Thursday, April 12, 2018

For Patients: The International Liver Congress 2018

International Liver Congress

April 11, 2018 - April 15, 2018
Paris, France
Congress Website

Whether your liver is infected with a virus, injured by alcohol, or you have the most common liver disease in the United States - non-alcoholic fatty liver disease (NAFLD) - you need accurate information to make an intelligent decision about both treatment and care. From April 11-15, the 53rd annual meeting of the European Association for the Study of the Liver (EASL) will present key developments in the world of hepatology.

Viral Hepatitis & Fatty Liver Disease
Viral hepatitis highlights include; current and emerging treatments for hepatitis B virus (HBV), current data on effective drugs to treat hepatitis C virus (HCV), with research into the importance of early HCV treatment, follow up care, testing and linkage to care. As well as current research on liver cancer, alcoholic liver disease, fatty liver disease (information on screening, noninvasive tests, follow-up care, diet, and new drugs on the horizon), fibrosis, cirrhosis and liver transplantation.

Practice Guidelines
The European Association for the Study of the Liver (EASL) will also release four major clinical practice guidelines; hepatocellular carcinoma, decompensated cirrhosis, alcoholic liver diseases and updated recommendations on hepatitis C, view the guidelines below.

Download: Recommendations on Treatment of Hepatitis C 2018
April 11, 2018
EASL just released Updated EASL Recommendations on Treatment of Hepatitis C 2018.
*Shared by @HenryEChang via Twitter.

You can view the following guidelines online in the Journal of Hepatology;
EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Overview: EASL updates liver cancer guidelines at International Liver Congress
April 13. 2018
Liz Highleyman
The European Association for the Study of the Liver (EASL) presented updated clinical practice guidelines for the management of hepatocellular carcinoma (HCC) during a special session at the 2018 International Liver Congress yesterday ...

EASL Clinical Practice Guidelines on hepatitis E virus infection

Practice Guidelines - Download Slide Decks

Clinical Care Options
April 27, 2018
Practice-Changing Data From EASL 2018
Listen to downloadable audio from a live Webinar in which Stefan Zeuzem, MD, assessed the clinical impact of new data reported at the Paris meeting and answered case questions from participants.
Free Registration Required 

Conference News
April 28, 2018
On This Blog
Updates before, during and after the meeting.

Hepatitis C Treatment
May 17, 2018
HCV Next, May/June 2018
Nancy S. Reau, MD
As we in the United States look ahead to Digestive Disease Week coming up and further to our fall meetings, the International Liver Congress gives us an opportunity to…

May 4, 2018
Available online @ NATAP
Summary from EASL 2018 for Hepatitis C (HCV)
HCV in 2018: Success stories and remaining challenges?
With the more recent introduction of the pangenotypic regimens sofosbuvir/velpatasvir and glecaprevir/pibrentasvir, two new fix dose combinations have become available which may even overcome the need for baseline HCV genotype assessment. Larger data sets however, from real-life cohorts still are missing but this gap has been filled at this year EASL.

May 1, 2018
Download HCV Advocates' May Newsletter
In this edition of the HCV Advocate we have devoted nearly the entire issue to the 2018 International Liver Congress. Lucinda Porter, RN and I cover some of our favorite posters and presentations in the current issue and in the upcoming June 2018 issue...

April 28, 2018
April "infohep bulletin" - Overview of EASL's 2018 International Liver Congress
Patients looking for an overview of EASL's 2018 International Liver Congress can find it in this month's "infohep bulletin".

International Liver Congress Sees Shift in Liver Diseases
I’ve been covering this conference since 2012, at the dawn of the era of direct-acting antivirals for hepatitis C. For about five years a large proportion of content—and the lion’s share of excitement—at this meeting was devoted to these new therapies.

April 21, 2018
Slides @ NATAP

Liver Fibrosis

Mavyret (glecaprevir/pibrentasvir)
The results of the first real-world studies assessing the effectiveness and safety of glecaprevir/pibrentasvir (G/P) in patients with chronic hepatitis C virus (HCV) infection have confirmed high rates of viral suppression and a favourable safety profile in patients receiving 8-16 weeks of treatment.

