Showing posts with label HCV News-weekly rewind. Show all posts
Showing posts with label HCV News-weekly rewind. Show all posts

Friday, September 25, 2015

TGIF Rewind: Big pharmaceuticals and the Hepatitis C drug trail dubbed a 'miracle cure'

Rewind: News and Views

Welcome to TGIF rewinda look back at this weeks hepatitis C headlines with updates from around the web.

In The News

Big pharmaceuticals and the Hepatitis C drug trail dubbed a 'miracle cure'
What would you do if you had a potentially lethal illness, knew of a "miracle" cure which would most likely fix the problem in three months by taking one pill a day, but you couldn't afford to buy the medicine from the drug company which owned the patent? This is the position that "Patient Zero" found himself in. And he, with a doctor and a group of campaigning mates, found an answer – one that they believe costs up to 30 times less than the drug company might expect them to pay.

State Reporting Requirements for Viral Hepatitis
Former hedge fund manager Martin Shkreli has the Internet ablaze after hiking the price of the drug that's been on the market for decades. Here's what happened. (Gillian Brockell/The Washington Post)

Health Care Industry Mergers Side Effect of Affordable Care Act
Many are worried that the huge consolidations will dampen competition and push up health care prices over time...

Many veterans who fought to protect and defend our country are still fighting to get the support they need from the federal government...

Why people don't trust drug makers
Insurers and pharmacy benefit managers - not drug companies - are the ones who determine what patients pay for medications. Consider the controversy surrounding the hepatitis C drug Sovaldi. When the medicine came on the market, it quickly became ...

Rhode Island Medicaid Denied 65% of Hep C Treatment Requests in 2015
It's a move that, while saving the state millions of dollars, is keeping hundreds of sick patients from accessing a cure.

Concern about drug costs has been particularly acute for state Medicaid programs, which face both limited budgets and high Hepatitis C prevalence among beneficiaries (higher than in the general population). And perhaps with good reason: In 2014, the ...

September 23, 2015 
A once-daily, fixed-dose combination of sofosbuvir (SOF) plus velpatasvir (VEL) had high success rates for the treatment of all six genotypes of hepatitis C virus, manufacturer Gilead Sciences reported.

In three of four phase III trials (ASTRAL-1ASTRAL-2, and ASTRAL-3), 1,035 HCV patients were given the drug combination for 12 weeks. In the fourth trial (ASTRAL-4), 267 HCV patients with decompensated cirrhosis were randomized to receive either the SOF/VEL combination for 12 weeks with or without ribavirin or 24 weeks of just SOF/VEL. The primary efficacy endpoint for all studies was a sustained virological response at 12 weeks, the company said in a statement.

The FDA has designated the SOF/VEL combination as “breakthrough therapy” status, granted to “investigational medicines that may offer major advances in treatment over existing options,” the statement said.Results showed that 98% of patients in the first three trials achieved the efficacy endpoint. In the ASTRAL-4 study, 94% of patients in the SOF/VEL plus ribavirin group achieved sustained virological response at 12 weeks. The rates of success in patients receiving the SOF/VEL combination for 12 or 24 weeks were 83% and 86%, respectively. The most common adverse effects were fatigue, nausea, and headache.

Press Release
Gilead Announces SVR12 Rates from Four Phase 3 Studies Evaluating Fixed-Dose Sofosbuvir/Velpatasvir (GS-5816) Pan-Genotypic

The Food and Drug Administration (FDA) announced that Rebetol(ribavirin; Merck) capsules and PegIntron (peginterferon alfa-2b; Merck) for Injection are being discontinued. The decision is business-related and not due to safety or efficacy issues with the drugs.

Rebetol is a nucleoside analogue indicated for chronic hepatitis C in combination with interferon alfa-2b (pegylated and nonpegylated), in patients ≥3 years of age with compensated liver disease. It is supplied as 200mg capsules in 56-, 70-, and 84-count bottles. The Rebetol discontinuation is effective February 1, 2016.

PegIntron is an antiviral indicated for treatment of chronic hepatitis C in patients with compensated liver disease. It is supplied as 50mcg/0.5mL, 80mcg/0.5mL, 120mcg/0.5mL, and 150mcg/0.5mL single-use vials and single-use pre-filled pens. No effective date is available for the PegIntron discontinuation.

For more information call (888) 463-6332 or visit

Conatus Announces emricasan Phase 2 study reduces liver portal hypertension predominantly due to NASH or HCV

A player in J&J's hep C cocktail helps hustle a quick cure 
September 17, 2015 | By John Carroll
Gilead has already made a megablockbuster fortune out of its hepatitis C cure. But the race to cure patients faster (and probably cheaper) is still on. And Achillion today posted some new data from small studies that show its NS5A inhibitor odalasvir (or ACH-3102) could feature prominently in one of the new cocktail therapies now in development at Johnson & Johnson...

Around The Web

Hepatitis C virus infection: a risk factor for Parkinson's disease
"In summary, our study not only demonstrated a significantly positive association between HCV infection and Parkinson's disease (PD) from a large population-based epidemiological study but also proved the dopaminergic neuronal toxicity by HCV in vitro at the molecular level through an increase in cytokines induced by HCV. Epidemiologically, we found that anti-HCV(+) patients had statistically significant increased risk of developing PD in the population-based study. 

Revolutionary new drugs to cure hepatitis C virus (HCV) infection represent one of the most important breakthroughs in clinical medicine in recent decades. However, high pricing of these well-tolerated, highly efficacious all-oral regimens and high demand (actual or anticipated) has led many payers in the United States and other countries to exclude people who have recently used illicit drugs, injectable drugs or alcohol (with the definitions of "use" varying by jurisdiction) from access to these treatments

N Engl J Med 2015; 373:1279-1281 September 24, 2015 
DOI: 10.1056/NEJMc1506108
To the Editor:
The cure rates associated with sofosbuvir, a new treatment for hepatitis C virus (HCV), have been remarkable.1 However, the high cost of the drug has raised concerns,2 particularly in regard to socioeconomically disadvantaged populations with a high prevalence of HCV infection, such as Medicaid beneficiaries. Demand for new HCV drugs in Medicaid populations drove historic surges in spending on drugs in 2014, the first full year during which sofosbuvir was available since its approval by the Federal Drug Administration (FDA) in late 2013.3 Given its recent introduction to the market, little is known about state-level utilization and spending patterns for sofosbuvir...

NICE recommends software to diagnose, monitor liver fibrosis
“As well as meaning that people with chronic hepatitis B or C could avoid having invasive liver biopsies, the associated savings of more than £400 per person ...

Interferon-based therapy still common for HCV among veterans
In a retrospective study, researchers found that the uptake of direct-acting antivirals, specifically Victrelis and Incivek, increased among veterans with HCV over time…

The guidelines for hepatitis C have been updated twice in the month of August.
The first update incorporated the approval of daclatasvir (Daklinza, Bristol-Myers Squibb) in the United States and, based on that approval, modified treatment recommendations for most of the treatment groups..

