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

Thursday, June 21, 2018

60,000 adults in the UK have cirrhosis, nearly 75% percent don't know it


7 in 10 people with liver disease in the UK don’t even know they have it 
Although over 60,000 adults in the UK have cirrhosis (scarring) of the liver, nearly 75% percent don't know it, according to research published in the Lancet. For many, the first indication is following admission to Accident and Emergency when the disease is advanced and chance of survival is very low. This week, 18th to 24th June, is Love Your Liver week, and the British Liver Trust has launched a new version of an online screening tool so that people can find out if they are at risk.

Although over 60,000 adults in the UK have cirrhosis (scarring) of the liver, nearly 75% percent don't know it, according to research published in the Lancet. For many, the first indication is following admission to Accident and Emergency when the disease is advanced and chance of survival is very low. This week, 18th to 24th June, is Love Your Liver week, and the British Liver Trust has launched a new version of an online screening tool so that people can find out if they are at risk.

Liver disease is one of the leading causes of premature death in England and is responsible for more than 1 in 10 deaths of people in their 40s.

Professor Nick Sheron, a liver expert from the University of Southampton involved in the research, said: "Liver disease develops silently with no signs or symptoms and is the second leading cause of years or working life lost. If current trends continue it become the leading cause of premature mortality in the UK. Yet, most people with fatal advanced liver disease only become aware that they have a liver problem when they are admitted as an emergency. We MUST diagnose these people much earlier."

Liver problems develop silently with no obvious symptoms in the early stages yet the disease is largely preventable through lifestyle changes. The Love Your Liver awareness campaign, promoted by the British Liver Trust, aims to reach the one in five people in the UK who may have the early stages of liver disease, but are unaware of it.

More than 90% of liver disease is due to three main risk factors: obesity, alcohol and viral hepatitis.

Judi Rhys, Chief Executive, British Liver Trust said, “Helping people understand how to reduce their risk of liver damage is vital to address the increase in deaths from liver disease. Although the liver is remarkably resilient, if left too late damage is often irreversible. I would urge everyone to take our online screener on our website to see if they are at risk.”

The British Liver Trust’s Love Your Liver campaign focuses on three simple steps to Love Your Liver back to health:

- Drink within recommended limits and have three consecutive alcohol-free days every week
- Cut down on sugar, carbohydrates and fat and take more exercise
- Know the risk factors for viral hepatitis and get tested or vaccinated if at risk

Finding out your risk of liver disease only takes a few minutes. It could be the most important thing you do today. Take the British Liver Trust’s screener here

Liver disease is one of the leading causes of premature death in England and is responsible for more than 1 in 10 deaths of people in their 40s.

Professor Nick Sheron, a liver expert from the University of Southampton involved in the research, said: "Liver disease develops silently with no signs or symptoms and is the second leading cause of years or working life lost. If current trends continue it become the leading cause of premature mortality in the UK. Yet, most people with fatal advanced liver disease only become aware that they have a liver problem when they are admitted as an emergency. We MUST diagnose these people much earlier."

Liver problems develop silently with no obvious symptoms in the early stages yet the disease is largely preventable through lifestyle changes. The Love Your Liver awareness campaign, promoted by the British Liver Trust, aims to reach the one in five people in the UK who may have the early stages of liver disease, but are unaware of it.

More than 90% of liver disease is due to three main risk factors: obesity, alcohol and viral hepatitis.

Judi Rhys, Chief Executive, British Liver Trust said, “Helping people understand how to reduce their risk of liver damage is vital to address the increase in deaths from liver disease. Although the liver is remarkably resilient, if left too late damage is often irreversible. I would urge everyone to take our online screener on our website to see if they are at risk.”

Finding out your risk of liver disease only takes a few minutes. It could be the most important thing you do today. Take the British Liver Trust’s screener here

Wednesday, May 9, 2018

Hepatitis Awareness Month - What is hepatitis C? What about hepatitis B or A?


Featured on the blog today in honor of Hepatitis Awareness Month, is a look at three common viruses that cause hepatitis, brought to you by Centers of Disease Control and Prevention (CDC), health experts, advocates, and patient bloggers, who work hard to spread information and awareness about viral hepatitis.

Hepatitis C
Lets start with the hepatitis C virus (HCV), a virus that once caused serious damage to my liver, putting me at risk for liver-related complications. The good news is after testing; it all starts with getting tested for HCV, I went on to successfully treat the virus. The bad news is close to 50% of people who have HCV have not yet been diagnosed. Why not take this opportunity to learn more about viral hepatitis, or better yet, have a long frank discussion with "yourself" about getting tested.

Young Or Not So Young - The Risk 
Today we have two different groups of people that are at risk for hepatitis C, young people who have injected drugs and well, older people. We know that the hepatitis C epidemic peaked between 1940 and 1965 due in part because of hospital transmissions caused by the practice of reusing needles. So if you are at risk for HCV, rather you are young or part of the baby boomer generation; people born between 1945 and 1965, I hope you consider getting tested for HCV.

Hepatitis C Risk Factors
-IV drug use, sharing needles and syringes; Spike in HCV Linked to Opioid Injection Hits Young Adults Hardest
-Vertical transmission from mother to baby; HCV in Pregnant Women on Rise Increased risk of HCV infected infants.
-You were born from 1945 through 1965
-Extensive surgical procedures
-Needlestick injuries in health care settings
- Recipients of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)
-People who received a blood product for clotting problems made before 1987
-Hemodialysis patients or persons who spent many years on dialysis for kidney failure
-Other possible risk behaviors: tattoos, body piercing, living and medical care in a developing country, folk medicine, intranasal cocaine
-Sexual transmission, rare; the risk of sexual transmission to an individual is probably less than 3% when a person is in a stable monogamous relationship - Unless you also have human immunodeficiency virus (HIV).
-Sharing personal care items, such as razors or toothbrushes, that may have come in contact with the blood of an infected person
-Unknown--up to 5% of patients have no identifiable risk factors

May 19th is Hepatitis Testing Day! 

Are You At Risk For Viral Hepatitis?
Find out if you should get tested or vaccinated by taking a quick, online Hepatitis Risk Assessment, developed by the CDC and get a personalized report.

Hepatitis C - A Few Facts
Of every 100 people infected with hepatitis C, 75 to 85 will develop chronic disease and 10-20 will go on to develop cirrhosis over a period of 20-30 years. Early on HCV doesn't always have noticeable symptoms but overtime and with certain co-factors the virus can lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer. Almost 80 percent of cases of hepatocellular carcinoma (HCC) are due to underlying chronic hepatitis B and C infection, and 80 to 90 percent of people with HCC have liver cirrhosis. According to the recent EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma; Vaccination against hepatitis B reduces the risk of HCC and is recommended for all new-borns and high-risk groups. In patients with chronic hepatitis, antiviral therapies leading to maintained HBV suppression in chronic hepatitis B and sustained viral response in hepatitis C are recommended, since they have been shown to prevent progression to cirrhosis and HCC development.

Show Me The Guidelines

Current EASL Clinical Practice Guidelines
During The International Liver Congress 2018, The European Association for the Study of the Liver (EASL) released updated practice guidelines to help physicians, as well as patients manage and treat HCV. (Link) EASL Practice Guidelines - Hepatitis C 2018, Decompensated Cirrhosis, Hepatocellular Carcinoma, Alcoholic Liver Disease & Hepatitis E.

Current AASLD Clinical Practice Guidelines
The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) with the International Antiviral Society developed a living document with ever evolving guidelines to treat HCV. The guidelines break down treatment according to liver damage and HCV genotype, updated when new HCV drugs are approved, or new real world data is established.

Help - Where Do I Begin?

Talk To Someone
Help‑4‑Hep is a non-profit, peer-to-peer helpline where counselors work with patients to meet the challenges of hepatitis C head-on. Callers talk one-to-one with a real person, typically someone who's had hepatitis C touch their own life. And they talk about the specifics of their particular situation. The phone call, support and information are all provided free of charge. Let us help you cut through the clutter and confusion. Call toll-free: 877‑Help‑4‑Hep (877‑435‑7443).
Begin here.......

