HepCure Webinar Series - Hep C & Fatty Liver, Treatment, Alcohol Use, Elderly Patients and More

Watch experts discuss important HCV related topics in this easy to access webinar series presented by HepCure.

June 26, 2018
Transplant & HCV
On Tuesday, June 26th, Dr. Thomas Schiano of Mount Sinai Medical Center presented on: “Transplant & HCV”
Watch, here….
Download Slides, here.....

June 19, 2018

Nonalcoholic Fatty Liver Disease and Hepatitis C

On June 19th Dr. Amon Asgharpour of the Icahn School of Medicine at Mount Sinai. Dr. Asgharpour presented “Nonalcoholic Fatty Liver Disease and Hepatitis C.”


Watch, here.….
Download Slides, here...…

Of Interest
Michael Carter
Published: 18 June 2018
Fatty liver improves rapidly after hepatitis C cure

Liver stiffness and liver fat (steatosis) in people with chronic hepatitis C virus (HCV) infection both improve significantly after treatment with direct-acting antivirals (DAAs) resulting in sustained virological response (SVR), investigators from Japan report in Alimentary Pharmacology and Therapeutics. Both measures of liver health were assessed six months after SVR. Improvement was associated with a reduction in ALT levels and an increase in platelet count.

On This Blog

June 18, 2018
Hepatitis C Weekend Video: NASH What Is It? 

Elsewhere

July 1, 2018

In the July Issue of the patient-friendly HCV Advocate newsletter, Lucinda Porter, RN., writes a must read article about: Avoiding Fatty Liver.

June 2018

Hepatitis C and Alcohol
On Tuesday, June 5th, Peter Hauser, MD, Director of the National VA Telemental Health Hub Long Beach presented on: “Hepatitis C and Alcohol”.


Watch, here...
Download Slides, here....

May 2018 - HCV Treatment
“Ace the Case” 

Program presented last month led by Dr. Douglas Dieterich of the Icahn School of Medicine at Mount Sinai. This webinar is patient based, with question and answer participation.

Topics
Late relapse in people with HCC
Reinfection
Chemo On HCV
Treating Patients with HCV & Depression & More....
Watch, here.....

HCV in the Elderly Patient
On May 29th, Dr. Roxana Bodin of Westchester Medical Center Health presented on: “HCV in the Elderly Patient”


Watch, here...
Download Slides here.....

Of Special Interest
"Innovation as Usual: Sustainable Financing for Viral Hepatitis Elimination" with Dr. Henry Chang. This webinar will discuss the global target to eliminate viral hepatitis as a major public health problem by the year 2030.
Watch, here.....
Download Slides, here...

Additional Topics
The HCV-Opioid Syndemic in Appalachia: Evidence from a Cohort of Rural Drug Users
Hepatitis C in Children and Adolescents
Cirrhosis & HCV

View All
Webinar Archive

Follow On Twitter
@hepcure 

HepCure Patient App
The patient app is a free resource for patients with hepatitis C, which allows them to track medication adherence, symptoms, and gain access to resources. It is available to download for free on iOS (App Store) and Android (Google Play) operating systems. While the app can be used by patients independently from the dashboard, it can also be linked with the provider dashboard. Providers can push lab data to patients and track treatment adherence and symptom data input by patients in real time.
Learn more here...…

USA HCV Dataset - Patients’ age, location, disease severity, treatment and cure status 2013-2016

Advances in Therapy

Development of a Comprehensive Dataset of Hepatitis C Patients and Examination of Disease Epidemiology in the United States, 2013–2016

Viktor V. Chirikov Steven E. Marx Shivaji R. Manthena John P. Strezewski Sammy Saab

First Online: 09 June 2018
Full-Text
View Online
Download PDF

Hepatitis C virus (HCV) infection may cause serious health problems and death. Unfortunately, the health care community does not have complete identification of patients with HCV. This study describes the creation of a dataset that combines information for HCV patients and shows relevant information about HCV patients’ age, geographic location, disease severity, and treatment and cure status from 2013 through 2016. This dataset helps the health care community understand the HCV patient landscape and make informed decisions about how to best treat this population.

Abstract
Introduction
Chronic infection with hepatitis C virus (HCV) is a leading cause of liver disease and infectious disease deaths. While recent and emerging treatment options for HCV patients have enabled higher rates of sustained virologic response (SVR), the demographic, clinical, geographic, and payer characteristics of the estimated 3.4 million chronic HCV patients in the USA are poorly understood. The goal of this study was to create a dataset describing the current HCV patient landscape in the USA.