Lucinda Porter
Hepatitis C: The Evolution of Treatment
Last week I discussed the history of hepatitis C. This week I focus on the evolution of hepatitis C treatment...

Healthy You

Green Tea Hidden Dangers: Teen Contracts Acute Hepatitis After Drinking Three Cups Per Day
A young woman has contracted hepatitis after drinking three cups of Chinese green tea per day.
Doctors have now warned of the hidden dangers of consuming too much of the herbal tea, which they believe was to blame for the teenager contracting acute hepatitis...

Over long term, diet and exercise are best to prevent diabetes
In a head-to-head comparison over 15 years, diet and exercise outperformed the drug metformin in preventing people at high risk for diabetes from developing the disease.

Metformin Link to Vitamin B12 Deficiency, Neuropathy, in Diabetes
Researchers link 4 years of metformin use to a net worsening of peripheral neuropathy in type 2 diabetes, even after accounting for improvements from HbA1c lowering.
Medscape Medical News, September 25, 2015 
Explore calculators, interactive worksheets, and more that will help you take a look at your drinking habits and understand how they may affect your health...

Off Topic

Should Dr Oz, a Prominent Surgeon, Be Fired for Quackery?
Last spring, 10 physicians wrote to Columbia University, where Dr Mehmet Oz is employed, demanding his removal for promoting quack remedies on TV. Should he be? See what your colleagues think.

Scientists stop and search malware hidden in shortened URLs on Twitter
Intelligent system created to stop and search malware links
Engineering and Physical Sciences Research Council

Cyber-criminals are taking advantage of real-world events with high volumes of traffic on Twitter in order to post links to websites which contain malware.

To combat the threat, computer scientists have created an intelligent system to identify malicious links disguised in shortened urls on Twitter. They will test the system in the European Football Championships next summer. The research is co-funded by the Engineering and Physical Sciences Research Council (EPSRC) and the Economic and Social Research Council (ESRC).

In the recent study the Cardiff University team identified potential cyber-attacks within five seconds with up to 83% accuracy and within 30 seconds with up to 98% accuracy, when a user clicked on a URL posted on Twitter and malware began to infect the device.

The scientists collected tweets containing URLs during the 2015 Superbowl and cricket world cup finals, and monitored interactions between a website and a user's device to recognise the features of a malicious attack. Where changes were made to a user's machine such as new processes created, registry files modified or files tampered with, these showed a malicious attack.

The team subsequently used system activity such as bytes and packets exchanged between device and remote endpoint, processor use and network adapter status to train a machine classifier to recognise predictive signals that can distinguish between malicious and benign URLs.

Dr Pete Burnap, Director of the Social Data Science Lab at Cardiff University, and lead scientist on the research, said: "Unfortunately the high volume of traffic around large scale events creates a perfect environment for Cyber-criminals to launch surreptitious attacks. It is well known that people use online social networks such as Twitter to find information about an event.

"Attackers can hide links to malicious servers in a post masquerading as an attractive or informative piece of information about the event.

"URLs are always shortened on Twitter due to character limitations in posts, so it's incredibly difficult to know which are legitimate. Once infected the malware can turn your computer into a zombie computer and become part of a global network of machines used to hide information or route further attacks.

"In a 2013 report from Microsoft these 'drive-by downloads' were identified as one of the most active and commercial risks to Cyber security.

"At the moment many existing anti-virus solutions identify malware using known code signatures, which make it difficult to detect previous unseen attacks."

Professor Omer Rana, Principal investigator on the project which is also includes Royal Holloway, University of London, City University London, the University of Plymouth and Durham University said:

"We are trying to build systems that can help law enforcement authorities make decisions in a changing Cyber Security landscape. Social media adds a whole new dimension to network security risk. This work contributes to new insight into this and we hope to take this forward and develop a real-time system that can protect users as they search for information about real-world events using new forms of information sources.

"We have the European Football Championships coming up next summer, which will provide a huge spike in Twitter traffic and we expect to stress-test our system using this event."

Professor Philip Nelson, Chief Executive, EPSRC said: "Using social media is an integral part of modern life, vital to organisations, businesses and individuals. The UK needs to operate in a resilient and secure environment and this research will help combat these criminal Cyber-attacks."

Hope everyone has a wonderful weekend.

Friday, September 4, 2015

TGIF Rewind - Free HCV Helpline With App and Big Questions about Hepatitis C

Welcome to TGIF rewind, a digest of this weeks publications, news and updates from around the web. 

In The News

Sept 5
Anger at hepatitis C trial with call for money to be spent on cures
A MEDICAL trial to teach hepatitis C sufferers how to avoid infecting their children with the virus has been criticised as fearmongering and a waste of desperately needed health funding.

The Program
New hepatitis C program to teach sufferers basic skills
A new program being trialled later this year will teach parents with hepatitis C how to reduce the chances of infecting their child.

The program, called Families Living Healthily with Hepatitis C, will teach sufferers how to better prevent the transmission of the blood borne disease to their children and families.

Sept 4
Free Helpline and App for Hepatitis C Patients Offer Peer Support and Self-Care Tools
Viral hepatitis is known as the silent epidemic, because it is a disease that is both under-recognized and underdiagnosed

Mechanism for air pollution-induced liver disease discovered
A research team led by Kezhong Zhang, Ph.D., at the Wayne State University School of Medicine's Center for Molecular Medicine and Genetics, has discovered that exposure to air pollution has a direct adverse health effect on the liver and causes liver fibrosis, an illness associated with metabolic disease and liver cancer.

Webinar: What Soaring Drug Prices Mean for Patients
Concerns over soaring drug prices have grown in recent months, and doctors have become increasingly outspoken about the extremely high prices of drugs used to treat diseases such as cancer, hepatitis C and cystic fibrosis.

We talk about the impact of Hepatitis C on future Medicaid drug trends, as well as options states have to address Hepatitis C now.

The pharmaceutical industry is feeling rising heat from all directions as a result of its excessive price increases that reflect a contempt for consumers and the nation's economy. In response, pharma has been mobilizing its defenders in the media and academia to deploy the industry's standard mixture of half-truths and outright distortions.

Therapy for Hepatitis C Genotype 3: Moving Forward
This article reviews the available therapy and the new treatment agents under development for patients with chronic hepatitis C GT3 infection.

This Editorial discusses three recent original papers related to direct-acting antivirals (DAAs) for the treatment of chronic genotype (GT) 4 HCV infection, published in this issue of the Journal of Hepatology

Hepatitis C - Fibrosis index based on four factors better predicts advanced fibrosis or cirrhosis than aspartate aminotransferase/platelet ratio index
Hepatic fibrosis is one of the important factors associated with the long-term prognosis of CHC patients. If noninvasive methods could accurately predict the severity of hepatic fibrosis, the majority of liver biopsies could be avoided.

