Showing posts with label Milk thistle. Show all posts
Showing posts with label Milk thistle. Show all posts

Saturday, February 2, 2019

Blog Updates - Common Liver Tests, Overview of Hepatitis A, B, and C

Common Liver Tests, Overview of Hepatitis A, B, and C
If you’re interested in useful information about viral hepatitis, check out the following blogs written by patient bloggers and healthcare professionals. Read articles covering an array of liver topics, from the difference between hepatitis A, B and C, to a supplement commonly taken by hepatitis patients. Additional posts include today's news, common liver tests, general food tips for a healthy liver, alcoholic liver disease and a warning about fruit juices sold in the U.S.  Make sure to check out coverage from this months HCV Special Conference as well.

News & Review 
Review a collection of noteworthy hepatitis C news articles in the latest issue of the Weekly Bull, published by the Canadian non-profit organization HepCBC.

Feb 6 - 2019 Hepatitis C - Testing, Treatment Options, Stages of fibrosis and Care
Feb 5 - In Egypt, Viral Hepatitis Elimination Starts With a Village: An Interview With Dr. Ammal Metwally
CDC reports Oklahoma among top states with Hepatitis C deaths
Hepatitis C: Out-of-Pocket Cost Burden for Specialty Drugs in Medicare Part D in 2019
For 28 of the 30 studied specialty drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis (MS), and rheumatoid arthritis (RA)—expected annual out-of-pocket costs for a single drug in 2019 range from $2,622 for Zepatier, a treatment for hepatitis C, to $16,551 for Idhifa, a leukemia drug.
Analysis Estimates Impact of Interventions on Global HCV Epidemic
FDA accepts new drug application for liver cancer T-cell therapy
Not content with billions of dollars in profits from the potent painkiller OxyContin, its maker explored expanding into an “attractive market” fueled by the drug’s popularity — treatment of opioid addiction, according to previously secret passages in a court document filed by the state of Massachusetts. In internal correspondence beginning in 2014, Purdue Pharma executives discussed how the sale of opioids and the treatment of opioid addiction are “naturally linked” and that the company should expand across “the pain and addiction spectrum,” according to redacted sections of the lawsuit by the Massachusetts attorney general. (Armstrong, 1/30)

Don't Miss

This weeks aidsmap news bulletin
HCV Advocate's weekly special: Sleep

Blog Updates
Blogs from Doctors Without Borders 
In medical emergencies around the world Médecins Sans Frontières / Doctors Without Borders (MSF) staff are working together to provide life-saving care. From doctors to nurses, administrators to mechanics, everyone has a role to play and a story to tell.

Pakistan: A new way of treating hepatitis C
Khurshid Ahmed
Feb 2, 2019
In Machar Colony, a slum area of Karachi, an Médecins Sans Frontières / Doctors Without Borders (MSF) team have been treating patients for Hepatitis C using a new line of drugs to combat the virus.

New drugs, known as Direct Acting Antivirals (DAAs) are now widely available in Pakistan, making it easy for primary healthcare workers like me and my colleagues – all nurses and general practitioners – to manage the majority of patients.
Read More:

I Help C
Karen Hoyt is devoted to offering support and accurate information to people coping with the effects of hepatitis C.
Crash Landing with Cirrhosis
Mindful Meditation and Your Health
Find Karen on Facebook or watch videos on her YouTube Page.
View all blog updates here.

Lucinda K. Porter
Lucinda Porter is a nurse, speaker, advocate and patient devoted to increasing awareness about hepatitis C.

Fear of Sickness or Sickness of Fear?
View all new blog updates, here....

Hep is an award-winning print and online brand for people living with and affected by viral hepatitis. 
Karen Hoyt - My Health Care Wishes: Prognosis Declaration
It’s best to know ahead of time how your health care will be managed. Then, you will be in control of how much information you want. 
View all blog updates, here...

Support At Hep
Hep Forums: Started Epclusa today 2/1/2019
All Posts

AGA Blog
Gastroenterology and Clinical Gastroenterology and Hepatology

Written by Dr. Kristine Novak
View all blog updates, here...

Life Beyond Hepatitis C
Life Beyond Hep C is where faith, medical resources and patient support meet, helping Hep C patients and their families navigate through the entire journey of Hep C
Tests for Hepatitis C
View all updates, here...

Canadian Liver Foundation
We strive to improve prevention and the quality of life of those living with liver disease by advocating for better screening, access to treatment, and patient care.

2019 - Canada’s Food Guide and your liver health
The Canadian Liver Foundation provided insight on this guide and how it can impact those living with liver disease. The new Food Guide also addresses concerns related to alcohol consumption and how this may impact the overall health of Canadians. This is highly relevant to Canadians with liver disease where caution should be considered. Although Health Canada’s Food Guide is restricted to diet, the Canadian Liver Foundation emphasizes that regular exercise and physical activity are essential components of the maintenance of good liver health and will enhance the benefits of a healthy diet.
View all blog updates, here...

Hepatitis B Foundation
The Hepatitis B Foundation is a national nonprofit organization dedicated to finding a cure and improving the quality of life for those affected by hepatitis B worldwide.
What is silymarin (milk thistle), and is it helpful for managing my hepatitis B and D? - Silymarin, an herb and extract of milk thistle seeds, is a supplement commonly taken by hepatitis patients across the world, yet its proven benefits remain controversial. It is not a treatment for hepatitis B or D, nor has it been shown to have any effect against fighting the viruses.

