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

Monday, February 18, 2019

The Year in Viral Hepatitis: Part 1

Gastroenterology & Endoscopy News
The Year in Viral Hepatitis: Part 1
Feb 18, 2019
Although 2018 saw no major drug approvals or dramatic breakthroughs for viral hepatitis, researchers continued to make progress against these infections. We asked Drs. Ira Jacobson and Saikiran Kilaru for an overview of the most important findings reported last year.

*** Free registration may be required to view article

Monday, February 11, 2019

Insights From Antiviral Therapy Into Immune Responses to Hepatitis B and C Virus Infection

Gastroenterology
January 2019 Volume 156, Issue 2, Pages 369–383 

Insights From Antiviral Therapy Into Immune Responses to Hepatitis B and C Virus Infection Barbara Rehermann, Robert Thimme 

Abstract
There are 257 million persons worldwide with chronic hepatitis B virus (HBV) infection, a leading causes of liver cancer. Almost all adults with acute HBV infection have a rapid immune response to the virus, resulting in life-long immunity, but there is no cure for individuals with chronic HBV infection, which they acquire during early life. The mechanisms that drive the progression of HBV through distinct clinical phases to end-stage liver disease are poorly understood. Likewise, it is not clear whether and how immune responses can be modulated to allow control and/or clearance of intrahepatic HBV DNA. We review the innate and adaptive immune responses to acute and chronic HBV infections and responses to antiviral therapy. Comparisons with hepatitis C virus infection provide insights into the reversibility of innate inflammatory responses and the potential for successful therapy to recover virus-specific memory immune responses.

Shared On Twitter: Henry E. Chang

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.

News
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: https://blogs.msf.org/bloggers/khurshid/pakistan-new-way-treating-hepatitis-c
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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.
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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....
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Hep
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
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AGA Blog
Gastroenterology and Clinical Gastroenterology and Hepatology

Written by Dr. Kristine Novak
View all blog updates, here...
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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...
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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...
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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....
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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....
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HepatitisC.net
At HepatitisC.net 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....
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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....
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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...
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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....
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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.
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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:
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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.
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JAMA - Medical News & Perspectives
Are Probiotics Money Down the Toilet? Or Worse?
Jennifer Abbasi
JAMA.Published online January 30, 2019.
doi:10.1001/jama.2018.20798
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.
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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.
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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.
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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!
Tina

Wednesday, January 30, 2019

Dicerna Announces Phase 1 Trial of DCR-HBVS for Chronic Hepatitis B Virus

Clinical Proof-of-Concept Data Expected in Second Half of 2019

CAMBRIDGE, Mass.--(BUSINESS WIRE)--Jan. 28, 2019-- Dicerna Pharmaceuticals, Inc. (NASDAQ: DRNA), (the “Company”) a leading developer of RNA interference (RNAi) therapeutics, today announced the dosing of the first human volunteer in its Phase 1 clinical trial of DCR-HBVS, the Company’s investigational GalXCTM-based therapy for the treatment of chronic hepatitis B virus (HBV) infection in adults. The Company anticipates human proof-of-concept data from the Phase 1 trial, which is known as DCR-HBVS-101, in the second half of 2019.

“The dosing of the first human in the DCR-HBVS-101 trial brings us a step closer to the potential availability of an innovative therapy for patients with chronic hepatitis B, a serious liver infection that can lead to advanced hepatic disease or liver cancer if not treated effectively,” said Ralf Rosskamp, M.D., chief medical officer of Dicerna. “We are hopeful that this three-part Phase 1 trial will validate RNA interference as a viable clinical strategy against chronic hepatitis B infection, based upon our encouraging preclinical data on DCR-HBVS.”

DCR-HBVS is comprised of a single GalXC molecule that targets HBV messenger RNAs (mRNAs) within the hepatitis B surface antigen (HBsAg) gene sequence region. Preclinical studies with a standard mouse model of HBV infection showed DCR-HBVS led to greater than 99% reduction in circulating HBsAg, suggesting superior HBsAg suppression (both in magnitude and duration of suppression), compared to targeting within the X gene sequence region.