Can vaccination contribute to hepatitis C elimination efforts?  Q+A 
In a recent research article published in BMC Medicine, Nick Scott and colleagues used a mathematical modeling approach to show that vaccination is likely to play a role in reducing hepatitis C prevalence. Dr Scott answers our questions about the ...

What Hepatitis C Patients Need to Know When Starting Sovaldi Regimen
Published on Sep 4, 2015 Specialty Pharmacy Times
Michael Sofia, PhD, the inventor of the groundbreaking hepatitis C drug Sovaldi, discusses what patients can expect when they begin a therapeutic regimen with the drug.

In Case You Missed It - Hepatitis C treatment and quality of life You can’t always get what you want, but you might get what you need

Published in Journal Of Hepatology
Published online: May 13 2015


Key Words - Antiviral therapy; Hepatitis C; Ledipasvir; Quality of life; Ribavirin; Sofosbuvir

Hepatitis C treatment and quality of life – You can’t always get what you want, but you might get what you need
Gautam Mehta, Geoffrey Dusheiko UCL Institute for Liver and Digestive Health, UCL Medical School, Royal Free Campus, London NW3 2PF, United Kingdom 

As shown in this study, symptoms are in fact associated with the presence of the virus, and a treatment effect and effect of cure on HRQL is evident. Will curing hepatitis C, and the symptomatic improvements observed in these trials, translate into improved work productivity and economic gain with these high cost regimens? Presently payers seek improvements in “hard” measurable outcomes such as hospitalisation for hepatic decompensation, transplantation rates, a reduction in hepatocellular carcinoma, and deaths attributable to hepatitis C. Whether these discernible improvements, in quality of life and productivity, will persuade payers to fund treatment for those with minimal fibrosis remains to be seen. The situation is akin to the words of a famous rock band of the 1960s, ‘You can’t always get what you want, but if you try sometimes, you just might get what you need...’
Continue reading @ J Hepatol

This Week In The News

World Hepatitis Summit harnesses global momentum to eliminate viral hepatitis
Around 400 million people are currently living with viral hepatitis, and the disease claims an estimated 1.45 million lives each year, making it one of the world’s leading causes of death. Hepatitis B and C together cause approximately 80% of all liver cancer deaths, yet most people living with chronic viral hepatitis are unaware of their infection.

More than 200,000 Brits chronically infected with HCV
Around 214,000 individuals are chronically infected with hepatitis C (HCV) in the UK, national estimates from Public Health England (PHE) suggest Hide related content: Show related content read more (Source: Nursing in Practice)

The Next HCV Drugs
10 promising new treatments are currently in development.


In a September 2 editorial, The New York Times Editorial Board concludes that “competitive market forces and hard-nosed bargaining” make “tremendously effective” new hepatitis C medicines not just more accessible to ailing patients – but also offer good value to the U.S. health care system.
Continue reading @

Editorial: When is the high cost of prescription drugs too high?
Friday, September 4, 2015 4:51pm
Other countries establish formulas that force drug treatments to prove cost effectiveness. By their nature, these systems place a dollar value on human life and suffering, an unpleasant prospect that America has so far avoided. Somehow, though, Congress must allow Medicare to find ways to limit costs — including allowing Medicare to negotiate with the drug companies. 
Continue reading @ Tampa Bay Times 

Costly Hepatitis C Drugs for Everyone?
September 2, 2015, Wednesday - BY THE EDITORIAL BOARD
Competition and discounts are going a long way toward resolving the problem of expensive hepatitis C drugs.
Key clinical point: Ledipasvir-sofosbuvir plus ribavirin for 12 weeks achieved high SVR rates among patients with hepatitis C virus infection and advanced liver disease.

Meta-analysis- SVR and its Treatment Predictors in HCV Genotype 4 Compared to Genotypes 1, 2, and 3
Does treatment with pegylated interferon and ribavirin bring about sustained virological response in HCV genotype 4 as compared to genotypes 1, 2, and 3?

Patients With Renal Disease: One of the Remaining Challenges in HCV Therapy
Nancy Reau MD
A recent patient discussion highlighted important questions about how to approach HCV infection in renal disease.

Updates Around The Web

Big Questions about Hepatitis C

HCV Advocate September Newsletter
Hepatitis C in Children
by Alan Franciscus, Editor-in-Chief
Find out what the prevalence of hepatitis C is in children, what the consequences are and what can be done about it.

HealthWise: Big Questions about Hepatitis C
by Lucinda K. Porter, RN
Lucinda answers the “Big Questions about Hepatitis C” including what does “not detected” mean when treatment is finished, what does “cured” mean and a recurring question about treatment and toothbrushes and many more questions….and answers!

by Alan Franciscus, Editor-in-Chief
This month’s column includes a brief overview of the antihistamine that is purported to have antiviral properties against hepatitis C, and a couple of brief overviews of Baby Boomer testing initiatives at two different hospitals.

Consumer Reports Best Buy Drugs Booklet
by Alan Franciscus, Editor-in-Chief
I discuss my experience shopping around for the best buy for a generic drug for my dog—Buddy—and a very good resource for people from Consumer Reporters that is free of charge.

Download September Newsletter

What’s New!
by Alan Franciscus, Editor-in-Chief
What’s New features two of our new Easy C fact sheets as well as our Training Workshop schedule for the rest of the year!

HCV Advocate Eblast: September 1, 2015
Attention: There are many insurance companies that are denying coverage of HCV medications to only the sickest of patients. I am working on a brief

Blog Updates

Karen Hoyt
You've wondered where I’ve been, so here’s the truth. I’m working on a post transplant nervous breakdown. It kind of started a few weeks ago. I was seated at my fave outdoor restaurant (to avoid germs) typing away from my notes. It was a blog titled “I Can Do Anything”. I’ve always said that, and I’ve always tried. Really tried. Hard. Always. Anyway, here I was looking at my own thoughts through a microscope when I realized that I can’t do everything. POW! Sucker punched, right there on the patio.

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 Blogs and are the go-to source for educational and social support for people living with hepatitis.

David Pieper
HIV/Hep C Co-infection activist; on treatment
4 September: The tip of the iceberg
There are 25 million people living with viral hepatitis in Indonesia. This is a tragedy. It puts my treatment experience into context and I realise that I am the merest tip of the iceberg
click here to enter

Grace Campbell
A nom de guerre for a person living with hepatitis C on Viekira Pak + Ribavirin
My Year of Living With Hepatitis C
I have four more days of treatment. Four more days of thinking about treatment. Then I can switch to thinking about treatment in the past tense. And no doubt I'll find something else to obsess over
click here to enter

National Viral Hepatitis Roundtable
 First-Ever World Hepatitis Summit meeting this week in Glasgow
An invite-only, exclusive event that will be the first of its kind to directly address the overwhelming global burden of viral hepatitis.
click here to enter

Connie M. Welch
Passionate Encourager for Christ, Writer, Speaker, and Hep C Warrior
Living Beyond Hep C with Faith and Trust
Hep C knows no boundaries, it does not hold back from race, sex, religion, social status, rich or poor, or country. Hep C like any other serious health condition causes you to look on the inside out of life.
click here to enter

Matt Starr
Hepatitis, Liver Disease Support Coach
 Hep C Meds - The Home Stretch
But, it's not easy sometimes to stay positive as effects of meds and liver disease compromise you.
click here to enter

Greg Jefferys
My Hep C Travel Diary, Hepatitis C Advocate
Hepatitis C Headlines, Hacking, and Scams
I need to again mention that there are a LOT of Harvoni scams going around now. I make the point again that there is no generic Harvoni in India at the moment, or anywhere else in the world.
click here to enter

Stay well, see you soon...

