works Well for Severe Liver Disease
High Cure Rates for HCV Patients Undergoing Liver Transplant with New DAAs
Begin, here

Infohep - Europe
The aim of infohep.org is to develop a high-quality online resource to increase awareness of viral hepatitis, its treatment, and the needs of people living with viral hepatitis in Europe.

In The News
Harm reduction should address the specific needs of couples who inject drugs
Roger Pebody / 03 April 2017
The sharing of drug injecting equipment most often occurs between sexual partners, but the ways in which couples manage risks and care for each other have been largely ignored by harm reduction ...

Early treatment for hepatitis C
Access to hepatitis C treatment in South East Asia
Liver cancer and treatment for viral hepatitis
Direct-acting antiviral treatment achieves high cure rates in the most advanced liver disease patients with HIV co-infection
Glecaprevir/pibrentasvir combination does not interact with HIV medications
Hepatitis A outbreak in Europe
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    World Hepatitis Alliance
    World Hepatitis Alliance (WHA) presents hepVoice, a monthly magazine with updates on the latest projects, news from WHA members and key developments in the field of hepatitis
    Begin, here.....
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    HepCBC - Canada
    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 Newsletter
    Latest Issue: Weekly Bull

    Journal Updates

    American Academy of Neurology
    Hepatitis B and C may be linked to increased risk of Parkinson's disease
    We report strong evidence in favor of an elevation of rates of subsequent PD in patients with hepatitis B and hepatitis C. These findings may be explained by factors peculiar to viral hepatitis, but whether it reflects consequences of infection, shared disease mechanisms, or the result of antiviral treatment remains to be elucidated. Further work is needed to confirm this association and to investigate pathophysiologic pathways, potentially advancing etiologic understanding of PD more broadly
    Article - Download PDF
    Download Editorial, here....
    Media Coverage Of This Article, here

    Elbasvir, grazoprevir in patients with HCV infection and compensated cirrhosis
    Patients with compensated, Child-Pugh A cirrhosis were allowed entry into the EBR/GZR phase 2/3 clinical trial program, and we have therefore conducted an integrated analysis of 402 patients with HCV GT1, 4, or 6 infection and compensated cirrhosis who received EBR/GZR alone or with RBV in these studies.
    Full Text, here
    Media Coverage Of This Article, here

    Grazoprevir/Elbasvir Effectively Induces SVR in HCV with Prior Failure
    Zepatier treatment for 12 weeks, with or without ribavirin, was highly effective for induction of sustained virologic response in patients infected with hepatitis C genotypes 1, 4 or 6, who failed prior peg-interferon and ribavirin treatments, according to the results of the C-EDGE Treatment
    Experienced trial.

    Spleen size, platelet transit time useful in assessment of liver fibrosis
    Concomitant morbidities included hepatocellular carcinoma (either secondary to hepatitis C or other causes), non-alcoholic steatohepatitis and other ...

    Reactivation of hepatitis B is an infrequent but not rare complication of DAA therapy in HBV/HCV coinfected patients.  The availability of curative treatments for hepatitis C has placed increased emphasis on diagnosing and treating this condition.   This is an apt time, however, to also remind ourselves of the importance of screening all HCV infected patients for HBV.   As with immunosuppressive drug therapy, HBV screening and early treatment  are the key elements in preventing HBVr during DAA therapy.

    Medicaid Reimbursement for Oral Direct Antiviral Agents for the Treatment of Chronic Hepatitis C
    Kohtaro Ooka , MD 1 , James J. Connolly , MD 1 and Joseph K. Lim , MD 2
    SUPPLEMENTARY MATERIAL is linked to the online version of the paper at http://www.nature.com/ajg
    Am J Gastroenterol advance online publication, 4 April 2017; doi: 10.1038/ajg.2017.87
    All-oral direct-acting antiviral (DAA) regimens are an excellent modality to treat chronic hepatitis C virus (HCV) infection. Federal Medicaid law requires states to cover all drugs from manufacturers with rebate agreements with the Department of Health and Human Services within their FDA label. However, because of their high cost, many state Medicaid agencies do not cover DAAs for those who have mild liver disease or who abuse substances (1 ,2) . These restrictions persist despite many analyses that confirm that DAA regimens are cost-effective (reduce the cost per quality adjusted life year) ( 3,4 ) and result in savings in healthcare spending ( 5 ). We sought to assess whether and how these restrictions have changed since oral DAAs first came on the market. On the basis of our experience and anecdotal evidence, we expected that despite loosening of restrictions, the majority of states have restrictions in excess of those recommended by professional societies.
    View Article
    Download PDF
    Many green tea supplements on the market claim to help with weight loss or a healthier metabolism, but health experts at Consumer Reports warn the products could actually be dangerous and recommend you avoid them altogether.

    Health Fraud Scams
    Health fraud scams refer to products that claim to prevent, treat, or cure diseases or other health conditions, but are not proven safe and effective for those uses. Health fraud scams waste money and can lead to delays in getting proper diagnosis and treatment. They can also cause serious or even fatal injuries.  

