Showing posts with label 2018 - International Liver Congress. Show all posts
Showing posts with label 2018 - International Liver Congress. Show all posts

Monday, June 4, 2018

June Newsletters - Hepatitis C in Colorado & Liver Congress 2018 Coverage

June Hepatitis Newsletters
Welcome, we start with a few June publications, followed by events you may have missed last month. Next, sift through the June index of newsletters, and finish off with a list of well written blogs with extremely useful information on the topic of viral hepatitis.

June Updates
A Guide to Understanding Hepatitis C (HCV)
HCV Advocate: We have completely updated and given our most popular publication and a new look. To download, click here

Despite the availability of new DAA regimens and changes in restrictions of these therapies, absolute denials of DAA regimens by insurers have remained high and increased over time, regardless of insurance type.

Updated Guidelines - Hepatitis C testing recommended for Canadians born between 1945 and 1975
More than 250,000 Canadians are believed to be infected with hepatitis C, but 40 to 70 per cent are unaware they harbour the blood-borne virus. The Canadian Association for the Study of the Liver, a national group of health-care providers and researchers, published its guidelines on testing and treating hepatitis C in Monday’s edition of the Canadian Medical Association Journal.

When to Initiate HCV Therapy and Overview Of New Drugs
Sit back, grab your favorite beverage and review; Making a Decision on When to Initiate HCV Therapy, updated a few days ago, published by Hepatitis C Online.

What You Missed In May
Screening for Hepatitis C Climbs in Colorado

Each year, more Coloradans are contracting hepatitis C, the infectious liver disease spread by contact with infected blood. The state’s hep C death rate is heading higher as well. An analysis by the Colorado Health Institute of newly available information from the state’s All Payer Claims Database (APCD) reveals the rate of Coloradans getting screened for the hepatitis C virus nearly tripled between 2011 and 2016.

Key Takeaways:
The rate of screening for hepatitis C among Coloradans nearly tripled between 2011 and 2016, a Colorado Health Institute analysis of newly available data shows.

Baby boomers between ages 55 and 64 saw the largest increase in screening rates during that time; millennials between 25 and 34, had the highest screening rate each year.

Medical advances, federal and state policy changes and fallout from the opioid epidemic have contributed to the rise in screening.  
Download the report.

Full of Life: The Stories of People Affected by Hepatitis C
The Institute’s Hepatitis Policy Project has released a new report that features the stories of people affected by hepatitis C. The report was authored by Sonia Canzater and Jeffrey S. Crowley. “Full of Life: The Stories of People Affected by Hepatitis C,” underscores the impact of hepatitis C and the potential for improving the lives of those with the disease.

Real people make up the HCV epidemic, and their experiences and the full lives they lead offer motivation and resolve to work to eliminate HCV as a public health threat. But, as this report will show, the reality of what is happening to respond to HCV in the United States (US) falls short of the possibility of what we could make happen to save lives and strengthen communities, read it here....
This project is supported by a grant from Gilead Sciences.

AASLD online HCV guide update includes key at-risk populations

May 31, 2018
The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America recently updated their hepatitis guideline website,, to include several new testing and management recommendations for pregnant women, men who have sex with men, people who inject drugs and incarcerated individuals. Kristen M. Marks, MD, assistant professor of medicine at Weill Cornell Medical College in New York and HCV Guidance co-chair, discussed the new updates with HCV Next, read it here...

New Hepatitis C Virus Guidelines and Lyme Disease Prevention

Perspective - New England Journal Of Medicine 
The FDA and the Next Wave of Drug Abuse — Proactive Pharmacovigilance
In response to the opioid crisis, the Food and Drug Administration (FDA) has taken action on multiple fronts. We have approved better measures for treating opioid use disorder and preventing deaths from overdose, have launched efforts to inform more appropriate prescribing as a way to limit clinical exposure to opioids, have taken actions to reduce the excess opioids available for abuse, and are working to facilitate development of new therapeutics that can effectively and safely help patients suffering from pain. Going forward, the FDA needs to remain vigilant to recognize shifting trends in the addiction landscape. Taking a systematic approach to monitoring such trends should allow us to intervene promptly and appropriately and protect the public from associated risks, read the article here...…

Surrey develops hepatitis C model that could help improve treatment
The University of Surrey has created a new mathematical model that details how the hepatitis C (HCV) infection develops and behaves more accurately than previous models, read the press release, here.....

New strategy to cure chronic hepatitis B infection
Scientists from Karolinska Institutet and Hannover Medical School have published two studies that provide insights into how the immune system responds and helps to clear a hepatitis B infection after treatment interruption. The findings offer a framework for future tailored treatment strategies and are published in The Journal of Infectious Diseases and Journal of Hepatology, read it here....

Conditions Related To HCV
Listen - Hepatitis C: It’s About More than Liver Disease
The National Viral Hepatitis Roundtable is pleased to present a webinar to discuss the health effects of hepatitis C virus (HCV) infection that occur outside the liver. Learn more about how conditions such as kidney disease, depression, certain types of cancer, and diabetes are related to HCV infection. The webinar will feature clinician and patient perspectives to facilitate discussion about the importance of recognizing these conditions as part of HCV management and the implications for early HCV treatment.
This webinar is now archived. Click here for the slides. Click here for the recording. (Click the link and then enter the requested information to view the webinar).

Fatigue & Achieving SVR

Do fatigue and quality of life improve after hepatitis C is cured?
Patient-reported outcomes such as fatigue, vitality and mental health improve substantially in the two years following hepatitis C cure for people with cirrhosis, but people with cirrhosis are less likely than others to experience rapid resolution of severe fatigue after successful hepatitis C treatment, according to two studies from the Center for Outcomes Research in Liver Diseases reported last month at the 2018 International Liver Congress in Paris, read it here...