Commentary - Real-world experience confirms Mavyret efficacy in HCV
Two real-world studies presented at the International Liver Congress 2018 confirmed the efficacy and safety of Mavyret in Italy and Germany even in the face of multiple comorbidities.

Slides - Real-life effectiveness & safety of G/P among 723 Italian patients with chronic HCV: interim analysis of data from the NAVIGATOR-II study


Integrated Efficacy and Safety of Glecaprevir/Pibrentasvir in Patients With Psychiatric Disorders - (04/13/18)


Time to Viral Suppression Does not Impact SVR in Patients Treated With Glecaprevir/Pibrentasvir for 8 Weeks - (04/23/18)

Clinical Care Options CCO - Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.

Zepatier (elbasvir/grazoprevir)
Commentary - Zepatier Yields High Hepatitis C Cure Rates in U.S. Veterans
April 13, 2018
Cure rates were near 100 percent even though the population in the study’s analysis had high rates of other health conditions.

Effectiveness of Elbasvir/Grazoprevir in Patients with Cirrhotic Genotype 1 or 4 Chronic Hepatitis C: Updated Retrospective Data Analyses from the TRIO Network - (04/13/18)

Clinical Care Options CCO - Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.
Second Interim Analysis of STREAGER: High Rate of SVR With 8 Weeks of Elbasvir/Grazoprevir in Treatment-Naive Patients With Nonsevere Fibrosis and Genotype 1b HCV Infection
Summary of Key Conclusions
In analysis of first 90 patients enrolled on a single-arm, open-label trial of treatment-naive patients with nonsevere fibrosis and genotype 1b HCV infection, 8 weeks of elbasvir/grazoprevir associated with sustained virologic response rate at 12 weeks post treatment (SVR12) of 97%
No grade 3/4 adverse events observed
Relapse observed in 4 patients (1 patient relapsed after achieving SVR12), including 1 patient with genotype 1e HCV infection wrongfully included in study

Harvoni (ledipasvir/sofosbuvir)
Slides @ NATAP
An eight-week course of sofosbuvir/velpatasvir (Epclusa) cured almost all people with hepatitis C genotype 3 without cirrhosis receiving treatment alongside opioid substitution therapy through community pharmacies or prisons in the Greater Glasgow area, Alison Boyle of Gartnavel Hospital, Glasgow, reported at the 2018 International Liver Congress in Paris on Thursday. Genotype 3 is especially common in people who inject drugs and former drug users. It has been considered 'harder to cure' although recent studies of newer agents in people with genotype 3 have shown high cure rates.

Clinical Care Options CCOReview Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.
High SVR12 Rate With 8 Weeks of Sofosbuvir/Velpatasvir in Real-World Retrospective Analysis of Treatment-Naive Patients With Genotype 3 HCV and Fibrosis
Main Findings
In ITT population, 93% (84/90) of noncirrhotic, treatment-naive patients with genotype 3 HCV infection achieved SVR12 following 8 weeks of sofosbuvir/velpatasvir
Lost to follow-up: n = 2
Premature discontinuation: n = 2
Death: n = 1
Reinfection without subsequent spontaneous clearance: n = 1
In mITT population, 100% of patients achieved SVR12
High rates of SVR12 observed across selected subgroups
Subgroup, n/N (%)
ITT Population
mITT Population
F3 fibrosis
23/28 (82.1)
23/23 (100)*†‡§
HCV RNA > 6,000,000 IU/mL
5/6 (83.3)
5/5 (100)
HIV coinfected
2/3 (66.6)
2/2 (100)
Quantifiable HCV RNA at end of treatment
7/7 (100)
7/7 (100)
Daily supervised methadone
35/38 (92.1)
35/35 (100)†‡
8/8 (100)
8/8 (100)
14/15 (93.3)
14/14 (100)
Positive screen for drugs of abuse
4/4 (100)
4/4 (100)