Where To Get Tested - Hepatitis C and Hepatitis B

Find A HCV Specialist 
Find a Specialist In Your Area

Hepatitis B 
More than 2 million Americans are chronically infected with hepatitis B virus (HBV), to learn more about HBV visit The Hepatitis B Foundation, for patients it's the best site for easy to understand information, here are a few links to get you started: 

What Is Hepatitis B?
Facts and Figures
Symptoms
Transmission
Acute vs. Chronic Infection
Commonly Asked Questions
The ABCs of Viral Hepatitis
Liver Cancer and Hepatitis B
Hepatitis Delta Coinfection
Hepatitis C Coinfection
HIV/AIDS Coinfection

AASLD 2018 hepatitis B guidance
Update on prevention, diagnosis, and treatment of chronic hepatitis B

ACIP Hepatitis B Vaccine Recommendations | CDC
You may have questions about the hepatitis A virus (HAV) after reading about HAV outbreaks across the US; Michigan, California, Indiana, Kentucky and Utah. The outbreak began in California in 2017, this year Michigan, Utah, and Kentucky have reported outbreaks with a high number of cases. Here is a Public Service Announcement from San Diego County Health & Human Services Agency on HAV prevention.


Immunization Action Coalition

Hepatitis A: Questions and Answers Information about the disease and vaccines
Read how hepatitis A is spread, the symptoms, how serious the virus is, when and who should get vaccinated.

CDC
I think I have been exposed to hepatitis A. What should I do?
If you have any questions about potential exposure to hepatitis A, call your health professional or your local or state health department. If you were recently exposed to hepatitis A virus and have not been vaccinated against hepatitis A, you might benefit from an injection of either immune globulin or hepatitis A vaccine. However, the vaccine or immune globulin are only effective if given within the first 2 weeks after exposure. A health professional can decide what is best based on your age and overall health.

What is postexposure prophylaxis (PEP)?
Postexposure prophylaxis (PEP) refers to trying to prevent or treat a disease after an exposure. For hepatitis A, postexposure prophylaxis is an injection of either immune globulin or hepatitis A vaccine. However, the vaccine or immune globulin are only effective in preventing hepatitis A if given within the first 2 weeks after exposure.
Begin here.......

Blog Updates: The ABCs Of Viral Hepatitis

Swedish Medical Center
What is hepatitis C, and how does it differ from hepatitis A or B?
By 2030, the World Health Organization wants to have hepatitis C eliminated from the planet. A key to reaching that goal is to create awareness of the disease among baby boomers, who suffer from it in larger numbers compared to the rest of the population, as well as those with increased lifestyle risks. But what is hepatitis C, and what can be done to reduce its numbers? Kris Kowdley, MD, director of the Liver Care Network and Organ Care Research at Swedish Medical Center in Seattle, WA, discusses hepatitis C in detail.
View the article here: https://www.swedish.org/blog/2018/05/ask-the-expert-all-about-hepatitis-c

HEP Blogs
Go-to online source for educational and social support for people living with hepatitis. The website is devoted to combating the stigma and isolation surrounding hepatitis.

What are the Different Types of Hepatitis?
May 9, 2018 • By Connie M. Welch
Viral hepatitis is a liver infection that causes inflammation and damage. There are 5 viruses that cause viral hepatitis, Hepatitis A, B, C, D, and E. Hepatitis A and E viruses can cause acute infections (infections that last less than 6 months). Hepatitis B, C, and D viruses can cause acute and chronic (lasting longer than 6 months and typically ongoing) liver infections.

Awareness
Get Organized for Hepatitis Awareness Month 
By Lucinda K. Porter, RN
Raising hepatitis awareness is a great deal more fun if you participate with others. Here are some tips.


HepatitisC.net
Hep C Daily Blog, Experts & Community

By Karen Hoyt · May 7, 2018
So, you are hanging out with the same crowd that you always have. They’re like your family. In many ways, they are closer to you than your own family.

The Fallout Guide for Hep C: Support Network
By Rick Nash · May 2, 2018
I am lucky after my transplant, I carry that reminder on my stomach. Because when someone hears you have a condition, they may not initially understand the reality of how that affects you.
This is part two of a six-part series, view part one here.

All updates: https://hepatitisc.net/community/

Hep B Blog
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.

May is Hepatitis Awareness Month
Hepatitis Awareness Month is dedicated to increasing awareness of hepatitis in the United States and to encourage high risk populations to get tested. If you’re not sure how you can get involved in the hepatitis B community this month, here are some ways you can!

Information On Hep B Blog:
Hepatitis B Diagnosis & Monitoring
Hepatitis B Prevention
Hepatitis B Treatment
Liver Cancer
Living with Hepatitis B
News

    Al D. Rodriguez Liver Foundation
    The Al D. Rodriguez Liver Foundation is a 501(c)(3) non-profit organization that provides resources, education and information related to screening, the prevention of and treatment for the Hepatitis Virus and Liver Cancer.

    A New York Post article about an unsafe “pizza joint manager” — who was reported to have sparked hepatitis C scare — made a few rounds on the panicked social media circuit earlier this year.


    Healio
    Healio features the industry’s best news reporting, dynamic multimedia, question-and-answer columns, CME and other educational activities in a variety of formats, quick reference content, blogs, and peer-reviewed journals. A quick free registration may be required.

    Hepatitis Awareness Month: 10 recent reports on viral hepatitis
    May 8, 2018
    The Centers for Disease Control and Prevention have designated May as Hepatitis Awareness Month to raise public awareness of viral hepatitis including the most common strains: hepatitis A, hepatitis B and hepatitis C. Additionally, the CDC designated May 19th as Hepatitis Testing Day. The following recent reports, many from recent meetings including the International Liver Congress 2018, include new research data on hepatitis prevalence and outbreaks, transmission risks and treatment outcomes...

    May 9, 2018
    Physicians should consider administering hepatitis A vaccines to their patients with hepatitis B and those with hepatitis C, according to a…

    Viral Hepatitis - An Overview
    By Osmosis
    What is the hepatitis virus? Well, the hepatitis virus invades liver cells and causes inflammation in the liver tissue. There are five known hepatitis viruses—hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E, all of which have slightly different presentations, symptoms and severity.


    Do you want to know your status? If you fall under any of the above mentioned risk groups please consider getting tested.

    Tina

    Thursday, May 3, 2018

    May Hepatitis Newsletters: 2018 International Liver Congress Recap & The Fallout Guide for Hep C

    May Hepatitis Newsletters
    Welcome to this month's index of viral hepatitis newsletters, with updates from your favorite bloggers and today's news.

    Where To Begin?
    HCV Advocate's May issue is all about key data presented at the 2018 International Liver Congress, with easy to understand commentary by Alan Franciscus and lovely Lucinda K. Porter. The ever so talented Rick Nash is working on a six-part series called: The Fallout Guide for Hep C, part one is ready over at HEPATITISC.NET. Additional blog and newsletter updates are provided below, enjoy!

    May Is Hepatitis Awareness Month
    The month of May is designated as Hepatitis Awareness Month in the United States, and May 19th is Hepatitis Testing Day. Learn more: Resources for Hepatitis Awareness Month and Hepatitis Testing Day

    National Viral Hepatitis Roundtable 
    NVHR Calls for Increased Recognition of Hepatitis C as a Systemic Health Condition
    Washington, D.C. (May 1, 2018) – The National Viral Hepatitis Roundtable (NVHR) today urged healthcare providers, policymakers, and the public health community to use Hepatitis Awareness Month as an opportunity to expand treatment opportunities for patients living with the hepatitis C virus (HCV) by reconsidering the way we think about HCV. Despite the availability of new, highly effective oral medications to cure the disease, the burden of hepatitis C continues to grow in the United States.
    View NVHR May Newsletter

    In The News
    Due to the opioid epidemic, the rate of hepatitis C virus infection among pregnant women increased 60 percent between 2006 and 2014, according to a study, yet only 30 percent of infants exposed to the virus were screened for infection. The study, “Hepatitis C Virus Screening Among Children ExposedDuring Pregnancy,” will be published in the June 2018 issue of Pediatrics (published online May 2).