Methods
Data from two large national laboratory companies representing the majority of US patients screened for HCV antibody and/or tested for HCV RNA from 2013 through 2016 were organized into the present study dataset. Age, gender, payer channel, 3-digit ZIP code and ordering physician specialty, and 3-digit ZIP code information were available for all patients. Among RNA-positive patients, additional clinical characteristics included HCV genotype, fibrosis stage, renal function, and HIV status. Initiating treatment and attaining cure were imputed using data-driven algorithms based on successive RNA viral load measurements.

Results
The number of RNA-positive HCV patients increased from 200,066 patients in 2013 to 469,550 in 2016. The availability of clinical data measurements and rates of treatment initiation increased over the study period, indicating improved care engagement for HCV patients. Treatment and cure rates varied by age, disease severity, geographic location, and payer channel. Sensitivity and specificity of the cure prediction algorithms were consistently above 0.90, validating the robustness of the data imputation approach.

Conclusion
This is the largest, most comprehensive dataset available to describe the current US HCV patient landscape. Our results highlight that the epidemiology of HCV is evolving with an increasing number of patients who are younger and have milder disease than described in previous years. Results of this study should help guide efforts toward the elimination of HCV in this country. Future work will focus on factors associated with varying treatment and cure patterns and describing recent changes in the HCV patient landscape.

Analysis of Treated Patients by State

To investigate treatment trends further, the prevalence of nearly 90,000 treated HCV patients in 2016 was determined on a state-by-state basis. States with the highest prevalence of treated HCV patients were mainly found on the West Coast, Appalachia, the Northeast, and the Southeast, while much of the Upper Midwest and Great Plains had the lowest prevalence of treated patients 

Continue reading: https://link.springer.com/article/10.1007/s12325-018-0721-1

Localized US Efforts to Eliminate Hepatitis C

Localized US Efforts to Eliminate Hepatitis C
https://doi.org/10.1016/j.idc.2018.02.009 

The following full-text article is available for download, shared by Henry E. Chang via twitter

Download Full Article:
https://jumpshare.com/v/3435iY7I8aaJIxv9Nk3w

Hepatitis Awareness Month: 10 recent reports on viral hepatitis

Hepatitis Awareness Month: 10 recent reports on viral hepatitis
May 8, 2018
The Centers for Disease Control and Prevention have designated May as Hepatitis Awareness Month to raise public awareness of viral hepatitis including the most common strains: hepatitis A, hepatitis B and hepatitis C. Additionally, the CDC designated May 19th as Hepatitis Testing Day.

The following recent reports, many from recent meetings including the International Liver Congress 2018, include new research data on hepatitis prevalence and outbreaks, transmission risks and treatment outcomes.

Read it here: https://www.healio.com/hepatology/viral-hepatitis/news/online/%7B13397d13-9d38-419d-967e-8403491bba8d%7D/hepatitis-awareness-month-10-recent-reports-on-viral-hepatitis

World Hepatitis Alliance - April Issue "Hep Voice"

Out of the 325 million people living with viral hepatitis globally, upward of 300 million (that’s 9 in 10!) are living with the hepatitis B or hepatitis C without knowing. Without a massive scale-up in diagnosis, treatment rates will fall, infection rates will rise and our opportunity to eliminate viral hepatitis by 2030 will be lost.

On World Hepatitis Alliance (WHA), we are launching the Find the Missing Millions global campaign to raise awareness of viral hepatitis, increase testing both at individual and policy level and improve linkage to care.

World Hepatitis Day (WHD) takes places every year on 28 July bringing the world together under a single theme to raise awareness of the global burden of viral hepatitis and to influence real change.

Join us on World Hepatitis Day 2018 in the quest to Find the Missing Millions. Sign up here.

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.

April Issue

Contents
This month in numbers NOhep
Visionaries, access to treatment, WHA members in Nigeria

Hep headlines
Hepatitis B among pregnant women, hepatitis C in PWIDs, new reports from WHO

World Hepatitis Day 2018 - Find the Missing Millions
WHD 2018 campaign launches with focus on diagnosis

Universal Health Coverage
#HealthForAll Community steps up efforts towards UHC

Wall of Stories snapshots: “Late diagnosis left me with cirrhosis”
Rosario from Uruguay shares her story

Reports
PROGRESS REPORT ON ACCESS TO HEPATITIS C TREATMENT FOCUS ON OVERCOMING BARRIERS  IN LOW- AND MIDDLE-INCOME COUNTRIES MARCH 2018

The World Hepatitis Alliance is an ambitious patient-led and patient-driven not-for-profit organisation who works with governments, national members and other key partners to raise awareness of viral hepatitis and influence global change – transforming the lives of the 325 million people living with viral hepatitis and the future we share.