“RNAi-based therapy has the potential to change the treatment paradigm for patients with chronic HBV infection. By silencing not only the S antigen but also other viral genes, through a powerful and long-acting mechanism, RNAi-based therapy could tip the balance toward allowing the patient’s own immune system to mount an effective immune response. This approach could help eradicate HBV and remove the need for life-long therapy,” said principal investigator Edward Gane, MBCHB, M.D., deputy director and hepatologist of the New Zealand Liver Transplant Unit at Auckland City Hospital and clinical professor of Medicine at the University of Auckland School of Medicine. “Given the encouraging inhibitory activity of DCR-HBVS in animal studies, as well as its favorable preclinical safety profile, we eagerly anticipate the first results from healthy volunteers in the DCR-HBVS-101 trial, and then in the second part of the study, from patients with chronic hepatitis B.”

About the DCR-HBVS-101 Trial
The DCR-HBVS-101 clinical trial is a randomized, placebo-controlled study designed to evaluate the safety and tolerability of DCR-HBVS in normal healthy volunteers (NHVs) and in patients with non-cirrhotic chronic HBV. Secondary objectives are to characterize the pharmacokinetic (PK) profile of DCR-HBVS and to evaluate preliminary pharmacodynamics (PD) and antiviral efficacy on plasma levels of HBsAg and HBV in blood. The study is divided into three phases or groups:

In Group A, 30 NHVs are to receive a single ascending-dose of DCR-HBVS (0.1, 1, 1.5, 3, 6, or 12 mg/kg), with a four-week follow-up period.

Group B is a single-dose study of DCR-HBVS (3 mg/kg) in eight patients with HBV who are naïve to nucleoside analog therapy; these patients will be followed for at least 12 weeks. The Company expects to initiate Group B dosing in the third quarter of 2019.

Group C is a multiple ascending-dose study of DCR-HBVS (1.5, 3, or 6 mg/kg) in 18 patients with HBV previously treated with nucleoside analogs with a follow-up period of 24 weeks or more. The Company expects to initiate Group C dosing in the second quarter of 2019.

For more information about the DCR-HBVS clinical study, please visit clinicaltrials.gov and use the identifier NCT03772249.

Wednesday, January 23, 2019

Screen All New Cancer Patients for Hepatitis?

Article download shared by @HenryEChang via twitter... 

Medscape Medical News
January 23, 2019

With no identifiable risk factors in most cases, universal screening before cancer therapy may prevent life-threatening complications.

Screen All New Cancer Patients for Hepatitis?
Kristin Jenkins
A new study has found "a large reservoir of patients with cancer and undiagnosed hepatitis virus infections" and has reignited the question of whether all newly diagnosed cancer patients should be screened for hepatitis.

The Viral Screening in Newly Diagnosed Cancer Patients (S1204) study involved 3051 patients and found that 6.5% had previously been infected with hepatitis B virus (HBV), 0.6% had chronic HBV infection, 2.4% had hepatitis C (HCV) infection, and 1.1% were infected with HIV.

The study was published online on January 17 in JAMA Oncology.

Read more: https://www.medscape.com/viewarticle/908173
Free registration may be required

Friday, January 11, 2019

Three-part series: What’s the Difference: Hepatitis B vs Hepatitis C?

Hepatitis B Foundation


With five different types of viral hepatitis, it can be difficult to understand the differences between them. Some forms of hepatitis get more attention than others, but it is still important to know how they are transmitted, what they do, and the steps that you can take to protect yourself and your liver!

This is part one in a three-part series. 

Wednesday, January 9, 2019

USPSTF Draft Recommendation - Hepatitis B Virus Infection in Pregnant Women: Screening

Draft Recommendation Statement
Hepatitis B Virus Infection in Pregnant Women: Screening
The USPSTF recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit.

The draft recommendation statement is available for comment from Jan. 8 to Jan. 29, 2019.
Draft Recommendation Statement
Draft Evidence Review
Comment on Recommendation

This opportunity for public comment expires on February 4, 2019 at 8:00 PM EST
Note: This is a Draft Recommendation Statement. This draft is distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF. The final Recommendation Statement will be developed after careful consideration of the feedback received and will include both the Research Plan and Evidence Review as a basis.

Media Coverage
USPSTF Affirms Guidance for Hep B Screening at First Prenatal Visit
 Last Updated: January 08, 2019.
The U.S. Preventive Services Task Force recommends hepatitis B virus infection screening in pregnant women at their first prenatal visit. These findings form the basis of a draft recommendation statement published online Jan. 8 by the task force.
Article: https://www.doctorslounge.com/index.php/news/pb/85739

Wednesday, December 19, 2018

December Newsletters: Curing Hep C May Dial Back Liver Damage


Hi folks, over the next few weeks I'll be taking a holiday break to spend time with the family. Can't wait to start my Christmas shopping, trick out my tree, and bake some millennial sugar cookies. Using Pillsbury ready to make slice-and-bake cookies, add sprinkles after baking. Bad Nana!

