Showing posts with label hbv. Show all posts
Showing posts with label hbv. Show all posts

Saturday, December 1, 2018

After The Liver Meeting 2018 Summary: Viral Hepatitis & Fatty Liver Disease

The Liver Meeting® 2018
San Francisco, CA.
November 9-13, 2018

Page updated: December 4, 2018

After The Liver Meeting
Hi folks, today we have a nice summary of the Liver Meeting, highlighting significant research on both viral hepatitis and fatty liver disease. Follow each post-meeting link provided below and start reviewing expert analysis of key data presented at the meeting, listen to audio live from the meeting, or view slidesets, and capsule summaries.

HCV Advocate December Newsletter
December 1, 2018
In this month's HCV Advocate Newsletter coverage of the Liver Meeting continues; read easy to understand commentary on HCV-related topics that matter most to patients. In next month's issue notable research on liver cancer presented at the meeting will be featured.
Start here: 
http://hcvadvocate.org/news/NewsUpdates_pdf/Advocate_2018/advocate1218.pdf

Webinar
Dec 4, 2018
Liver Meeting 2018 Updates” presented by Tatyana Kushner, MD, MSCE from Mount Sinai Medical Center, available now over at HepCure.

Webcast Coming Soon
Chronic Liver Disease Foundation
Symposium live from the meeting featuring table discussions with leading physicians discussing viral hepatitis, soon to be launched by Chronic Liver Disease Foundation (CLDF).
Symposium on Hepatitis featuring table discussions with leading physicians!
The primary goal of this CME symposium is to better understand how to effectively identify, manage, and treat patients with viral hepatitis in order to achieve viral eradication by 2030.

Updates
Healio
Website Healio - Twitter @HealioHep
December 4, 2018
This year at The Liver Meeting, data presented on liver transplantation focused on comorbid complications, such as alcohol misuse and obesity, and their correlated…

ID Practitioner
December 4, 2018
Hepatitis C debrief: Therapy has matured, access issues remain
The Liver Meeting 2018: Hepatitis B novel therapies debrief – key abstracts

Modern Medicine 
December 4, 2018
HCV Expert Interview with Jordan Feld, MD, MPH
In this interview, Jordan Feld, MD, MPH, discusses key highlights from studies presented at The Liver Meeting 2018, held recently in San Francisco by the American Association for the Study of Liver Diseases (AASLD).

Hep
Website: Hep 
December 3, 2018
By Benjamin Ryan 
A review of the major findings presented at the Annual Meeting of the American Association for the Study of Liver Diseases in San Francisco

infohep
November 30, 2018
Website infohep Twitter - @infohep
This month’s infohep bulletin focuses on news from The Liver Meeting 2018, organised by the American Association for the Study of Liver Diseases (AASLD), which took place in San Francisco, USA, from 9 to 13 November 2018.
Link: Conference bulletin

Medscape
November 29, 2018
Website Medscape Twitter @Medscape
Viral Hepatitis: Five Highlights From the Liver Meeting
Dr William Balistreri reports on the most important viral hepatitis news from this year's Liver Meeting.

Clinical Care Options
Nov 27, 2018
Website Clinical Care Options - Twitter @CCO_Hepatitis 
Hot Topics in NASH
Nov 28, 2018
Website Healio - Twitter @HealioHep
Healio presents highlights of Fatty Liver and NASH data presented this year at The Liver Meeting.
Fatty liver highlights from The Liver Meeting 2018

Hep B Foundation
Nov 27, 2018
After the Liver Meeting, Dr. Tim Block, the @HepBFoundation's co-founder & President, answered some of the most asked questions about the path to a hepatitis B cure. This is a two-part series. Read the first Q & A here: http://ow.ly/UEAT50jOb61 

Video
Quick Review: Each Day Of The Meeting
Practice Point is once again launching daily clinical clips reviewing hot topics in HCV, presented each day at the meeting. Although the activity is intended for physicians and health care professionals, anyone, especially patients can benefit from each 5-minute review as well:
Independent Conference Coverage from the 2018 Annual Meeting of the American Association for the Study of Liver Disease (AASLD)*

In this video series, Dr. Saab will present ‘what you need to know in 5‐minutes’ regarding today's presentations from AASLD 2018 in San Francisco, CA
Free "registration" is required, once accomplished:
ACCESS ACTIVITY
Answer 3 question pre-test, and click Access Activity.
Twitter - @Practice_Point

Navigate This Blog - Stay Updated

Check back for updates
Enjoy the weekend!
Tina

Thursday, November 29, 2018

HIV, HCV and HBV: A Review of Parallels and Differences

Infect Dis Ther. 2018 Dec;7(4):407-419. doi: 10.1007/s40121-018-0210-5. Epub 2018 Sep 4.