Liver disease burden and required treatment expenditures for hepatitis C virus (HCV) infection in Thailand

Liver disease burden and required treatment expenditures for hepatitis C virus (HCV) infection in Thailand: Implications for HCV elimination in the new therapeutic era, a population-based study
Rujipat Wasitthankasem, Preeyaporn Vichaiwattana, Nipaporn Siripon, Nawarat Posuwan, Chompoonut Auphimai, Sirapa Klinfueng, Napha Thanetkongtong, Viboonsak Vuthitanachot, Supapith Saiyatha, Chaiwat Thongmai, Saowakon Sochoo, Natnada Pongsuwan, Kittiyod Poovorawan, Pisit Tangkijvanich, Yong Poovorawan

Published: April 24, 2018
https://doi.org/10.1371/journal.pone.0196301

Full-Text
Available Online

Abstract

The prevalence of hepatitis C virus (HCV) infection has been decreasing globally, but the growing effects of HCV-related morbidity and mortality remain of concern. Advances in curative medicine, involving direct-acting antivirals (DAAs), have led many countries to aim to eradicate HCV. Information on epidemiology and disease burden is essential for national policy development. Thus, this study aimed to determine the HCV-related hepatic disease burden in areas of Thailand with high and average HCV prevalence in order to extrapolate the viral burden across Thailand. Patients previously diagnosed as positive for anti-HCV antibodies were recruited to assess chronic HCV infection (CHC) status, liver function, HCV-RNA level and hepatic fibrosis. The number of patients eligible for Universal Health Coverage (UC) scheme and the approximately required expenditure on interferon (IFN)-based treatment were estimated. In areas of both high (12%) and average (2%) HCV viremic prevalence, over half of the patients (52.2% to 62.5%) had advanced liver fibrosis (F3 and F4). A striking percentage of patients with F4 (38.9%) were found in the high-prevalence area, while comparable proportions of advanced liver fibrosis presented in the two areas and disease burden peaked at 50–59 years. Under the current UC program treatment scenario, 78–83% of CHC patients with stage F2–F4 fibrosis were eligible for treatment. The estimated expenditure required for overall CHC treatment across the whole country was 1,240 million USD at this current status, but the declining cost of generic DAA-based therapy may reduce the requirement to <90 million USD. This study provides information on the estimated number of CHC patients, liver disease burden and expenditure requirements for Thailand. To eliminate HCV by 2030, proactive government strategies raising public health to minimize transmission and emphasizing targeted screen-and-treatment programs, novel therapeutic guideline development for decentralizing treatment, and effective budget allocation are urgently needed.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0196301

TAGline Spring 2018: Activism and the elimination of HIV, HCV, and TB

TAGline Spring 2018: Bend the curves
05/04/2018

Bend the curves: Activism and the elimination of HIV, HCV, and TB
Incremental change—activism that successfully defends or advances critical research or policy—can sometimes feel inconsequential, particularly when it is hard won, resource intensive, and intangible. But in the context of public health strategies with ambitious targets and formidable stakeholder engagement, it is an undeniable facet of progress. In this issue of TAGline, Treatment Action Group (TAG) highlights some important recent successes and challenges in meeting its overarching goals: moving beyond achingly slow trends and sharply bending the curves on new HIV, hepatitis C, and TB infections, suffering, and deaths.

Spring TAGline contains:
Bend the Curves:
Activism and the Elimination of HIV, HCV, and TB
By Tim Horn
The Usual Suspects:
Common Challenges for ETE Planning and Implementation in Emerging Jurisdictions
By Jeremiah Johnson
New York State EtE Campaign Update:
Successes & Challenges
By Jeremiah Johnson
The Role of Vaccines and Cures in HIV Elimination
By Richard Jefferys
It’s up to You, New York:
Moving towards HCV Elimination in the Empire State
By Annette Gaudino
Global HCV Elimination Targets and Challenges:
An Interview with Andrew Hill
By Bryn Gay & Annette Gaudino
From Moscow to New York and Beyond:
The Future of Tuberculosis Research and Development
By Safiqa Khimani and Mark Harrington
The United Nations’ Back Yard:
TB Elimination in New York State and the U.S.
By Erica Lessem
In a State of Disunion:
HIV, TB, and HCV Elimination Policies and Priorities Under the Trump Administration
By Suraj Madoori

TAGline Spring 2018

Other Updates @ TAG
Now Available in Spanish: Training Manual for Treatment Advocates: Hepatitis C Virus & Coinfection with HIV
April 4, 2018 – You can now download a Spanish version of our Training Manual for Treatment Activists: Hepatitis C and HIV Coinfection!