Can anti-viral therapy reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus?
In this study, changes in liver stiffness and steatosis as determined by MRI in patients with chronic HCV genotype 1 or 2 infection who received direct-acting anti-viral therapy and achieved SVR is investigated, read the article here....

Screening & Treating HCV
HCV From Screening to Cure
The following video presentation; "HCV From Screening to Cure: A Closer Look at Changing At-Risk Populations and an Evolving Treatment Landscape" with Ira M. Jacobson, MD., and provided by Medical Learning Institute, Inc. and PVI, PeerView Institute for Medical Education, will discuss screening strategies, stigma, patient-related barriers to treatment, hepatitis C testing for identifying current infection, and tests used to stage fibrosis. Also discussed is treatment for HCV patients with cirrhosis, as well as treatment adherence, duration, treatment according to HCV genotype, ending with "How Much Care Do The Cured Need?" Watch the video, here....

Supervised injection sites are coming closer to reality in several cities in the United States.
U.S. Cities Consider Supervised Injection Sites
Safe injection facilities can reduce overdoses, disease transmission, and public drug use.

Prospective Study: No psychiatric side effects with new IFN-free treatment for HCV 
Treatment of Hepatitis C virus (HCV) infection has evolved from interferon (IFN)-based treatments to direct-acting antivirals (DAAs). Patients with HCV have an elevated psychiatric morbidity (including substance abuse) and patients with such comorbidity have often been excluded from treatment with IFN. To date, little is known about psychiatric adverse effects of DAA-based regimens. We therefore aimed to study the psychiatric side effects of new IFN-free treatment for HCV (including depressive symptoms and sleep) in real world patients also including those with a history of psychiatric diagnosis, substance abuse or drug dependence, read the article here....

The Truth about Hepatitis C Treatment long term Side Effects
Karen Hoyt is devoted to offering support and accurate information to people coping with the effects of liver disease through a series of informative videos, topics include ascites, hepatic encephalopathy and other liver-related complications.
Here is the latest video: The Truth about Hepatitis C Treatment long term Side Effects.

AASLD Special Collection: Treating Liver Disease in 2018
Topics include: Hepatitis C virus reactivation in patients receiving cancer treatment, drug‐drug interactions in hepatitis C virus treatment and more. Start here...…

Fatty Liver
Journal of Gastroenterology and Hepatology
Special Issue: Burden of Nonalcoholic Fatty Liver Disease in Australia.
In this review, we present available data on the prevalence of NAFLD in Australia, its associated health burden in terms of hepatic and extrahepatic complications, common presentations, and evidence‐based therapeutic options. We also outline a research agenda highlighting gaps in knowledge that are needed to improve diagnosis and management of people with NAFLD specific to the Australian context. Full-text available here.....  

Behind The Headlines
Most multivitamins and supplements are a 'waste of money' 
The review found that taking the most widely used supplements – multivitamins, vitamin D, vitamin C and calcium – had no significant effect on the risk of heart-related illnesses. And some supplements, such as vitamin B3 (niacin) may do more harm than good, read it here.... 

A new edition of our 'Antiretroviral drugs chart' is now available online. This one-page reference guide lists all the anti-HIV drugs licensed for use in the European Union, with information on formulation, dosing, key side-effects and food restrictions, read it here ….

The Controversy 
Do direct acting antivirals cure chronic hepatitis C?
A controversial review by the Cochrane Collaboration published June 6, 2017/updated September 8 2017, cast doubt on the effectiveness of new hepatitis C treatments, on May 12, 2018, BMJ published; Do direct acting antivirals cure chronic hepatitis C ? by Cochrane author Janus Christian Jakobsen. BMJ talk medicine also aired a follow-up podcast with Jakobsen; New antivirals for Hepatitis C - what does the evidence prove? On May 16, 2018 experts weighed in on the program, read what they had say: Experts Respond To Latest BMJ Article: Do direct acting antivirals cure chronic hepatitis C?

June 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.
June Issue
We are continuing our conference coverage of the International Liver Congress 2018 and we have the following posters and presentations:
More of Lucinda’s Highlights from the 2018 International Liver Congress:
STUDY Abstract: THU-099 Lowering the upper limit of serum alanine aminotransferase levels may detect significant liver disease in the elderly – H. Schmilovitz-Weiss, et al.
STUDY Abstract: THU-100 Hepatitis C patients with HIV co-infection demonstrate unique liver-related complications and health behaviors compared to HCV mono-infected patients – M. Lu, et al.
STUDY Abstract: THU-399 Incidence and prevalence of extrahepatic manifestations of HCV – H. El-Serag, et al.
STUDY Abstract: THU-418 Lymphomas incidence in HIV/HCV coinfected versus HIV monoinfected patients over twenty-one years of follow up (1993–2014) – A.M. de Cea, et al.
STUDY Abstract: FRI-368 Long-term immunological and clinical impact of HCV eradication with directacting antivirals in patients with HCV-associated cryoglobulinemia vasculitis – M. Bonacci, et. al.
STUDY Abstract: THU-412 Among 1945–1965 birth cohort patients with at least one additional hepatitis C virus risk factor, one in eight were positive for HCV antibody: an underserved safety-net population experience – G. Hirode, et. al.
STUDY Abstract: THU-429 Strong increase of acute HCV infections in HIV-negative men having sex with men – L. Cotte, et. al.