HIV, HCV and HBV: A Review of Parallels and Differences.
Leoni MC1,2, Ustianowski A3,4, Farooq H3, Arends JE5.

Abstract
Elimination of the three blood-borne viruses-human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV)-as public health issues may be plausible in the near future. Spectacular advances have been made with the introduction of highly effective antiviral agents into clinical practice, and prevention strategies are available for all three infections. Effective disease control, laid out by WHO global strategies, is currently feasible for all three viruses. However, for worldwide elimination of these viruses, effective vaccines are required that are currently only available for HBV. In this review differences and parallels among HIV, HCV and HBV will be discussed with a focus on virologic and therapeutic issues, and prospects for the future of HBV will be presented.

Article:
Shared via twitter by @HenryEChang
View Online:
https://link.springer.com/article/10.1007%2Fs40121-018-0210-5

Thursday, November 15, 2018

In Older Hep B Patients, Carcinoma Surveillance Is Advised

Medscape Medical News > Conference News > AASLD 2018
In Older Hep B Patients, Carcinoma Surveillance Is Advised
Laird Harrison
November 15, 2018 

SAN FRANCISCO — Surveillance for hepatocellular carcinoma (HCC) should continue in patients older than 50 years, even after they have undergone 5 years of therapy for chronic hepatitis B, according to an analysis of the PAGE-B cohort.

But the risk for the cancer is low enough in younger patients — except for those with cirrhosis — that surveillance might not be warranted, said George Papatheodoridis, MD, PhD, from Athens University Medical School in Greece.

"It will save monitoring in some patients," he told Medscape Medical News.

Long-term monotherapy with entecavir (Baraclude, Bristol-Myers Squibb) or tenofovir disoproxil fumarate (Viread, Gilead) suppresses the hepatitis B virus and improves liver lesions, so the survival rate in patients without compensated cirrhosis is comparable to that in the general population, Papatheodoridis explained here at The Liver Meeting 2018...

Free registration may be required

Meeting Coverage
Twitter @Medscape

Recommended Coverage 
Updates on this blog (LINK), recommended coverage elsewhere (LINK). 

Friday, November 9, 2018

Gilead Presents Latest Data from Viral Hepatitis Research Programs at The Liver Meeting® 2018