NVHR Urges Congress to Pass the Eliminating Opioid-Related Infectious Diseases Act

NVHR Urges Congress to Pass the Eliminating Opioid-Related Infectious Diseases Act

Bill Would Increase Funding to Fight infectious Diseases Like Hepatitis B and C

Washington, DC (March 27, 2018) - The National Viral Hepatitis Roundtable (NVHR) today called for immediate passage of the Eliminating Opioid-Related Infectious Diseases Act, a bill that would increase funding for fighting infectious diseases like hepatitis B and C.

Congressman Leonard Lance (R-NJ) and Joseph P. Kennedy III (D-MA) introduced the bipartisan legislation (H.R. 5353) on March 20, 2018. A Senate companion bill (S. 2579) has been introduced by Senators Todd Young (R-IN) and Edward J. Markey (D-MA). The Eliminating Opioid-Related Infectious Diseases Act would expand surveillance and education about infections associated with injection drug use. The bill would appropriate $40 million for the Centers of Disease Control and Prevention to implement programs that address the high rates of infectious diseases such as hepatitis B and C, which have been dangerously on the rise because of the opioid crisis.

Skyrocketing rates of infection with hepatitis C and hepatitis B are among the devastating public health consequences of the opioid crisis in the United States. Hepatitis C is the deadliest infectious disease in America, killing nearly 20,000 people in 2014 alone,1 and injection drug use is the cause of most new infections.2 From 2010 to 2015, the number of new hepatitis C infections jumped by 294 percent, with particularly sharp increases among states hardest hit by the opioid crisis.3 Reported cases of hepatitis B, which can also be transmitted via injection drug use, increased 20.7 percent in 2015.4

The underfunding of surveillance and testing programs for hepatitis B and C has contributed in part to the explosion of these epidemics. “Even a modest increase in funding would help
1 Centers for Disease Control and Prevention, “Hepatitis C Kills More Americans than Any Other Infectious Disease” (May 2016), available at https://www.cdc.gov/media/releases/2016/p0504-hepc-mortality.html. 2 Campbell, Canary, Smith, et al. State HCV Incidence and Policies Related to HCV Preventive and Treatment Services for Persons Who Inject Drugs — United States, 2015–2016. MMWR MORB MORTAL WKLY REP 2017;66:12. 3 Id. 4 Centers for Disease Control and Prevention, “Surveillance for Viral Hepatitis – United States, 2015” (June 2017), available at https://www.cdc.gov/hepatitis/statistics/2015surveillance/commentary.htm.
communities hard-hit by the opioid crisis and suffering from high rates of hepatitis B and C,” said Elizabeth Paukstis, NVHR’s Public Policy Director. “The Eliminating Opioid-Related Infectious Diseases Act would take a step in the right direction by allocating desperately needed funding toward the prevention of these devastating diseases.”

“Because of the direct link between injectable opioid use and hepatitis C and B, any initiative to tackle the opioid crisis in America must include a robust effort to screen, provide hepatitis B vaccination, and treat people for hepatitis B and C,” said Dr. Stacey Trooskin, Director of Viral Hepatitis Programs at Philadelphia FIGHT Community Health Centers. “We cannot afford to ignore the tragic public health consequence of this crisis any longer. The Eliminating OpioidRelated Infectious Diseases Act is commonsense legislation that should be passed and enacted without delay.”

About NVHR: The National Viral Hepatitis Roundtable (NVHR) is a national coalition working together to eliminate hepatitis B and C in the United States. NVHR’s vision is a healthier world without hepatitis B and C.

Press Release

Ministers have talked the talk. It's now time to deliver on Hep C

Ministers have talked the talk. It's now time to deliver on Hep C

Steve Ryder

Two years ago, the Government made a promise. Alongside 193 other countries it pledged to help eliminate the life-threatening Hepatitis C virus (HCV) by 2030. Then, in January, NHS England announced it was going one further: it will eliminate the virus by 2025, making us the first country in the world to do so.

These are certainly noble aims. But the burden of HCV is still growing. Some 160,000 people are infected in the UK, while a report last year found that only nine countries are set to hit the original 2030 target. The UK isn’t one of them.

Continue reading: https://www.telegraph.co.uk/news/0/ministers-have-talked-talk-now-time-deliver-hepatitis-c/

Podcast Series: Diagnosis and Treatment Of Hepatitis C

In case you missed it, interesting podcast. 

Diagnosis and Treatment Of Hepatitis C
February 22, 2018

Hepatitis C (HCV) is the most-deadly infectious disease in America.

• More than 20,000 die every year because of HCV
• Half of people infected do not know that they have the virus
• HCV can remain undetected for decades

HCV is curable, even among past and current drug users. You can help turn the tide. Learn how to screen (hint: it's easy) and how screening can save lives.