Clinical Care Options CCO
Addition of RBV Associated With Increased Efficacy of 12 Weeks Sofosbuvir/Velpatasvir in Patients With Genotype 3 HCV Infection and Compensated Cirrhosis
Summary of Key Conclusions
In NS5A-naive patients with genotype 3 HCV infection and compensated cirrhosis, sustained virologic response at 12 weeks posttreatment (SVR12) rate numerically higher in those receiving sofosbuvir (SOF)/velpatasvir (VEL) with ribavirin (RBV) vs SOF/VEL alone
SVR12 rate 96% vs 91%, respectively
Fewer relapses observed with use of RBV
In both treatment arms, NS5A resistance associated substitutions (RAS) at baseline associated with reduced SVR12 rate, particularly Y93H
Treatment well tolerated
Few grade 3/4 adverse events (AEs), serious AEs, discontinuations for AEs in both treatment arms
Use of RBV associated with increased toxicities

Safety and Efficacy of Sofosbuvir/Velpatasvir with and without Ribavirin in Genotype 3 HCV-Infected Patients with Cirrhosis - (04/13/18)

Vosevi (Sofosbuvir/Velpatasvir/Voxilaprevir) 
Clinical and virological characteristics of DAA-experienced patients with chronic HCV infection treated with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX): results from the Frankfurt Resistance Database - (04/20/18)

Ravidasvir combined with sofosbuvir
Video Healio:
$300 HCV combination reaches 97% cure rates in Malaysia, Thailand
April 13, 2018
PARIS — Using a new medication and generic sofosbuvir, researchers reached 97% sustained virologic response in patients with hepatitis C both with and without…

Commentary - New affordable hepatitis C combination shows 97% cure rate
April 12, 2018
The combination of sofosbuvir and the new NS5A inhibitor ravidasvir cured 97% of people with hepatitis C in a study carried out in Malaysia, and could provide a safe and effective cure for hepatitis C in low- and middle-income countries for $300 or less, researchers of the Drugs for Neglected Diseases Initiative reported on the opening day of the 2018 International Liver Congress in Paris.

April 12, 2018
New affordable hepatitis C combination treatment shows 97% cure rate
An affordable hepatitis C combination treatment including the new drug candidate ravidasvir has been shown to be safe and effective, with extremely high cure rates for patients, including hard-to-treat cases, according to interim results from the Phase II/III STORM-C-1 trial presented by the non-profit research and development organisation Drugs for Neglected Diseases initiative (DNDi) at the International Liver Conference in Paris.

Commentary - The Latest Hepatitis C News From the 2018 International Liver Congress
April 13, 2018
By Lucinda K. Porter, RN
The 2018 International Liver Congress (ILC) began yesterday in Paris. This annual meeting is hosted by the European Association for the Study of the Liver (EASL). It is an important event for liver specialists, and people gather from all over the world to share their latest findings. In the next week, I’ll post more frequently with highlights from some posters and presentations. (Note: Conference presentations represent part of the story and unless and until these studies are published in a peer-reviewed journal, these data and conclusions are considered preliminary.)

Treat Early
(at earlier stages of fibrosis)
EASL Press Release - Liver Congress™ 2018 Scotland: Direct-acting antiviral agent therapy reduces the burden of HCV-related decompensated cirrhosis
April 12, 2018
Two presentations given this week at The International Liver Congress™ 2018 in Paris, France illustrate the impact that DAAs can have in averting HCV-related liver disease, and reducing the clinical and economic burden of this chronic infection.

Slides @ NATAP
EASL: Early versus Delayed Hepatitis C Treatment Provides Increased Health Benefits at Lower Costs: A Pan-Genotypic Cost-Effectiveness Analysis Set in Scotland -

The early treatment of hepatitis C infection with a pan-genotypic drug combination is more effective and less expensive than if therapy is delayed until liver fibrosis develops, health economists report. A health state-transition model of the natural history of hepatitis C shows that early therapy with the combination of glecaprevir and pibrentasvir (Mavyret, AbbVie) results in lower lifetime costs because of reductions in the risk for decompensated cirrhosis, hepatocellular carcinoma, liver transplantation, and liver-related mortality, said researcher Scott Johnson, PhD, from Medicus Economics in Boston.

Commentary - Early-stage HCV treatment saves money, improves QOL
April 12, 2018
Treating hepatitis C virus in the early stage of disease saves money in drug and medical costs while lowering risk for decompensated cirrhosis, hepatocellular carcinoma, liver transplant and liver-related death.