Three-part series; This is part one
What’s the Difference: Hepatitis B vs Hepatitis C?
Part two
What’s the Difference: Hepatitis A vs Hepatitis B
View all updates, here....

ADRLF (Al D. Rodriguez Liver Foundation)
Al D. Rodriguez Liver Foundation is a non-profit organization that provides resources, education and information related to screening, the prevention of and treatment for the Hepatitis Virus and Liver Cancer. 
View all updates, here....
At we empower patients and caregivers to take control of Hepatitis C by providing a platform to learn, educate, and connect with peers and healthcare professionals.
Understanding Your Test Results: Liver Function Tests
If you have been diagnosed with hepatitis C, your healthcare provider may order regular blood tests to monitor your health...
View all updates, here....

U.S. Department of Health & Human Services - Viral Hepatitis Blog
CDC, HRSA, & HHS gathered input about the next editions of the National HIV/AIDS Strategy and National Viral Hepatitis Action Plan a recent national conference. Also check out The US Department of Health & Human Services public health blog
View all news updates....

KevinMD Blog
Kevin Pho is a practicing physician and most known for his blog KevinMD. Thousands of authors contribute to his blog: primary care doctors, surgeons, specialist physicians, nurses, medical students, policy experts. And of course, patients, who need the medical profession to hear their voices. 
If you are not in a high-risk category and feel the flu coming on, seeking treatment at an urgent care facility will not only help save you time and money, but it also keeps emergency rooms clear for those whose lives depend upon immediate treatment. Urgent cares also provide expert care for conditions such as colds, sore throats, ear infections, sprains, strains and more, often at lower costs and shorter wait times. 
View latest blog entry here...

The goal of our publications is to bring people around the world the most current health information that is authoritative, trustworthy, and accessible, drawing on the expertise of the 10,000+ faculty physicians at Harvard Medical School.

The flu is different from the common cold, but it’s not always easy to tell them apart, especially at the beginning. The flu usually comes on suddenly, and its symptoms can include fever, runny nose, cough, sore throat, headache, muscle aches,
feeling tired, and generally just feeling rotten.

One of the key questions that researchers in the field of neuropsychiatry are trying to answer is why some people are more vulnerable to addiction.
All articles here....

University of Michigan - Lab Blog
Providing physicians with virtual access to specialists can be lifesaving to liver disease patients.

In most cases, moderate drinking — one drink a day for women, two drinks a day for men — will not lead to alcoholic liver disease (ALD) but overindulging can. And for those already suffering from liver disease — some of whom may not know it — even small amounts of alcohol can exacerbate their liver damage.

Kevin Joy 
The seasonal return of two unpleasant viruses offers a reminder for good hygiene and vigilance. Here’s how to stop the spread of flu and increase norovirus prevention.

To improve the diagnosis, treatment & support of Americans with fatty liver, NAFLD or NASH through awareness, education, screening and patient advocacy.
What I Wish I Had Known Sooner
When we finally figured out what was really going on, I found myself looking back and lamenting “If only I had known.”. Wayne and I have put together a list of some of the things we wish we had known at the start of our journey, in the hopes that it may be helpful and valuable to you.

Message Boards:
Living with Fatty Liver or NASH is a community of the Fatty Liver Foundation dedicated to supporting individuals who have been diagnosed or are at-risk of developing Fatty Liver or nonalcoholic steatohepatitis (NASH).

On This Blog
Nonalcoholic Steatohepatitis (NASH) and Non-alcoholic Fatty Liver Disease (NAFLD):
Current research & media articles available on this blog:

Scope Blog
Scope is published by Stanford Medicine 
Stanford psychologist Ian Gotlib is examining how depression develops and working to identify potential opportunities for intervention.

JAMA - Medical News & Perspectives
Are Probiotics Money Down the Toilet? Or Worse?
Jennifer Abbasi
JAMA.Published online January 30, 2019.
With interest growing in natural therapies, the popularity of probiotics is on the rise. In 2012, almost 4 million US adults reported using probiotics or prebiotics—4 times more than in 2007. Probiotics were used in more than 50 000 hospitalizations in 139 US hospitals in 2012. And last year alone, US consumers spent an estimated $2.4 billion on the supplements.
Comment and opinion from readers, authors, and editors.
Tim Spector: Breakfast—the most important meal of the day?
The mantra of breakfast being the most important meal of the day has been ingrained in most of us from an early age—from our mother’s mouth as we were late for school to government campaigns to get us to “go to work on an egg.” Over the past 50 years we have been bombarded with messages extolling the health benefits of various processed cereals and porridge oats. The British fry-up is thought by many to be the country’s main contribution to world cuisine.

A new Consumer Reports study found that half of the fruit juices sold in the U.S. had elevated levels of arsenic, cadmium, and/or lead. Consumer Reports tested 45 drinks and found 21 contained enough of a single heavy metal or a combination of the metals to concern experts who worked with Consumer Reports on the study.

For the full list, including healthier alternatives, go to Consumer Reports' website.

