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

Monday, March 4, 2019

Hepatitis B and C among diabetes mellitus type 2 individuals

Prevalence of hepatitis B and hepatitis C among diabetes mellitus type 2 individuals 
Livia Melo Villar , Bruno Geloneze , Ana Carolina Junqueira Vasques , Maria Lucia Elias Pires , Juliana Custódio Miguel , Elisangela Ferreira da Silva , Vanessa Alves Marques , Leticia de Paula Scalioni , Elisabeth Lampe

Published: February 28, 2019
https://doi.org/10.1371/journal.pone.0211193

Abstract
Diabetes mellitus type 2 (DM2) patients have higher risk to be infected with parenterally transmitted viruses, like hepatitis B or C virus. This study aims to determine HBV and HCV infection prevalence in DM2 patients from Northeast and Southeast Brazil. A total of 537 DM2 patients were included, 194 (36.12%) males and 343 (63.87%) females, with mean age of 57.13±11.49 years. HBV and HCV markers were determined using serological and molecular analysis, and risk factors were evaluated in a subgroup from Southeast (n = 84). Two HBV acute (HBsAg+/anti-HBc -) and one HBV chronic case (HBsAg+/anti-HBc+) were found. Six individuals (1.1%) were isolated anti-HBc, 37 (6.9%) had HBV infection resolved (anti-HBc+/anti-HBs+), 40 (7.4%) were considered HBV vaccinated (anti-HBc-/anti-HBs+). Thirteen patients (2.42%) had anti-HCV and 7 of them were HCV RNA+. In the subgroup, anti-HBc positivity was associated to age and anti-HCV positivity was associated to age, time of diabetes diagnosis, total bilirubin, indirect bilirubin, alkaline phosphatase at bivariate analysis, but none of them was statistically significant at multivariate analysis.

As conclusion, low prevalence of HBV and high prevalence HCV was found in DM2 patients.

Full-text available online:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211193

Saturday, February 23, 2019

Real impact of liver cirrhosis on the development of hepatocellular carcinoma in various liver diseases—meta‐analytic assessment

Cancer Med. 2019 Feb 21. doi: 10.1002/cam4.1998. [Epub ahead of print]
Real impact of liver cirrhosis on the development of hepatocellular carcinoma in various liver diseases-meta-analytic assessment.
Tarao K1, Nozaki A2, Ikeda T3, Sato A4, Komatsu H5, Komatsu T6, Taguri M7, Tanaka K8.

Abstract BACKGROUND:
It is well known that the incidence of developing hepatocelluler carcinoma (HCC) is increased in liver cirrhosis of different etiologies. However, comparison of HCC incidence in various liver diseases has not yet been estimated. We surveyed this comparison.

METHODS: The PubMed database was examined (1989-2017) for studies published in English language regarding the prospective follow-up results for the development of HCC in various liver diseases. A meta-analysis was performed for each liver disease.

RESULTS: The annual incidence (%) of HCC in the non-cirrhotic stage and cirrhotic stage, and the ratio of HCC incidence in the cirrhotic stage/non-cirrhotic stage were as follows. (a) hepatitis B virus liver disease: 0.37%→3.23% (8.73-fold), (b) hepatitis C virus liver diseases: 0.68%→4.81% (7.07-fold), (c) primary biliary cholangitis (0.26%→1.79%, 6.88-fold), (d) autoimmune hepatitis (0.19%→0.53%, 2.79-fold), and (e) NASH (0.03%→1.35%, 45.00-fold). Regarding primary hemochromatosis and alcoholic liver diseases, only follow-up studies in the cirrhotic stage were presented, 1.20% and 2.06%, respectively.

CONCLUSIONS: When the liver diseases advance to cirrhosis, the incidence of HCC is markedly increased. The development of HCC must be closely monitored by ultrasonography, magnetic resonance imaging, and computed tomography, irrespective of the different kinds of liver diseases.

DISCUSSION
--Download Full-text--
It is known that cirrhosis is present in 80~90% of HCC patients with any underlying liver disease,119 and it is the most important risk factor for HCC. However, comparison of the incidence of HCC in various liver diseases was not accurately and precisely evaluated in previous studies. In this study, we found that the incidence of HCC is highest in HCV LC (4.81%/year) and second highest in HBV LC (3.23%), followed by alcoholic LC (2.06%), PBC LC (1.79%), NASH LC (1.35%), primary hemochromatosis (1.20%), and AIH (0.53%).
        
The incidence of HCC has been wildly studied in patients with HBV LC and HCV LC, and was reported to be 3% and 5%,29, 120 which was almost the same as that in our study.

In this study, we also demonstrated that the incidence of HCC is markedly increased (2.79‐ to 45.00‐fold) in the cirrhotic state compared with non‐cirrhotic state, irrespective of the etiology of liver disease. Why this increase in HCC development occurs in the cirrhotic state must be considered.

First, chronic inflammation may be a key mechanism for HCC development in the cirrhotic state. In this respect, we made clinical observation in the HCV LC patients (Child A) in the past. The LC patients were divided into three groups: Group A: 28 patients whose annual average serum alanine aminotransferase (ALT) level was persistently high (≧80 IU; high‐ALT group); Group B: 28 patients whose annual average serum ALT levels was persistently low (<80 IU; low‐ALT group), and Group C: 13 unclassified patients. The patients had been followed up prospectively. The 5‐year incidence rate of HCC in the high‐ALT group was as high as 53.6% compared with only 7.1% in the low‐ALT group (P < 0.001).120 Thus, this clinical observation demonstrated the importance of chronic inflammation in the development of HCC in HCV LC.
        