November 09, 2018

– Data Demonstrate Sofosbuvir-Based Regimens Achieve High Cure Rates in Hepatitis C Patient Populations with Unmet Need –
– Early Data from Gilead’s Functional Hepatitis B Cure Program Suggest Activation of Immune Cells Crucial to Viral Clearance –
SAN FRANCISCO--(BUSINESS WIRE)--Nov. 9, 2018-- Gilead Sciences, Inc. (Nasdaq: GILD) today announced results from studies investigating Epclusa® (sofosbuvir 400mg/velpatasvir 100mg) in chronic hepatitis C virus (HCV) infected patients with severe renal impairment undergoing dialysis and Harvoni® (ledipasvir/sofosbuvir) in pediatric HCV patients aged three to five years, adding to the efficacy and safety profile of sofosbuvir-based regimens across diverse patient populations. These results, along with data from Gilead’s hepatitis B virus (HBV) cure development program, are being presented at The Liver Meeting® 2018 in San Francisco this week.
“Our scientific leadership has helped transform the treatment of patients with chronic hepatitis C infection and we remain committed to ensuring effective and well-tolerated treatment options for a broad range of patient populations.” said John McHutchison, AO, MD, Chief Scientific Officer, Head of Research and Development, Gilead Sciences. “For patients with chronic hepatitis B infection, we are intensifying our efforts to advance research and development toward a functional cure.”
Further Progress in the Treatment of Hepatitis C
Results from an open-label Phase 2 study demonstrated that treatment with the once-daily single-tablet regimen of Epclusa for 12 weeks in patients with genotype 1, 2, 3, 4 or 6 HCV and severe renal impairment undergoing dialysis resulted in cure rates (SVR12, or undetectable viral load 12 weeks after completion of therapy) of 95 percent (n=56/59) with only two patients experiencing virologic failure. The most common adverse events (AEs) (>10 percent) were headache, fatigue, nausea, vomiting and insomnia. No patients discontinued therapy due to an adverse event.
In another open-label Phase 2 study, children aged three to five years old with genotype 1 or 4 HCV infection received weight-based oral dosing of ledipasvir/sofosbuvir granules 33.75 mg/150 mg if < 17 kg or 45 mg/ 200 mg if ≥ 17 kg) once-daily for 12 weeks. Overall, 97 percent (n=33/34) of the patients were cured, and none experienced virologic failure. The most common AEs (>10 percent) were vomiting, cough, pyrexia, rhinorrhea and streptococcal pharyngitis. One patient discontinued treatment due to an adverse event of abnormal drug taste.
The use of Epclusa and Harvoni, including granules formulation, in the aforementioned patient populations is investigational; their safety and efficacy have not been established. The granule formulation is not approved. Epclusa and Harvoni are both indicated in the US for the treatment of chronic HCV infection in patients with no cirrhosis or compensated cirrhosis: Epclusa for adults with genotypes 1-6; and Harvoni for patients 12 years and older (or ≥35 kg) with genotypes 1, 4, 5 and 6. The US product labels for Epclusa and Harvoni each contain a Boxed Warning for the risk of hepatitis B reactivation in HCV/HBV co-infected patients. See below for US Important Safety Information.
Hepatitis B Cure Research
Gilead is presenting data on GS-9688, an investigational, oral selective toll-like receptor 8 (TLR8) agonist, one of several compounds under investigation as part of Gilead’s HBV cure program. The data support continued development of GS-9688 as a potential therapeutic approach for achieving a functional cure for patients with chronic HBV infection.
In the first-in-human, healthy volunteer safety study, GS-9688 was well-tolerated at single ascending doses up to 5mg and resulted in pharmacodynamic activity as demonstrated by the production of the systemic cytokines IL-1RA and IL-12p40 and by the activation of key relevant immune cells including natural killer (NK) cells and mucosal-associated invariant T (MAIT) cells. The most commonly reported AEs among people receiving doses up to and including 5 mg were nausea and vomiting. There were no reports of Grade 3 or higher AEs, laboratory AEs or serious adverse events (SAEs) and no discontinuations or deaths.
In a Phase 1b safety and tolerability study of GS-9688 in HBV chronically infected patients, dose-dependent activation of the cytokines IL-12p40 and IL-1RA was demonstrated with once weekly dosing for up to 4 weeks in viremic and virally-suppressed patients. There were no reports of SAEs; the most common AEs were headache and nausea. Based on these data, GS-9688 is currently being evaluated in Phase 2 studies in patients with chronic hepatitis B.
GS-9688 is an investigational agent and not approved; its safety and efficacy have not been established.
Latest Research in Hepatitis B Treatment
Presentations on Vemlidy® (tenofovir alafenamide 25mg, TAF) add further evidence to its established safety and efficacy profile in adults with chronic HBV and compensated liver disease, including longer term data on the safety of Vemlidy in virologically suppressed HBV patients. Through three years of treatment, patients originally randomized to receive TAF continued to show an improved bone and renal safety profile compared to treatment with tenofovir disoproxil fumarate 300mg (TDF) with maintained viral suppression. In a separate study in post-liver transplant patients virally suppressed on TDF-based regimens, switching to TAF maintained viral suppression in all TAF-treated patients with improvements in renal function and bone mineral density, after 48 weeks of treatment.
The use of Vemlidy in post-liver transplant patients is investigational; its safety and efficacy have not been established. Vemlidy is indicated in the US for the treatment of chronic HBV infection in adults with compensated liver disease. The US Prescribing Information for VEMLIDY contains a Boxed Warning regarding the risk of post treatment severe acute exacerbation of hepatitis B; see below for Important Safety Information.
US Important Safety Information About Epclusa and Harvoni
BOXED WARNING: RISK OF HEPATITIS B VIRUS REACTIVATION IN HCV/HBV COINFECTED PATIENTS