Friday, August 28, 2015

TGIF HCV Rewind: A Week In Review With A Spotlight On Don Crocock and Greg Jefferys

TGIF HCV Rewind: A Week In Review With A Spotlight On Don Crocock and Greg Jefferys

Hello everyone, we made it through another week, only a few day's until September, where does the time go?

Did you all see the article from "People" on Pamela Anderson? After living with HCV for over sixteen years she has decided to start therapy.

Its always great when hepatitis C is in the news, especially when a celebrity is involved, Anderson's announcement may reach more people over the next week than a year of "advocacy programs" designed to raise HCV awareness and testing, here is the statement.

After Living with Hepatitis C for 16 Years, Pamela Anderson Now Says 'I Could Be Cured Within a Month'
After experimenting with various alternative medicines, Anderson recently decided to try the new anti-viral medication. The Baywatch actress says, "I could be Hep C free within the month."
Lovely Pamela is not alone, close to 130-170 million people worldwide have HCV and those numbers do not include people who have no idea they are infected. The good news is that we have a cure, the bad news is the cost. Here is an article written by Lucinda K. Porter on the sad reality....

Creating a World Free of Hepatitis C
Lucinda K. Porter, RN
Hepatitis C Treatment is Worth Fighting for
Aug 20
Hepatitis C infection is curable. Unfortunately, a hepatitis C diagnosis is not an automatic qualifier for getting the medication. Many people are engaged in what seems like an endless fight for the newest hepatitis C drugs. Insurance companies were happy to approve treatment in the past, when treatments were difficult, risky, and less successful. Now that the drugs are costly, insurance companies are denying, denying, denying.....

Despite everything you hear, sometimes there is no fight at all. This is from a reader:
I am currently taking Harvoni (after having Hep C for 40 years) and here’s how I was able to get it – FOR FREE!

To learn more about FDA approved treatments for hepatitis C, start here, to read patient friendly newsletters published by our devoted HCV community, click here.

In The Spotlight

Today the spotlight shines brightly on two familiar HCV advocates, both men may not be Hollywood celebrities, but they sure are famous in my book. Don Crocock and Greg Jefferys have waged a campaign using Twitter and Facebook offering information and support to anyone battling hepatitis C.

Don Crocock
I have great admiration for Don, his years of zealous work to increase HCV awareness to me is simply outstanding. 

HCV survivor takes advocacy to social media to help other patients and spread awareness

Don Crocock: The Hepatitis C Dragon Slayer
Don Crocock was not ashamed of his hepatitis C diagnosis in September 2008. Shocked, yes. Shaken, yes. But not ashamed. For many, a diagnosis of hepatitis C virus (HCV) comes with a sense of embarrassment due to the disease’s stigma of being “dirty.” But for Crocock, the news came with a sense of empowerment and a deep desire to share information about the virus with others in order to prevent further spread of the disease.
Read more

Connect with Dan on Facebook or Twitter.

Greg Jefferys
Greg Jefferys, a blogger at "Hep Blogs" is featured in an August article published online at "ABC." The author writes about Mr. Jefferys incredible journey to India in search of an affordable generic version of Gilead's Sovaldi (Sofosbuvir), 

Hepatitis C sufferer imports life-saving drugs from India, takes on global pharmaceutical company
By Michael Atkin and Joel Keep
Mr Jefferys was so sick from hepatitis C last year that he was unable to get out of bed some days.

He dropped out of his university PhD studies and quit many of his hobbies, including kayaking and fishing.

He desperately needed a drug called Sovaldi, manufactured by US pharmaceutical giant Gilead, but could not afford it without selling his house.
Read more

Mr. Jefferys has documented his trip to India, and so much more here on his website.
Connect with Greg on Facebook.

Next up we have a few editorials, a new "learning activity," an inspiring patient video, plus a collection of great articles written by your favorite bloggers, followed by research and news.


World Journal of Hepatology
Three decades of hepatitis B control with vaccination
It is now 50 years since the discovery of the hepatitis B virus (HBV). Effective vaccines have been available since the 80s and vaccination has proved to confer lifelong protection against hepatitis B and was highly successful in reducing the disease burden. However, the occurrence of breakthrough infections, the immunological effect of natural boosting and the effectiveness of universal hepatitis B vaccination remains a challenge. The fight against HBV is not over
Clinical Liver Disease
Hepatitis C treatment: Back to the warehouse
Like many physicians that specialize in hepatitis C virus (HCV) treatment, I have spent the last few years advising many of my patients with chronic HCV infection to defer treatment and wait for new therapies. For those without advanced fibrosis or an extraintestinal manifestation of HCV, this process of “warehousing” patients for future HCV treatment made perfect sense.
Read more

HCV: The Best Cure Possible or the Best Possible Cure?
Is a regimen combining interferon (IFN) with a highly effective direct-acting antiviral agents (DAA) still an acceptable choice in 2015? The ultimate goal for society as a whole is to obtain what is best for each individual, but in doing so, it should aim not towards the best possible cure, but the best cure possible.
Read more

HCV Treatment: What Can I Do Now? What's Coming Next?
The development of direct-acting antivirals represents a significant improvement in HCV treatment. New combinations of drugs have led to improved response rates, even in patients with characteristics previously associated with having lower response rates: African American, high viral load, concomitant cirrhosis, infection with genotype 1a, and failed treatment with other anti-HCV drugs.

Expert Answers – Should people who use injection drugs be treated?
By Editorial Team
Injection drug use is the most common means of hepatitis C transmission. It’s estimated 70-90% of current and former injection drug users are infected with hepatitis C. Many in the community debate whether injection drug users should be treated.
Read more

Recent Approval Holds Promise for Genotype 3, but Hurdles Anticipated
HCV Next, August 2015
Genotype 3 accounts for 10% to 15% of patients with hepatitis C in the United States, but has been estimated to be the second most prevalent genotype…
Read more

Learning Activity

From Medscape Education Gastroenterology

Initiating Antiviral Therapy for HCV Infection in a New Era of Care: Treatment Vignette CME
A new CME was recently launched over at "Medscape" for physicians, and other healthcare professionals examining follow up care after HCV diagnosis. Although the "CME questions or post test" may not be of interest or patient friendly, a fictitious patient video vignette in the CME is worth watching for anyone considering treatment. The scenario is that of a newly diagnosed HCV patient at a two week follow up appointment.  In this "Treatment Vignette" liver heath, lifestyle changes, HCV testing of family members, adherence to treatment and follow up blood tests is examined.