The same tendency was demonstrated in HBV LC. Chen et al121 reported that high serum levels of HBV DNA and ALT were independent risk factors for HCC development in HBV infection. Ishikawa et al20 also reported that serum aminotransferase are one of predictive factor for the development of HCC. One important mechanism for high incidence of HCC in HCV LC and HBV LC as compared with the incidence of HCC in LC caused by other etiologies may be the sustained high‐grade inflammation.
        
Furthermore, in autoimmune hepatitis, persistent elevation of serum aminotransaminase was reported to lead to the development of HCC.78 This suggests a role for inflammation in the development of HCC, but this hypothesis has not been confirmed solidly.
         
Second, increases in DNA synthesis in the hepatocytes of cirrhotic patients is suspected as a possible mechanism of HCC development. In our previous study, we demonstrated that in the high DNA synthetic group [BrdU (thymidine analog) labeling index ≧1.5%] 64.3% of patients developed HCC in 5 years, in contrast to 14.3% in the low DNA synthesis (Brd U LI <1.5%) group in HCV LC patients (P < 0.05).122 We further demonstrated that in HCV‐associated cirrhosis patients who showed nodular formation on ultrasound, the cell cycle of hepatocytes was markedly accelerated, as estimated by the bromodeoxyuridine (thymidine analog) uptake into hepatocytes in vitro, and the incidence of HCC was greatly increased.123

Third, accumulated genomic change was also important factor for HCC development. In this respect, Hiatt et al124 reported that C282Y mutation itself may increase the risk of HCC development in hereditary hemochromatosis. In addition, in alcoholic LC, the genetic effect of long‐term alcoholic intake may influence the development of HCC.125

Fourth, obesity, and diabetes are suspected to increase the incidence of developing HCC. In a large epidemiologic study, patients with BMI >35 had an increased risk of cancer, especially HCC, with hazard ratio (HR) of 4.52.126 In addition, diabetes is associated with HCC occurrence, with a HR of 2.39 in a US cohort.127 It is generally accepted that NASH is associated with obesity and diabetes in high percentages.

Notably, in 2014, Flemming et al128 predicted the risk of HCC in patients with cirrhosis, using the ADRESS‐HCC risk model. They examined the l‐year probability of HCC in various liver diseases in 34 932 patients in the national transplantation waitlist database. HCC developed in 1960 patients (5.6%) during a median follow‐up of 1.3 years. Six baseline clinical variables including age, diabetes, race, etiology of cirrhosis, sex, and severity (ADRESS) of liver dysfunction were independently associated with HCC. They settled ADRESS‐HCC risk model from these data and the risk model well‐coincided with the clinical observation. They concluded that the risk model was clinically useful tool for predicting the risk of HCC in patients with diverse etiologies.

In addition, the aging of the patients must be taken into the consideration, as the cirrhotic patients were considered to be older than the non‐cirrhotic patients in almost all liver diseases. In this regard, Asahina et al129 investigated the difference of HCC incidence in aging in HCV‐associated liver disease, and found that the incidence of HCC was higher in the older patients (>65 years old) than the younger patients (<65 years old). The same tendency was observed by Taura et al130 However, the difference in incidence was approximately twofold. So, it is difficult to explain the marked difference in HCC incidence between the cirrhotic state and non‐cirrhotic state found in this meta‐analysis. Regarding other liver diseases, there were very few reports which demonstrated a difference between patients in the non‐cirrhotic and cirrhotic states concerning age.

The next consideration is the prevention of patients not to become cirrhosis state. We demonstrated that the incidence of HCC in the cirrhotic state and that in the non‐cirrhotic state were markedly different in many liver diseases; therefore, efforts to prevent patients with liver diseases from progressing to the cirrhotic state by all means is very important.

In HBV infection, the effort to diminish HBV‐DNA by pegylated interferon (Peg IFN)19 or oral antiviral agents, such as entecavir (ETV), tenofovir, and tenofovir anafenamide, is important. Indeed, ETV and tenofovir were reported to prevent the occurrence of HCC.131, 132In HCV infection, Peg IFN plus ribavirin or direct‐acting antivirals (DAAs) are effective to eliminate HCV, and may be prevent the progression of the disease, resulting in prevention of HCC development.

In primary biliary cholangitis, administration of ursodeoxycholic acid is important. Indeed, the risk of HCC in UDCA‐treated PBC patients was reported to be relatively low.59, 63

In autoimmune hepatitis, well‐designed corticosteroid therapy is important to prevent HCC development, and persistent elevation of serum aminotransaminase is reported to lead the development of HCC.78 It seems that alleviation of serum ALT levels might prevent HCC development, but this hypothesis is not confirmed solidly.
        
In NASH patients, improvement in metabolic syndrome, especially improvement in diabetes mellitus and obesity, is important.

Next, we mentioned whether the treatment of underlying liver diseases substantially modulates the HCC risk or not. We restricted the survey chiefly to the cirrhotic patients because they are at high risk of HCC development.

Continue to full-text article:
https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.1998

© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

KEYWORDS: hepatocellular carcinoma; liver cirrhosis; liver diseases; meta-analysis; risk of HCC

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

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

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

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

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

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

Navigate This Blog - Stay Updated

Check back for updates
Enjoy the weekend!
Tina

Thursday, November 29, 2018

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

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

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

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

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