More of Alan’s Highlights from the 2018 International Liver Congress:
STUDY Abstract: GS-018 Long-term follow-up of patients with chronic HCV infection and compensated or decompensated cirrhosis following treatment with sofosbuvir-based regimens – A. Mangia, et. al.
STUDY Abstract: LBO-008 A phase 3b, open-label, randomized, pragmatic study of glecaprevir/ pibrentasvir +/− ribavirin (RBV) for HCV genotype 1 subjects who previously failed an NS5A inhibitor + sofosbuvir (SOF) therapy – A. Lok, et. al.
STUDY Abstract: THU-121 Track, Trace & Treat: Results from a retrieval strategy to identify lost to follow-up chronic hepatitis c patients – I. Munsterman, et. al.
STUDY Abstract: LBP-0231 The percentage of patients with HCV infection in need of a liver transplant is rapidly declining while their survival after transplantation is improving: a study based on European Liver Transplant Registry – G. Perricone, et al.
STUDY Abstract: FRI-028 Liver transplant waitlist mortality, transplantation rates and post-liver transplant outcomes in Hispanics – P.J. Thuluvath, et al.
STUDY ABSTRACT: FRI-374 The impact of sustained virologic response on severe fatigue in patients with chronic hepatitis C: the role of HCV viremia and co-morbidities – Z. Younossi, et. al.
STUDY Abstract: THU-075 hepatitis C screening within the National Elimination Program in the country of Georgia – A. Gamkrelidze, et. al. 

STUDY Abstract: THU-075 hepatitis C screening within the National Elimination Program in the country of Georgia – A. Gamkrelidze, et. al.
STUDY Abstract: THU-104 The first result from the general population hepatitis screening in Mongolia: 38% of 40– 65-year-olds screened and anti-HCV prevalence of 15.6% among 40– 65-year-olds – B. Dashtseren, et. al.
STUDY Abstract: PS-090 Direct-acting antiviral treatment in sub-Saharan Africa: A prospective trial of ledipasvir/ sofosbuvir for chronic hepatitis C infection in Rwanda (The SHARED Study) – N. Gupta, et. al.

Hepatitis Materials Available:

We have a limited supply of free materials available. They are pre-packaged in the following quantities:
A Box of 1,500 Palm cards
A box of 1,000 Palm cards, 500 Baby Boomer postcards, & 500 website cards.

Please email us at if you have a need for materials to distribute.

Pack Health
Don’t forget to check out Pack Health: a free resource to help patients navigate their HCV treatment journey from applying for treatment to cure.
Enter your contact info
Use promo code: HCV2017
Get 3 months of membership free! As easy as 1-2-3!

Questions? Call us at 885-255-2362 8am-5pm | Monday-Friday 
• Get a personal Health Advisor to coach you on your journey 
• Develop a personalized plan – you set the goals, we’ll help you get there 
• Find answers and accountability to get the results you want 
• Use the tools and guides we send you to track your progress.
View all newsletters here....

Hep - Your Guide to Hepatitis
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.

June - Hep Summer Issue 2018
Alive and Kicking
A photographer helps his mom get cured of hep C after reading Hep magazine.

Mother and Child Reunion 
Connie Dewbre’s son convinced her to get cured of HCV again after visiting our Hep magazine website.
Read the news
Check out the talented people who blog at Hep.

The National Viral Hepatitis Roundtable
The National Viral Hepatitis Roundtable (NVHR) is national coalition working together to eliminate hepatitis B and C in the United States.

The New York City Hepatitis C Task Force
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.
View all: Hep Free NYC Newsletters

HCV Action
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.
View recent newsletters

Healio: International Liver Congress 2018
HCV Next is a monthly publication offering patients the latest research, news and commentary on liver disease and viral hepatitis, published online at Healio.
Read a nice summary of the liver meeting in the May/June issue.

World Hepatitis Alliance
We run global campaigns, convene high-level policy events, build capacity and pioneer global movements, ensuring people living with viral hepatitis guide every aspect of our work.
Read all updates
Newsletters - 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.

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.
View all updates here....

Weekly Bull

HepCBC is a Canadian non-profit organization offering awareness with basic information about HCV and a weekly digest of news.
Read the highly successful Weekly Bull.

Pacific Hepatitis C Network (PHCN)

Welcome to the Pacific Hepatitis C Network (PHCN)‘s Hepatitis C News in Review 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.
View all updates
Newsletter Sign Up

CATIE strengthens Canada’s response to HIV and hepatitis C by bridging research and practice. We connect healthcare and community-based service providers with the latest science, and promote good practices for prevention and treatment programs.
Sign up for CATIE Email Newsletters
Updates - News

CanHepC - Canadian Network on Hepatitis C
CanHepC is a collaborative research network funded by the Canadian Institutes of Health Research (CIHR) and the Public Health Agency of Canada (PHAC) dedicated to translational research linking over 100 researchers, trainees, knowledge-users (community members, community-based organizations, policy and decision makers) in the field of Hepatitis C (HCV) from across Canada as well as international partners.
View all newsletters here.....

Hepatitis Victoria
Hepatitis Victoria is the peak not-for-profit community organisation working across the state for people affected by or at risk of viral hepatitis.
GOOD LIVER MAGAZINE is our quarterly newsletter, providing in-depth articles, interviews and reports, as well as detailing upcoming events, support groups, liver clinics, and other items likely to be of interest to our members. HepChat is our monthly electronic newsletter sharing news and information about hepatitis and the projects and activities we're working on, subscribe to HepChat. We also produced short podcasts interviewing health experts and practioners on topics related to viral hepatitis - come have a listen!

British Liver Trust
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.