Nancy Reau, MD

CME Released: 08/24/2015 

For Your Viewing Pleasure 

Hepatitis C Patient Journey: Coping With Drug Side Effects
In part four, Jim Wilson, RPh, MBA, president of WilsonRx, discusses the difficulties he faced during treatment from interferon therapy following his liver transplant.

Wilson was infected with an acute case of Non-A/Non-B hepatitis in 1975 due to a tainted blood supply but was not diagnosed with the disease until 1999. After receiving a liver transplant in 2006, he was finally cured of HCV in 2012 after enrolling in a 12-week clinical trial of the drug Harvoni.


Blogger Updates

Lucinda K. Porter, RN @ Hep blogs
Aug 24
Surprising Updates to the HCV Guidelines
The HCV Guidelines added the combination of Daklinza/Sovaldi for 12 weeks for genotype 3 patients without cirrhosis or 24 weeks with/without ribavirin for those with cirrhosis.

What I did not anticipate was that the panel would make off-label recommendations for daclatasvir. Off-label use allows physicians to prescribe approved drugs according to their clinical judgment, regardless of the indication the FDA has approved for the drug.
Read more

Greg Jefferys
Did I sound a bit angry in my last post?
That's because I was. I was angry because every day I get emails from people who are desperate to begin treatment with these new antiviral drugs and they go to their doctor and the doctor refuses to write them a prescription.
Or their specialist sneers at them and asks,
"How do you know what is in these India drugs? How do you know they are safe?"

An Unintended, but Necessary Hepatitis C Advocacy
So take the interferon treatment, with a 50% possibility of a cure and a high chance of permanent organ damage but don't use Indian generics because there is a possibility they might be sub standard (or not). Go figure that out!

Rick Nash
Aug 19
Why Harvoni and Sovaldi failed me. They are amazing new drugs with high efficacy, but they may not be best for your situation..

View all blog updates at Hep Blogs , here.

Hepatitis C Research Center Blog
HCV Drug Costs: A Treatment Access Barrier
Posted on August 27, 2015
In a newly published, thought-provoking article in the journal Clinical Infectious Diseases, Stacey B. Trooskin and colleagues discuss how the high cost of newer hepatitis C therapies has become a major treatment access barrier in the US (Trooskin SB, et al. Clin Infect Dis. 2015 Aug 12 [Epub ahead of print]). Controversial insurance coverage restrictions and treatment rationing has resulted in national patient advocacy mobilization, US Congressional inquiry, and legal challenges. Authors of this article state that the establishment of a federal program, analogous to the successful AIDS Drug Assistance Programs (ADAP), would substantially reduce access barriers and facilitate focused price negotiations between pharmaceutical companies and payers.
Read more

AGA Journals BlogAug 28
Kristine Novak
Public Health Officials Call for Wider Access to HCV Drugs
Experts from the Public Health Service and President Obama’s Advisory Council on HIV/AIDS are calling on federal and state Medicaid officials to widen access to prescription drugs that could cure tens of thousands of people with hepatitis C virus (HCV) infection. They say restrictions on the drugs imposed by many
Read more

Aug 26
Is Nonceliac Gluten Sensitivity Real?
When patients with nonceliac gluten sensitivity (NCGS) unknowingly ingested small amounts of gluten for 1 week, they developed more severe abdominal pain and bloating that patients who ingested a matched placebo, researchers report in the September issue of Clinical Gastroenterology and Hepatology. The study provides evidence for a form of

Aug 19
Can we Reduce Muscle Cramps in Patients with Cirrhosis?
L-carnitine appears to be safe and effective for reducing muscle cramps in patients with cirrhosis, researchers report in the August issue of Clinical Gastroenterology and Hepatology. Many patients with cirrhosis develop frequent muscle cramps, which reduce their quality of life. L-carnitine (L-beta-hydroxy-gamma-N-trimethyl aminobutyric acid) is an amino acid that transports
Read more

Aug 12
What Causes Different Types of Fatty Liver Disease?
Hepatic steatosis and steatohepatitis are increasing in prevalence, and can progress to histologically identical, more severe liver disease. They are associated with 3 main factors: alcohol, obesity or metabolic syndrome, and exposure to toxins. Researchers review the similarities, differences, and pathogenic mechanisms of alcohol-associated steatohepatitis (ASH), nonalcoholic steatohepatitis (NASH), and toxicant-associated fatty liver

Aug 10
Does Weight Loss Resolve Fatty Liver Disease?
Two separate studies in the August issue of Gastroenterology show that weight loss, via diet or bariatric surgery, reduce features of non-alcoholic steatohepatitis (NASH). Eduardo Vilar-Gomez et al associated extent of weight loss, produced by lifestyle changes, with level of improvement in histologic features of NASH. The highest rates of NASH reduction
Read more

Aug 20
When to Start HCV Treatment: The Intersection of Guidelines and Real-World Practice
By Kelly Eagen, MD
Treatment for hepatitis C virus (HCV) infection is changing at a pace almost too rapid for the average physician to keep up with. Until recently, HCV treatment required weekly interferon injections plus oral ribavirin for up to a year and
Read more

HIV and ID Observations
Aug 23
Post-Exposure Prophylaxis for HCV Can’t Be Cost-Effective — But We Might End Up Recommending It Anyway
An email query from a colleague:
Hi Paul,
Just got a call from one of our surgeons who got a needlestick from a suture needle, small amount of blood. Patient is HCV +. Any post-exposure prophylaxis recommended?
Read more


Interferon-free regimens overcome the effects of portal hypertension on virological responses in Hep C
Aug 28
September's publication of the Alimentary Pharmacology & Therapeutics investigated the effects of portal pressure on virological responses in hepatitis C patients treated with interferon-free regimens.
Read more

Resistance-Associated Gene Variants Found In Hep C Patients Who Received First-Generation DAAs
First-generation triple therapies for hepatitis C virus (HCV) infection are being phased out in favor of next-generation interferon-free direct-acting antiviral agents (DAAs).
Read more..

Mechanisms of Non-response to Hepatitis C Therapy
Liver International, August 28, 2015
Since the introduction of interferon-based therapy for hepatitis C virus (HCV) infection, predictors of response have been carefully evaluated to determine which patients are more likely to respond and why. While many of these factors were identified and explained, the presence of cirrhosis remains one of the well established yet least understood conditions that complicate HCV therapy.[1] In this review, we aim to shed light on the various and likely multifactorial mechanisms responsible for impaired responses in patients with cirrhosis.
Read more

Fatty Liver and Diabetes Increase Liver Fibrosis Risk
The combination of diabetes and nonalcoholic fatty liver disease increase the risk for liver fibrosis more than fivefold, according to a large prospective cohort study published online July 14 in Hepatology.