Cedars-Sinai Blog
Committed to helping you build a healthy lifestyle for you and your family.
Q&A: Rheumatoid Arthritis
We take for granted that our immune system is always looking out for us.
But in the case of rheumatoid arthritis (RA)—an autoimmune condition that affects over 1 million adults in the US—the body’s defense system turns on us.

What’s the difference between an NP and a doctor?
Many medical offices and hospitals offer care provided by nurse practitioners, commonly referred to as NPs. These highly trained medical professionals can provide many primary care services or be part of your specialty care team.

Check back for updates!

Thursday, May 17, 2018

Hepatitis C and Dietary Supplements

Hepatitis C and Dietary Supplements
Most consumers assume that herbs and botanical products in dietary supplements are safe, however they are not regulated by the FDA, in addition these products can interact with prescription drugs, over-the-counter drugs, and other dietary supplements.

As an example milk thistle is the most commonly used herbal supplement in the United States for liver problems, including viral hepatitis. If you are interested in learning more about the science behind milk thistle, probiotics, zinc, or other commonly used supplements, check out the National Center for Complementary and Integrative Health (NCCIH) website, in particular the following publication: Hepatitis C and Dietary Supplements, updated this month.

Wednesday, September 6, 2017

Mediterranean Diet and Antioxidant Formulation in Non-Alcoholic Fatty Liver Disease: A Randomized Study

Effect of Mediterranean Diet and Antioxidant Formulation in Non-Alcoholic Fatty Liver Disease: A Randomized Study
Ludovico Abenavoli 1,*, Marta Greco 1, Natasa Milic 2, Francesca Accattato 1, Daniela Foti 1, Elio Gulletta 1 and Francesco Luzza 1 1 Department of Health Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy 2 Department of Pharmacy, University of Novi Sad, 21000 Novi Sad, Serbia * Received: 3 July 2017 / Accepted: 8 August 2017 / Published: 12 August 2017

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide, characterized by liver fatty acid accumulation and fibrosis, not due to excessive alcohol consumption. Notably, nutritional habits have been reported to be implicated in the onset and severity of the hepatic damage, while the Mediterranean diet has shown beneficial effects on NAFLD. Free radicals and oxidative stress were suggested to be involved in the pathogenesis and progression of NAFLD, and several data highlighted the efficacy of antioxidant supplementation in its treatment. The aim of this study was to compare the effects of the Mediterranean diet, with or without an antioxidant complex supplement, in overweight patients suffering from NAFLD. In this prospective study, fifty Caucasian overweight patients were randomized into three groups (Groups A–C). A personalized moderately hypocaloric Mediterranean diet was prescribed to all patients included in the A and B groups. In addition to the diet, Group B was administered antioxidant supplementation daily and for the period of six months. Group C did not have any type of treatment. The study proved that the Mediterranean diet alone or in association with the antioxidant complex improved anthropometric parameters, lipid profile and reduced hepatic fat accumulation and liver stiffness. However, Group B patients, in which the diet was associated with antioxidant intake, showed not only a significant improvement in insulin sensitivity, but also a more consistent reduction of anthropometric parameters when compared with Group A patients. Taken together, these results support the benefit of antioxidant supplementation in overweight patients with NAFLD.

Discussion Only
Full Text Available Online
Despite the rapidly growing recognition of NAFLD over the last few decades, the treatment of this condition remains debated [39,40]. In the clinical management of NAFLD patients, a dietary change and increased physical exercise are essential to reduce body weight, in order to improve metabolic parameters and normalize the biochemical blood profile, as well as transaminase levels [24]. The “ideal” treatment for NAFLD should reduce the liver damage and its progression by reducing anthropometric parameters, by improving insulin resistance and impairment in glucose and lipid metabolism and by reducing the cytokine-mediated pathophysiological link between adipose tissue and liver [41]. The traditional Mediterranean diet is a dietary pattern that was associated with favorable health impact, in particular on cardiovascular diseases, cancer and in the treatment of metabolic syndromes [42]. Carotenoids, fibers and folic acid, which are basic components of this diet, can play a pivotal role in preventing or slowing down the oxidative stress process. In addition, vegetables, which are the staple foods included in the Mediterranean diet, are the main source of phytosterols, known as natural cholesterol-lowering agents, reducing cardiovascular risk [43,44].
Several pharmaceutical agents are currently being evaluated for the treatment of NAFLD, and NASH in particular. However, no single therapy has been approved so far [23,45]. On this basis, the beneficial effects of complementary medicine, and particularly of herbal extracts, on NAFLD patients have received increasing attention in the last few years. The use of this approach has many advantages, including worldwide availability, minimal reported side effects and wide application due to low treatment costs [46].

However, literature data are often inconclusive on this topic, due to the high number of biases found in many trials and to the limited number of studies testing single herbal remedies [47].

In the last two decades, several studies have emphasized the benefits in the NAFLD treatment of Silybum marianum, commonly called milk thistle (MT), a plant native to the Mediterranean area, which has been used for many centuries to treat liver diseases [48,49]. The active complex of MT is a lipophilic extract from the seeds of the plant, and it is composed by three flavonolignan isomers, silybin, silydianin and silychristin, collectively called silymarin.