In any event, here's your list of December newsletters with blog updates from across the web.

News & Review 
Catch up on what you missed this week by reading one of two HCV week in review publications:
The Weekly Bull is published by the Canadian non-profit organization HepCBC, the second publication by Caring Ambassadors Program, is filled with news as well, in addition to a monthly review of relevant HCV research published on PubMed.

News Update
Jan 1, 2019
CDC: Could be a tough flu season based on early viruses, hospitalizations
By Anne-Gerard Flynn
The country could be in for another challenging flu season. There are already 11 pediatric deaths associated with the flu and hospitals rates among very young children are high, according to the Centers for Disease Control and Prevention.

Dec 19, 2018
NPR - Even in a setting with an identified risk factor in opioid-use disorder, too few youths are being screened for hepatitis C
As the number of people who inject drugs and share needles has soared, the rate of infection with Hep C has climbed too. Yet many drug treatment patients aren't tested for the liver-damaging virus.

Dec 17, 2018
Great news for New Zealanders pangenotypic regimen Maviret unrestricted access from Feb 2019 with $0 co-payment - PHARMAC funding decision gives Kiwis with hepatitis C access to a potential cure

December Newsletters
The aim of infohep.org is to develop a high-quality online resource to increase awareness of viral hepatitis, its treatment, and the needs of people living with viral hepatitis in Europe. 
The December edition of the infohep bulletin is now online: 
Highlights
Global trends in non-alcoholic fatty liver disease
NAFLD can occur in lean people too
Hepatitis C and the US opioid epidemic
Resistance testing for hepatitis C
Rwanda aims for hepatitis C elimination
Egypt hepatitis C elimination

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 HepMag.com are the go-to source for educational and social support for people living with hepatitis.
Winter Issue 2018
Highlights
Curing Hep C May Dial Back Liver Damage
Hep C Testing Slowly Rising Among Baby Boomers
People Who Inject Drugs Succeed With Hep C Treatment
and more....

The HCV Advocate newsletter is a valuable resource designed to provide the hepatitis C community with monthly updates on events, clinical research, and education.
In this month's 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 as well.

On This Blog
After The Liver Meeting Summary: Viral Hepatitis & Fatty Liver Disease
For patients - An index of links provide an overview of the meeting with a focus on HCV; read expert analysis of key data, interviews with leading researchers and clinicians, or listen to live presentations, view slidesets and capsule summaries. Sit back and watch daily clips or a live symposium, finally review a webinar with all the notable Liver Meeting updates. 

HCV Action brings together hepatitis C health professionals from across the patient pathway with the pharmaceutical industry and patient representatives to share expertise and good practice.
Read the latest: HCV Action e-update

The World Hepatitis Alliance goal is to achieve a world free from viral hepatitis, World Hepatitis Alliance provides global leadership in awareness-raising, advocacy and in efforts to find the missing millions.
News & Headlines 
Click here to read our latest newsletter.

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.
December Newsletter: Reminder: NYC Hep C Task Force Meeting. December 5 (3-5 PM) @ 132 West 32nd St.
NYC Hep C Task Force
All - Hep Free NYC Newsletters

Hepatitis NSW provides information, support, referral and advocacy for people affected by viral hepatitis in NSW. We also provide workforce development and education services both to prevent the transmission of viral hepatitis and to improve services for those affected by it.
News Updates

GI & Hepatology News covers the world of liver disease with breaking news, on-site medical meeting coverage, and expert perspectives both in print and online. 
View all updates here....

Hepatitis Victoria is the peak not-for-profit community organisation working across the state for people affected by or at risk of viral hepatitis.
View the Latest Newsletter, or relax and listen to a short podcasts interviewing health experts and practioners on topics related to viral hepatitis - have a listen!

The British Liver Trust is the leading UK liver disease charity for adults – we provide information and support; increase awareness of how liver disease can be prevented and promote early diagnosis; fund and champion research and campaign for better services. 
View Recent Newsletters, here.