"These findings underline the significant role of these — potentially modifiable — risk factors in liver fibrosis and stress the importance of early targeting insulin resistance and/or [diabetes mellitus]," write Edith M. Koehler, MD, from the Erasmus MC University Hospital Department of Gastroenterology and Hepatology in Rotterdam, the Netherlands, and associates. "[They also] suggest that [nonalcoholic fatty liver disease] may be an important determinant of clinically relevant fibrosis in a population that has a very low prevalence of viral hepatitis."
Read more

Interferon-free regimens for the treatment of hepatitis C virus in liver transplant candidates or recipients
Treatment against hepatitis C virus has dramatically improved with the novel direct-acting antivirals (DAAs). The currently available DAAs are sofosbuvir, simeprevir, daclatasvir, ledipasvir/sofosbuvir, paritaprevir/ombitasvir and dasabuvir. IFN-free combinations of these novel DAAs with or without ribavirin give excellent sustained virological response in patients with decompensated cirrhosis awaiting liver transplantation and those with recurrence of hepatitis C post liver transplantation. More data regarding the safety and efficacy of these new DAAs are needed, but ongoing clinical trials and real life data will clarify better these issues.
Read more

Prevalence of Insomnia and Sleep Patterns among Liver Cirrhosis Patients
Few studies are available regarding the prevalence of sleep disturbance in cirrhotic patients without overt hepatic encephalopathy. This study aimed to assess the prevalence of insomnia in stable liver cirrhosis patients who are attending the outpatient clinics at King Abdulaziz Medical City, Riyadh (KAMC-KFNGH).

Hepatitis C in the UK 2015 report

Hot Topic

One in Four Hepatitis C Patients Denied Initial Approval for Drug Treatment
New Haven, Conn. -- Nearly one in four patients with chronic hepatitis C (HCV) are denied initial approval for a drug therapy that treats the most common strain of the infection, according to a Yale School of Medicine study. The finding, published Aug. 27 in PLOS ONE, identifies a new barrier to caring for patients with this severe condition.

A Look At This Week's Headlines

Hepatitis C: Meet the Meds
By Roger Pebody
August 28, 2015
Hepatitis C treatment used to have a terrible reputation. Until very recently, it consisted of weekly injections with pegylated interferon and daily tablets of ribavirin.

Not everyone did badly, but a significant number of people had debilitating side effects from the injections, including fever, tiredness and depression. Treatment usually lasted six months to one year. Worse, it didn't get rid of hepatitis C in everyone.

The new generation of hepatitis C treatments are different. You only need to take pills, and often just for 12 weeks (three months).

Oysters harbor, transmit human norovirus: Avoid raw ones
American Society for Microbiology
Washington DC - August 28, 2015 - Oysters not only transmit human norovirus; they also serve as a major reservoir for these pathogens, according to research published August 28 in Applied and Environmental Microbiology, a journal of the American Society for Microbiology. "More than 80 percent of human norovirus genotypes were detected in oyster samples or oyster-related outbreaks," said corresponding author Yongjie Wang, PhD.

FDA warns of severe joint pain risk with DPP-4 diabetes drugs
- A class of diabetes drugs that include Merck & Co Inc's Januvia have been linked with severe joint pain, the U.S. Food and Drug Administration said on Friday.

Harvoni Sees Near-Perfect Cure Rate for Hep C Genotype 4
Gilead Sciences’ Harvoni (ledipasvir/sofosbuvir) cured almost all people with genotype 4 of hepatitis C in a small trial.

Health ministry approves new hepatitis C drug under insurance scheme
A health ministry panel has added a new highly effective, but expensive, hepatitis C virus drug to the national health insurance scheme, giving high hopes for patients who have had to endure painful interferon injections. 

Wider Reach Is Sought for Costly New Hepatitis C Treatments
WASHINGTON — Federal and state Medicaid officials should widen access to prescription drugs that could cure tens of thousands of people with hepatitis C, including medications that can cost up to $1,000 a pill, health care experts have told the White House.

Hepatitis C - Liver Damage Significantly Underestimated and Underreported
The number of hepatitis C patients suffering from advanced liver damage may be grossly underestimated and underdiagnosed, according to a study led by researchers at Henry Ford Health System and the U.S. Centers for Disease Control and Prevention.

Of Interest

August 2015
Summary report: Hepatitis C Good Practice Roadshow, London
This report provides a summary of the good practice hepatitis C roadshow held by HCV Action and Public Health England on 26th June 2015. The roadshow was aimed at sharing good practice around hepatitis C and instigating local action to address the virus. The report includes summaries of the talks and workshops held on the day, as well as suggested next steps to be taken in order to tackle hepatitis C more effectively in the capital. 

August 2015
Developed by the Hepatitis C Coaltiion on the basis of interviews with patient and clinical experts, as well as drawing upon the expertise within the Hepatitis C Coalition’s membership, this fact-sheet provides an overview of the linkages between hepatitis C and alcohol-related liver disease. As well as detailing the interactions between the two conditions, it also details the health impact, as well as the latest relevant policy developments.

View Complete List Of August Reports @ HCV Action.

Enjoy the upcoming weekend.

Friday, July 3, 2015

TGIF- July Weekly Rewind of Hepatitis C News And Updates Around The Web

TGIF- Weekly Rewind of Hepatitis C News and Updates 

It's Friday folks, the end of another week of work and the start of the holiday weekend.

Happy Forth of July!

Here is a look back at this weeks headlines with updates around the web and a bit of today's news.

Today Gilead announced Harvoni ® was approved by Japan's Mininstry of Health, read the press release here.

Japan's Ministry of Health, Labour and Welfare Approves Gilead's Harvoni®, the First Once-Daily Single Tablet Regimen for the Treatment of Genotype 1 Chronic Hepatitis C
Gilead Sciences, Inc. (NASDAQ:GILD) today announced that the Japanese Ministry of Health, Labour and Welfare (MHLW) has approved Harvoni® (ledipasvir 90 mg/sofosbuvir 400 mg), the first once-daily single tablet regimen for the treatment of chronic hepatitis C genotype 1 infection in adults. Harvoni combines the NS5A inhibitor ledipasvir with the nucleotide analog polymerase inhibitor sofosbuvir, approved by the MHLW under the trade name Sovaldi® in March 2015. Harvoni is indicated for the suppression of viremia in patients with genotype 1 chronic hepatitis C virus (HCV) infection with or without compensated cirrhosis, with a treatment duration of 12 weeks.
Continue reading...