    Seatbelts may protect against severe liver injury in car crashes
    (Reuters Health) - Wearing a seatbelt may not prevent liver injuries in a car crash, but it could lessen their severity and make a major difference in the accident’s consequences and costs, researchers say. Among more than 50,000 people with liver injuries as a result of a car crash, those with severe liver injuries were twice as likely to die as those with mild or moderate liver injuries, researchers found.

    NEW YORK (Reuters) - The number of Americans sickened each year by bites from infected mosquitoes, ticks or fleas tripled from 2004 through 2016, with infection rates spiking sharply in 2016 as a result of a Zika outbreak, U.S. health officials said on Tuesday.

    Hospital: Injected patients at risk of Hep C exposure from nurse who stole drugs
    May 1, 2018
    A hospital is warning 2,600 emergency room patients they may be at risk of Hepatitis C exposure from a nurse who admitted to stealing drugs.

    Take-home Narcan kits lifesaving in opioid overdoses
    (Reuters Health) - Distributing take-home overdose prevention kits substantially reduced the number of deaths from opioid overdoses in a Canadian province, researchers say.

    Flu Vaccines Have High Impact, Even With Relatively Low Efficacy
    Last Updated: April 30, 2018.
    Even relatively low-efficacy influenza vaccines can have a high impact, especially with optimal distribution across age groups, according to a study published online April 30 in the Proceedings of the National Academy of Sciences.

    In Case You Missed It
    Cochrane Review Flawed For Discounting SVR As A Marker Of Viral Cure & Endpoint For Measuring Treatment Impact.
    Patients, advocates, and experts agree stigma and discrimination remains a barrier to testing and treatment, however, the benefit of curing hepatitis C with astounding cure rates is not all that controversial. Reason enough for experts to get caught up in a 2017 systematic review published by the Cochrane Collaboration on the benefit of achieving a cure using hepatitis C direct-acting antivirals (DAAs). The review concluded patients who were cured with DAA-based regimens did not reduce their risk for HCV-related morbidity or all-cause mortality. Within days, an outcry emerged from experts urging patients not to be influenced by the misleading and harmful conclusion, or be confused by any media coverage that followed....

    Dietary improvements may prevent NAFLD
    (Reuters Health) - People who make an effort to improve their diet may have a lower risk of non-alcoholic fatty liver disease (NAFDL) than individuals who stick to unhealthy eating habits, a U.S. study suggests. While dietary changes are recommended to treat NAFLD, research hasn't clearly demonstrated whether these changes can work for prevention.

    Radiation segmentectomy a potential curative therapy for liver cancer
    NEW YORK (Reuters Health) - Long-term outcomes with radiation segmentectomy are on par with curative-intent treatments for patients with early-stage hepatocellular carcinoma (HCC), according to a new paper.

    2018 International Liver Congress
    Patients looking for an overview of EASL's 2018 International Liver Congress can find it in this month's "infohep bulletin".

    Clinical Care Options
    Key Viral Hepatitis Studies Influencing My Practice Following EASL 2018
    Expert faculty members summarize key viral hepatitis studies from this important annual conference.

    Listen to downloadable audio from a live Webinar by Zobair M. Younossi, MD, MPH, FACP, FACG, AGAF, in which the clinical impact of new NAFLD/NASH data reported at the Paris meeting is discussed.
    *Free registration required

    EASL LiverTree - Open To All
    This year webcasts and congress materials are open access! Watch freely the conferences and ePosters: https://livertree.easl.eu/easl/#!*menu=6*browseby=3*sortby=2*ce_id=1307
    *Free registration required

    HepCBC
    Read today's news or a nice summary of notable headlines published in the latest issue of The Weekly Bull.

    Caring Ambassadors
    Literature Review
    Monthly Pubmed Review of the Most Relevant Research on Hepatitis C
    March & April 2018

    Healio
    SVR after HCV therapy reduces extrahepatic mortality, manifestations
    Results of a recent systematic review and meta-analysis showed that sustained virologic response after hepatitis C therapy can reduce extrahepatic manifestations including insulin resistance and cardiovascular risks...

    Conatus completes enrollment in phase 2 trial for NASH cirrhosis inhibitor
    Conatus Pharmaceuticals completed enrollment in its ENCORE-PH phase 2 clinical trial for emricasan, an orally-active pan-caspase inhibitor designed to treat nonalcoholic…

    Healio Updates
    Read the latest news
    Current Publications
    HCV Next
    Healio Gastroenterology
    Infectious Disease News

    Newsletters

    HCV Advocate 
    In this edition of the HCV Advocate we have devoted nearly the entire issue to the 2018 International Liver Congress. Lucinda Porter, RN and I cover some of our favorite posters and presentations in the current issue and in the upcoming June 2018 issue.

    May Newsletter

    Lucinda’s Highlights from the 2018 International Liver Congress:
    Risk of Liver Fibrosis Progression in Patients with Undiagnosed Hepatitis C Virus Infection
    Protective Effect of Cannabis and Coffee Consumption on HCV-related Mortality in French HIV-HCV Co-Infected Patients
    Poor Awareness of Liver Disease Shortly Before Cirrhosis Death: Findings from a Large Community Cohort in the UK
    The Covert “C”; Prevalence: Risk Factors and Management of Hepatitis C in Psychiatric In-Patients
    Effectiveness of Hepatitis C Virus Screening Laws in the United States: Evidence from Paid Claims Data from 2010 to 2016
    Lower Risk of Multiple Sclerosis in Patients with Chronic Hepatitis
    Screening for Neurocognitive Dysfunction in Non-Cirrhotic Chronic Hepatitis C Infection in an Irish Academic Unit

    Alan’s Highlights from the 2018 International Liver Congress:

    Testing and linkage to care outcomes in baby boomers versus young adults tested in the community and linked to care at a Federally Qualified Health Center in the US
    Linkage to HCV care and reincarceration following release from New York City jails
    Direct Antiviral Agents are safe and efficacious in pediatric patients with chronic hepatitis C; Real-world data from the public health perspective
    Salvage treatment of HCV patients by Sofosbuvir, Daclatasvir, Simeprevir, and Ribavirin after repeated treatment failures is associated with SVR and reduced risk of hepatocellular carcinoma

    Hepatitis Headlines – read about a new hepatitis C therapy in clinical trials, hepatitis C screening rates among baby boomers, the opioid epidemic and about Hepatitis Awareness Month in May.

    What’s Up!
    We have updated the following HCSP’s Guide and Fact Sheets:

    A Guide to Understanding HCV is our most popular downloaded publication. We have completely rewritten and designed the Guide.

    HCSP Fact Sheets:
    Overview of Disease Progression
    HCV Disease Progression: What is Fibrosis?

    Don’t forget to check out PackHealth.com for a free resource to help patients navigate their HCV treatment journey. Click on PackHealth.com/hcv and use promo code HCV2017.

    Check out our Hep C Video of a patient journey through treatment and cure . . .

    The New York City Hepatitis C Task Force

    British Liver Trust
    We’d love to keep in touch to let you know how your support is helping so to keep receiving our newsletter and updates, please click here to register your preferences today.

    HCVAction
    May - Good practice case study: Nottingham University Hospitals NHS Trust Homecare treatment delivery
    This HCV Action good practice case study focuses on Nottingham University Hospitals Trust's Homecare treatment delivery project. The project offered patients the option to receive treatment for hepatitis C in their own homes. The project proved popular with patients and resulted in a number of benefits to the service compared with delivering treatment in secondary care.
    View All Updates: http://www.hcvaction.org.uk/

    POZ
    April/May 2018 Issue
    In every issue, you’ll find the hottest topics of interest to our readers along with cutting-edge health information.
    View all updates: https://www.poz.com/

    National Institutes of Health
    A monthly newsletter from the National Institutes of Health, part of the U.S. Department of Health and Human Services
    May Newsletter
    Newsletters: https://newsinhealth.nih.gov/

    World Hepatitis Alliance
    Successful hepatitis C virus (HCV) therapy reduces the risk of a serious cardiovascular event in people with compensated liver cirrhosis, French.
    Read all updates: http://www.worldhepatitisalliance.org/latest-news

    Newsletter: HEPVOICE - World Hepatitis Alliance

    Pacific Hepatitis C Network

    Help-4-Hep BC Celebrates 1 Year!
    4 May 2018
    by Daryl Luster, PHCN Board President
    As we near the completion of our first year operating the Help-4-Hep helpline herein BC, I thought it would be a good time to reflect back. A private and confidential service like our helpline fills a gap not met by other resources. With the stigma still unfortunately alive and well across all populations affected by hep c, Help-4-Hep BC provides a means to access peer support and knowledge, as well as resources to help people navigate a process that can be overwhelming.

