Pediatric HCV: Small Patients, Big Decisions

Pediatric HCV: Small Patients, Big Decisions

Hi everyone, the September 2015 digital edition of HCV Next is now available for your viewing pleasure online at Healio.

HCV Next provides an overview of current hepatitis C topics, as well as content on all forms of viral hepatitis, and other liver related disease.

Table of Contents

5 Questions
A Conversation with Philip Rosenthal, MD

Cover Story
Pediatric HCV: Small Patients, Big Decisions

Editorial
HCV Guidelines: A Living Breathing Document

In the Journals
Caffeine Decreases Risk of Hepatic Fibrosis in Male HCV Patients

Liver Disease Expected to Increase in Switzerland Over Time

Researchers Recommend Use of HCV-Positive Organs for Kidney Transplant

HCV may Increase Risk for Coronary Atherosclerosis in MSM

SVR Leads to Survival Benefit Among HCV Patients

Cirrhosis in HCV Patients may be Underdiagnosed

Patient Profile

Southern Perspective: Practical Solutions for Daily Management of HCV
Ryan Ford, MD

Special Series
Global View: Egypt in Focus

Trend Watch
WHO Encourages Safe Injection Use to Prevent HBV, HCV

AASLD/IDSA Release Updated HCV Treatment Guidelines

Georgia Launches HCV Elimination Program

Janssen Initiates Phase 1 Trial of Simeprevir/Odalasvir for AL-335 Pharmacokinetics

AASLD/IDSA Update - HCV guidance for Cost, Reimbursement and Cost-Effectiveness Considerations

The American Association for the Study of Liver Diseases (AASLD), in partnership with the Infectious Diseases Society of America (IDSA) and in collaboration with the International Antiviral Society-USA (IAS-USA), created Recommendations for Testing, Managing, and Treating Hepatitis C in 2014. an online living document with ever evolving guidelines to aid practitioners treating patients infected with hepatitis C virus (HCV). An update to the HCV guidance for Cost, Reimbursement and Cost-Effectiveness Considerations was recently published online, here.

OVERVIEW OF COST, REIMBURSEMENT, AND COST-EFFECTIVENESS CONSIDERATIONS FOR HEPATITIS C TREATMENT REGIMENS

The Hepatitis C Guidance describes how to diagnose, link to care, and treat most groups of patients with HCV. (AASLD/IDSA/IAS-USA, 2015) However, a common challenge is reduced access to treatment caused by restrictions on drug reimbursement. This section summarizes the US payer system, explains the concepts of cost, price, cost-effectiveness, value, and affordability, and reviews current evidence of the cost-effectiveness of strategies to improve access to treatment. Although these may sound similar and are often confused, the following discussion will seek to clarify these terms with regard to HCV therapy. To be clear, this section is informational. As explained below, actual costs are rarely known. Accordingly, the HCV Guidance does not utilize cost-effectiveness analysis to guide recommendations at this time.

Continue reading, here.... 

AASLD/IDSA Guidlines Updated: When and In Whom to Initiate Therapy

The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) with the International Antiviral Society developed a living document with ever evolving guidelines to treat HCV.

The new guidelines have a complex algorithm for practitioners around the country to follow and see whats the right right treatment, for the right patients, for the right about of time. The document is patient friendly, which benefit patients living with or considering HCV therapy. 

When new HCV drugs are approved, and new real world data is established, the guidelines are updated.

Guidance Sections Updated

The When and In Whom to Initiate Therapy, Initial Treatment, Retreatment, Acute HCV Infection, and Unique Populations (HIV/HCV Coinfection, Decompensated Cirrhosis, and Renal Impairment) sections have been updated to reflect newly available data presented at the European Association for the Study of the Liver (EASL) International Liver Congress 2015.