Studies of patients with NAFLD showed that silymarin treatment was associated with positive changes in insulin resistance and transaminase serum levels [50,51]. Loguercio et al., in a multicenter phase III double-blind clinical trial, showed that MT extracts, after 12 months, led to an improvement of insulin resistance, liver enzymes and liver histology, without any increase in body weight in NAFLD patients [52]. More recently, in a randomized clinical study, we have found out that Mediterranean diet, in association with silymarin and other antioxidants, is able to induce, after six months, significant changes in glucose and lipid metabolism [53].

According to these data, in our cohort, we demonstrated an improvement of BMI, waist and hip circumference, TG, total cholesterol and LDL-C serum level in all patients who followed the Mediterranean diet for a period of six months (Group A and B). The diet also led to the decrease of intra-hepatic fat accumulation, evaluated by the FL index, and of liver stiffness, assessed by TE. However, in the overweight NAFLD Group B patients, who followed the Mediterranean diet in association with BIL antioxidant treatment, we reported the statistical reduction of the HOMA-IR and the TyG index, two surrogate indexes widely used to evaluate insulin resistance.

The changes in glucose and lipid metabolism described in Group B can be explained also by the presence of chlorogenic acid, one component of the BIL complex. Chlorogenic acid is one of the most abundant polyphenols in the human diet. It is contained in coffee, fruits and vegetables and displays many biological properties, such as antidiabetic effects by stimulating glucose uptake in both insulin-sensitive and insulin-resistant adipocytes and by improving early fasting glucose and insulin responses [54]. The metabolic changes observed in our study can be explained by the synergic action of the Mediterranean diet in association with chlorogenic acid and silymarin.

Another component of the BIL complex is protopine, an isoquinoline alkaloid present in Fumaria officinalis, with antioxidant and choleretic properties that inhibit the production of pro-inflammatory cytokines [55]. Our data suggest that protopine could be a potential candidate for NAFLD treatment.
The increase in oxidative stress and free radical production observed in NAFLD lead not only to increased consumption of glutathione, the major intra-cellular antioxidant, but it also reduces the activity of s-adenosyl-l-methionine, the main biological methyl donor and a precursor of glutathione, essential for protecting antioxidant pathways [56]. Recent studies suggest that the reduction of glutathione levels, in combination with lower ATP availability due to mitochondrial deregulation, leads to an unbalance of reactive oxygen species production and to the subsequent progression of hepatic injury [57]. In this context, the administration of reduced glutathione and methionine can help to restore the oxidative balance.

The BIL antioxidant complex treatment alone, not in association with physical activity and a calorie-controlled diet, is not effective in improving insulin resistance. However, our data confirm the possible therapeutic role of this antioxidant complex as a complementary approach to the treatment of overweight NAFLD patients and in particular in the management of insulin resistance in NAFLD-related pathologies.

An important goal for modern hepatologists is to find effective non-invasive diagnostic approaches to NAFLD. In the last two decades, non-invasive diagnostic modalities for NAFLD have been investigated. On the basis of literature data, three non-invasive methods have been employed in the present study for the evaluation of NAFLD. In addition to the US examination, in particular, the FL index and TE have been used to assess respectively hepatic fat accumulation and liver stiffness. The FL index is an accurate and easy to employ predictor score to define steatosis presence that utilizes routine measurements in clinical practice such as a BMI, waist circumference, triglycerides and γGT [36]. In this way, the clinical use of the FL index is useful to identify patients with NAFLD to include in an outpatient lifestyle change program. The data on the reduction of hepatic fat accumulation were also confirmed by the reduction of the Hamaguchi score at the US examination in Groups A and B, compared to Group C.

TE is a non-invasive tool for the evaluation of liver damage that demonstrated good accuracy in quantifying the levels of hepatic stiffness and to define fibrosis, in patients with liver diseases and in particular with NAFLD [37]. This technique is reliable, fast and reproducible, with a good intra- and inter-observer agreement, thus allowing for population-wide screening and disease follow-up.
Finally, our study clearly shows that patients following a balanced diet and taking the antioxidant complex had a more significant attenuation of insulin resistance, hepatic fat accumulation and liver stiffness than patients following the diet alone. These results supported the effectiveness of the BIL complex to reduce liver fatty acid infiltration and its related damages, by positively influencing the mitochondrial function and by reducing oxidative stress.

6. Conclusions
Our study confirms that the Mediterranean diet can improve anthropometric parameters and lipid profile and can contribute to reducing hepatic fat accumulation and liver stiffness. Moreover, the association of this dietetic regimen with antioxidant supplementation can contribute to improving the insulin sensitivity parameters. These data support a possible role of antioxidant supplementation as a coadjuvant therapy in patients with NAFLD.
Full Text Available Online

Wednesday, June 28, 2017

The Liver - Super Foods & Supplements

Liver Super Foods

Published on May 30, 2017
Source - American Liver Foundation Great Lakes Division

In The News
Go Easy on the Avocado Toast: ‘Good Fat’ Can Still Be Bad for You, Research Shows
By on

Thursday, January 26, 2017

Review - Silymarin/Silybin and Chronic Liver Disease: A Marriage of Many Years

Molecules 2017, 22(2), 191; doi:10.3390/molecules22020191
Silymarin/Silybin and Chronic Liver Disease: A Marriage of Many Years
Alessandro Federico *, Marcello Dallio and Carmelina Loguercio           
Department of Clinical and Experimental Medicine, Second University of Naples, 80131 Naples, Italy