Treatment is now simpler, more effective, and shorter than ever. And it should be offered to nearly everyone with HCV, regardless of the level of cirrhosis.

Tune in to START HCV Radio Hour to listen and learn as our expert faculty explore important topics, using patient stories in an engaging moderated DKBmed Talk, modeled after the famous and popular TED Talks.

• Learn how to detect HCV infection with a simple blood test
• Become familiar with revolutionary new treatment options that cure 99% of people who use them
• Prevent the spread of HCV and the morbidity and mortality that can follow

The expert faculty includes Mark Sulkowski, MD, professor of medicine and medical director of the Viral Hepatitis Center at the Johns Hopkins University School of Medicine; Alain Litwin, MD, professor of medicine at Albert Einstein College of Medicine in New York; Kathleen Brady, MD, Distinguished University Professor at the Medical University of South Carolina and Director of the South Carolina Clinical and Translational Research Institute; and Raymond Chung, MD, director of hepatology and the Liver Center at Massachusetts General Hospital in Boston.

Start HCV: Part 1

Start HCV: Part 2

Begin here.......

The characteristics of residents with unawareness of hepatitis C virus infection in community

The characteristics of residents with unawareness of hepatitis C virus infection in community
Pin-Nan Cheng ,Yen-Cheng Chiu,Hung-Chih Chiu, Shih-Chieh Chien

Published: February 22, 2018

https://doi.org/10.1371/journal.pone.0193251

Full Text

View Online

Download PDF

Abstract
Background
Control of hepatitis C virus infection (HCV) is an increasingly important issue. Enhancing screening coverage is necessary to discover more HCV infected subjects in community. However, a substantial population is unaware of HCV infection that needs more attention.

Aim
The aims of this study were to evaluate the status of HCV infected residents in remote villages, to compare characteristics between already known and unaware HCV infection subjects, and to analyze the disease insights.

Patients and methods
Screening intervention for liver diseases was conducted in remote villages of Tainan City of southern Taiwan from August 2014 to July 2016. Items of screening examinations included questionnaire, blood sampling for liver tests and viral hepatitis markers (hepatitis B surface antigen and anti-HCV antibody), abdominal sonography survey, and liver stiffness measurement by transient elastography. Quantitation of HCV RNA was measured for residents with positive anti-HCV antibody.

Results
A total of 194 (13.5%) out of 1439 participants showed positive for anti-HCV antibody. HCV viremia was detected in 119 (61.3%) residents. Previously unaware HCV infection by questionnaire record was present in 68 (35.1%) of ant-HCV positive residents. By multivariate logistic analysis, unaware HCV infected residents exhibited significantly mild liver fibrosis (OR 0.876, 95% CI 0.782~0.981, p = 0.022), more prevalent of heart diseases (OR 6.082, 95% CI 1.963~18.839, p = 0.002), and less cluster of family history of liver diseases (OR 0.291, 95% CI 0.113~0.750, p = 0.011) when comparing with already known HCV infected residents. Among the 126 already know HCV infected residents, only 59 (46.8%) received antiviral treatment or regular follow-up. No concept or no willing to receive medical care was observed in 44 (34.9%) residents.

Conclusion
In HCV endemic villages of Taiwan, residents with unaware HCV infection comprised about one third of HCV infected residents and exhibited obscure characteristics to identify. Less than half of already known HCV infected residents received adequate medical care. To eliminate HCV infection, vigorous efforts on enhancing screening coverage, educating update knowledge of liver diseases, and linking to medical care are urgently needed.

Read full article: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193251

The Canadian Treatment Action Council Launches Campaign to End Hepatitis C in Canada

CTAC Launches Campaign to End Hepatitis C in Canada

TORONTO, Feb. 6, 2018 /CNW/ - The Canadian Treatment Action Council (CTAC) has published a white paper entitled, "The time has come to eliminate hepatitis C in Canada," which summarizes the increasing gaps in Canada's response to the hepatitis C epidemic and identifies seven calls-to-action. CTAC is once again demonstrating its commitment to securing and ensuring access to testing, treatment, care and support for Canadians living with HIV and hepatitis C virus (HCV).

Along with like-minded allies, CTAC is calling upon policymakers and community leaders to respect their engagement to eliminate hepatitis C infection in Canada by adopting a public health strategy and making a clear commitment toward the elimination of viral hepatitis. Commenting on the campaign, CTAC Executive Director Shelina Karmali said, "We're hoping our white paper stimulates a response at all levels of government so that every Canadian managing HCV will have access to equitable and timely testing and treatment." Ms. Karmali added, "HCV is 100 per cent curable."