Commentary - Earlier HCV Tx May Lower Complication Rate, Save Money
April 12, 2018
PARIS -- Treating patients with hepatitis C virus (HCV) at earlier stages of fibrosis may be reduce both complications and cost, a commercially sponsored modeling study showed here. There was a lower risk of decompensated cirrhosis, hepatocellular carcinoma, liver transplant, and liver-related death among patients who started treatment at the mild, F0-F1 stage compared to those who started treatment at advanced/compensated cirrhosis (F4/CC).

NATAP Slides

Commentary - DAA therapy effective in patients with HCV and advanced cirrhosis
April 16, 2018
PARIS — Direct-acting antiviral therapy effectively treated hepatitis C virus in patients with high MELD scores, producing a high rate of…
Slides @ NATAP - Direct Acting Antiviral HCV Therapy is Safe and Effective in Patients with Decompensated Cirrhosis: Real World Experience from the HCV-TARGET Cohort - (04/12/18)

EASL Press Release - Liver Congress™ 2018 - Mediterranean-style diet improves gut microbial diversity reduces hospitalization in liver cirrhosis
April 12, 2018
'Our hypothesis for this study was that diet and the severity of cirrhosis might interact to determine microbiota composition and, ultimately, clinical outcomes in patients with liver cirrhosis'.

Press Release - Liver Congress™ 2018 A third of bacterial infections in patients with cirrhosis across the world are multi-drug resistant 
April 12, 2018
'The finding that over one in three of bacterial infections occurring in hospitalized patients with cirrhosis are induced by multidrug resistance microorganisms is very worrisome', said Prof. Annalisa Berzigotti from the University of Bern, Switzerland, and EASL Governing Board Member.

Commentary - 'Alarming' New Numbers on Bacterial Infection in Cirrhosis
April 12, 2018
PARIS — Infections caused by multidrug-resistant bacteria, which are common in patients with cirrhosis, are associated with a significant elevation in risk for in-hospital mortality, results from a global study show.

Liver Transplant
April 15. 2018
Therapies also appear to reduce liver-related mortality
Since use of direct acting antiviral combination therapies for hepatitis C virus (HCV) infection became widespread, the need for liver transplantation for patients with the infection has plummeted, researchers reported here.

Scale-up of HCV diagnosis and treatment
EASL Press Release - Linkage to care specialist facilitates access to HCV treatment for people who inject drugs
April 12, 2018
'Based on our analysis', said Sarah Robbins from the Polaris Observatory, 'we predict that given the current standard of care for the next 15 years, the total HCV-infected population in Europe would increase by an estimated 1% by 2030 and that, in order to meet WHO goals, the number of individuals diagnosed annually would need to increase to at least 800,000 by 2022, with 900,000 being treated each year by 2025. Improving linkage to care coupled with increased access to DAA therapy is needed to achieve such goals'.

Liver Cancer
Liver-related & HCC events were rare after up to 144 weeks of follow-up in patients with F2-F3 fibrosis who had achieved SVR with DAA therapy: Results from the Gilead Sciences SVR Registry

Slides @ NATAP
Commentary - EASL updates liver cancer guidelines at International Liver Congress
Liz Highleyman
The European Association for the Study of the Liver (EASL) presented updated clinical practice guidelines for the management of hepatocellular carcinoma (HCC) during a special session at the 2018 International Liver Congress yesterday ...

April 12, 2018
'HCC surveillance in HCV patients after sustained virological response is a matter of debate', said Prof. Markus Cornberg from the Hannover Medical School, Germany, and EASL Governing Board Member. 'This study is important because it emphasizes the importance of HCC surveillance by ultrasound in patients with cirrhosis, even if HCV has been eliminated. However, the study also challenges the need for surveillance in patients with advanced fibrosis but without cirrhosis'.

Video Healio:
April 13, 2018
“Long-term follow-up studies and data will be required to identify those who are at risk for tumor development and also to better tailor surveillance guidelines,” Zangneh concluded. – by Talitha Bennett
April 12, 2018
Celsion’s Phase III OPTIMA Study is expected to enroll up to 550 patients in up to 70 clinical sites in the United States, Europe, China and Asia Pacific, and will evaluate ThermoDox® in combination with optimized RFA, which will be standardized to a minimum of 45 minutes across all investigators and clinical sites for treating lesions three to seven centimeters, versus optimized RFA alone.