    In Case You Missed It
    US could be rid of hepatitis B and C as public health problems, preventing nearly 90,000 deaths by 2030, with better attention to prevention, screening, treatment, and creative financing for medicines

    April Newsletters

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

    April Newsletter

    HealthWise – Sleep: The Key to a Healthy Liver by Lucinda K. Porter, RN. In this month’s column Lucinda explores the connection between sleep, the liver, a person’s health and the dreaded daylight saving time.

    SnapShots—by Alan Franciscus. I discuss three studies: Zepatier to treat people with bleeding disorders, the transformation of HCV treatment from the interferon era to direct-acting antiviral era with the VA system and finally the incidence of fatty liver in people with HIV, HCV, HIV/HCV coinfection and those with neither—and the very surprising outcome from the study.

    Under the Umbrella—Five Ways Hepatitis C is Unique to Women by Matthew Zielske. Matthew lays out five important facts about women and hepatitis C that you may or may not know about women infected with hepatitis C.

    What’s Up!
    HCSP Fact Sheets *Updated*:

    Bleeding Disorders
    HCSP Guide *Updated*

    A Guide to Understanding HCV
    Harm Reduction *New*:
    Begin, here

    The National Viral Hepatitis Roundtable is a broad coalition working to fight, and ultimately end, the hepatitis B and hepatitis C epidemics. We seek an aggressive response from policymakers, public health officials, medical and health care providers, the media, and the general public through our advocacy, education, and technical assistance.

    View all newsletters, here

    Recent Additions
    NVHR Hails National Academies Hepatitis B & C Elimination Strategy
    The National Viral Hepatitis Roundtable hails the release of the National Academies of Sciences, Engineering, and Medicine's report A National Strategy for the Elimination of Hepatitis B & C.

    Hepatitis C Coalition Quarterly Newsletter - UK
    The Hepatitis C Coalition is a group of leading clinicians, patient organisations, professional groups, industry and other interested parties committed to the reduction of morbidity and mortality associated with hepatitis C and its eventual elimination.  The Hepatitis C Coalition has funding from AbbVie, Gilead Sciences and Merck Sharp & Dohme.

    This quarterly newsletter provides a concise summary of developments in hepatitis C for policymakers, clinicians, commissioners, local government, charities and others with an interest in hepatitis C or public health.

    Quarterly Newsletter
    Public Health England (PHE) has published a report on Hepatitis C in England, subtitled, ‘Working towards its elimination as a major public health threat.’

    Hepatitis C Trust launches Patient Perspectives and Nurses' Perspectives reports

    Begin, here

    Pacific Hepatitis C Network (PHCN) - Canada
    Welcome to the Pacific Hepatitis C Network (PHCN) newsletter. This is where we review all of the major current issues and events around hepatitis C and hep C treatments. It is an email that includes links to our recent blog posts—including links to blog posts about Public Health Agency of Canada funding.

    Subscribers to our mailing list will receive a bi-weekly newsletter, via email, highlighting all of the blog posts written by PHCN and published for PHCN's Newsletter and Hep C TIP News. Current subscribers of either blog will begin receiving this one bi-weekly newsletter. Open them for information and links to blog posts that interest you.
    Sign up here.

    New Online
    Relapse, Recurrence, Null & Partial Response/rs: The Basics
    In hepatitis C and hep C treatment there are three ‘R’s that are big, sad, and scary. They are the bringers of sadness that if doctors, friends, and communities could protect someone from, they would.

    April Newsletter
    Daryl Luster, Pacific Hepatitis C Network's president, uses his vast experience with hep C to write about his thoughts about the virus in blog posts published online by HepatitisC.net.

    Hepatitis C Tip News
    Drug Pipeline 
    Help4Hep: Canada’s Hep C Helpline

    GI & Hepatology News
    Over 17,000 gastroenterologists and hepatologists rely on GI & Hepatology News every month to cover the world of medicine with breaking news, on-site medical meeting coverage, and expert perspectives both in print and online. The official newspaper of the AGA Institute was launched in partnership with IMNG in January 2007.

    Liver Disease

    Review all newsletters, here

    British Liver Trust  - UK
    The British Liver Trust is the leading UK liver disease charity for adults – we provide information and support; increase awareness of how liver disease can be prevented and promote early diagnosis; fund and champion research and campaign for better services.

    View all Newsletters here.

    A firm foundation for working towards eliminating hepatitis C as a major public health threat in England
    Since new direct acting antiviral drugs have become available, the initial focus has understandably been on their role in averting severe hepatitis C-related liver disease and preventing the early death that can result from this.

    In fact, our recently published hepatitis C report suggests that we may be making headway here, with better access to improved treatment leading to the first fall in deaths from this indication observed in a decade.

    HCV Action - UK
    HCV Action brings together hepatitis C health professionals from across the patient pathway with the pharmaceutical industry and patient representatives to share expertise and good practice.

    Latest Newsletter

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

    View all issues, here.

    Check back for updates.

    Stay safe, healthy and informed.

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