    GI & Hepatology

    Blog Updates

    Why Bringing Liver Research to Life Matters
    If liver disease is a jigsaw puzzle, then research are the puzzle pieces. When put in the right sequence these pieces have the ability to create a full and detailed picture…

    HEP Blogs
    Hepatitis Awareness Month is Officially Here
    It is Hepatitis Awareness Month and for the next 31 days we pay extra attention to issues surrounding viral hepatitis. I am committing to do at least one daily action to raise awareness about virus hepatitis. I hope you will join me today and throughout this month, as we work to educate, challenge, and eventually eliminate viral hepatitis.

    5 Ways You Can Take Care of Your Liver
    An unhealthy diet can lead to liver disease and compromise the function of your liver. The American Liver Foundation states,“eating high fatty foods will put you at risk of being overweight and having non-alcoholic fatty liver disease and at risk for other disease.”

    Still in India, Greg writes the next installment of his blog sitting in the back seat of a taxi driving from Udaipur to Jaipur.

    Common Co-Infections with Hepatitis C
    A look at some of the common co-infections that may accompany hepatitis C

    Is hepatitis C criminalized in your state?


    HEPATITISC.NET
    This is part one of a six-part series called The Fallout Guide for Hep C. Six emotional components of living with hep C which are important to address to maintain our sense of self as we traverse the difficult hardships ahead.

    I Help C
    Have you ever had a perfectly fine day turn into a hot mess? It happened to me recently. I made it through, and even learned a few lessons. Mostly, I survived. It started when I met with the mechanic for an engine check. We had been feeling it downshift occasionally. I was fine right up until the checker inner guy asked me what was wrong. All of a sudden, I slumped down and tears sprang to my eyes. The room went blurry. My purse felt like it weighed 90 pounds. After leaning on the counter, I tried to tell him my story. Looking back, I was falling apart with the long term side effects from Hepatitis C.

    Then I went in for my 3 months screening and sure enough, the tumor was back. It’s the same one that I had the Transcatheter Arterial Chemoembolization (TACE) for. It worked and knocked that sucker out for a while. But I understood that it could grow again. They call it a recurrent or residual tumor.
    Read all updates: http://www.ihelpc.com/

    Creating a World Free of Hepatitis C
    Last week, I talked about how to read drug product information (PI). This week I’ll discuss the parts of the PI that I didn’t cover last week in Medication: Reading the Fine Print. This includes the more complicated concepts, which I will try to put in to simpler terms.
    Read all updates: http://www.lucindaporterrn.com/blog/

    Hep B Blog
    Welcome to “Journey to the Cure.” This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.
    Read all updates: http://www.hepb.org/blog/2018/04/

    Confused and trying to understand your hepatitis B blood test results? Check out our easy to use chart. http://www.hepb.org/prevention-and-diagnosis/diagnosis/understanding-your-test-results/

    HIV and ID Observations
    As mentioned last week, I’m currently attending on the general medical service, a chance to brush up on non-ID clinical skills, and more importantly, to work with smart, energetic house staff and medical students.
    Not surprisingly, there’s a wide range of clinical ID on this service, and this year we’ve had a rash of streptococcal infections.
    Read all updates: https://blogs.jwatch.org/hiv-id-observations/

    Al D. Rodriguez Liver Foundation
    Alcohol’s Heart Benefits May Not Apply to People With Liver Disease
    Numerous articles and videos circulated on social media and reputable websites, stating that light to moderate alcohol intake offers cardio-vascular health benefits. But does this apply to everyone? Studies show that it might not be the case for people with liver disease.
    Read all updates: http://www.aldrodriguezliverfoundation.com/homepage-2/

    Harvard Health Blog
    Journal Of Hepatology
    May 2018 Volume 68, Issue 5, Pages 1063–1075
    Fructose and sugar: A major mediator of non-alcoholic fatty liver disease
    Thomas Jensen , Manal F. Abdelmalek, Shelby Sullivan, Kristen J. Nadeau, Melanie Green, Carlos Roncal, Takahiko Nakagawa, Masanari Kuwabara, Yuka Sato, Duk-Hee Kang, Dean R. Tolan, Laura G. Sanchez-Lozada, Hugo R. Rosen, Miguel A. Lanaspa, Anna Mae Diehl, Richard J. JohnsonFull-Text
    View Online
    PDF (952 KB)
    TAKE-HOME MESSAGE
    While we have known for many years that fructose and beverages sweetened with high fructose corn syrup can contribute to nonalcoholic fatty liver disease, this is an excellent review of the literature to date on this topic. In addition, it postulates the potential mechanisms that could be contributing to fructose's contribution to the development of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. It also highlights the factors that can potentiate the effect that fructose has on the liver, including genetic mechanisms, the role of fructokinase, high-fat diets, and alcohol.

    Even one drink a day linked to lower life expectancy
    Even light drinkers who enjoy a single beer or glass of wine every night may still be more likely to die prematurely than people who drink less, a recent study suggests.

    Benzodiazepines: America's 'Other Prescription Drug Problem'
    Public Radio Tulsa
    Drugs like Valium, Xanax and Ativan are more popular than ever. Frequently used to treat anxiety, the medicines can be risky, especially when mixed with alcohol or opioids.

    The BMJ 28 Apr 2018
    From Richard Lehman’s journal review—30 April 2018
    Old surgeons and good outcomes
    Watching snooker on the television is a harmless pastime, though you must be sure to press the mute button. Then you can listen to music, or trawl through lists of references, or have a snooze. Such are the diminishing pleasures of elderly life. Should you happen to watch the game, you will find that younger players tend to become overconfident and take on shots which, when missed, lead to their eventual downfall. Older players simply go for safety, and end up winning. Here is a study which shows that surgeons are the same. “Using national data on Medicare beneficiaries in the US, this study found that patients treated by older surgeons had lower mortality than patients treated by younger surgeons. There was no evidence that operative mortality differed between male and female surgeons.” Strange there are so few female snooker players.

    Dietary interventions may be able to send type 2 diabetes into remission, and intensive lifestyle interventions with some help from modern technology means more patients may now have the support they need to accomplish this.

    On This Blog
    HCV, type 2 diabetes & fatty liver disease - Importance of diet and exercise


    Just So You Know

    Reports that dark chocolate 'improves eyesight' are unconfirmed
    "Dark chocolate improves your eyesight," is the unusual headline from the Mail Online following a small trial comparing the effects of dark and milk chocolate on vision. The theory is that dark chocolate is high in antioxidant flavanols, which are touted as having many potential health benefits, including effects on the nervous system.

    Dark chocolate and health: Fudging the evidence with USA Today
    How does dark chocolate “support” your health? According to USA Today, it can do so because an unpublished pilot study involving just five people–yes, five–showed eating lots of it over a few days “influenced gene activity, increased anti-inflammatory agents and increased infection-fighting cells.” A second pilot study also showed it can “positively impact brain function” on five people, the paper reported.