Received: 6 December 2016 / Accepted: 18 January 2017 / Published: 24 January 2017 

View Full-Text Article

Silymarin is the extract of Silybum marianum, or milk thistle, and its major active compound is silybin, which has a remarkable biological effect. It is used in different liver disorders, particularly chronic liver diseases, cirrhosis and hepatocellular carcinoma, because of its antioxidant, anti-inflammatory and antifibrotic power. Indeed, the anti-oxidant and anti-inflammatory effect of silymarin is oriented towards the reduction of virus-related liver damages through inflammatory cascade softening and immune system modulation. It also has a direct antiviral effect associated with its intravenous administration in hepatitis C virus infection. With respect to alcohol abuse, silymarin is able to increase cellular vitality and to reduce both lipid peroxidation and cellular necrosis. Furthermore, silymarin/silybin use has important biological effects in non-alcoholic fatty liver disease. These substances antagonize the progression of non-alcoholic fatty liver disease, by intervening in various therapeutic targets: oxidative stress, insulin resistance, liver fat accumulation and mitochondrial dysfunction. Silymarin is also used in liver cirrhosis and hepatocellular carcinoma that represent common end stages of different hepatopathies by modulating different molecular patterns. Therefore, the aim of this review is to examine scientific studies concerning the effects derived from silymarin/silybin use in chronic liver diseases, cirrhosis and hepatocellular carcinoma.

Keywords: silymarin; silybin; antioxidants; alcoholic liver disease; viral hepatitis; non-alcoholic fatty liver disease; hepatocellular carcinoma

Continue to full text article @ Molecules

About This Journal
Molecules (ISSN 1420-3049, CODEN: MOLEFW) is an open access journal covering all aspects of organic chemistry. Originally conceived as a forum for papers on synthetic organic chemistry and natural product chemistry, like the field, Molecules has evolved over its 20 years, with increasing numbers of papers on more theoretical subjects, physical organic chemistry, nanomaterials and polymer chemistry and applied studies. All articles are peer-reviewed and published continuously upon acceptance. Molecules is published by MDPI, Basel, Switzerland.

Tuesday, May 10, 2016

5 Things You Should Know About Dietary Supplements for Hepatitis C

National Institutes of Health
On This Blog
June 2018
NIH launches HerbList, app with information about safety and effectiveness of herbal products

May 2018
Hepatitis C and Dietary Supplements 

Hepatitis C Is Our Featured Topic
5 Things You Should Know About Dietary Supplements for Hepatitis C
Clinical Digest:
Hepatitis C and Dietary Supplements  
Several dietary and herbal supplements have been studied for hepatitis C, and substantial numbers of people with hepatitis C have tried herbal supplements. For example, a survey of 1,145 participants in the HALT-C (Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis) trial found that 23 percent of the participants were using herbal products. Although participants reported using many different herbal products, silymarin (milk thistle) was by far the most common. However, no dietary supplement has been shown to be efficacious for hepatitis C.

This issue provides information on the evidence base of several dietary supplements studied for hepatitis C.
Continue reading...

Thursday, August 14, 2014

August Hepatitis Newsletters;The good, the bad and the ugly of the new treatments for hepatitis C virus

Hepatitis C Newsletters

Welcome to this months edition of Hepatitis Newsletters, published by advocacy groups devoted to increasing awareness and information about viral hepatitis.

Sit back and enjoy a review of July and August news with articles covering everything from Milk Thistle, conditions outside the liver, to new drugs to treat hepatitis C.

We begin with this months issue of "Annals of Hepatogly" with an article addressing the cost of new HCV therapies.

The good, the bad and the ugly of the new treatments for hepatitis C virus
September - October, 2014
Vol. 13 Issue 5

The good, the bad and the ugly of the new treatments for hepatitis C virus
The cost of new hepatitis C treatments
Karen V. Silva-Vidal, Nahum Méndez-Sánchez. Liver Research Unit ...

Reducing the cost of new hepatitis C drugs
An index of current articles expressing concerns about the pricing of Gilead's Sovaldi.

In case you missed it, this week a new section was added to AASLD/IDSA Hepatitis C guidelines; When and in Whom to Initiate HCV Therapy.

The American Association for the Study of Liver Disease (AASLD) and the Infectious Diseases Society of America (IDSA), in collaboration with the International Antiviral Society-USA (IAS-USA), today released the latest section of their website,, which assists clinicians treating patients with hepatitis C virus (HCV). The new section is titled, "When and in Whom to Initiate HCV Therapy.

With the addition of the new section, now offers clinicians information on how to prioritize treatment for those patients who will derive the most benefit or will have the greatest impact on limiting further HCV transmission. Highest priority should be given to patients with advanced fibrosis with compensated cirrhosis and liver transplant recipients and high priority given to patients at high risk for liver-related complications and severe extra-hepatic HCV complications. The guidance provides further detailed information on additional conditions that warrant prioritization of treatment.
Continue reading...

Article published in MedPageToday

Guidelines: Treat Sickest HCV Patients First

Published: Aug 11, 2014

Patients with less advanced fibrosis but other life-threatening complications, such as cryoglobulinemia, should also be at the head of the list for new direct-acting treatment regimens, Jensen told MedPage Today during a teleconference on the new guidelines.

