Friday, January 5, 2018

2018 Year in Review - Hepatitis Newsletters, Headlines & Updates

Welcome folks, for a recap of this year's HCV accomplishments check out the following newsletters, as well as blog and journal updates. We begin with news, please check back for updates.

In The News
Children with liver transplants often don't stick to their meds
By Scott Baltic
NEW YORK (Reuters Health) - Children with liver transplants who initially adhere to their prescribed immunosuppressive medications do not necessarily remain adherent in the second year after transplant, and those with higher rates of nonadherence more often face late acute rejection, researchers report.

"Our results suggest that good baseline adherence does not guarantee adherence later on, that nonadherence is likely to persist in the absence of interventions, and that monitoring of adherence and interventions to improve it should be expected to last for years if transplant outcomes are to be improved," write the study authors, led by Dr. Eyal Shemesh of the Department of Pediatrics and Kravis Children's Hospital at the Icahn School of Medicine at Mount Sinai in New York City.

Hepatitis C: '6000 in Wales have virus without knowing'
BBC News-6 hours ago
About 12,000 people in Wales are living with hepatitis C, half of whom have it unknowingly, a charity has said. The Hepatitis C Trust said many people did not know sharing razors increased their risk of contracting it. Wales aims to eliminate the virus as a major public health threat by 2030. Dr Christopher Williams from ...

Proton Pump Inhibitors Decrease Efficacy of DAAs in HCV Infection
Infectious Disease Advisor-Jan 5, 2018
Among patients with hepatitis C infection receiving direct-acting antivirals (DAAs), the use of proton pump inhibitors was shown to be associated with a 26% increased risk for failure to achieve sustained virologic response compared with non-use of proton pump inhibitors, according to the results of research published in ..

10 reports from 2017 on liver cancer incidence rates, major risk factors
January 5, 2018
Liver cancer rates continue to increase, prompting researchers to focus on leading causes such as hepatitis C and identifying major risk factors. Recent studies have identified some of these factors to include age, comorbidities and ethnicity.

The following reports focus on the incidence of hepatocellular carcinoma among specific demographics and after HCV therapy with direct-acting antivirals, and the efforts made to improve treatment and aftercare.

How the elimination of HCV in England could become a reality
Dr Andrew Ustianowski
Hepatitis C virus (HCV) infection is a significant public health issue in England, but one which the World Health Organization (WHO) has announced can be eliminated within a generation. New direct-acting antiviral curative treatments have been available in the UK since 2015, which means that theoretically it is possible to meet the WHO target and eliminate a disease which currently is a heavy burden on patients, carers and the health system. However, although England has pledged support for the WHO initiative, without a formal elimination strategy in place it is going to be difficult to meet this aim.

This is totally unnecessary: Calls grow for tighter control of acetaminophen
Elizabeth Payne
A key to preventing unintentional overdoses, Yoshida believes, would be limiting sales of acetaminophen to 325 mg tablets, which would mean the end of popular Extra Strength Tylenol, which contains 500 mg of acetaminophen.

Clinical Care Options
How Injection Drug Use Affects HCV Treatment
Norah Terrault MD, MPH - 1/3/2018
Here’s my take on why colocalization of HCV treatment with other medical and social services may be ideal for persons who inject drugs.

2018 - January Newsletters

Weekly Bull
Read The Latest Issue: Weekly Bull
Another year has come and gone; and what a year it has been! Again, major breakthroughs in HCV treatment made their way to the public, with new options for re-treatment, shorter treatment and ease of treatment. The new pan-genotypic treatments require less testing and some of the newer drugs have drastically lower prices!

HCV Advocate - Happy Anniversary
This month you're in for treat, featured in HCV Advocates 20th Anniversary Newsletter is a look back at the early days of HCV, and the people who made the Hepatitis C Support Project possible.

Here is an overview:
By Alan Franciscus
In 1996, shortly after a diagnosis of HCV, I started the Hepatitis C Support Project (HCSP). The HCV Advocate newsletter, our website and our national training program came later. Our humble beginnings started with support groups (HCV and HIV/HCV coinfected) and a local helpline. I also had one-on-one counseling in my home (I had no boundaries!). Additionally, I started to develop educational materials—the first one was our HCV Information Packet

By Lucinda K. Porter, RN
When the first HCV Advocate was published, hep C treatment was long, tough, and the response rates were low. The only treatment was interferon. It was not pegylated and injections were three times weekly. Ribavirin was not yet in the picture. Now HCV medications can cure just about everyone with a short, tolerable treatment.