    Wishing you all a good week ahead, thanks for stopping by.
    Tina

    Thursday, April 19, 2018

    Hepatic Steatosis and its Effects on Fibrosis in Patients With Chronic Hepatitis B Virus Infection

    Clinical Gastroenterology and Hepatology (CGH)
    April 2018 Volume 16, Issue 4, Pages 491–494

    Hepatic Steatosis and its Effects on Fibrosis in Patients With Chronic Hepatitis B Virus Infection
    Mauricio Garcia-Saenz-de-Sicilia, MD, Andres Duarte-Rojo, MD, MS, DSC

    Full-Text
    Read Online
    Download PDF

    Obesity rising prevalence has reawakened interest in the potential interactions between chronic viral hepatitis and hepatic steatosis. The metabolic syndrome and its components are independent risk factors associated with fibrosis progression, development of cirrhosis,1 and potentially with lack of fibrosis reversal following antiviral therapy in chronic viral hepatitis.2 However, the particular role of hepatic steatosis, the hallmark of nonalcoholic fatty liver (NAFLD), has been less of a focus of attention in chronic hepatitis B virus (HBV) infection when compared with chronic hepatitis C, in part because of the lack of proper evaluation tools.3

    Liver biopsy is considered to be the gold standard for steatosis grading. However, it is invasive, has potential life-threatening complications, can result in sampling errors particularly when fatty infiltration is unevenly distributed (typical biopsy represents 1/50,000 of liver), and interpretation reaches only moderate interobserver or intraobserver agreement.4 Furthermore, repeated monitoring following a therapeutic intervention is hard to justify because of the invasive nature of the procedure and cost, and the fact that noninvasive options are now available. Imaging techniques provide reliable noninvasive alternatives to assess steatosis. Proton density fat fraction from magnetic resonance is perhaps the most accurate method for steatosis quantification; however, it is not a point-of-care method, and has associated high costs and limited availability, making it impractical for routine clinical care at most institutions. All of these limitations are at least partially overcome by the controlled attenuated parameter (CAP) feature from FibroScan (Echosens, Paris, France). This technique, based on the principle that fat affects ultrasound propagation, quantifies variations in M-mode (unidimensional) ultrasound attenuation during liver stiffness measurement (LSM) with vibration-controlled transient elastography, to yield a steatosis estimate. When testing CAP against steatosis grading by liver biopsy, fair to excellent performance has been reported across studies, and discrepancies are likely explained by variations in liver disease etiology, population body composition, and spectrum bias (Table 1). Although CAP interpretation has been limited by uncertainty as to the optimal cutoff values between grades of steatosis, Karlas et al5 have recently brought some certainty to this issue. In a meta-analysis including 2735 cases with histology and CAP analysis, the authors defined cutoff values and variables influencing the output, such as body mass index (BMI), diabetes, and etiology.

    Thursday, April 12, 2018

    Liver Congress™ 2018 Personalized T cell therapy shows signs of clinical effectiveness against HBV-related HCC

    Personalized T cell therapy shows signs of clinical effectiveness against HBV-related HCC

    European Association for the Study of the Liver

    April 12, 2018, Paris, France: Multiple adoptive transfers of T cells engineered to carry hepatitis B virus (HBV)-specific T cell receptors (TCRs) has resulted in an objective positive response in a patient with hepatitis B surface antigen (HBsAg)-negative HCC metastases in the lungs following liver transplant. The patient, described today in a presentation at The International Liver Congress™ 2018 in Paris, France, had a volumetric reduction of almost all lung lesions and no new lesions detected in the lung or liver.

    HCC is the most common primary liver cancer and more than 50% of cases around the world are thought to be associated with chronic HBV.1,2 With a poor prognosis and limited therapeutic options, HCC is the second most common cause of cancer mortality worldwide.2,3 Liver transplantation is an option for some patients but HCC recurs in up to 20% of cases,4 with the lungs the most common site of metastases.5,6 Cytotoxic T cells play a key role in killing cancerous and infected cells when TCRs on their surface recognize short epitopes presented on the affected cell's surface and initiate a series of cytotoxic mechanisms. In HBV-related HCC tumours, integrated HBV DNA can result in both oncogenic transformation and expression of HBV epitopes on the cell surface.7

    'We hypothesized that HBV transcriptomic profiles of HCC cells could guide the selection of HBV-specific TCRs to be used in engineering T cells for HCC-targeted immunotherapy.' explained Dr Anthony Tan from the Emerging Infectious Diseases Programme at Duke-NUS Medical School in Singapore, the lead author of the study. 'We first had to test if short, integrated HBV DNA fragments in tumour cells can produce HBV epitopes recognized by cytotoxic T cells'.

    Characterization of the expression of short, specific regions of integrated HBV DNA in natural HBV-related HCC lines negative for serological markers of HBV infection identified HBV epitopes that were functionally presented on the cell surface. These HCC cells could be lysed in vitro by T cells engineered to express TCRs specific for the epitopes that had been identified. A similar analysis was able to identify a region of HBV envelope encoded by integrated HBV DNA fragments derived from the primary HCC of a liver transplant patient with HBsAg-negative HCC metastases in the lungs. The TCR specific for this HBV envelope region was introduced into T cells using mRNA electroporation. Multiple adoptive transfers of the resulting HBV-specific TCR T cells into the patient were performed over a period of 6 months.

    No therapy-related adverse events were observed, and computed tomography imaging performed before and during therapy showed an objective positive response with a volumetric reduction of nearly all lung lesions detected, with no new lesions detected in the lung or liver to date. As of January 2018, the tumour lesions in the lung remain stable.

    'The use of mRNA electroporation for exogenous TCR expression reduces the potential toxicity of this approach compared with previous techniques using viral vectors,' said Dr Tan. 'Further development of this new immunotherapeutic strategy may offer new hope of a cure for HCC'.

    'This study further explores the potentially beneficial role of immunotherapy in the management of advanced HCC', said Prof. Alejandro Forner from the Hospital Clinic Barcelona, Spain, and EASL Governing Board Member. 'With this interesting approach, the authors have been able to develop a personalized T cell adoptive immunotherapy for patients with HBV-related HCC with promising signs of clinical effectiveness. Further studies will be needed to confirm that this strategy is a viable option for patients'.

    References
    1. European Association for the Study of the Liver; European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908-43.
    2. Ghouri YA, et al. Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis. J Carcinog. 2017;16:1.
    3. International Agency for Research on Cancer (IARC). GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide. Available from: http://globocan.iarc.fr/old/FactSheets/cancers/liver-new.asp. Last accessed: February 2018.
    4. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Liver transplantation. J Hepatol. 2016;64(2):433-85.
    5. Xiang ZW, et al. Progress in the treatment of pulmonary metastases after liver transplantation for hepatocellular carcinoma. World J Hepatol. 2015;7:2309-14.
    6. Becker AK, et al. Extrahepatic Metastases of Hepatocellular Carcinoma: A Spectrum of Imaging Findings. Canadian Association of Radiologists Journal. 2014;65:60-66.
    7. Koh S, et al. Targeted therapy of hepatitis B virus-related hepatocellular carcinoma: present and future. Diseases. 2016;4(1):10.

    For Patients: The International Liver Congress 2018

    International Liver Congress

    April 11, 2018 - April 15, 2018
    Paris, France
    Congress Website

    Whether your liver is infected with a virus, injured by alcohol, or you have the most common liver disease in the United States - non-alcoholic fatty liver disease (NAFLD) - you need accurate information to make an intelligent decision about both treatment and care. From April 11-15, the 53rd annual meeting of the European Association for the Study of the Liver (EASL) will present key developments in the world of hepatology.

    Viral Hepatitis & Fatty Liver Disease
    Viral hepatitis highlights include; current and emerging treatments for hepatitis B virus (HBV), current data on effective drugs to treat hepatitis C virus (HCV), with research into the importance of early HCV treatment, follow up care, testing and linkage to care. As well as current research on liver cancer, alcoholic liver disease, fatty liver disease (information on screening, noninvasive tests, follow-up care, diet, and new drugs on the horizon), fibrosis, cirrhosis and liver transplantation.

    Practice Guidelines
    The European Association for the Study of the Liver (EASL) will also release four major clinical practice guidelines; hepatocellular carcinoma, decompensated cirrhosis, alcoholic liver diseases and updated recommendations on hepatitis C, view the guidelines below.

    Download: Recommendations on Treatment of Hepatitis C 2018
    April 11, 2018
    EASL just released Updated EASL Recommendations on Treatment of Hepatitis C 2018.
    *Shared by @HenryEChang via Twitter.

    You can view the following guidelines online in the Journal of Hepatology;
    EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

    Overview: EASL updates liver cancer guidelines at International Liver Congress
    April 13. 2018
    Liz Highleyman
    The European Association for the Study of the Liver (EASL) presented updated clinical practice guidelines for the management of hepatocellular carcinoma (HCC) during a special session at the 2018 International Liver Congress yesterday ...