Speaking of fireworks, a study published in the July edition of Hepatology reported adding ribavirin to ledipasvir and sofosbuvir did not significantly increase SVR:
Adding the antiviral drug ribavirin to the fixed-dose combination of viral inhibtor ledipasvir and nucleotide inhibitor sofosbuvir offered no better result than ledipasvir/sofosbuvir alone, says a study led by Saleh Alqahtani, M.D., and Mark Sulkowski, M.D., of the Johns Hopkins University School of Medicine. In fact, say the study’s authors, the ribavirin combination was associated with a higher rate of adverse events.
Click here to read a quick overview of the study...

Bangladesh's Beximco launches copy of Sovaldi
One tablet will cost Tk 600 in Bangladesh, and the total cost of the therapy would be Tk 50,400 for a 12-week course compared to the whooping Tk 67 lakh in developed countries

China rejected patent linked to Gilead hepatitis C drug
China has rejected a Gilead Sciences Inc patent application related to its costly hepatitis C drug, a U.S. advocacy group said, adding the move may lead to other countries to consider rejecting patents for the controversial treatment.

AbbVie's HOLKIRA™ PAK Now Reimbursed in Ontario
Following the positive CDR recommendation announcement, Ontario is the second province to reimburse HOLKIRA PAK on its public formulary through its Exceptional Access Program (EAP) as of June 29, 20152. In Ontario, HOLKIRA PAK will be covered under the following EAP criteria: for treatment-naïve and treatment-experienced adult patients with GT1 chronic HCV infection, with compensated cirrhosis.

Holkira Pak is a combination of dasabuvir, ombitasvir and paritaprevir boosted with ritonavir. Ombitasvir, paritaprevir and ritonavir are co-formulated into one tablet that is taken once per day. Dasabuvir is a separate tablet that is taken twice per day. Holkira Pak may be prescribed with ribavirin. Holkira Pak appears to have few side effects. Common side effects are generally mild and include fatigue, headache, weakness and nausea. Hep C treatment can cure a person from Hep C. However, a person could become infected again, read more @ Catie 

Of Interest
Updates @ NATAP
Viekira Pak - AbbVie hepatitis C cocktail succeeds in late-stage study
- 3b Results in Genotype 1b Chronic Hepatitis C Patients with Compensated Liver Cirrhosis
- 100 percent SVR(12) rate achieved with VIEKIRAX® (ombitasvir/paritaprevir/ritonavir tablets) + EXVIERA® (dasabuvir tablets) without ribavirin(1)

Updates Around The Web
We begin with "HCV Virtual Patient" an easy to follow case by case video CME over at "ViralEd." Cases 1-4 include a look at HCV re-treatment, current treatment options for various HCV genotypes, HCV recurrence after liver transplantation, and treatment in HCV/HIV co-infection. Follow "ViralEd on Twitter "or visit "ViralEd" for future launch dates. I am patiently waiting for ViralEd to release Case 5; HCV Genotype 3, Previous Failure. 

"HCV Advocate" has just published their "July Newsletter." Check out an overview of liver toxic herbs, part 2 of a two-part series discussing pain associated with hepatitis C, and long term treatment outcomes and the benefits of achieving an SVR. 

As always "" has a group of talented bloggers who share their personal story about living with HCV, view all updates, here and news updates, here

Gilead Controversy
The controversy over Gilead Sciences hepatitis C treatments was in the media again this week when it was announced that; Public Health Groups Sued The FDA For Disclosure of Clinical Trial Data for Costly Hep C Drugs. Read a great commentary over at the WSJ

Medicaid has come under much scrutiny in recent months because of Medicaid reimbursement restrictions for newer hepatitis C medications. A study in "Annals Of Internal Medicine." offers insight into how the program works.

July 1
Two studies published online June 29 in the Annals of Internal Medicine examine how states are deciding which Medicaid patients will get sofosbuvir, the $1000-per-pill treatment for hepatitis C that has a 90% cure rate.

The authors of both studies find restrictions vary tremendously across states' Medicaid fee-for-service programs and often differ with guidelines set out by professional associations. One study says the restrictions violate the federal Medicaid law.

June 29
(Reuters Health) - State-run insurance programs for the poor may be putting up illegal barriers that prevent people with hepatitis C from getting a new treatment, a new study suggests.

California Caps What Patients Pay For Pricey Drugs. Will Other States Follow?

Reducing the cost of new hepatitis C drugs
An index of articles pointing the reader to the current controversy over the high price of Sovaldi, Harvoni (ledipasvir/sofosbuvir) and AbbVie Viekira Pak.

Veterans Waiting for HCV Therapy
One year after VA scandal, veterans wait to be treated for everything from Hepatitis C to post-traumatic stress
VA’s leadership attributed the growing wait times to soaring demand from veterans for medical services, brought on by the opening of new centers and a combination of aging Vietnam veterans seeking care, the return of younger veterans from Iraq and Afghanistan and the exploding demand for new and costly treatments for Hepatitis C.
Continue reading......

July 1
Vietnam era veteran carries battle cry of hepatitis C

June 30
If you’re in a long-term monogamous relationship of at least 5-10 years, though, the risk of getting hep C through vaginal sex is “extremely low,” Wang says.

A recent study in the journal Hepatology shows that the chance someone will spread the virus to a partner this way is 0.07% per year, or 1 in 190,000 sexual contacts.

“The majority of couples in my clinic -- people who are married or partnered for a long time -- do not use condoms,” says hepatologist Andrew J. Muir, MD, an associate professor of medicine at Duke University Medical Center.. “The key is to have a comfortable sex life. You need to have a conversation and make that person feel comfortable.”

Tips to Deal With Hepatitis C Fatigue
By John Donovan
WebMD Feature
Reviewed by Lisa B. Bernstein, MD
When you have hepatitis C, being tired -- really tired -- can be a fact of life. But there are ways you can boost your energy.

Here, three people who have experience with fatigue from the disease share their tips...

That's all folks, check back later for more updates.


Friday, June 26, 2015

HCV TGIF Rewind - Peak body, Gilead welcome hepatitis report

HCV TGIF Rewind 

Welcome to TGIF rewind, a weekly digest of news, research and a look at today's headlines.

Wednesday AbbVie announced clinical trial results from TURQUOISE-III which showed 100% of genotype 1b patients with compensated liver cirrhosis reached a sustained virologic response at 12 weeks post-treatment after therapy with Viekirax and Exviera, here is the press release, a summary available online @ Healio.  

The June issue of "Clinical Liver Disease" is up folks, the journal is an official digital educational resource from the American Association for the Study of Liver Diseases. Visitors can read full text articles or sit back and watch either an author interview, or a presentation of each article, begin here.

In 2014 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 "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. Yesterday the AASLD announced updates for the use of hepatitis C drugs with a summary published in the AASLD journal, Hepatology.

VA In The Headlines
VA to outsource care for 180000 vets with hepatitis C
"The VA had set aside nearly $700 million this year for HCV antiviral drugs. In documents and a written statement, department officials confirmed soaring patient loads and medication expenses have nearly wiped out that budget with several months to go in the federal fiscal year that ends Sept. 30. That's an estimated $400 million shortfall with more dramatic costs expected, beginning in October."