WHO’s 2030 hepatitis C elimination goals
April 12, 2018
New research presented at this year’s International Liver Congress in Paris, France (11-15 April) shows that while several European countries are now on target to meet WHO’s 2030 hepatitis C elimination goals, many others are off track and problems screening and diagnosing enough patients threaten the progress of all countries.

Hepatitis B
Press Release - Assembly Biosciences Presents Positive Interim Data from Phase 1a and 1b Studies of ABI-H0731 in HBV Patients in a Late-Breaker Session at the EASL Conference
April 12, 2018
The Phase 1b patient study enrolled both HBeAg positive and negative patients. Potent antiviral activity was observed across patient cohorts in a dose dependent manner. Specifically, in the ongoing 300 mg dose cohort, the mean overall decline from baseline is currently ≥2.8 log10 IU/mL, with ≥2.9 and 2.5 log10 IU/mL mean declines in HBeAg positive and negative patients, respectively. Maximal viral load declines of 3.6 to 4.0 log10 IU/mL were observed in certain HBeAg negative patients treated at all dose levels (100 to 400 mg). The company intends to report complete results from this study at a scientific conference later this year.

Slides @ NATAP

View all HBV coverage at NATAP

Fatty Liver Disease: NAFLD/NASH

April 13, 2018
'We demonstrated that German patients with NAFLD/NASH who develop compensated cirrhosis have a substantial burden of comorbidities and that their healthcare costs jump with the development of cirrhosis', said Dr Canbay. 'Novel treatment options are needed to improve patient outcomes'. 'This study highlights the burden of NASH cirrhosis on healthcare systems and reinforces the need for new therapies to tackle the epidemic currently affecting many European countries', said Prof. Phil Newsome from the Queen Elizabeth Hospital and University of Birmingham, UK, and EASL Governing Board Member.

Press Release - Gilead Presents Data on Multiple Investigational Regimens for the Treatment of Patients With Nonalcoholic Steatohepatitis (NASH) and Advanced Fibrosis at The International Liver CongressTM 2018
Gilead Presents Data on Multiple Investigational Regimens for the Treatment of Patients With Nonalcoholic Steatohepatitis (NASH) and Advanced Fibrosis at The International Liver CongressTM 2018

Commentary - Low food security increases risk for advanced fibrosis
Food insecurity an increased risk for advanced fibrosis, particularly among patients with diabetes, according to a presentation at the International Liver Congress 2018. According to a presentation by Russell Rosenblatt, MD, from the New York Presbyterian Hospital, food insecurity is the state of being without reliable access to a sufficient quantity of affordable, nutritious food, often in the form of low-cost, energy-dense, nutritionally poor foods. “Food insecurity’s risk for diabetes doesn’t stop there,” Rosenblatt said. “We know that diabetes increases the risk for NAFLD, and diabetes is also an increased risk factor for advanced fibrosis.”

April 13, 2108
Deep-learning approaches to pattern recognition in liver biopsy samples have moved one step closer to clinical application, with a new study reporting a good correlation between an automated image analysis system and an expert reviewer for the identification of key markers of disease activity in a pre-clinical model of non-alcoholic steatohepatitis (NASH).

April 13, 2018
presented the positive results from the interim analysis of the Phase 2 clinical trial of MN-001 (tipelukast) in NASH (non-alcoholic steatohepatitis) and NAFLD (non-alcoholic fatty liver disease) with hypertriglyceridemia

April 12. 2018
The research demonstrated that adding fructose (sugar) and fatty acids to three-dimensional bioprinted human liver tissue produced NASH-type liver pathology, including steatosis, inflammation, ballooning and fibrosis. Addition of MSDC-0602K to the tissue showed evidence of reduced disease progression, including reductions in collagen deposition and stellate cell activation, in the liver model.

Commentary - Cenicriviroc shows safe long-term antifibrotic activity in adults with NASH
April 12, 2018
PARIS — Cenicriviroc, an oral C-C chemokine receptor type 2 and type 5 antagonist also known as CVC, was well-tolerated and provided…

April 11, 2018
Two independent studies have today reported that alcoholic liver disease has now replaced hepatitis C virus (HCV) infection as the leading cause of liver transplantation in the USA in patients without HCC. Non-alcoholic steatohepatitis (NASH) is also on the increase, now ranking second as a cause of liver transplantation due to chronic liver disease.