The Issues
An estimated 220,000 - 245,000 Canadians are infected with HCV. Unfortunately, around 44% of those individuals are unaware of their status, and are often only diagnosed incidentally to something else. There is a large population of individuals currently aging with HCV, whether diagnosed or not, who are now experiencing complications of HCV, some of which are quite severe, such as cirrhosis, liver failure and death. The cost to the healthcare system is greater than treating HCV. Indigenous communities, people who inject drugs, ethno-cultural communities and baby boomers are at an increased risk of being affected by HCV.

In 2016, Canada committed at the WHO to work to eliminate HCV as a public health threat by 2030. Canada's WHO commitment is to have treated 80% of people with the disease. In 2018, hepatitis C prevention and care strategies remain fragmented across the country.

A Unique Opportunity
The goal to cure hepatitis C is achievable, and Canada has had access to these curative medications (highly effective, highly tolerable direct-acting antivirals) since 2015. The pan-Canadian Pharmaceutical Alliance (pCPA) announced in early 2017 a new framework that has brought down the price of treatment. Despite significant treatment cost reductions; too few people are being treated, and in Canada, as elsewhere, hepatitis C rates are on the rise because we have not implemented comprehensive public health strategies to stem the tide.

The 7-Point Solution
There is a role for coordinated national response, including collaboration between federal, provincial and territorial governments, around ending hepatitis C in the next 10 years. CTAC is calling for policymakers and community leaders to adopt a more comprehensive action plan of how hepatitis C elimination will be achieved in Canada by adopting the following:
Increased access to testing, including point-of-care testing, rapid testing, and one-time cohort screening for all baby boomers
Removal of restrictive eligibility requirements to access treatment
Access to all hepatitis C medications approved by Health Canada on public drug programs
Creation of a framework by the pan-Canadian Pharmaceutical Alliance (pCPA) to standardize processes and timelines and add transparency
Removal of the time delay between the close of pCPA negotiations and the signing of Product Listing Agreements with individual provincial and territorial formularies
Lower drug costs
A standalone viral hepatitis plan

Get Involved
CTAC is asking individual and organizational influencers to endorse the calls to action. This can be done electronically by going to www.ctac.ca/EliminateHepC. In addition, for those wishing to take further action, a letter-generated electronic form will be available for submission to individual provincial and territorial health ministers so that a unified voice can be heard and action taken to get Canada back on track toward its stated commitment to eliminate HCV as a public health threat by 2030.

About CTAC
CTAC is Canada's non-governmental organization led by and for people living with HIV and HIV/HCV co-infection, focusing on access to treatment. Since 1996, we have been working to secure and ensure equitable, affordable and timely access to testing, treatment, care and support for people in Canada living with HIV and HIV/HCV co-infection and other co-morbidities. We work with community, public, private and not-for-profit leaders to inform research and public policy, and promote public awareness and discussion.

SOURCE Canadian Treatment Action Council

https://www.newswire.ca/news-releases/ctac-launches-campaign-to-end-hepatitis-c-in-canada-672915243.html
Canadian Treatment Action Council

The Hepatitis C Trust launches 'Eliminating Hepatitis C in Scotland' report

The Hepatitis C Trust has today launched a new report, ‘Eliminating Hepatitis C in Scotland: A Call to Action’. The report follows an inquiry conducted by The Hepatitis C Trust and the cross-party Scottish Hepatitis C Parliamentary Champions group over the course of 2017, which involved oral evidence sessions and the submission of written evidence by individuals and organisations working across the hepatitis C patient pathway.

On the basis of this evidence, The Hepatitis C Trust produced the ‘Eliminating Hepatitis C in Scotland’ report, which looks in detail at Scotland’s approach to hepatitis C, including:

• Elimination strategy

• Awareness

• Prevention

• Testing and diagnosis

• Linkage to care

• Access to treatment

• Funding

The report calls on the Scottish Government to produce a hepatitis C elimination strategy, with ambitious targets to decrease national incidence, mortality and overall prevalence. Additional recommendations on awareness-raising, prevention, testing and treatment are contained in the report, and include calls for:

• An introduction of opt-out testing for hepatitis C in substance misuse services, with commissioning contracts stipulating clear mechanisms to hold services to account for failures to meet testing targets.
• National guidance to be issued on effective implementation of opt-out testing in prisons.
• Treatment cost reductions to be reinvested into additional treatments or services to ensure access to treatment is available to all who need it.
• The Scottish Government to explore alternative treatment funding models offering the opportunity to rapidly increase the number of patients receiving treatment.

Charles Gore, Chief Executive of The Hepatitis C Trust said: “Without renewed efforts to find and treat the thousands of undiagnosed patients living with hepatitis C, Scotland may no longer be considered a world leader in tackling this deadly virus.