Test all patients for evidence of current or prior hepatitis B virus (HBV) infection before initiating treatment with EPCLUSA or HARVONI. HBV reactivation has been reported in HCV/HBV coinfected patients who were undergoing or had completed treatment with HCV direct acting antivirals (DAAs) and were not receiving HBV antiviral therapy. Some cases have resulted in fulminant hepatitis, hepatic failure, and death. Cases have been reported in patients who are HBsAg positive, in patients with serologic evidence of resolved HBV, and also in patients receiving certain immunosuppressant or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV DAAs may be increased in patients taking these other agents. Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV treatment and post-treatment follow-up. Initiate appropriate patient management for HBV infection as clinically indicated.
Warnings and Precautions
Serious Symptomatic Bradycardia When Coadministered with Amiodarone: Amiodarone is not recommended for use with EPCLUSA or HARVONI due to the risk of symptomatic bradycardia, particularly in patients also taking beta blockers or with underlying cardiac comorbidities and/or with advanced liver disease. A fatal cardiac arrest was reported in a patient taking amiodarone who was coadministered a sofosbuvir containing regimen. In patients without alternative, viable treatment options, cardiac monitoring is recommended. Patients should seek immediate medical evaluation if they develop signs or symptoms of bradycardia.
Risk of Reduced Therapeutic Effect Due to Use with P-gp Inducers and/or Moderate to Potent Inducers of CYP: Rifampin, St. John’s wort and carbamazepine are not recommended for use with EPCLUSA or with HARVONI. P-gp inducers may significantly decrease ledipasvir, sofosbuvir and/or velpatasvir plasma concentrations. Moderate to potent inducers of CYP2B6, CYP2C8 or CYP3A4 may significantly decrease sofosbuvir and/or velpatasvir plasma concentrations.
Adverse Reactions
The most common adverse reactions (≥10%, all grades) with EPCLUSA were headache and fatigue.
The most common adverse reactions (≥10%, all grades) with HARVONI were fatigue, headache, and asthenia.
Drug Interactions
EPCLUSA: Coadministration is not recommended with topotecan due to increased concentrations of topotecan; or with proton-pump inhibitors, oxcarbazepine, phenobarbital, phenytoin, rifabutin, rifapentine, efavirenz, and tipranavir/ritonavir due to decreased concentrations of sofosbuvir and/or velpatasvir.
HARVONI: Coadministration is not recommended with oxcarbazepine, phenobarbital, phenytoin, rifabutin, rifapentine, and tipranavir/ritonavir due to decreased concentrations of ledipasvir and sofosbuvir; or with co-formulated elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate due to increased concentrations of tenofovir; or with simeprevir due to increased concentrations of ledipasvir and simeprevir; or with rosuvastatin due to increased concentrations of rosuvastatin.
Consult the full Prescribing Information for EPCLUSA and HARVONI for more information on potentially significant drug interactions, including clinical comments.
US Important Safety Information About Vemlidy
BOXED WARNING: POST TREATMENT SEVERE ACUTE EXACERBATION OF HEPATITIS B
Discontinuation of anti-hepatitis B therapy, including VEMLIDY, may result in severe acute exacerbations of hepatitis B. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue anti-hepatitis B therapy, including VEMLIDY. If appropriate, resumption of anti-hepatitis B therapy may be warranted.
Warnings and Precautions
Risk of Development of HIV-1 Resistance in HBV/HIV-1 Coinfected Patients: Due to this risk, VEMLIDY alone should not be used for the treatment of HIV-1 infection. Safety and efficacy of VEMLIDY have not been established in HBV/HIV-1 coinfected patients. HIV antibody testing should be offered to all HBV-infected patients before initiating therapy with VEMLIDY, and, if positive, an appropriate antiretroviral combination regimen that is recommended for HBV/HIV-1 coinfected patients should be used.
New Onset or Worsening Renal Impairment: Cases of acute renal failure and Fanconi syndrome have been reported with the use of tenofovir prodrugs. In clinical trials of VEMLIDY, there have been no cases of Fanconi syndrome or proximal renal tubulopathy (PRT). Patients with impaired renal function and/or taking nephrotoxic agents (including NSAIDs) are at increased risk of renal-related adverse reactions. Discontinue VEMLIDY in patients who develop clinically significant decreases in renal function or evidence of Fanconi syndrome. Monitor renal function in all patients – See Dosage and Administration.
Lactic Acidosis and Severe Hepatomegaly with Steatosis: Fatal cases have been reported with the use of nucleoside analogs, including tenofovir DF. Discontinue VEMLIDY if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity develop, including hepatomegaly and steatosis in the absence of marked transaminase elevations.
Adverse Reactions
Most common adverse reactions (incidence ≥5%; all grades) were headache, abdominal pain, cough, back pain, fatigue, nausea, arthralgia, diarrhea, and dyspepsia.
Drug Interactions
Coadministration of VEMLIDY with drugs that reduce renal function or compete for active tubular secretion may increase concentrations of tenofovir and the risk of adverse reactions.
Coadministration of VEMLIDY is not recommended with the following: oxcarbazepine, phenobarbital, phenytoin, rifabutin, rifampin, rifapentine, or St. John’s wort. Such coadministration is expected to decrease the concentration of tenofovir alafenamide, reducing the therapeutic effect of VEMLIDY. Drugs that strongly affect P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) activity may lead to changes in VEMLIDY absorption.
Consult the full prescribing information for VEMLIDY for more information on potentially significant drug interactions, including clinical comments.
Dosage and Administration
Dosage: Adults; 1 tablet taken once daily with food.
Renal Impairment, Screening, and Monitoring: VEMLIDY is not recommended in patients with CrCl <15 mL/min. In all patients, assess serum creatinine, estimated creatinine clearance, urine glucose, and urine protein prior to initiating and during treatment, on a clinically appropriate schedule. In patients with chronic kidney disease, also assess serum phosphorus.
Hepatic Impairment: Not recommended in patients with decompensated (Child-Pugh B or C) hepatic impairment.
Testing Prior to Initiation: HIV infection.