Hepatitis B Foundation
Hepatitis B Foundation is a national nonprofit dedicated to finding a cure and improving the quality of life for people affected by hepatitis B worldwide.
All newsletters, sign up
Blog & News

Hepatitis A - Voice of San Diego
Voice of San Diego is an award-winning nonprofit news organization based in San Diego, California.
The Hep A Fallout Continues: On this week’s San Diego Explained, Voice of San Diego’s Jesse Marx and NBC 7’s Monica Dean take a look back at San Diego’s response to last year’s hepatitis A outbreak, listen here.

National Institutes of Health
A monthly newsletter from the National Institutes of Health, part of the U.S. Department of Health and Human Services
June Newsletter
View all newsletters:

The Best Of The Best
HCV Advocate - Hepatitis C Blog - Daily Updates - Updated with about 5 posts per week
Lucinda K. Porter - Updated about once a week
Hep - Updated with 5 or more posts per week
ADRLF (Al D. Rodriguez Liver Foundation) - Updated monthly
Hepatitis NSW Updated about twice or more per month
Life Beyond Hepatitis C - Updated with about 3 posts per week
I Help C - Updated about twice or more per month
CATIE Blog - Updated about twice or more per month
Canadian Liver Foundation - Updated about twice or more per month
AGA Journals - Updated once a week
Hepatitis B Foundation - Updated once a week or more.
HIV and ID Observations - Updated once a week
The Hepatitis C Mentor and Support Group - (News) Updated once a week or more

Live Fit Liver Fit Get Fit (American Liver Foundation) - Monthly updates
Harvard Health Blog - Updated with about 3 posts per week
ACP Internist and American College of Physicians - Weekly & monthly updates
Healio Med Blog- Monthly updates

Digestive Disease Week® (DDW) 2018
June 2-5, 2018
Website - Digestive Disease Week® (DDW)
DDW Blog
DDW Daily News
Topics at DDW:
AASLD’s annual Hepatology Update: The Year in Review session will feature recent advances in hepatitis C, hepatitis B, nonalcoholic fatty liver disease, and liver transplantation. Other sessions include Functional GI and Motility Disorders; Irritable Bowel Syndrome, Functional Dyspepsia.

On This Blog

Meeting Coverage
Healio staff will report live on breaking news presented at the meeting and capture video interviews with experts to gain their perspectives on important presentations. 
Free registration may be required

Thanks for stopping by!

Thursday, May 17, 2018

HCV Next overview from EASL 2018: Dr. Reau’s summary of key HCV data & real-world studies

May/June 2018 Issue
PCPs will play critical role in future HCV treatments
View the latest issue of HCV NEXT, published online at Healio

HCV Next is a monthly publication offering patients the latest research, news and commentary on liver disease and viral hepatitis.

Table of Contents
The Take Home
The Take Home: International Liver Congress 2018
Nancy S. Reau, MD
This year, although there was much buzz about hepatitis B virus (HBV) and nonalcoholic steatohepatitis, hepatitis C virus (HCV) still held a prominent place in the oral presentations. As clinicians, we can take home some new data about 8-week regimens, real-world data, treatment failures and retreatments and how sustained virologic response affects both hepatocellular carcinoma risk as well as the risk for extrahepatic malignancies.

International Liver Congress Offers Insight on the ‘Social Science’ of HCV
Ira M. Jacobson, MD
This month’s issue has a very nice summary of the data on therapeutic regimens presented at the International Liver Congress by Nancy S. Reau, MD. For me, the meeting highlighted how high is the summit to which we’ve climbed after years of a massive international effort to cure HCV, and how much the focus is shifting. We heard little about new HCV regimens and instead focused on real-world data sets on existing regimens and, equally important, the theme that HCV treatment has become as much of as social science as a medical one as we strive toward elimination. We saw an appropriate emphasis being placed on screening, linkage and access to care, including underprivileged and high-risk populations, on a national and global scale.

HCV hospitalizations increasing among baby boomers, men, drug users

PCPs will play critical role in future HCV treatments

In the Journals Plus
HCV finger-stick test accurate, gives results in 1 hour

View the Current Issues
HCV Next
Infectious Diseases in Children
Infectious Disease News

Wednesday, May 16, 2018

Do fatigue and quality of life improve after hepatitis C is cured?

Do fatigue and quality of life improve after hepatitis C is cured?
Keith Alcorn
Published: 16 May 2018

Patient-reported outcomes such as fatigue, vitality and mental health improve substantially in the two years following hepatitis C cure for people with cirrhosis, but people with cirrhosis are less likely than others to experience rapid resolution of severe fatigue after successful hepatitis C treatment, according to two studies from the Center for Outcomes Research in Liver Diseases reported last month at the 2018 International Liver Congress in Paris.

Quality of life can be severely impaired in people with chronic hepatitis C, especially in people with cirrhosis. Fatigue, insomnia, problems in physical functioning, depression, anxiety and mood disorders are reported by a substantial proportion of people with hepatitis C....

Recommended Reading
Conference highlights

For more information on hepatitis visit
Infohep is a project we're working on with the World Hepatitis Alliance and the European Liver Patients Association.

Sunday, May 13, 2018

HCV in 2018: Success stories and remaining challenges? EASL 2018 Summary from NATAP

Just In Case You Missed It
Coverage highlights of EASL's 2018 International Liver Congress

The National AIDS Treatment Advocacy Project (NATAP)
Available online @ NATAP
May 4, 2018
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.

Healio - HCV Next May/June Issue
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…

HCV Advocate
May 1, 2018
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...

infohep bulletin
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"

Clinical Care Options CCO
Expert faculty members summarize key viral hepatitis studies from this important annual conference.
Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.
*Free registration required

Practice Guidelines - EASL Recommendations on Treatment of Hepatitis C 2018
During the meeting The European Association for the Study of the Liver (EASL) released the following four major clinical practice guidelines; hepatocellular carcinoma, decompensated cirrhosis, alcoholic liver diseases and updated recommendations on hepatitis C.