The Hepatitis C Trust is run by patients with the goal of eliminating HCV in the United Kingdom. The Trust’s mission is to reverse the rapidly increasing death toll caused by hepatitis C in the UK until no-one dies from this preventable and treatable disease and, ultimately, it is all but eradicated in this country.

The National Viral Hepatitis Roundtable (NVHR) is national coalition working together to eliminate hepatitis B and C in the United States.
NVHR 2018 Year in Review
View all NVHR newsletters

Check out the latest National Institutes of Health Newsletter.
December Newsletter
Plan Your Plate - Shifting to a Healthy Eating Style

Blog Updates
Karen Hoyt is devoted to offering support and accurate information to people coping with the effects of hepatitis C.
Latest blog entry: Holiday and Health Problems
Find Karen on Facebook
YouTube Page

Lucinda K. Porter
Lucinda Porter is a nurse, speaker, advocate and patient devoted to increasing awareness about hepatitis C.
View all new blog updates, here....

Hep 
Hep is an award-winning print and online brand for people living with and affected by viral hepatitis.
Latest blog updates: 
By Lucinda K. Porter, RN
By Connie M. Welch 
Hepatitis C Cure 
By Greg Jefferys
View all blog updates, here...

AGA Blog
Gastroenterology and Clinical Gastroenterology and Hepatology
View all blog updates, here...

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.
Latest blog entry: 5 Common Questions and Answers about Hepatitis C Treatment
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.
Latest blog entry: Tips for a struggling caregiver
View all updates, here...

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.
Latest blog entry: My partner has been diagnosed with hepatitis B. Can transmission be prevented by vaccination?
 Ask An Expert: Managing Hepatitis Delta During Pregnancy
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 HepatitisC.net 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.
Part 1: Doctors and Dragons: The Adventure Continues - By Rick Nash
View all updates, here....

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.
View latest blog entry, here... 

Harvard Health Blog
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.
Latest blog entry: Alcohol use disorder: When is drinking a problem?
Benefits of a healthy diet — with or without weight loss
Safe and effective use of insulin requires proper storage

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

In Case You Missed It
Webcast
Dec 13, 2018
New HCV Clinical Advances
Sit back and watch a live symposium from the November 2018 Liver Meeting featuring table discussions with leading physicians discussing viral hepatitis, launched by Chronic Liver Disease Foundation (CLDF) on December 13, 2018.

December 21, 2018
NEW @ JAMA
During 2013 to 2016, what proportion of adults were living with hepatitis C virus (HCV) infection in each US state?
Regions with long-standing HCV epidemics, and those with newly emergent ones partly driven by the opioid crisis, face substantial HCV prevalence.
Prevalence of Hepatitis C Virus Infection in US States and the District of Columbia, 2013 to 2016
Prevalence of HCV infection varies widely in the United States. Highest rates are frequently in states deeply affected by the opioid crisis or with a history of increased levels of injection drug use and chronic HCV infection, particularly in the West. Progress toward hepatitis C elimination is theoretically possible with the right investments in prevention, diagnosis, and cure. The urgency for action and the resources necessary will vary by jurisdiction.

JAMA In The News: Hepatitis C Cases Cluster in States Hit Hard by Opioids
FRIDAY, Dec. 21, 2018 (HealthDay News) -- More than half of Americans with hepatitis C are living in just nine U.S. states -- five of those in a region hit hard by the opioid epidemic, a new study shows.

JAMA Patient Page
This JAMA Patient Page describes recent advancements in hepatitis C treatment.
December 4, 2018
Treating Hepatitis C
From a medical point of view, almost all patients with hepatitis C should be treated.

See you soon!
Tina

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 13, 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

The Liver Meeting® Content Now Available On Demand
Open Access: The Best of The Liver Meeting®. This product, bundled as downloadable slide sets, contains highlights from the meeting and investigates nine topics with key findings, data and analyses.

View the summary slide decks by topic.
Alcoholic Liver Disease
Basic and Translational Research
Cholestatic and Autoimmune Liver Diseases
Liver and Biliary Cancer
NAFLD/NASH
Pediatric Liver Diseases
Portal Hypertension/Cirrhosis
Liver Transplant
Viral Hepatitis

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
Dec 13, 2018
Chronic Liver Disease Foundation
Symposium live from the meeting featuring table discussions with leading physicians discussing viral hepatitis, launched in December by CLDF. 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
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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:
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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
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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.