“Many state Medicaid systems have removed restrictions on access to HCV medications based on liver disease severity. Hopefully, in 2018 all the restrictions on disease severity will be removed.”

By Matthew Zielske
We cannot fail to fuel the eradication of this epidemic with heart and inspiration as much as logic and science. We must look back to understand what we missed so that we can see what is in front of us.

Studies highlight liver disease risk to our children
Two studies published in December highlighted that young people are putting themselves at increased risk of developing liver disease. The studies focused on obesity and alcohol – two of the major risk factors for liver disease.

National Viral Hepatitis Roundtable
Read NVHR’s December 2017/January 2018 newsletter to read about NVHR’s 2017 accomplishments, conference recaps, NVHR’s Job Announcement, and more!

NIH News in Health
NIH News In Health Newsletter
Last year more than 1.7 million people were diagnosed with cancer in the United States. Cancer can be difficult to treat because each tumor is unique. Scientists are now gaining a better understanding of the changes that lead to cancer—and figuring out how to target them for personalized treatments.

Journal Updates
Need for prompt treatment of HCV infection in these special populations (i.e., hemodialysis, liver transplantation, HIV co-infection).

On This Blog
2018 HCV Genotypes and Treatment
Offered on this page is research updates with a focus on treating HCV according to genotype using FDA approved medicines. Information is extracted from news articles, peer-reviewed journals, as well as liver meetings/conferences, research manuscripts and interactive learning activities.

Of Interest
Hepatitis B virus (HBV) is a ubiquitous viral pathogen associated with large-scale morbidity and mortality in humans. However, there is considerable uncertainty over the time-scale of its origin and evolution. Initial shotgun data from a mid-16th century Italian child mummy, that was previously paleopathologically identified as having been infected with Variola virus (VARV, the agent of smallpox), showed no DNA reads for VARV yet did for hepatitis B virus (HBV).

On Twitter
The following articles were shared and downloaded by @HenryEChang

Local specialty pharmacy & specialty clinic collaboration assists access to hepatitis C direct-acting antivirals
The effective management of costly DAA therapies seemed to be closely linked to the collaboration among the LSP, specialty clinics, and patients to address insurance barriers. 

Hepatocellular carcinoma (HCC) has limited treatment options in patients with advanced stage disease and early detection of HCC through surveillance programs is a key component towards reducing mortality. The current practice guidelines recommend that high-risk cirrhosis patients are screened every six months with ultrasonography but these are done in local hospitals with variable quality leading to disagreement about the benefit of HCC surveillance. The well-established diagnostic biomarker╬▒-Fetoprotein (AFP) is used widely in screening but the reported performance varies widely across studies. We evaluate two biomarker screening approaches, a six-month risk prediction model and a parametric empirical Bayes (PEB) algorithm, in terms of their ability to improve the likelihood of early detection of HCC compared to current AFP alone when applied prospectively in a future study.

Given the recent approval of the first pan-genotypic chronic hepatitis C virus (HCV) therapy, managed care, health systems, and clinicians will need to evaluate current practices related to essential laboratory assessments used to select therapy. Historically, clinicians and payers required a battery of tests to determine HCV genotype, viral load, degree of fibrosis, and organ function. In light of current and forthcoming approvals of pan-genotypic therapy, clinicians and payers can expect a more competitive marketplace and a downward curve in the price of therapy. Ultimately, this development will lead to the cost of screenings and assessment shaving an increased role in selecting an optimal HCV therapy

Blog Updates

Hepatitis B Foundation
2017 A Year in Review
January 5, 2018
2017 was a big year for us at the Hepatitis B Foundation! I’ll give you a rundown of some of our accomplishments over the year.

We asked our readers to vote for their choice of the most important HIV or hepatitis C story of 2017.

HEP Blog 
Liver Fibrosis, Cirrhosis and Hepatitis C: The Good News
By Greg Jefferys
One of the questions that keeps coming up is how well the liver can heal itself once the virus is removed from the equation.

By Greg Jefferys
Treating Hep C with any DAA significantly REDUCES the chance of a person developing liver cancer.

By Connie M. Welch
Having a “when-win” attitude changes your outlook and can help fuel proactive steps toward overcoming your hepatitis C.