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

On This Blog
Link to websites offering coverage, meeting highlights, learning activities, and a summary of the meeting, here....

Friday, May 4, 2018

Fewer non-liver cancers in people treated with DAAs compared to the interferon era

Fewer non-liver cancers in people treated with DAAs compared to the interferon era
By Keith Alcorn
The risk of non-liver cancer is lower in people treated with direct-acting antivirals (DAAs) than in those treated with interferon and is probably an effect of the improved cure rate of hepatitis C on these drugs, according to an analysis of US patients treated for HCV presented last month at the 2018 International Liver Congress in Paris.

Several non-hepatic cancers occur more frequently in people with chronic hepatitis C infection, especially non-Hodgkin lymphoma. Successful interferon-based treatment for hepatitis C has been shown to reduce the risk of non-hepatic cancers but part of this effect may be a consequence of a direct anti-tumour effect of interferon. Any reduction in cancer incidence in people treated with DAAs might represent an effect of hepatitis C cure on cancer risk as DAAs have no known anti-tumour effects.

To investigate whether curing hepatitis C with DAAs reduces the risk of non-liver cancers compared to interferon-based treatment, researchers from pharmaceutical company Gilead Sciences looked at 367,156 adults with hepatitis C identified from US health insurance claims databases. Insurance claims data were used to identify treatment for both hepatitis C and for any form of cancer.

The researchers compared people treated for hepatitis C in two periods: between January 2006 and May 2011, when people would have been exposed to interferon or pegylated interferon only, and from December 2013 to March 2017, when people would have been exposed to DAA treatment (and excluding the first generation of DAAs that were used in combination with interferon).

The study identified 10,989 people treated with interferon and 22,894 people treated with DAAs. People treated with interferon were younger than those treated with DAAs (a median of 51 years compared to 57 years of age) and tended to have a lower prevalence of co-morbidities, risk factors for cancer such as smoking and obesity, and less advanced liver disease.

Interferon-treated individuals were treated for a median of 2.6 years and DAA-treated individuals for a median of one year.

Analysis of the relative risk of cancer showed that whereas the risk of cancers strongly associated with hepatitis C – non-Hodgkin lymphoma and bile duct cancer – was no lower in people treated with DAAs, the risk of several major cancers was reduced in people treated with DAAs. Prostate cancer, lung cancer, leukaemia and bladder cancer occurred less frequently in people treated with DAAs.

The reduction in the risk of a major cancer ranged from a 29% reduction in the risk of prostate cancer (adjusted hazard ratio 0.71, 95% CI 0.52-0.97), the most common major cancer in the study population (three cases per thousand people during each year of follow-up), to a 62% reduction in the risk of leukaemia (aHR 0.38, 95% CI 0.24-0.60), which occurred in less than one in a thousand people during each year of follow-up.

The study found no significant reduction in the risk of colorectal, breast, oesophageal or pancreatic cancers in people treated with DAAs.

The overall risk of any major cancer was reduced by 14% in those treated with DAAs when compared to those treated with interferon (aHR 0.86, 95% CI 0.80-0.93).

The investigators concluded that although the mechanisms for the differences in risk by tumour site are unclear, the overall reduction in the risk of major cancers may reflect the difference in cure rates between people treated with interferon-based regimens and people treated with much more effective DAA regimens.

Chokkalingam A et al. Risk of total non-hepatic cancer following treatment for HCV infection with direct-acting antiviral agents. The International Liver Congress, Paris, abstract PS-155, 2018. Journal of Hepatology 68: S86, 2018.

Source - infohep

Coverage @ infohep: The International Liver Congress

Thursday, May 3, 2018

May Hepatitis Newsletters: 2018 International Liver Congress Recap & The Fallout Guide for Hep C

May Hepatitis Newsletters
Welcome to this month's index of viral hepatitis newsletters, with updates from your favorite bloggers and today's news.

Where To Begin?
HCV Advocate's May issue is all about key data presented at the 2018 International Liver Congress, with easy to understand commentary by Alan Franciscus and lovely Lucinda K. Porter. The ever so talented Rick Nash is working on a six-part series called: The Fallout Guide for Hep C, part one is ready over at HEPATITISC.NET. Additional blog and newsletter updates are provided below, enjoy!

May Is Hepatitis Awareness Month
The month of May is designated as Hepatitis Awareness Month in the United States, and May 19th is Hepatitis Testing Day. Learn more: Resources for Hepatitis Awareness Month and Hepatitis Testing Day

National Viral Hepatitis Roundtable 
NVHR Calls for Increased Recognition of Hepatitis C as a Systemic Health Condition
Washington, D.C. (May 1, 2018) – The National Viral Hepatitis Roundtable (NVHR) today urged healthcare providers, policymakers, and the public health community to use Hepatitis Awareness Month as an opportunity to expand treatment opportunities for patients living with the hepatitis C virus (HCV) by reconsidering the way we think about HCV. Despite the availability of new, highly effective oral medications to cure the disease, the burden of hepatitis C continues to grow in the United States.
View NVHR May Newsletter

In The News
Due to the opioid epidemic, the rate of hepatitis C virus infection among pregnant women increased 60 percent between 2006 and 2014, according to a study, yet only 30 percent of infants exposed to the virus were screened for infection. The study, “Hepatitis C Virus Screening Among Children ExposedDuring Pregnancy,” will be published in the June 2018 issue of Pediatrics (published online May 2).