    EASL Clinical Practice Guidelines on hepatitis E virus infection

    Practice Guidelines - Download Slide Decks

    Clinical Care Options
    April 27, 2018
    Practice-Changing Data From EASL 2018
    Listen to downloadable audio from a live Webinar in which Stefan Zeuzem, MD, assessed the clinical impact of new data reported at the Paris meeting and answered case questions from participants.
    Free Registration Required 

    Conference News
    April 28, 2018
    On This Blog
    Updates before, during and after the meeting.

    Hepatitis C Treatment
    May 17, 2018
    HCV Next, May/June 2018
    Nancy S. Reau, MD
    As we in the United States look ahead to Digestive Disease Week coming up and further to our fall meetings, the International Liver Congress gives us an opportunity to…

    May 4, 2018
    Available online @ NATAP
    Summary from EASL 2018 for Hepatitis C (HCV)
    HCV in 2018: Success stories and remaining challenges?
    With the more recent introduction of the pangenotypic regimens sofosbuvir/velpatasvir and glecaprevir/pibrentasvir, two new fix dose combinations have become available which may even overcome the need for baseline HCV genotype assessment. Larger data sets however, from real-life cohorts still are missing but this gap has been filled at this year EASL.

    May 1, 2018
    Download HCV Advocates' May Newsletter
    In this edition of the HCV Advocate we have devoted nearly the entire issue to the 2018 International Liver Congress. Lucinda Porter, RN and I cover some of our favorite posters and presentations in the current issue and in the upcoming June 2018 issue...

    April 28, 2018
    April "infohep bulletin" - Overview of EASL's 2018 International Liver Congress
    Patients looking for an overview of EASL's 2018 International Liver Congress can find it in this month's "infohep bulletin".

    International Liver Congress Sees Shift in Liver Diseases
    I’ve been covering this conference since 2012, at the dawn of the era of direct-acting antivirals for hepatitis C. For about five years a large proportion of content—and the lion’s share of excitement—at this meeting was devoted to these new therapies.

    April 21, 2018
    Slides @ NATAP


    Liver Fibrosis


    Mavyret (glecaprevir/pibrentasvir)
    The results of the first real-world studies assessing the effectiveness and safety of glecaprevir/pibrentasvir (G/P) in patients with chronic hepatitis C virus (HCV) infection have confirmed high rates of viral suppression and a favourable safety profile in patients receiving 8-16 weeks of treatment.

    Commentary - Real-world experience confirms Mavyret efficacy in HCV
    Two real-world studies presented at the International Liver Congress 2018 confirmed the efficacy and safety of Mavyret in Italy and Germany even in the face of multiple comorbidities.

    Slides - Real-life effectiveness & safety of G/P among 723 Italian patients with chronic HCV: interim analysis of data from the NAVIGATOR-II study


    NATAP Slides - FIRST REAL-WORLD DATA ON SAFETY AND EFFECTIVENESS OF GLECAPREVIR/PIBRENTASVIR FOR THE TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION: DATA FROM THE GERMAN HEPATITIS C-REGISTRY - (04/13/18)

    Integrated Efficacy and Safety of Glecaprevir/Pibrentasvir in Patients With Psychiatric Disorders - (04/13/18)



    RETREATMENT OF HEPATITIS C VIRUS INFECTION IN PATIENTS WHO FAILED GLECAPREVIR/PIBRENTASVIR - (04/12/18)

    Time to Viral Suppression Does not Impact SVR in Patients Treated With Glecaprevir/Pibrentasvir for 8 Weeks - (04/23/18)

    Clinical Care Options CCO - Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.

    Zepatier (elbasvir/grazoprevir)
    Commentary - Zepatier Yields High Hepatitis C Cure Rates in U.S. Veterans
    April 13, 2018
    Cure rates were near 100 percent even though the population in the study’s analysis had high rates of other health conditions.




    Effectiveness of Elbasvir/Grazoprevir in Patients with Cirrhotic Genotype 1 or 4 Chronic Hepatitis C: Updated Retrospective Data Analyses from the TRIO Network - (04/13/18)

    Clinical Care Options CCO - Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.
    Second Interim Analysis of STREAGER: High Rate of SVR With 8 Weeks of Elbasvir/Grazoprevir in Treatment-Naive Patients With Nonsevere Fibrosis and Genotype 1b HCV Infection
    Summary of Key Conclusions
    In analysis of first 90 patients enrolled on a single-arm, open-label trial of treatment-naive patients with nonsevere fibrosis and genotype 1b HCV infection, 8 weeks of elbasvir/grazoprevir associated with sustained virologic response rate at 12 weeks post treatment (SVR12) of 97%
    No grade 3/4 adverse events observed
    Relapse observed in 4 patients (1 patient relapsed after achieving SVR12), including 1 patient with genotype 1e HCV infection wrongfully included in study

    Harvoni (ledipasvir/sofosbuvir)
    Slides @ NATAP
    An eight-week course of sofosbuvir/velpatasvir (Epclusa) cured almost all people with hepatitis C genotype 3 without cirrhosis receiving treatment alongside opioid substitution therapy through community pharmacies or prisons in the Greater Glasgow area, Alison Boyle of Gartnavel Hospital, Glasgow, reported at the 2018 International Liver Congress in Paris on Thursday. Genotype 3 is especially common in people who inject drugs and former drug users. It has been considered 'harder to cure' although recent studies of newer agents in people with genotype 3 have shown high cure rates.

    Clinical Care Options CCOReview Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis.
    High SVR12 Rate With 8 Weeks of Sofosbuvir/Velpatasvir in Real-World Retrospective Analysis of Treatment-Naive Patients With Genotype 3 HCV and Fibrosis
    Main Findings
    In ITT population, 93% (84/90) of noncirrhotic, treatment-naive patients with genotype 3 HCV infection achieved SVR12 following 8 weeks of sofosbuvir/velpatasvir
    Lost to follow-up: n = 2
    Premature discontinuation: n = 2
    Death: n = 1
    Reinfection without subsequent spontaneous clearance: n = 1
    In mITT population, 100% of patients achieved SVR12
    High rates of SVR12 observed across selected subgroups
    Subgroup, n/N (%)
    SVR
    ITT Population
    mITT Population
    F3 fibrosis
    23/28 (82.1)
    23/23 (100)*†‡§
    HCV RNA > 6,000,000 IU/mL
    5/6 (83.3)
    5/5 (100)
    HIV coinfected
    2/3 (66.6)
    2/2 (100)
    Quantifiable HCV RNA at end of treatment
    7/7 (100)
    7/7 (100)
    Daily supervised methadone
    35/38 (92.1)
    35/35 (100)†‡
    IVDU
    8/8 (100)
    8/8 (100)
    Non-IVDU
    14/15 (93.3)
    14/14 (100)
    Positive screen for drugs of abuse
    4/4 (100)
    4/4 (100)

    Clinical Care Options CCO
    Addition of RBV Associated With Increased Efficacy of 12 Weeks Sofosbuvir/Velpatasvir in Patients With Genotype 3 HCV Infection and Compensated Cirrhosis
    Summary of Key Conclusions
    In NS5A-naive patients with genotype 3 HCV infection and compensated cirrhosis, sustained virologic response at 12 weeks posttreatment (SVR12) rate numerically higher in those receiving sofosbuvir (SOF)/velpatasvir (VEL) with ribavirin (RBV) vs SOF/VEL alone
    SVR12 rate 96% vs 91%, respectively
    Fewer relapses observed with use of RBV
    In both treatment arms, NS5A resistance associated substitutions (RAS) at baseline associated with reduced SVR12 rate, particularly Y93H
    Treatment well tolerated
    Few grade 3/4 adverse events (AEs), serious AEs, discontinuations for AEs in both treatment arms
    Use of RBV associated with increased toxicities


    Safety and Efficacy of Sofosbuvir/Velpatasvir with and without Ribavirin in Genotype 3 HCV-Infected Patients with Cirrhosis - (04/13/18)

    Vosevi (Sofosbuvir/Velpatasvir/Voxilaprevir) 
    Clinical and virological characteristics of DAA-experienced patients with chronic HCV infection treated with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX): results from the Frankfurt Resistance Database - (04/20/18)

    Ravidasvir combined with sofosbuvir
    Video Healio:
    $300 HCV combination reaches 97% cure rates in Malaysia, Thailand
    April 13, 2018
    PARIS — Using a new medication and generic sofosbuvir, researchers reached 97% sustained virologic response in patients with hepatitis C both with and without…

    Commentary - New affordable hepatitis C combination shows 97% cure rate
    April 12, 2018
    The combination of sofosbuvir and the new NS5A inhibitor ravidasvir cured 97% of people with hepatitis C in a study carried out in Malaysia, and could provide a safe and effective cure for hepatitis C in low- and middle-income countries for $300 or less, researchers of the Drugs for Neglected Diseases Initiative reported on the opening day of the 2018 International Liver Congress in Paris.