Eliminating a public health issue that disproportionately affects some of the poorest and most marginalised groups in our society is an extraordinary and eminently achievable opportunity which should be seized with both hands.”

The full report can be accessed here. 

Hepatitis Alert: HCV Elimination—Closing the Gaps in Screening, Care Linkage, and Treatment

Clinical Care Options 

Learn strategies to increase screening, diagnosis, engagement in care, and treatment for HCV.

Webinar Series

Hepatitis Alert: HCV Elimination—Closing the Gaps in Screening, Care Linkage, and Treatment

In this downloadable slideset, Norah Terrault, MD, MPH, and Stacey Trooskin, MD, PhD, review important strategies for closing gaps along the HCV care continuum with a focus on overcoming barriers to reach and treat persons who inject drugs.

Source: Viral Hepatitis Alerts—A CME/CE/CPE-Certified Webinar Series
Date Posted: 12/19/2017
Free registration required

Downloadable Slidesets
Alert 1: First-Line HCV Treatment
Alert 2: Treating DAA-Experienced Pts With HCV
Alert 3: HCV Elimination Downloadable Audio
Alert 1: First-line HCV Treatment
Alert 2: Treating DAA-Experienced Pts With HCV

Clinical Thought
First-line HCV Therapy Treating DAA-Experienced Pts With HCV
Begin here: https://www.clinicaloptions.com/Hepatitis.aspx

Podcast: What it will take for hepatitis C to be cured in Canada

AMI Podcast
November 13, 2017 episode
2017 World Hepatitis Summit

Hepatitis C in Canada 
Dr. Jordan Feld from the Toronto Centre for Liver Disease discuss what it will take for hepatitis C to be cured in Canada.

Of all infectious disease in Canada the one disease that causes most years of life lost is hepatitis C. 

Listen here......

Comment - Funding the elimination of viral hepatitis: donors needed

The Lancet Gastroenterology & Hepatology
Comment
Funding the elimination of viral hepatitis: donors needed
Charles Gore , Jessica Hicks, Wouter Deelder
Published: 31 October 2017

DOI: http://dx.doi.org/10.1016/S2468-1253(17)30333-3

PDF Download

Chronic hepatitis B and C are life-threatening infectious diseases that cause serious liver damage, cancer, and premature death. More than 300 million people are infected with hepatitis B or hepatitis C¹ and are at risk of developing escalating health problems. These infectious diseases cause 1·3 million deaths every year¹ and are responsible for more than half of all new cases of liver cancer and one in every 12 cancer deaths.² Whereas the burden of other major infectious diseases such as HIV, tuberculosis, and malaria is decreasing as a result of consistent large-scale global investment, viral hepatitis has been neglected, resulting in ever increasing numbers of people dying from hepatitis B and C...
http://www.thelancet.com/journals/langas/article/PIIS2468-1253(17)30333-3/fulltext

Why the VA is so Successful Tackling HCV

Why the VA is so Successful Tackling HCV

by Pippa Wysong
Contributing Writer, MedPage Today

VA experts tell how they get high-risk patients engaged, nationally

The U.S. Department of Veterans Affairs (VA) is a leader in its ability to reach hepatitis C virus (HCV)-infected patients and engage them in care. Here, the secrets to its success are laid bare.

According to a recent paper in the Annals of Internal Medicine, the VA is the country's largest care-provider for HCV-infected patients and is well on its way to eliminating the disease in its population.

As of July 2017, a total of 51,000 veterans remain potentially eligible for treatment, a significant drop from more than 168,000 only 3 years ago. The number of people infected is decreasing by an estimated 30,000 per year...
Read the article at... MedPage Today

Expert Critique

Michelle Long

Assistant Professor of Medicine, Department of Medicine, Section of Gastroenterology

Boston University School of MedicineBoston, MA

With the success of direct-acting antiviral (DAA) medication for the treatment of hepatitis C virus (HCV), the challenges now are in linking patients with hepatitis C to care. The U.S. Department of Veterans Affairs (VA) has been very successful in treating patients infected with HCV, and the number of people infected within the VA care system is decreasing by about 30,000 people per year. The VA is well suited to treat HCV since it has a single integrated, electronic health record and a large case registry to link patients to care. Using these systems, the VA is able to screen high-risk populations and monitor disease incidence and prevalence. Patients who were eligible for screening were reached via letters or phone calls or through partnerships with shelters. The VA also has utilized care-delivery teams that personalize care delivery to different clinical settings and allowed outreach to patients in remote locations. The VA also was able to place DAA medications on the formulary, which lowered costs and allowed better access to medications.

https://www.medpagetoday.com/reading-room/aga/lower-gi/68810

Native Americans Have Highest HCV Rates Limited funding restricts access to care

AGA Reading Room 10.12.2017

Native Americans Have Highest HCV Rates
Limited funding restricts access to care

by Pippa Wysong
Contributing Writer, MedPage Today

HCV infection patterns among Native Americans occur in patterns similar to those found in the rest of North America: younger cohorts who get the infection largely from unsafe injection drug use, and the baby boomer population. But incidence is disproportionately high. For example, American Native veterans born from 1945 to 1965 have an antibody-positive seroprevalence of 10%. All of this demonstrates this is an important cohort to treat.