The societies launched their guidelines in January to help physicians cope with an expected demand for treatment as new regimens reach the clinic.

Unusually, the guidelines are online and under constant revision, making them a "living document" that can cope with a rapidly changing field, according to Michael Saag, MD, of the University of Alabama at Birmingham, the guidelines co-chair for IAS-USA.

The latest addition, reporters were told, is a section on when -- and in which patients -- to initiate therapy.

An estimated 3 million to 4 million Americans have chronic HCV and about half are not aware of it. Many will develop advanced liver disease or liver cancer.

The advent of the novel direct-acting agents -- the first were approved in 2011 -- offers the possibility of eradicating the disease in a "very high percentage" of patients, Jensen said.

The guidelines argue that all patients with chronic HCV could benefit from treatment -- but some need it more urgently than others, he added. Not all patients "can receive treatment immediately upon the approval of new agents," he said. "From a clinical perspective, we are most concerned with those with severe liver disease," he said. The guidelines do not directly address the issue of the cost of the some of the new agents, which has raised concern about the impact on the healthcare system if many thousands of patients seek therapy.

"We hope that the cost issues will be sorted out in another venue," Jensen said, "but it's really patient-directed care that we're concerned about."

"We understand that the system is struggling because these medications are expensive," Saag added, "and we need to provide some at least indirect guidance on who has the highest priority."

The CDC is currently recommending that all Americans born from 1945 to 1965 be tested at least once for HCV, since studies suggest that about 2 million of them have the virus.

One goal of the guidelines is to create a larger clinical workforce capable of treating patients with HCV, especially if that testing takes hold and a large number of people suddenly begin demanding treatment.

"There aren't enough hepatologists in the United States to see all these patients," Saag said. "These guidelines will be able to help educate not only those who are very expert in the field about new and emerging treatment trends, but also to educate those who are perhaps new to the treatment of hepatitis C."

Bloggers Corner

Lucinda K. Porter, RN
Hepatitis C and Milk Thistle
A patient wrote to me this week, asking what I thought of a particular protocol purporting to cure hepatitis C. The protocol uses a variety of herbs, mostly milk thistle. I told her that I don’t believe that herbs can cure hepatitis C. I think that when used appropriately, herbs may help a variety of ailments, but when it comes to curing hepatitis C, we haven’t yet found an herbal path..

Watching the world get better

August Newsletters 

Project Inform believes it is possible to create the first generation free of HIV and hepatitis C within the next decade. To achieve that dream, we focus our work in four areas: drug development, bio-medical prevention, education and health care access.

Project Inform launches new provider toolkit for screening hepatitis C in people living with HIV
This month, Project Inform launched “A Toolkit for Screening, Counseling and Patient Education: Hepatitis C Infection and People Living with HIV,” which includes materials for medical providers and other health care staff as well as patient fact sheets.

It is estimated that at least 300,000 people or 25% of those living with HIV are also infected with hepatitis C. HCV-related liver disease is the leading non-AIDS cause of death in HIV-infected patients, and HCV disease progression is more rapid in this group, making detection of both acute and chronic hepatitis C extremely important in clinical practice.

To request a free copy of the toolkit, fill out the order form here, or email Andrew Reynolds, Hepatitis C Education Manager, at

Project Inform can help clients and patients living with co-infection, or who are at risk of HCV infection, with additional educational materials and services. Our three-booklet Health and Wellness series for patients living with HIV and HCV is one resource. You can order sets here.

Additionally, providers can direct patients to the national hepatitis C helpline, HELP-4-HEP at 1-877-Help-4-Hep (877-435-7443). Trained counselors and health educators are available to talk with your patients Monday-Friday, 9am to 7pm EST. You can also order HELP-4-HEP posters, brochures and tear pads here.

Project Inform’s wrap-up from World Hepatitis Day 2014
In honor of World Hepatitis Day, which is observed on July 28 every year and is one of only four disease-specific days recognized by the World Health Organization (the others being tuberculosis, malaria, and HIV), Project Inform participated in two events in Washington, DC. The first…

Help Lines
HELP-4-HEP (hepatitis C helpline)
Toll-free at 1-877-435-7443 Monday–Friday, 9am–7pm (Eastern Time). 
Learn more.

HIV Health InfoLine
Toll-free at 1-800-822-7422 Monday–Friday, 10am–4pm (Pacific Time), call-back service only. English only. 

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The HCV Advocate newsletter is a valuable resource designed to provide the hepatitis C community with monthly updates on events, clinical research, and education. 

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HCV Advocate Newsletter

August Newsletter

In This Issue:

Alan Franciscus, Editor-in-Chief
This month Alan discusses Daklinza and Sunpreva from BMS, AbbVie's 3D, the Olysio/Sovaldi combination and the side effects of some of these new medications. 

Lucinda K. Porter, RN
Lucinda reviews studies on genotype 3, cirrhosis and cancer; HCV and end-stage kidney disease; alternatives to liver biopsy, and testing policy. 

Lucinda K. Porter, RN
This month Lucinda talks about hepatic encephalopathy, and what happens when liver disease hijacks the brain.