Primary sclerosing cholangitis
April 13, 2018
'Studies like this one are key, since they investigate possible novel treatments for PSC, a disease that currently has no effective therapies', said Prof. Marco Marzioni from the University Hospital of Ancona, Italy, and EASL Governing Board Member. 'Although this trial did not achieve fully positive results in terms of reduction of markers of disease progression, it certainly indicates that the manipulation of key molecules involved in the pathophysiology of PSC is the route to cure for our patients'.

April 12, 2018
PARIS — Patients with primary sclerosing cholangitis who took statins – likely for another indication – showed reduced risk for transplant and morbidity, according to a presenter at the International Liver Congress 2018. - View Press Release

April 10, 2018
Animated short created to raise public awareness about liver failure European Association for the Study of the Liver
The ad highlights the innovative DIALIVE technology, a novel 'liver dialysis device' which after 25 years of research is undergoing two clinical trials which will assess its safety and efficacy. View the ad, here..... Press release, here....

Healio live from EASL’s 2018 International Liver Congress
Guidelines, Expanded Opportunities Mark EASL's Liver Congress
Liver Cancer on the Rise in Backdrop of Undiagnosed Hep C

Conference Coverage

Link: Practice Point 
Independent Conference Coverage from the 53rd Annual Congress of the European Association for the Study of the Liver (EASL)*
In this video series, Dr. Brown will present ‘what you need to know in 5‐minutes’ regarding today's presentations from The International Liver Congress EASL 2018 in Paris, France. These educational Clinical Clips will spotlight the latest advances in the prevention and treatment of hepatitis C through a series of daily, ‘what you need to know in 5-minutes’ videos each day from the conference.
Free registration required

To learn more, or view highlights see: Liver Congress 2018 - ‘what you need to know in 5-minutes’ video clips each day from the conference

EASL LiverTree - Open To All
This year webcasts and congress materials are open access! Watch freely the conferences and ePosters
*Free registration required

The National AIDS Treatment Advocacy Project - NATAP
Slide decks, press updates, commentary, and full-text articles

Link: Healio
Coverage of the meeting will include, videos, perspectives and interviews with leading researchers and clinicians.
About Healio

Link: infohep
Patient-friendly coverage

News, with patient-friendly commentary
About NAM

Link: MedPage Today
Commentary and news updates

Link: Medscape 
Read clinically focused news coverage of key developments from ILC 2018.
*Free registration may be required
About Medscape

Link: Clinical Care Options CCO
Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis and NAFLD/NASH from Paris.About CCO

Link: Liz Highleyman @ Cancer Health

Link: HCV Advocate
Download HCV Advocate's - May Newsletter
In this edition of the HCV Advocate we have devoted nearly the entire issue to the 2018 International Liver Congress. Lucinda Porter, RN and I cover some of our favorite posters and presentations in the current issue and in the upcoming June 2018 issue...

HCV Advocate Greg Jefferys blogs from the conference.
Inside the convention hall were display stands for Zepatier, Mavyret and Epclusa and many other products related to treating liver diseases. The three DAA stands were by far the biggest but Gilead easily won the “Biggest and Most Number of display stands” award with three huge and separate stands.

Follow On Twitter
Liz Highleyman‏ @LizCancerHealth

Abstract Book
Start by reviewing the first abstracts of the meeting, and embargo policy, available online and shared via Twitter by Henry E. Chang.
Download Here:

HEPAHEALTH Project Report
EASL report on the burden of liver disease across Europe
April 12, 2017
Link: Watch - Liver Congress™ 2018 - First Press Conference HEPAHEALTH Project Report
The European region is the highest consumer of alcoholic beverages in the world and efforts to reduce alcohol consumption are stalling in many countries. Likewise, rates of obesity have risen across almost every country the report surveyed since 2013 and the rates of Non-Alcoholic Fatty Liver Disease (NAFLD) are increasing accordingly. In Southern and Eastern Europe viral hepatitis is the leading cause of liver disease mortality.
Twitter #Hepahealth

Watch - Daily Press Conference

*Page updated May 5, 2018

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