    April 12, 2018
    New affordable hepatitis C combination treatment shows 97% cure rate
    An affordable hepatitis C combination treatment including the new drug candidate ravidasvir has been shown to be safe and effective, with extremely high cure rates for patients, including hard-to-treat cases, according to interim results from the Phase II/III STORM-C-1 trial presented by the non-profit research and development organisation Drugs for Neglected Diseases initiative (DNDi) at the International Liver Conference in Paris.

    Commentary - The Latest Hepatitis C News From the 2018 International Liver Congress
    April 13, 2018
    By Lucinda K. Porter, RN
    The 2018 International Liver Congress (ILC) began yesterday in Paris. This annual meeting is hosted by the European Association for the Study of the Liver (EASL). It is an important event for liver specialists, and people gather from all over the world to share their latest findings. In the next week, I’ll post more frequently with highlights from some posters and presentations. (Note: Conference presentations represent part of the story and unless and until these studies are published in a peer-reviewed journal, these data and conclusions are considered preliminary.)

    Treat Early
    (at earlier stages of fibrosis)
    EASL Press Release - Liver Congress™ 2018 Scotland: Direct-acting antiviral agent therapy reduces the burden of HCV-related decompensated cirrhosis
    April 12, 2018
    Two presentations given this week at The International Liver Congress™ 2018 in Paris, France illustrate the impact that DAAs can have in averting HCV-related liver disease, and reducing the clinical and economic burden of this chronic infection.

    Slides @ NATAP
    EASL: Early versus Delayed Hepatitis C Treatment Provides Increased Health Benefits at Lower Costs: A Pan-Genotypic Cost-Effectiveness Analysis Set in Scotland -

    The early treatment of hepatitis C infection with a pan-genotypic drug combination is more effective and less expensive than if therapy is delayed until liver fibrosis develops, health economists report. A health state-transition model of the natural history of hepatitis C shows that early therapy with the combination of glecaprevir and pibrentasvir (Mavyret, AbbVie) results in lower lifetime costs because of reductions in the risk for decompensated cirrhosis, hepatocellular carcinoma, liver transplantation, and liver-related mortality, said researcher Scott Johnson, PhD, from Medicus Economics in Boston.

    Commentary - Early-stage HCV treatment saves money, improves QOL
    April 12, 2018
    Treating hepatitis C virus in the early stage of disease saves money in drug and medical costs while lowering risk for decompensated cirrhosis, hepatocellular carcinoma, liver transplant and liver-related death.

    Commentary - Earlier HCV Tx May Lower Complication Rate, Save Money
    April 12, 2018
    PARIS -- Treating patients with hepatitis C virus (HCV) at earlier stages of fibrosis may be reduce both complications and cost, a commercially sponsored modeling study showed here. There was a lower risk of decompensated cirrhosis, hepatocellular carcinoma, liver transplant, and liver-related death among patients who started treatment at the mild, F0-F1 stage compared to those who started treatment at advanced/compensated cirrhosis (F4/CC).

    Cirrhosis
    NATAP Slides

    Commentary - DAA therapy effective in patients with HCV and advanced cirrhosis
    April 16, 2018
    PARIS — Direct-acting antiviral therapy effectively treated hepatitis C virus in patients with high MELD scores, producing a high rate of…
    Slides @ NATAP - Direct Acting Antiviral HCV Therapy is Safe and Effective in Patients with Decompensated Cirrhosis: Real World Experience from the HCV-TARGET Cohort - (04/12/18)

    EASL Press Release - Liver Congress™ 2018 - Mediterranean-style diet improves gut microbial diversity reduces hospitalization in liver cirrhosis
    April 12, 2018
    'Our hypothesis for this study was that diet and the severity of cirrhosis might interact to determine microbiota composition and, ultimately, clinical outcomes in patients with liver cirrhosis'.

    Press Release - Liver Congress™ 2018 A third of bacterial infections in patients with cirrhosis across the world are multi-drug resistant 
    April 12, 2018
    'The finding that over one in three of bacterial infections occurring in hospitalized patients with cirrhosis are induced by multidrug resistance microorganisms is very worrisome', said Prof. Annalisa Berzigotti from the University of Bern, Switzerland, and EASL Governing Board Member.

    Commentary - 'Alarming' New Numbers on Bacterial Infection in Cirrhosis
    April 12, 2018
    PARIS — Infections caused by multidrug-resistant bacteria, which are common in patients with cirrhosis, are associated with a significant elevation in risk for in-hospital mortality, results from a global study show.

    Liver Transplant
    April 15. 2018
    Therapies also appear to reduce liver-related mortality
    Since use of direct acting antiviral combination therapies for hepatitis C virus (HCV) infection became widespread, the need for liver transplantation for patients with the infection has plummeted, researchers reported here.

    Scale-up of HCV diagnosis and treatment
    EASL Press Release - Linkage to care specialist facilitates access to HCV treatment for people who inject drugs
    April 12, 2018
    'Based on our analysis', said Sarah Robbins from the Polaris Observatory, 'we predict that given the current standard of care for the next 15 years, the total HCV-infected population in Europe would increase by an estimated 1% by 2030 and that, in order to meet WHO goals, the number of individuals diagnosed annually would need to increase to at least 800,000 by 2022, with 900,000 being treated each year by 2025. Improving linkage to care coupled with increased access to DAA therapy is needed to achieve such goals'.


    Liver Cancer
    Liver-related & HCC events were rare after up to 144 weeks of follow-up in patients with F2-F3 fibrosis who had achieved SVR with DAA therapy: Results from the Gilead Sciences SVR Registry


    Slides @ NATAP
    Commentary - EASL updates liver cancer guidelines at International Liver Congress
    Liz Highleyman
    The European Association for the Study of the Liver (EASL) presented updated clinical practice guidelines for the management of hepatocellular carcinoma (HCC) during a special session at the 2018 International Liver Congress yesterday ...

    April 12, 2018
    'HCC surveillance in HCV patients after sustained virological response is a matter of debate', said Prof. Markus Cornberg from the Hannover Medical School, Germany, and EASL Governing Board Member. 'This study is important because it emphasizes the importance of HCC surveillance by ultrasound in patients with cirrhosis, even if HCV has been eliminated. However, the study also challenges the need for surveillance in patients with advanced fibrosis but without cirrhosis'.

    Video Healio:
    April 13, 2018
    “Long-term follow-up studies and data will be required to identify those who are at risk for tumor development and also to better tailor surveillance guidelines,” Zangneh concluded. – by Talitha Bennett
    April 12, 2018
    Celsion’s Phase III OPTIMA Study is expected to enroll up to 550 patients in up to 70 clinical sites in the United States, Europe, China and Asia Pacific, and will evaluate ThermoDox® in combination with optimized RFA, which will be standardized to a minimum of 45 minutes across all investigators and clinical sites for treating lesions three to seven centimeters, versus optimized RFA alone.

    WHO’s 2030 hepatitis C elimination goals
    April 12, 2018
    New research presented at this year’s International Liver Congress in Paris, France (11-15 April) shows that while several European countries are now on target to meet WHO’s 2030 hepatitis C elimination goals, many others are off track and problems screening and diagnosing enough patients threaten the progress of all countries.

    Hepatitis B
    Press Release - Assembly Biosciences Presents Positive Interim Data from Phase 1a and 1b Studies of ABI-H0731 in HBV Patients in a Late-Breaker Session at the EASL Conference
    April 12, 2018
    The Phase 1b patient study enrolled both HBeAg positive and negative patients. Potent antiviral activity was observed across patient cohorts in a dose dependent manner. Specifically, in the ongoing 300 mg dose cohort, the mean overall decline from baseline is currently ≥2.8 log10 IU/mL, with ≥2.9 and 2.5 log10 IU/mL mean declines in HBeAg positive and negative patients, respectively. Maximal viral load declines of 3.6 to 4.0 log10 IU/mL were observed in certain HBeAg negative patients treated at all dose levels (100 to 400 mg). The company intends to report complete results from this study at a scientific conference later this year.