Alan Franciscus, Editor-in-Chief
This month Alan talks about extrahepatic manifestations of hepatitis C, such as vasculitis, glomerulonephritis, cryoglobulinemia and non-Hodgkin lymphoma and the need for physician awareness of these conditions—especially now that the new treatments are becoming available.

View All Newsletters

Connect With HCV Advocate
Hep is an award-winning print and online brand for people living with and affected by viral hepatitis. Offering unparalleled editorial excellence since 2010, Hep and are the go-to source for educational and social support for people living with hepatitis.

August News

August 13, 2014
When Positive Hep C Tests Go Unconfirmed, Care Can Go Awry
In the event that individuals receive an unconfirmed positive test for hep C, they are subject to cracks in the health care system and potentially unnecessary care.

August 11, 2014
New Clinical Guidelines Prioritize Care Among Hep C Patients
Two clinical groups have issued new hepatitis C treatment guidelines that instructs clinicians on how to prioritize care among patients seeking a cure.

August 06, 2014
Donors Only Reaching 7% of Global Harm Reduction Needs
Major international donors are only spending 7 percent of the estimated funding needed to support harm reduction for injection drug users worldwide.

Program for Drug-Using Couples Lowers Hep C and Risky Sex Rates
An intervention for couples who use drugs lowers their risk of contracting hepatitis C virus as well as raises their rate of condom use.

August 04, 2014
Olysio-Sovaldi Cures High Rates of Hepatitis C Genotype 1
Twelve weeks of Olysio (simeprevir) and Sovaldi (sofosbuvir) cures high rates of genotype 1 of hepatitis C without the need for ribavirin.

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Liver Lowdown is the monthly general interest e-newsletter of the American Liver Foundation.

July/August 2014 Edition - Not Yet Published....
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The hepc.bull, has been “Canada’s hepatitis C journal” since the late 1990′s and has been published nonstop since 2001. The monthly newsletter contains the latest research results, government policy changes, activities and campaigns you can get involved in, articles by patients and caregivers, and a list of support groups plus other useful links.

August Newsletter

In This Issue
RX&D Rebuttal /Review 2 New Drug
Co-infection: Bob’s Story / Hep C News 
RhoGAM/ Marathon News / Percuro 2
What is a Fibroscan? 

Stay Connected

The New York City Hepatitis C Task Force is a city-wide network of service providers and advocates concerned with hepatitis C and related issues. The groups come together to learn, share information and resources, network, and identify hepatitis C related needs in the community. Committees form to work on projects in order to meet needs identified by the community. 

NYC Viral Hepatitis Monthly E-Newsletter

August Newsletter

In this Newsletter

New Provider Resources
Updated City Health Information (CHI): Diagnosing and Managing Hep C: Clinical guidance for medical providers.

Updated Hep C Dear Colleague Letter from the NYC Commissioner of Health.New Video PSA | Protect Your Family: Get Tested for Hepatitis B. 30 sec in English, CantoneseMandarin, Korean & Vietnamese.

Hep C: Get Tested, Get Cured! 32 second video illustrating the risks of Hep C, and the importance of testing and treatment. Share widely!

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GI & Hepatology News is the official newspaper of the AGA Institute and provides the gastroenterologist with timely and relevant news and commentary about clinical developments and about the impact of health-care policy. The newspaper is led by an internationally renowned board of editors. 

Current Issue (Vol. 8 No. 8 August 2014): Download PDF Or View Interactive Issue

In This Issue
Fewer than 10% of HCV patients finish treatment
Sofosbuvir achieves SVR12 in patients with HCV + HIV
Interferon-free regimens yield 96%-100% SVRs
Everolimus fails to improve HCC survival

Stay connected

Hep C Connections - Website
Our mission is to educate the general public about hepatitis C and to provide resources and support for those affected by the virus. Hep C Connection offers a helpline to answer your questions regarding hepatitis C (HCV). You can expect respect, patience & understanding, in clear, jargon-free language from our staff & volunteers. Call 1-800-522-HEPC (4372) today!

In This Issue
Support Groups
Upcoming Events
Articles of Interest
Financial Resources
Featured Clinical Trials

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Welcome to the new HCV Action website, the home of the UK’s hepatitis C professional community. Browse our tailored resource libraries, view our case study map or find out more information, here.

The HCV Action network brings together health professionals from across the patient pathway, including GPs, specialist nurses, clinicians, drug action teams, public health practitioners, prison healthcare staff and commissioners. We provide resources for commissioners, medical and drug services professionals, promoting good practice in HCV care across the UK.Visit their new website, here. 

News Updates
South Asian community: get advice on hep C at the Birmingham Mela
Scottish study: hepatitis C in the gay community

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Hepatitis Foundation International 
The Hepatitis Foundation International is dedicated to liver health and the prevention of liver related diseases. We inform and educate by making available reliable and up-to-date facts. We want you to make well-informed decisions for yourself and your loved ones' health and well-being. We are proud to present this website as your personal Internet gateway to hepatitis information and liver care.