Tuesday, November 6, 2018

Reviewing the state of HCV and HBV in children

From the Journals
Reviewing the state of HCV and HBV in children
Publish date: November 6, 2018
By Mark S. Lesney ID Practitioner 
The natural histories of hepatitis B virus (HBV) and hepatitis C virus (HCV) are very different in children, compared with their progress in adults, and depends on age at time of infection, mode of acquisition, ethnicity, and genotype, according to a review in a special pediatric issue of Clinics in Liver Disease. Most children infected perinatally or vertically continue to be asymptomatic but are at uniquely higher risk of developing chronic viral hepatitis and progressing to liver cirrhosis and hepatocellular carcinoma (HCC), according to Krupa R. Mysore, MD, and Daniel H. Leung, MD, both of the Baylor College of Medicine, Houston. In addition, because the risk of progression to cancer along with such other liver damage is high in children, the reviewers stated that HCV and HBV can be classified as oncoviruses.

Thursday, November 1, 2018

New horizons in hepatitis B and C in the older adult.

Age Ageing. 2018 Oct 31. doi: 10.1093/ageing/afy170. [Epub ahead of print]
New horizons in hepatitis B and C in the older adult.
Kemp L, et al. Age Ageing. 2018. 

Published:
31 October 2018 

Key points

HCV is curable.
HBV complications are preventable.
Diagnosis of blood-borne viruses (BBvs) in the elderly is important.
Opportunistic testing should be considered in the correct clinical context in at risk patients.
Hepatocellular carcinoma is a devastating complication of untreated chronic infectious hepatitis.

Abstract 
Hepatitis C (HCV) and hepatitis B (HBV), are blood-borne viruses that can cause acute hepatitis; but are clinically relevant because chronic infection is associated with development of cirrhosis and hepatocellular carcinoma. Both these viruses are becoming more common in the older population, due to the ageing of generations exposed to the risk factors associated with infection; intravenous drug use, multiple sexual partners and men who have sex with men. This review will cover the natural history and epidemiology of these infections as well as the revolution in drug therapy that now allows cure of HCV infection and complete control of HBV infection.

Full-Text Article
Age and Ageing, afy170, https://doi.org/10.1093/ageing/afy170

Sunday, October 28, 2018

Long term outcome of antiviral therapy in HBV patients with cirrhosis

World J Gastroenterol. Oct 28, 2018; 24(40): 4606-4614
Published online Oct 28, 2018. doi: 10.3748/wjg.v24.i40.4606
Long term outcome of antiviral therapy in patients with hepatitis B associated decompensated cirrhosis 
Young-Cheol Ju, Dae-Won Jun, Jun Choi, Waqar Khalid Saeed, Hyo-Young Lee, Hyun-Woo Oh 

Full-text Article 
https://www.wjgnet.com/1007-9327/full/v24/i40/4606.htm

Core tip: It is well known that antiviral treatment improves clinical outcomes of chronic hepatitis B-associated decompensated cirrhosis. However, long term and large scale clinical data regarding survival rate, and incidence of hepatocellular carcinoma in patients with decompensated cirrhosis in the antiviral era are lacking. We investigated the survival rate and incidence of hepatocellular carcinoma (HCC) in patients with decompensated cirrhosis by using the Health Insurance Review and Assessment database. Long term outcome of treating hepatitis B-associated decompensated cirrhosis using antiviral agents improved much compare to previous reports. Cumulative mortality rate and incidence of HCC was sharply decreased after one year antiviral treatment.

AIM
To investigate survival rate and incidence of hepatocellular carcinoma (HCC) in patients with decompensated cirrhosis in the antiviral era. 