It’s a New Year in Hepatitis C Land 
By Lucinda K. Porter, RN
Taking a look back at the hepatitis C landscape over the past 20 years.

Creating a World Free of Hepatitis C
Lucinda Porter
January 4, 2018 
Do you ever ask what the best diet is? I don’t mean the best way to lose weight. I am talking about the healthiest way to eat.

7 Steps to Cope with Chronic Illness
By Carleen McGuffey - January 4, 2018
Coping with a chronic illness is not easy. Here are some things that helped me: Assign a spokesperson: When I spent a month in the hospital after complications from a liver biopsy...

Life Before and After Hep C
By Daryl Luster - January 3, 2018
In my effort to think of interesting or insightful things to write about, I am inspired by things I hear from people like you, much more than the scientists, doctors, and other...

What’s your hep C diagnosis story?
By Editorial Team - January 2, 2018
A hep C diagnosis can be overwhelming and difficult to process. You may have a million questions and unsure where to start. Everyone’s experience and road to a diagnosis can different but...

Harvard Health Blog
A new shingles vaccine may be more effective than the existing one and has been FDA approved for people age 50 and older, even if they had been previously vaccinated.

While there are two medications used to treat opioid use disorder that can be prescribed on an outpatient basis, a study comparing them found interesting differences in treatment results.

Healthy You

Increased levels of obesity are driving an epidemic of non-alcoholic fatty liver disease. Understanding, diagnosing and treating this progressive condition are now priorities.

The liver is a resilient organ that's easy to ignore - until something goes wrong. Because of its wide-ranging responsibilities, your healthy liver can come under attack by viruses, toxic substances, contaminants and diseases. However, even when under siege, the liver is very slow to complain. People who have problems with their liver are frequently unaware because they may have few, if any, symptoms. Your liver is such a determined organ that it will continue working even when two thirds of it has been damaged. The Canadian Liver Foundation is bringing liver research to life by sharing what we learn from important research to help Canadians protect their liver health and prevent liver disease in themselves and their loved ones.

How your digestive system works
Emma Bryce
Constantly churning inside of you, the digestive system performs a daily marvel: it transforms your food into the vital nutrients that sustain your body and ensure your survival. Emma Bryce traces food’s nine-meter-long, 40-hour journey through the remarkable digestive tract.

Problems and potential with probiotics
Probiotics are becoming more prevalent in both consumer and health care settings, but the excitement is tempered by problems, including how to define what is and what isn't one.

Flu Updates - Flu activity is widespread in most of the United States.
CDC Flu Activity Update (Key Flu Indicators)
Influenza activity increased sharply again in this week’s FluView report. The number of jurisdictions experiencing high activity went from 21 states to 26 states and New York City and the number of states reporting widespread activity went from 36 to 46. Influenza-like illness (ILI) went from 4.9% to 5.8%. ‎These indicators are similar to what was seen at the peak of the 2014-2015 season, which was the most severe season in recent years. Typically, severity indicators (e.g., hospitalization rates) lag behind activity indicators (ILI and geographic spread). CDC continues to recommend influenza vaccination as flu viruses are likely to continue circulating for weeks. In addition, in the context of widespread influenza activity, CDC is reminding clinicians and the public about the importance of antiviral medications for treatment of influenza in people who are severely ill and people who are at high risk of serious flu complications.

Geographic Spread of Influenza Viruses: Widespread influenza activity was reported by 46 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming). Regional influenza activity was reported by 4 states (Hawaii, Maine, New Hampshire, and New Jersey). Local influenza activity was reported by the District of Columbia. Guam, Puerto Rico and the U.S. Virgin Islands did not report. Geographic spread data show how many areas within a state or territory are seeing flu activity, read the report here, view the weekly US map: Influenza Summary Update for the Week Ending Dec 30, 2017 - Week 52

It’s not just one or two pockets,” said Dr. Randy Bergen, a Walnut Creek pediatrician. “It’s from Santa Rosa to Fresno and from Santa Clara to Roseville. We’re seeing a lot of people with the flu and a lot of busy clinics.” .... The flu got off to an early start this season and has been on a vicious tear throughout the Bay Area and California. State health officials have confirmed 17 deaths of people younger than 65 statewide, though news reports from counties around the state indicate the death toll is in the dozens.

Stay warm, here in Michigan its below zero, hope the sun is shining in your part of the world. 

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