In This Issue Of Health-e Bytes
HFI In The Know

Health Observances
Advocacy Alert
World Hepatitis Day

HFI Launches Patient Registry
Grand Rounds
Science, Research and Medical Updates

Hepatitis Highlights 
By Regions (WHO) 
Helping Hands

HFI’s Fundraising Appeal Activities
There's An App for That 
Health Information for your Mobile Phone and Tablets

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Of Interest

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

Scientists detail urgent research agenda to better understand, address chronic disease toll
Health care systems that keep HIV patients from dying early in low- and middle-income nations need urgently to be repurposed to treat the chronic diseases that many of these patients now have, experts say.

Featured In The August Issue

Illustration of a patient being treated in a hospital room.Surviving Sepsis
Taming a Deadly Immune Response

Many people have never heard of sepsis, but it’s one of the top 10 causes of disease-related death in the U.S.

Read more about sepsis.

Can You Recognize a Heart Attack or Stroke?
What To Do When Every Moment CountsIllustration of a woman steadying herself against a wall while a concerned passerby makes a call for help.

How would you react to a medical emergency? When it comes to life-threatening conditions like heart attack or stroke, every minute counts. 

Healthy You

Hepatitis C - Understanding The Liver, and Cirrhosis
Watch a few innovative videos offering a better understanding of HCV, how the liver works, possible disease complications, and a quick look at treatment, brought to you by Armando Hasudungan and Joe Galati, M.D.

This morning from NPR

Just So You Know

"HCV Next" Is In The News

Published August 11, 2014

University at Buffalo experts in the Division of Gastroenterology, Hepatology and Nutrition are contributing co-authors to HCV Next, the first multidisciplinary publication focused exclusively on the hepatitis C virus.

In Case You Missed It.....
Millennials, Drugs and HCV
HCV Next, July/August 2014

Available in print and on the website, the magazine offers context and perspective on the latest research developments. It is designed to inform and educate an estimated 10,000 specialty and general physicians who diagnose and treat HCV.

Content also helps patients understand the disease and new treatment options that may be available to them.

Collaboration, Communication Among Specialists is Key

“With the rapid pace of drug development in HCV as well as the development of regional centers of excellence in hepatology — such as we have recently established here at UB within clinics — there is a tremendous need for rapid dissemination of new information for physicians of all specialties,” notes Andrew H. Talal, MD, MPH, professor of medicine and a member of the HCV Next editorial board.

“HCV Next is attempting to fill that void.”

“Contributing to this publication offers an excellent opportunity to promote the faculty and trainees here at UB on the national stage as leaders in the field,” he adds.

“It also helps establish UB as a leader in the eyes of the pharmaceutical industry, which can help attract clinical trials, allowing us to offer cutting-edge therapies to patients before they are widely available.”

In a May/June 2014 HCV Next interview, co-chief medical editor Ira M. Jacobson, MD, emphasized the importance of collaboration and open communication among liver and infectious disease doctors and addiction medicine specialists to address the multiple needs of patients.

Jacobson, the medical director of the Center for the Study of Hepatitis C in New York City, notes that Talal has led efforts to create physical spaces where patients are seen by multidisciplinary specialists.

At Buffalo General Medical Center, for example, “our liver clinic involves gastrointestinal fellows, pharmacists, internists, hepatologists and addiction medicine specialists who all see patients with various forms of liver disease,” says Talal. “We also have research nurses who consult with potential subjects for clinical trials.”

UB Items Discuss Pregnancy, Abnormal Proteins

In addition to Talal, HCV Next co-authors have included the following UB faculty members and physician-trainees in the gastroenterology, hepatology and nutrition fellowship program:
Manoj Kumar, MD, MPH, clinical assistant professor
Thomas C. Mahl, MD, clinical professor and interim chief of the division
Anthony D. Martinez, MD, clinical associate professor
Alia Hasham, MD, fellow
Sandeep T. Samuel, MD, fellow

Talal, Kumar and Hasham co-authored the patient profile, “The Challenge of Pregnancy in HCV Infection,” in the magazine’s premiere January/February 2014 issue.

“Since pregnancy modifies host-virus interactions, it is crucial to understand clinical manifestations of the infection and its effect on the overall magnitude of the disease, its diagnosis and management,” notes Talal.

“Physicians also should understand the effect of pregnancy on HCV immunity and appreciate the factors that influence mother-to-child viral transmission.”

Samuel, Talal and Martinez co-authored “Current Concepts on the Patient With HCV and Cryoglobulinemia,” a patient profile in the March/April issue. The article discusses current best practices for treating HCV patients with abnormal blood proteins.

Hasham and Mahl collaborated on “The Patient With NAFLD and Chronic HCV” for the July/August issue. This patient profile discusses diagnosis and care for HCV patients with non-alcoholic fatty liver disease.

Need for HCV Information Will Likely Grow

According to the World Health Organization, more than 150 million people carry the virus and more than 350,000 people die every year from HCV-related liver disease.

The need for HCV information will likely grow, as newly approved treatments are adopted and evolve.

In addition, more people are expected to be diagnosed with the infection, as new U.S. Centers for Disease Control and Prevention guidelines call for screening all people born between 1945 and 1965. A New York State law now requires health care providers to offer HCV screening to patients in this age group.

Magazine Published 6 Times Each Year

HCV Next is published every other month by the New Jersey-based SLACK Incorporated, publisher of Infectious Disease News.

Topics include diagnostics, practice management issues, drug interactions and the treatment of patients with comorbidities.

Stay healthy and happy, until next time.

Always Tina