Seatbelts may protect against severe liver injury in car crashes
(Reuters Health) - Wearing a seatbelt may not prevent liver injuries in a car crash, but it could lessen their severity and make a major difference in the accident’s consequences and costs, researchers say. Among more than 50,000 people with liver injuries as a result of a car crash, those with severe liver injuries were twice as likely to die as those with mild or moderate liver injuries, researchers found.

NEW YORK (Reuters) - The number of Americans sickened each year by bites from infected mosquitoes, ticks or fleas tripled from 2004 through 2016, with infection rates spiking sharply in 2016 as a result of a Zika outbreak, U.S. health officials said on Tuesday.

Hospital: Injected patients at risk of Hep C exposure from nurse who stole drugs
May 1, 2018
A hospital is warning 2,600 emergency room patients they may be at risk of Hepatitis C exposure from a nurse who admitted to stealing drugs.

Take-home Narcan kits lifesaving in opioid overdoses
(Reuters Health) - Distributing take-home overdose prevention kits substantially reduced the number of deaths from opioid overdoses in a Canadian province, researchers say.

Flu Vaccines Have High Impact, Even With Relatively Low Efficacy
Last Updated: April 30, 2018.
Even relatively low-efficacy influenza vaccines can have a high impact, especially with optimal distribution across age groups, according to a study published online April 30 in the Proceedings of the National Academy of Sciences.

In Case You Missed It
Cochrane Review Flawed For Discounting SVR As A Marker Of Viral Cure & Endpoint For Measuring Treatment Impact.
Patients, advocates, and experts agree stigma and discrimination remains a barrier to testing and treatment, however, the benefit of curing hepatitis C with astounding cure rates is not all that controversial. Reason enough for experts to get caught up in a 2017 systematic review published by the Cochrane Collaboration on the benefit of achieving a cure using hepatitis C direct-acting antivirals (DAAs). The review concluded patients who were cured with DAA-based regimens did not reduce their risk for HCV-related morbidity or all-cause mortality. Within days, an outcry emerged from experts urging patients not to be influenced by the misleading and harmful conclusion, or be confused by any media coverage that followed....

Dietary improvements may prevent NAFLD
(Reuters Health) - People who make an effort to improve their diet may have a lower risk of non-alcoholic fatty liver disease (NAFDL) than individuals who stick to unhealthy eating habits, a U.S. study suggests. While dietary changes are recommended to treat NAFLD, research hasn't clearly demonstrated whether these changes can work for prevention.

Radiation segmentectomy a potential curative therapy for liver cancer
NEW YORK (Reuters Health) - Long-term outcomes with radiation segmentectomy are on par with curative-intent treatments for patients with early-stage hepatocellular carcinoma (HCC), according to a new paper.

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".

Clinical Care Options
Key Viral Hepatitis Studies Influencing My Practice Following EASL 2018
Expert faculty members summarize key viral hepatitis studies from this important annual conference.

Listen to downloadable audio from a live Webinar by Zobair M. Younossi, MD, MPH, FACP, FACG, AGAF, in which the clinical impact of new NAFLD/NASH data reported at the Paris meeting is discussed.
*Free registration required

EASL LiverTree - Open To All
This year webcasts and congress materials are open access! Watch freely the conferences and ePosters:!*menu=6*browseby=3*sortby=2*ce_id=1307
*Free registration required

Read today's news or a nice summary of notable headlines published in the latest issue of The Weekly Bull.

Caring Ambassadors
Literature Review
Monthly Pubmed Review of the Most Relevant Research on Hepatitis C
March & April 2018

SVR after HCV therapy reduces extrahepatic mortality, manifestations
Results of a recent systematic review and meta-analysis showed that sustained virologic response after hepatitis C therapy can reduce extrahepatic manifestations including insulin resistance and cardiovascular risks...

Conatus completes enrollment in phase 2 trial for NASH cirrhosis inhibitor
Conatus Pharmaceuticals completed enrollment in its ENCORE-PH phase 2 clinical trial for emricasan, an orally-active pan-caspase inhibitor designed to treat nonalcoholic…

Healio Updates
Read the latest news
Current Publications
HCV Next
Healio Gastroenterology
Infectious Disease News


HCV Advocate 
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.

May Newsletter

Lucinda’s Highlights from the 2018 International Liver Congress:
Risk of Liver Fibrosis Progression in Patients with Undiagnosed Hepatitis C Virus Infection
Protective Effect of Cannabis and Coffee Consumption on HCV-related Mortality in French HIV-HCV Co-Infected Patients
Poor Awareness of Liver Disease Shortly Before Cirrhosis Death: Findings from a Large Community Cohort in the UK
The Covert “C”; Prevalence: Risk Factors and Management of Hepatitis C in Psychiatric In-Patients
Effectiveness of Hepatitis C Virus Screening Laws in the United States: Evidence from Paid Claims Data from 2010 to 2016
Lower Risk of Multiple Sclerosis in Patients with Chronic Hepatitis
Screening for Neurocognitive Dysfunction in Non-Cirrhotic Chronic Hepatitis C Infection in an Irish Academic Unit

Alan’s Highlights from the 2018 International Liver Congress:

Testing and linkage to care outcomes in baby boomers versus young adults tested in the community and linked to care at a Federally Qualified Health Center in the US
Linkage to HCV care and reincarceration following release from New York City jails
Direct Antiviral Agents are safe and efficacious in pediatric patients with chronic hepatitis C; Real-world data from the public health perspective
Salvage treatment of HCV patients by Sofosbuvir, Daclatasvir, Simeprevir, and Ribavirin after repeated treatment failures is associated with SVR and reduced risk of hepatocellular carcinoma

Hepatitis Headlines – read about a new hepatitis C therapy in clinical trials, hepatitis C screening rates among baby boomers, the opioid epidemic and about Hepatitis Awareness Month in May.