    Slides @ NATAP

    View all HBV coverage at NATAP

    Fatty Liver Disease: NAFLD/NASH




    April 13, 2018
    'We demonstrated that German patients with NAFLD/NASH who develop compensated cirrhosis have a substantial burden of comorbidities and that their healthcare costs jump with the development of cirrhosis', said Dr Canbay. 'Novel treatment options are needed to improve patient outcomes'. 'This study highlights the burden of NASH cirrhosis on healthcare systems and reinforces the need for new therapies to tackle the epidemic currently affecting many European countries', said Prof. Phil Newsome from the Queen Elizabeth Hospital and University of Birmingham, UK, and EASL Governing Board Member.

    Press Release - Gilead Presents Data on Multiple Investigational Regimens for the Treatment of Patients With Nonalcoholic Steatohepatitis (NASH) and Advanced Fibrosis at The International Liver CongressTM 2018
    Gilead Presents Data on Multiple Investigational Regimens for the Treatment of Patients With Nonalcoholic Steatohepatitis (NASH) and Advanced Fibrosis at The International Liver CongressTM 2018

    Commentary - Low food security increases risk for advanced fibrosis
    Food insecurity an increased risk for advanced fibrosis, particularly among patients with diabetes, according to a presentation at the International Liver Congress 2018. According to a presentation by Russell Rosenblatt, MD, from the New York Presbyterian Hospital, food insecurity is the state of being without reliable access to a sufficient quantity of affordable, nutritious food, often in the form of low-cost, energy-dense, nutritionally poor foods. “Food insecurity’s risk for diabetes doesn’t stop there,” Rosenblatt said. “We know that diabetes increases the risk for NAFLD, and diabetes is also an increased risk factor for advanced fibrosis.”

    April 13, 2108
    Deep-learning approaches to pattern recognition in liver biopsy samples have moved one step closer to clinical application, with a new study reporting a good correlation between an automated image analysis system and an expert reviewer for the identification of key markers of disease activity in a pre-clinical model of non-alcoholic steatohepatitis (NASH).

    April 13, 2018
    presented the positive results from the interim analysis of the Phase 2 clinical trial of MN-001 (tipelukast) in NASH (non-alcoholic steatohepatitis) and NAFLD (non-alcoholic fatty liver disease) with hypertriglyceridemia

    April 12. 2018
    The research demonstrated that adding fructose (sugar) and fatty acids to three-dimensional bioprinted human liver tissue produced NASH-type liver pathology, including steatosis, inflammation, ballooning and fibrosis. Addition of MSDC-0602K to the tissue showed evidence of reduced disease progression, including reductions in collagen deposition and stellate cell activation, in the liver model.

    Commentary - Cenicriviroc shows safe long-term antifibrotic activity in adults with NASH
    April 12, 2018
    PARIS — Cenicriviroc, an oral C-C chemokine receptor type 2 and type 5 antagonist also known as CVC, was well-tolerated and provided…

    April 11, 2018
    Two independent studies have today reported that alcoholic liver disease has now replaced hepatitis C virus (HCV) infection as the leading cause of liver transplantation in the USA in patients without HCC. Non-alcoholic steatohepatitis (NASH) is also on the increase, now ranking second as a cause of liver transplantation due to chronic liver disease.

    Primary sclerosing cholangitis
    April 13, 2018
    'Studies like this one are key, since they investigate possible novel treatments for PSC, a disease that currently has no effective therapies', said Prof. Marco Marzioni from the University Hospital of Ancona, Italy, and EASL Governing Board Member. 'Although this trial did not achieve fully positive results in terms of reduction of markers of disease progression, it certainly indicates that the manipulation of key molecules involved in the pathophysiology of PSC is the route to cure for our patients'.

    April 12, 2018
    PARIS — Patients with primary sclerosing cholangitis who took statins – likely for another indication – showed reduced risk for transplant and morbidity, according to a presenter at the International Liver Congress 2018. - View Press Release

    April 10, 2018
    Animated short created to raise public awareness about liver failure European Association for the Study of the Liver
    The ad highlights the innovative DIALIVE technology, a novel 'liver dialysis device' which after 25 years of research is undergoing two clinical trials which will assess its safety and efficacy. View the ad, here..... Press release, here....

    Healio live from EASL’s 2018 International Liver Congress
    Guidelines, Expanded Opportunities Mark EASL's Liver Congress
    Liver Cancer on the Rise in Backdrop of Undiagnosed Hep C

    Conference Coverage

    Websites
    Link: Practice Point 
    Independent Conference Coverage from the 53rd Annual Congress of the European Association for the Study of the Liver (EASL)*
    In this video series, Dr. Brown will present ‘what you need to know in 5‐minutes’ regarding today's presentations from The International Liver Congress EASL 2018 in Paris, France. These educational Clinical Clips will spotlight the latest advances in the prevention and treatment of hepatitis C through a series of daily, ‘what you need to know in 5-minutes’ videos each day from the conference.
    Free registration required

    To learn more, or view highlights see: Liver Congress 2018 - ‘what you need to know in 5-minutes’ video clips each day from the conference

    EASL LiverTree - Open To All
    This year webcasts and congress materials are open access! Watch freely the conferences and ePosters
    *Free registration required

    Link: NATAP
    The National AIDS Treatment Advocacy Project - NATAP
    Slide decks, press updates, commentary, and full-text articles
    About NATAP

    Link: Healio
    Coverage of the meeting will include, videos, perspectives and interviews with leading researchers and clinicians.
    About Healio

    Link: infohep
    Patient-friendly coverage

    News, with patient-friendly commentary
    About NAM

    Link: MedPage Today
    Commentary and news updates

    Link: Medscape 
    Read clinically focused news coverage of key developments from ILC 2018.
    *Free registration may be required
    About Medscape

    Link: Clinical Care Options CCO
    Review Capsules Summaries, download slides, and listen to audio commentary from expert-led Webinars covering critical studies on viral hepatitis and NAFLD/NASH from Paris.About CCO

    Link: Liz Highleyman @ Cancer Health

    Newsletters
    Link: HCV Advocate
    Download HCV Advocate's - May Newsletter
    In this edition of the HCV Advocate we have devoted nearly the entire issue to the 2018 International Liver Congress. Lucinda Porter, RN and I cover some of our favorite posters and presentations in the current issue and in the upcoming June 2018 issue...

    Blogs
    HCV Advocate Greg Jefferys blogs from the conference.
    Inside the convention hall were display stands for Zepatier, Mavyret and Epclusa and many other products related to treating liver diseases. The three DAA stands were by far the biggest but Gilead easily won the “Biggest and Most Number of display stands” award with three huge and separate stands.

    Follow On Twitter
    @EASLnews
    @HenryEChang 
    @JMPawlotsky 
    @DonaldJensenMD
    Liz Highleyman‏ @LizCancerHealth
    @Homie_Razavi
    @rixwolff
    @JVLazarus
    @HepatitisEurope

    Abstract Book
    Start by reviewing the first abstracts of the meeting, and embargo policy, available online and shared via Twitter by Henry E. Chang.
    Download Here: https://jumpshare.com/v/rz9OhagvCF0FEPy7zwHQ

    HEPAHEALTH Project Report
    EASL report on the burden of liver disease across Europe
    April 12, 2017
    Link: Watch - Liver Congress™ 2018 - First Press Conference HEPAHEALTH Project Report
    The European region is the highest consumer of alcoholic beverages in the world and efforts to reduce alcohol consumption are stalling in many countries. Likewise, rates of obesity have risen across almost every country the report surveyed since 2013 and the rates of Non-Alcoholic Fatty Liver Disease (NAFLD) are increasing accordingly. In Southern and Eastern Europe viral hepatitis is the leading cause of liver disease mortality.
    Twitter #Hepahealth

    Watch - Daily Press Conference

    *Page updated May 5, 2018