VA to outsource care for 180000 vets with hepatitis C
The Department of Veterans Affairs is moving to outsource care nationwide for up to 180,000 veterans who have hepatitis C, a serious blood and liver condition treated with expensive new drugs that are costing the government billions of dollars.

July 25
Wonder Drugs Blow a $1 Billion Hole in VA's Budget
Senior official at the Department of Veterans Affairs testified on Thursday that his agency is not rationing costly new drugs for veterans suffering from the potentially deadly Hepatitis C virus, as some have suspected, but acknowledged that the VA is reeling from the skyrocketing costs of providing the miracle drugs.

High Cost Of Specialty Drugs
June 26
Peak body, Gilead welcome hepatitis report
Australian Journal of Pharmacy
The report by the House of Representatives Standing Committee on Health, The Silent Disease – Inquiry into Hepatitis C in Australia has been welcomed by the peak body representing more than 230,000 Australians living with hepatitis C.

June 25
The rising cost of specialty drugs to treat complex, chronic or life-threatening conditions has the potential to break the pocket books of businesses, consumers, insurance companies and the state, according to Milam Ford of Blue Cross and Blue Shield of Louisiana.

Ford is the vice president of pharmacy services for Blue Cross and Blue Shield of Louisiana. He spoke with The News-Star Thursday about the rising cost of specialty drugs, which are used for cases of hepatitis C, cancer, rheumatoid arthritis, multiple sclerosis and more.

Related; June Updates
An index of articles pointing the reader to the current controversy over the high price of Sovaldi, Harvoni (ledipasvir/sofosbuvir) and AbbVie Viekira Pak.

June 24
Community outreach program cures Pearland resident of Hepatitis-C
When Pearland resident John Rocks went into the hospital in 2012, the last thing he expected was to be diagnosed with Hepatitis-C(HEP-C) [an inflammation of the liver due to virus or bacteria], yet that's exactly what the doctor told him. “I had a ...

June 23
China rejects patent linked to Gilead hepatitis C drug
China has rejected a Gilead Sciences Inc patent application related to its costly hepatitis C drug, a U.S. advocacy group said, adding the move may lead to other countries to consider rejecting patents for the controversial treatment.

World Journal of Gastroenterology 2015 June 28
Hepatitis C virus (HCV) infection is a significant threat to the health of elderly patients, in whom liver disease progresses very rapidly and extrahepatic complications affect the quality of life. Till now, treatment attempts have been substantially limited by the side effects of interferon (IFN). Here we discuss how the availability of IFN-free regimens should prompt us to change our mind when assessing treatment indication and to consider a significantly larger number of possible candidates among elderly patients. Drug-drug interactions and assessment of liver disease-dependent vs comorbidities-dependent life expectancy, rather than anagraphic age, are likely to guide the choice of the aged HCV patients to be treated in the next future.

June 25
Clinical Care Options
Date Posted: 6/25/2015
In this downloadable slideset, Paul Y. Kwo, MD, reviews strategies for managing HCV infection in challenging patient populations, including an overview of data on the safety and efficacy of current regimens as well as potential future options.

June 23
MedPage Today
by Sarah Wickline Wallan
Various cannabinoid compounds did not improve nausea, vomiting, or appetite, and only slightly improved chronic pain and spasticity, in patients with various long-term health conditions, a review of randomized clinical trials found.

The greatest reductions in chronic pain were reported by patients who smoked tetrahydrocannabinol (THC) in eight of the trials, but the majority of the 79 trials in the meta-analysis demonstrated cannabinoids had little effect on HIV/AIDS patients with low-appetite and actually worsened chemotherapy-related nausea and vomiting, Penny F. Whiting, PhD, of University Hospitals Bristol NHS in England, and colleagues reported in the Journal of the American Medical Association.

Big Pharma
June 26
BMS is stopping early-stage discovery work in virology as part of a reshuffle in its R&D operations, reports.

The company stressed that the decision will not affect projects that have already reached the clinical development stage, which include beclabuvir for hepatitis C virus (HCV) in phase III and two HIV drugs in phase II, or indeed its marketed antiviral drugs including new HCV therapy Daklinza (daclatasvir).

The decision will mainly affect early programmes in hepatitis B and HIV, said the company, which said around 100 positions will be lost as a result. It will organisation will continue to focus on research in immuno-oncology as well as heart failure, fibrosis, genetically defined diseases and immunoscience.

Meanwhile, structural changes caused by the reshuffle include the opening of a facility in Cambridge, Massachusetts, due to open in 2018, as well as a the closure of its sites in Wallingford, Connecticut, and Waltham, Massachusetts, in 2018.

Around 200 workers from the two closing units and BMS’ New Jersey operations will relocate to the new unit, which will focus on discovery efforts in genetic diseases, molecular discovery technologies and discovery platform chemistry, said the company.
26 Jun 2015 | PharmaBusiness Daily

Blog Updates
June 26
The Top-Selling Drugs in America
NerdWallet (blog)-32 minutes ago
Sovaldi was first approved for most types of hepatitis C in 2013 and quickly skyrocketed to the top earnings spot in 2014. There are six genotypes of hepatitis C, ...

Greg Jefferys
My Hep C Travel Diary, Hepatitis C Advocate
Last Entry: Hepatitis C Musings (2015-06-25 15:03:51)
Tomorrow I should get my hepatitis C viral load results back.
click here to enter

Matt Starr
Hepatitis, Liver Disease Support Coach
Last Entry: Hepatitis C and Treatment - The Long Haul (2015-06-25 06:24:05)
Regardless of one's personal situation, what does it mean to hunker down for the long haul? Can we deal with liver disease and hepatitis, get serious and be open to a wide range of possible treatments, while still maintaining our love for life and what is all around us?
click here to enter

Karen Hoyt
Hepatitis C Advocate
Last Entry: Going Back to Bed after Liver Transplant Surgery(2015-06-24 06:40:27)
After the surgery, my transplant coordinators, friends, and family all conspired to make me rest. Then they got me all jacked up on steroids which made it totally impossible for me to sit still. It was quite a conundrum.
click here to enter

Rick Nash
Hepatitis C Advocate
Last Entry: Road Tips (2015-06-23 14:11:01)
On my road trip to from San Diego to San Francisco, I took a critical look and what i did well, and where i could've improved and made a new road trip tip list for people living with the complications of Liver Disease.
click here to enter

Kim Bossley
Hepatitis C Advocate and Co-Founder, The Bonnie Morgan Foundation
Last Entry: Everyday Life (2015-06-22 12:21:29)
I am not what I used to be but I am happy, I am a fighter wanting to survive.
click here to enter

Lucinda K. Porter, RN
Author, Hepatitis C Advocate, Health Educator
Last Entry: When Hepatitis C Treatment is Hard and Scary (2015-06-22 06:07:58)
What if hepatitis C treatment isn't a cakewalk for you?

Enjoy the weekend!