Native Americans living in cities settings can get care at urban IHS clinics (in those cities that have them), many of which also serve as community health centers -- but these facilities are also struggling with funding issues.

IHS medical providers will apply to state Medicaid programs for DAAs on behalf of their patients, but the accessibility to treatment with DAAs varies between states. Sometimes coverage isn't available unless patients with substance use disorders are abstinent -- "which is not an AASLD [American Association for the Study of Liver Diseases] requirement," Leston said. And states vary in terms of the rules around accessibility to the drugs.

Continue reading - https://www.medpagetoday.com/reading-room/aga/lower-gi/68492

Primary Source

New England Journal of Medicine

Source Reference: Reilley B and Leston J "A tale of two epidemics -- HCV treatment among Native Americans and veterans" New Engl J Med 2017; DOI: 10.1056/NEJMp1705991.

A documentary following the lives of three people in America who have been cured of Hepatitis C

A documentary following the lives of three people in America who have been cured of
Hepatitis C

Hep C Free Documentary - YouTube

https://www.youtube.com/watch?v=_0x_32KX1ZY

Deaths caused by viral hepatitis surpassed all chronic infectious diseases including HIV/AIDS, malaria and tuberculosis

Viral hepatitis kills more people than HIV, malaria or tuberculosis

Sept 15, 2017

World Hepatitis Alliance calls for immediate political action to counteract fatal trend

According to the Global Burden of Disease study released today, deaths caused by viral hepatitis have surpassed all chronic infectious diseases including HIV/AIDS, malaria and tuberculosis.

The study illustrates that in 2016, the total deaths caused by viral hepatitis, including liver cancer, acute cases, cirrhosis, hepatitis A, E, B, C and D account for 1.34 million deaths globally, exceeding tuberculosis (1.2 million), HIV/AIDS (1 million) and malaria (719,000).

These staggering death rates occurred despite recent advances in hepatitis C medications that can cure most infections within three months and the availability of highly-effective vaccinations for hepatitis B.

"It's outrageous, but not surprising, that the Global Burden of Disease Report found that deaths related to viral hepatitis have surpassed HIV, TB and malaria" said Charles Gore, President of the World Hepatitis Alliance. "This is largely due to a historic lack of political prioritisation coupled with an absent global funding mechanism".

The study shows that viral hepatitis remains amongst the top ten leading global killers which include heart disease, road accidents, Alzheimer's disease, amongst others. If we are to reverse this trend, immediate action must be taken at both a regional and national level.

One such action is the scaling up of testing and diagnosis. Globally, only 5% of people living with viral hepatitis are aware of their condition, greatly increasing the chance of infecting others and missing the opportunity to access life-saving treatment. Because viral hepatitis has few noticeable symptoms, many people are either misdiagnosed or do not come forward for testing.

"World leaders and national decision-makers must heed these findings and note that with targeted funding, political prioritisation and specific interventions, hepatitis deaths can be avoided." said Raquel Peck, CEO of World Hepatitis Alliance.

Reducing hepatitis related deaths by 65% by 2030 is a key component of the World Health Organization's (WHO) Global Hepatitis Strategy. The Strategy, which was adopted by 194 governments, sets out a list of key targets, which, if achieved will eliminate viral hepatitis by 2030.

On 1- 3 November, hundreds of policymakers, patients, civil society and public health experts will gather at the World Hepatitis Summit, in São Paulo, Brazil to discuss how advance the elimination of viral hepatitis.

The three-day event, which is a joint initiative between WHO and the World Hepatitis Alliance, will focus on key ways to implement WHO's Global Hepatitis Strategy, with a specific focus on how to improve surveillance data, scale up testing and treatment at a national level, and support service delivery amongst vulnerable populations. The event will also encourage innovation in research and have a dedicated focus on sustainable financing for elimination, all of which are needed to eliminate viral hepatitis by 2030.

Find the full report here: www.thelancet.com/gbd

http://www.worldhepatitisalliance.org/news/sep-2017/viral-hepatitis-kills-more-people-hiv-malaria-or-tuberculosis