HCV Guidance is available as an "Accepted Article" in HEPATOLOGY

Article first published online: 4 AUG 2015

Hepatology
Full Text
Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus
The pace of hepatitis C virus (HCV) drug development in recent years has accelerated dramatically. For patients to benefit from these impressive advances, practitioners need access to the most up-to-date data and to advice from experienced experts. Such information and advice can be difficult to access readily given the diverse sources from which information is available and the sometimes lengthy time needed for publication of original articles and scholarly perspectives. Traditional practice guidelines for more established areas of medicine and care often take years to develop and bring to publication. In the new era in hepatitis C treatment, such a process would not be nimble or timely enough to address the needs of patients with HCV infection, practitioners caring for these patients, or payers approving therapies for use. A living document made available in a web-based system, such as that used by the US Department of Health and Human Services for human immunodeficiency virus (HIV) treatment recommendations (http://aidsinfo.nih.gov/guidelines), was selected as the best model to provide timely recommendations for hepatitis C management. In 2013, the two major membership societies supporting liver and infectious disease specialists (American Association for the Study of Liver Diseases [AASLD] and Infectious Diseases Society of America [IDSA]) joined forces to develop guidance for the management of hepatitis C in this rapidly moving field. The International Antiviral Society-USA, which has experience in developing treatment guidelines in HIV disease, was invited to join the effort as a collaborating partner responsible for managing the panel and the guidance development process.

The goal of the hepatitis C guidance is to provide up-to-date recommendations for HCV care practitioners on the optimal screening, management, and treatment for adults with HCV infection in the United States, using a rigorous review process to evaluate the best available evidence. This review provides a condensed summary of recommendations from the guidance. The complete guidance, which is updated regularly, is available at www.hcvguidelines.org.

Continue to HEPATOLOGY...

AASLD updates guidance for use of hepatitis C drugs

AASLD updates guidance for use of hepatitis C drugs

The American Association for the Study of Liver Diseases (AASLD), in partnership with the Infectious Diseases Society of America (IDSA) and in collaboration with the International Antiviral Society-USA (IAS-USA), created online Recommendations for Testing, Managing, and Treating Hepatitis C in 2014 to aid practitioners treating patients infected with hepatitis C virus (HCV). Now an update to the Guidance, with a summary of recommendations regarding treatment with direct-acting antiviral drugs, is published in the AASLD journal, Hepatology.

HCV is a blood-borne virus that infects the liver and may lead to cirrhosis or liver cancer (hepatocellular carcinoma). In the past 25 years HCV has gone from an undiagnosed disease to an epidemic level, with the World Health Organization (WHO) estimating that up to 150 million people worldwide live with chronic disease.

In the U.S., close to 30,000 new acute cases were reported in 2013 and 2.7 million Americans have chronic HCV according to the Centers for Disease Control and Prevention (CDC). "The good news is that HCV is now on the cusp of being a curable disease for the millions of Americans, many of whom are undiagnosed," says Dr. Gary Davis, President of MedLogician Consulting and co-chair of the AASLD/IDSA HCV Guidance writing panel. "The web-based Guidance document is an easy-to-use resource for practitioners treating HCV patients with novel antivirals."

A panel of 26 hepatologists and infectious diseases specialists and a patient advocate developed the original consensus recommendations that include:

HCV testing details and linkage to care
Recommendations for initial treatment of HCV infection in patients starting treatment
Retreatment information in persons in whom prior therapy has failed
Unique patient populations data

"The Guidance is a living document that will continually be updated with evidence-based advice about how to best use the next generation of direct-acting antivirals and other treatment options," comments Dr. Keith Lindor from the Arizona State University and President-elect of AASLD. "Our role as associations of researchers and clinicians is to provide key information in the appropriate format to patients and those who care for them."

Practitioners involved with treating patients with liver disease may access the Guidance, including new updates, at http://www.HCVGuidelines.org.

This guidance is published in Hepatology. Media wishing to receive a PDF of this article may contact sciencenewsroom@wiley.com.

Full citation: "Hepatitis C Guidance: AASLD-IDSA Recommendations for Testing, Managing, and Treating Adults Infected with Hepatitis C Virus." Authors on behalf of the Hepatitis C Guidance Panel (see AASLD/IDSA HCV Guidance panel members and authors). Hepatology; Published Online: June 25, 2015, (DOI: 10.1002/hep.27950).

URL: http://doi.wiley.com/10.1002/hep.27950

About the Journal
Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://wileyonlinelibrary.com/journal/hep.