METHODS
We used the Korean Health Insurance Review and Assessment. Korea’s health insurance system is a public single-payer system. The study population consisted of 286871 patients who were prescribed hepatitis B antiviral therapy for the first time between 2007 and 2014 in accordance with the insurance guidelines. Overall, 48365 antiviral treatment-naïve patients treated between 2008 and 2009 were included, and each had a follow-up period ≥ 5 years. Data were analyzed for the 1st decompensated chronic hepatitis B (CHB) and treatment-naïve patients (n = 7166). 

RESULTS
The mean patient age was 43.5 years. The annual mortality rates were 2.4%-19.1%, and 5-year cumulative mortality rate was 32.6% in 1st decompensated CHB treatment-naïve subjects. But the annual mortality rates sharply decreased to 3.4% (2.4%-4.9%, 2-5 year) after one year of antiviral treatment. Incidence of HCC at first year was 14.3%, the annual incidence of HCC decreased to 2.5% (1.8%-3.7%, 2-5 year) after one year. 5-year cumulative incidence of HCC was 24.1%. Recurrence rate of decompensated event was 46.9% at first year, but the annual incidence of second decompensation events in decompensated CHB treatment-naïve patients was 3.4% (2.1%-5.4%, 2-5 year) after one year antiviral treatment. 5-year cumulative recurrence rate of decompensated events was 60.6%. Meanwhile, 5-year cumulative mortality rate was 3.1%, and 5-year cumulative incidence of HCC was 11.5% in compensated CHB treatment-naïve patients. 

CONCLUSION
Long term outcome of decompensated cirrhosis treated with antiviral agent improved much, and incidence of hepatocellular carcinoma and mortality sharply decreased after one year treatment.
Continue reading......

Monday, October 15, 2018

Blog & News Updates: Link between viral hepatitis and liver cancer?

Save The Date
October 16th, 3 p.m. EST
In honor of Liver Cancer Awareness Month we have a few news and blog updates to share with you. On Tuesday, October 16th, join Hepatitis B Foundation for a Twitter chat to discuss the link between hepatitis and liver cancer. Representatives from Hepatitis B Foundation, CDC’s Division of Viral Hepatitis, and NASTAD will co-host the chat at 3 p.m. EST.

In addition check out this years Liver Cancer Awareness Campaign aimed at encouraging individuals with an increased risk for liver cancer to receive ongoing screening, launched by the American Liver Foundation (ALF) and Bayer Healthcare. Find out if you're at risk for liver cancer.

October 23, 2018 2:00 p.m. to 3:00 p.m. EST 

Webinar
Timothy M. Block, Ph.D.President and Director, Baruch S. Blumberg Institute and the Hepatitis B Foundation
Read More

November 29, 2018 (1:00-2:30 pm ET)
Strategies to Eliminate HCV in Veterans Webinar November 29
Join NVHR on November 29, 2018 (1:00-2:30 pm ET) for a webinar to discuss how government and community organizations are working to treat Veterans living with hepatitis C.
Read More

Blog & Journal Updates Around The Web
Oct 17, 2018
The Link Between Hepatitis B and Liver Cancer
hepbtalk
October is Liver Cancer Awareness Month! Despite the aggressive nature of this cancer – only one out of every five diagnosed patients survive beyond five years – liver cancer receives little attention from those outside of the health field. To help raise awareness and support those who have been affected, we are using our #justB campaign to share the stories of individuals who have been directly impacted by liver cancer throughout the month of October. The stories are featured throughout the month on the Hepatitis B Foundation, Liver Cancer Connect and Hep B United social media outlets. Check out Alice, Bunmi, Dai, and Kim’s stories.

Oct 15, 2018 
Liver Cancer Awareness Month
• By Lucinda K. Porter, RN
While the incidence of most cancers are declining in the United States, the rate of hepatocellular carcinoma (HCC or liver cancer) is increasing. More than 40,000 people in this country will be diagnosed this year with primary liver cancer, facing a 5-year survival rate of only 18 percent. According to the National Cancer Institute, liver cancer is the fifth leading cause of cancer death. Worldwide, it is the second leading cause of cancer death.
Read More

Oct 14, 2018
VA Continues Hepatocellular Screening, but Study Questions the Value
by Annette Boyle 
SAN FRANCISCO—Although a recent study determined that screening veterans with cirrhosis for hepatocellular carcinoma did not reduce the risk of death associated with liver cancer, the VA has no plans to change its screening practices.