What’s Up!
We have updated the following HCSP’s Guide and Fact Sheets:

A Guide to Understanding HCV is our most popular downloaded publication. We have completely rewritten and designed the Guide.

HCSP Fact Sheets:
Overview of Disease Progression
HCV Disease Progression: What is Fibrosis?

Don’t forget to check out for a free resource to help patients navigate their HCV treatment journey. Click on and use promo code HCV2017.

Check out our Hep C Video of a patient journey through treatment and cure . . .

The New York City Hepatitis C Task Force

British Liver Trust
We’d love to keep in touch to let you know how your support is helping so to keep receiving our newsletter and updates, please click here to register your preferences today.

May - Good practice case study: Nottingham University Hospitals NHS Trust Homecare treatment delivery
This HCV Action good practice case study focuses on Nottingham University Hospitals Trust's Homecare treatment delivery project. The project offered patients the option to receive treatment for hepatitis C in their own homes. The project proved popular with patients and resulted in a number of benefits to the service compared with delivering treatment in secondary care.
View All Updates:

April/May 2018 Issue
In every issue, you’ll find the hottest topics of interest to our readers along with cutting-edge health information.
View all updates:

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

World Hepatitis Alliance
Successful hepatitis C virus (HCV) therapy reduces the risk of a serious cardiovascular event in people with compensated liver cirrhosis, French.
Read all updates:

Newsletter: HEPVOICE - World Hepatitis Alliance

Pacific Hepatitis C Network

Help-4-Hep BC Celebrates 1 Year!
4 May 2018
by Daryl Luster, PHCN Board President
As we near the completion of our first year operating the Help-4-Hep helpline herein BC, I thought it would be a good time to reflect back. A private and confidential service like our helpline fills a gap not met by other resources. With the stigma still unfortunately alive and well across all populations affected by hep c, Help-4-Hep BC provides a means to access peer support and knowledge, as well as resources to help people navigate a process that can be overwhelming.

GI & Hepatology

Blog Updates

Why Bringing Liver Research to Life Matters
If liver disease is a jigsaw puzzle, then research are the puzzle pieces. When put in the right sequence these pieces have the ability to create a full and detailed picture…

HEP Blogs
Hepatitis Awareness Month is Officially Here
It is Hepatitis Awareness Month and for the next 31 days we pay extra attention to issues surrounding viral hepatitis. I am committing to do at least one daily action to raise awareness about virus hepatitis. I hope you will join me today and throughout this month, as we work to educate, challenge, and eventually eliminate viral hepatitis.

5 Ways You Can Take Care of Your Liver
An unhealthy diet can lead to liver disease and compromise the function of your liver. The American Liver Foundation states,“eating high fatty foods will put you at risk of being overweight and having non-alcoholic fatty liver disease and at risk for other disease.”

Still in India, Greg writes the next installment of his blog sitting in the back seat of a taxi driving from Udaipur to Jaipur.

Common Co-Infections with Hepatitis C
A look at some of the common co-infections that may accompany hepatitis C

Is hepatitis C criminalized in your state?

This is part one of a six-part series called The Fallout Guide for Hep C. Six emotional components of living with hep C which are important to address to maintain our sense of self as we traverse the difficult hardships ahead.

I Help C
Have you ever had a perfectly fine day turn into a hot mess? It happened to me recently. I made it through, and even learned a few lessons. Mostly, I survived. It started when I met with the mechanic for an engine check. We had been feeling it downshift occasionally. I was fine right up until the checker inner guy asked me what was wrong. All of a sudden, I slumped down and tears sprang to my eyes. The room went blurry. My purse felt like it weighed 90 pounds. After leaning on the counter, I tried to tell him my story. Looking back, I was falling apart with the long term side effects from Hepatitis C.

Then I went in for my 3 months screening and sure enough, the tumor was back. It’s the same one that I had the Transcatheter Arterial Chemoembolization (TACE) for. It worked and knocked that sucker out for a while. But I understood that it could grow again. They call it a recurrent or residual tumor.
Read all updates:

Creating a World Free of Hepatitis C
Last week, I talked about how to read drug product information (PI). This week I’ll discuss the parts of the PI that I didn’t cover last week in Medication: Reading the Fine Print. This includes the more complicated concepts, which I will try to put in to simpler terms.
Read all updates:

Hep B Blog
Welcome to “Journey to the Cure.” This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.
Read all updates:

Confused and trying to understand your hepatitis B blood test results? Check out our easy to use chart.

HIV and ID Observations
As mentioned last week, I’m currently attending on the general medical service, a chance to brush up on non-ID clinical skills, and more importantly, to work with smart, energetic house staff and medical students.
Not surprisingly, there’s a wide range of clinical ID on this service, and this year we’ve had a rash of streptococcal infections.
Read all updates:

Al D. Rodriguez Liver Foundation
Alcohol’s Heart Benefits May Not Apply to People With Liver Disease
Numerous articles and videos circulated on social media and reputable websites, stating that light to moderate alcohol intake offers cardio-vascular health benefits. But does this apply to everyone? Studies show that it might not be the case for people with liver disease.
Read all updates:

Harvard Health Blog
Journal Of Hepatology
May 2018 Volume 68, Issue 5, Pages 1063–1075
Fructose and sugar: A major mediator of non-alcoholic fatty liver disease
Thomas Jensen , Manal F. Abdelmalek, Shelby Sullivan, Kristen J. Nadeau, Melanie Green, Carlos Roncal, Takahiko Nakagawa, Masanari Kuwabara, Yuka Sato, Duk-Hee Kang, Dean R. Tolan, Laura G. Sanchez-Lozada, Hugo R. Rosen, Miguel A. Lanaspa, Anna Mae Diehl, Richard J. JohnsonFull-Text
View Online
PDF (952 KB)
While we have known for many years that fructose and beverages sweetened with high fructose corn syrup can contribute to nonalcoholic fatty liver disease, this is an excellent review of the literature to date on this topic. In addition, it postulates the potential mechanisms that could be contributing to fructose's contribution to the development of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. It also highlights the factors that can potentiate the effect that fructose has on the liver, including genetic mechanisms, the role of fructokinase, high-fat diets, and alcohol.