“The VA currently follows the American Association for the Study of Liver Diseases (AASLD) guidelines for HCC screening among patients with cirrhosis,” explained Maggie Chartier, PsyD, MPH, the VA’s deputy director of HIV, Hepatitis and Related Conditions and associate professor at the University of California, San Francisco. The AASLD recommends screening patients with cirrhosis for HCC using ultrasound (USS) with or without serum alpha fetoprotein measurement every six months
Read More

Oct 10, 2018
..positive impact on HRQoL with improvement in mobility, pain/discomfort, anxiety/depression...

Oct 9, 2018
Paul E. Sax, MD
There’s so much going on no one can cover it all, certainly not me. So here’s a sampling of some (emphasis on some) of the interesting research presentations from last week, a “Mini” Really Rapid Review™ of the conference. Use the comments section to chime in with your favorites.

Oct 9, 2018
What support do people with liver cirrhosis and their families need?
People with liver cirrhosis and their families need more information about their condition and prognosis and greater access to palliative care, a systematic review of studies on the needs of people with cirrhosis of the liver has concluded.

Oct 9, 2018
Malnutrition decreases quality of life, social function in cirrhosis
PHILADELPHIA — Malnutrition as measured by subjective global assessment correlated significantly with decreased health-related quality of life in patients with…

Do you know that the liver doesn’t have any nerve cells? Here are some facts about this amazing organ in honor of Liver Awareness Month...

Alcohol and Increased Cirrhosis-related Deaths
Many of us are well aware that excessive (particularly long-term) consumption of alcohol is not good for our body — and is especially not friendly to our liver. But a newly published research study might very well convince us that the effects of alcohol on our liver health are even worse than we may have initially imagined. What’s the sobering research finding? The likelihood that increased cirrhosis-related mortality rates from 1999 to 2016 may be due to alcohol abuse and alcohol-induced liver disease...

Hepatitis C affects more than just the liver- it can affect many parts of the body, and mental wellbeing... 

Stress is not good for any of us, it can lead to serious health issues and depression. Stress is the..

In a pilot study from the October issue of Clinical Gastroenterology and Hepatology, colony stimulating factor 3 (CSF3, also called GCSF) improved liver function and increased survival times in patients with severe alcohol-associated hepatitis (AH), compared with standard therapy. Addition of N-acetyl cysteine (NAC) to GCSF did not improve patient outcomes... 

To all of you with gluten intolerance, first, let me say: I’m sorry. You’re looking for good food for celiac and liver disease. I worked in the kitchen and saved my life with The Liver Loving Diet, I had no idea what celiac was....

In The News
HepCBC - Weekly Review
Here's the latest issue of the Weekly Bull.

Oct 15, 2018
Liver Cancer Treatment Paradigm Undergoing Major Overhaul

Oct 15, 2018
Study Casts Doubt on Connection Between DAAs and Liver Cancer Risk
“There are no significant differences between DAA regimens in HCC risk after antiviral treatment,” concluded the authors, led by Elijah J. Mun, MD, of the University of Washington.

Oct 10, 2018
Hepatitis C - Vosevi safe, effective in ‘triple-infected’ patients with HCV, HBV, HIV
PHILADELPHIA – The direct-acting antiviral Vosevi demonstrated an average sustained virologic response rate of 87% among patients who were “triple-infected” with hepatitis C genotype 3, hepatitis B and HIV, as presented at the American College of Gastroenterology Annual Meeting.

By Nguyen Quy October 8, 2018 
A report by the World Cancer Research Fund International, a leading organization on cancer-prevention research related to diet, nutrition and physical activity, ranks Vietnam fourth among 25 countries with the highest rates of liver cancer this year. The report is based on the latest statistics from Globocan, an interactive web-based platform with cancer statistics from 185 countries....

Mass. General-led study supports ability of regular aspirin use to reduce liver cancer risk
The results of a study led by Massachusetts General Hospital (MGH) investigators support evidence from previous studies suggesting the regular use of aspirin can reduce the risk of developing primary liver cancer – also called hepatocellular carcinoma (HCC). Their report analyzing data from two long-term epidemiologic studies appears in JAMA Oncology and finds that regular aspirin use – taking two or more 325 mg tablets a week for five years or more – led to a significantly reduced risk of developing HCC, which is the second leading cause of cancer death worldwide...

"Compelling" evidence of link between aspirin use, lower hepatoma risk
NEW YORK (Reuters Health) - Regular, long-term use of aspirin is associated with a reduced risk of developing hepatocellular carcinoma (HCC), according to pooled data from more than 133,000 people. "Animal studies have shown that aspirin can block primary liver cancers from developing. Although these studies have been promising, data in humans have been limited," said Dr. Andrew Chan from Massachusetts General Hospital, in Boston.

Scientists use CRISPR to treat genetic liver diseases in neonatal and adult mice
by Arlene Weintraub
The newest issue of the journal Nature Medicine features two animal studies that show progress is being made towards achieving the holy grail of gene editing: the ability to prevent or treat diseases that are caused by gene mutations. In both cases, the researchers used modified versions of CRISPR-Cas9, the most commonly used gene-editing system.

Recommended reading

Evidence does not support statin use for conditions other than heart …
Despite studies suggesting benefits for conditions beyond cardiovascular disease (CVD), the evidence does not support revising current statin …

Early liver disease detection during pregnancy key for improved outcomes
October 7, 2018
PHILADELPHIA — Early detection of liver-related complications and hepatic diseases in patients who are pregnant leads to reduced risks and improved outcomes for…

NAFLD has ‘bidirectional’ course in patients with type 2 diabetes
October 8, 2018
PHILADELPHIA – Nonalcoholic fatty liver disease may have a “bidirectional” nature in patients with type 2 diabetes as NAFLD regressed in 2.2% of patients without any NAFLD-specific interventions despite increase in the prevalence of risk factors, according to a presentation at the American College of Gastroenterology Annual Meeting.

Obesity, Weight Gain Linked to Fibrosis Progression in NAFLD
Medscape Medical News 
October 4, 2018
Obesity and weight gain are independently associated with an increased risk for fibrosis progression in patients with nonalcoholic fatty liver disease (NAFLD), a large cohort study has found. Weight loss was negatively associated with fibrosis progression...

At-Risk Teens and Young Adults Overlooked During Opioid Crisis Too Few Tested for Hepatitis C, Research Suggests 
SAN FRANCISCO – Teens and young adults who have injected drugs are at risk for contracting hepatitis C, but most aren’t tested and therefore don’t receive life-saving treatment, according to a national study being presented at IDWeek 2018. The study of more than 250,000 at-risk youth found only one-third of those with diagnosed opioid use disorder (OUD) were tested for hepatitis C...

NEW YORK (Reuters Health) - The risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) treated with tenofovir is lower than in those treated with entecavir, according to a nationwide study from South Korea. "Patients with CHB have about 1% risk of developing HCC," Dr. Young-Suk Lim from the University of Ulsan College of Medicine, in Seoul, told Reuters Health by email. "Once diagnosed with HCC, the overall prognosis of the patients is very poor, with 5-year survival rate of less than 30%. Therefore, prevention of HCC is of utmost importance in the management of CHB patients."

Healthy You
October 25. 2018'
The food supplement that ruined my liver'
Trying to identify the cause of Jim's liver injury, those treating him ruled out alcohol. "For the last 30 years I drank maybe a six-pack of beer a year, no wine. So alcohol was not a big part of my life," Jim says. They also ruled out prescription drugs - he wasn't taking any at the time - and smoking, something he had never done. "Then my hepatologist drilled in to, 'What about any over-the-counter supplements?'" says Jim....

October 13, 2018
Dietary Supplements Can Contain Viagra, Steroids, or Worse
October 13, 2018
You know those sexual enhancement dietary supplements for sale at gas stations and markets across the country? Beware, they might actually be viagra. Or steroids. Or an antidepressant. Many supposed dietary supplements for weight loss, erectile dysfunction, and muscle building may contain actual pharmaceuticals—but you likely have no way of knowing what's in them...

October 13, 2018
Weekend Reading - Baby Boomers and the Flu
Did you know that you are more susceptible to flu-related complications if you're over 65, living with chronic liver disease, or viral hepatitis?

Recommended
ACGBLOG
Worldwide Epidemiology of Hepatocellular Carcinoma
In this presentation from the 2017 ACG Annual Scientific Meeting, Dr. El-Serag describes current and evolving global epidemiology, natural history, clinical course and risk factors for HCC.
Watch and listen HERE.

September 2018
Herbal and dietary supplement-induced liver injury is more severe than other types of drug-induced liver injury (DILI), and re-exposure is more likely, researchers report in the September issue of Clinical Gastroenterology and Hepatology. Increasing awareness of the hepatoxic effects of herbal and dietary supplements could help physicians make earlier diagnoses
Read more

Recent Updates
Online learning activity
Screening and Diagnosis of Hepatitis C Infection
Topics; HCV Transmission FAQs, Risk Factors for Acquiring HCV, HCV Disease Burden and more...

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Tina