Even one drink a day linked to lower life expectancy
Even light drinkers who enjoy a single beer or glass of wine every night may still be more likely to die prematurely than people who drink less, a recent study suggests.

Benzodiazepines: America's 'Other Prescription Drug Problem'
Public Radio Tulsa
Drugs like Valium, Xanax and Ativan are more popular than ever. Frequently used to treat anxiety, the medicines can be risky, especially when mixed with alcohol or opioids.

The BMJ 28 Apr 2018
From Richard Lehman’s journal review—30 April 2018
Old surgeons and good outcomes
Watching snooker on the television is a harmless pastime, though you must be sure to press the mute button. Then you can listen to music, or trawl through lists of references, or have a snooze. Such are the diminishing pleasures of elderly life. Should you happen to watch the game, you will find that younger players tend to become overconfident and take on shots which, when missed, lead to their eventual downfall. Older players simply go for safety, and end up winning. Here is a study which shows that surgeons are the same. “Using national data on Medicare beneficiaries in the US, this study found that patients treated by older surgeons had lower mortality than patients treated by younger surgeons. There was no evidence that operative mortality differed between male and female surgeons.” Strange there are so few female snooker players.

Dietary interventions may be able to send type 2 diabetes into remission, and intensive lifestyle interventions with some help from modern technology means more patients may now have the support they need to accomplish this.

On This Blog
HCV, type 2 diabetes & fatty liver disease - Importance of diet and exercise

Just So You Know

Reports that dark chocolate 'improves eyesight' are unconfirmed
"Dark chocolate improves your eyesight," is the unusual headline from the Mail Online following a small trial comparing the effects of dark and milk chocolate on vision. The theory is that dark chocolate is high in antioxidant flavanols, which are touted as having many potential health benefits, including effects on the nervous system.

Dark chocolate and health: Fudging the evidence with USA Today
How does dark chocolate “support” your health? According to USA Today, it can do so because an unpublished pilot study involving just five people–yes, five–showed eating lots of it over a few days “influenced gene activity, increased anti-inflammatory agents and increased infection-fighting cells.” A second pilot study also showed it can “positively impact brain function” on five people, the paper reported.

Wishing you all a good week ahead, thanks for stopping by.

Sunday, April 29, 2018

Cochrane Review Flawed For Discounting SVR As A Marker Of Viral Cure & Endpoint For Measuring Treatment Impact.

One Step Forward, Two Steps Back
Is it just me, or does it seem like each emerging milestone we make on the war against hepatitis C is eventually somewhat derailed? Either in the media, or worse yet, by failed and highly disputed research. Let me explain, over the years it went something like this; awareness (test all baby boomers, not everyone agreed), stigma (still working on it), cost (great drugs, too expensive), access & coverage (restrictions, you're not sick enough), and finally we cure the virus (Cochrane Review, cure, no proof of benefit).

Cochrane Review - Controversial Paper On HCV Therapy
Patients, advocates, and experts agree stigma and discrimination remains a barrier to testing and treatment, however, the benefit of curing hepatitis C with astounding cure rates is not all that controversial. Reason enough for experts to get caught up in a 2017 systematic review published by the Cochrane Collaboration on the benefit of achieving a cure using hepatitis C direct-acting antivirals (DAAs). The review concluded patients who were cured with DAA-based regimens did not reduce their risk for HCV-related morbidity or all-cause mortality. Within days, an outcry emerged from experts urging patients not to be influenced by the misleading and harmful conclusion, or be confused by any media coverage that followed.

*In case you missed the backstory, click here to review each expert rebuttal.

Cochrane Research Flawed 
Published April 10, 2018, online in Critical Public Health, patients can further explore the most recent rebuttal; Evidence-making controversies: the case of hepatitis C treatment and the promise of viral elimination.

*Thank you Henry E Chang, for downloading and sharing the full-text report on Twitter.

Here is an excerpt to get you started:
The EASL claims the Cochrane research has a ‘flawed methodological approach’, and that this is linked to its lack of hepatology expertise, including an ‘ignorance of the natural history of hepatitis C’. This ‘ignorance’ centres on the truth most troubled by the Cochrane review; that it ‘fails to accept that DAA treatment to attain an SVR is a pivotal outcome of treatment’, and that it ‘does not accept the likelihood that an SVR will reduce the risks of long-term outcomes of hepatitis C’. All the published responses we analysed (see above) present as ‘unanimous’ in characterising the Cochrane review as flawed for its discounting of SVR as a marker of viral cure and as an appropriate endpoint for measuring treatment impact.
Begin here.....

EASL's 2018 International Liver Congress - The Evidence Is In
Although this months "infohep bulletin" is not an official rebuttal over the failed Cochrane group's review, it does offer us an overview of EASL's 2018 International Liver Congress, and highlighted two studies at the meeting that "provided clear evidence that curing hepatitis C infection results in a reduction in the risk of dying from a liver-related cause."

Begin here....

Until next time,