Friday, January 3, 2014

Ask the Expert: Liver Cysts, Liver Lesions, and Liver Hemangioma


Robert Goldstein, MD, FACS, director of the Liver and Pancreas Disease Center answers common questions about liver cysts, liver cancer and lesions in three "Ask the Expert" videos.

Liver Cysts  
A cyst is a small, fluid-filled sack. On the skin, it's usually considered a harmless blemish patients may or may not have removed.

What about cysts on the liver?

Are they dangerous and how are they removed?
 
 
   
Liver Lesions
 
Dr. Goldstein answers common questions about liver cancer and lesions, including types of liver cancer, symptoms and the wide range of treatment options available to patients at Baylor. 
  
 
Liver Hemangioma  
What is a liver hemangioma?

Is it something you need to worry about?

Dr. Goldstein discusses this benign condition and when it should become a concern for patients and health care professionals. 
 
 

 
 

In Most Cases Antidepressant-Induced Liver Injury Is Unpredictable

 
"Dr. Perlemuter and colleagues say that antidepressants with a higher potential for hepatotoxicity should be used with caution in elderly patients, in patients with coprescriptions, and in patients with substantial alcohol use, illicit substance use, or evidence of chronic liver disease."
 
 
Antidepressant-Induced Liver Injury Underestimated
 
Megan Brooks
December 31, 2013

All antidepressant drugs may potentially cause liver injury, even at recommended doses, and some groups are more vulnerable than others, French researchers report.

"Antidepressant liver toxicity has been underestimated in the scientific literature," say Gabriel Perlemuter, MD, PhD, from AP-HP Hôpital Bicêtre, Kremlin-Bicêtre, France, and colleagues.

In some cases, antidepressant-induced liver injury can be irreversible. Given that there currently is no strategy available to prevent antidepressant-induced liver injury, "early detection and prompt drug discontinuation remain critical," they say.

Their research was published online December 20 in the American Journal of Psychiatry.

Liver Injury Unpredictable

The investigators reviewed clinical data on antidepressant-induced liver injury from 158 reports, including 88 case reports, 38 original articles, and 32 reviews.

They calculate that 0.5% to 3% of patients treated with antidepressants may develop asymptomatic mild elevation of serum alanine aminotransferase (ALT) levels.

In most cases, liver damage is "idiosyncratic and unpredictable, and it is generally unrelated to drug dosage," they say. Liver damage may occur between several days and 6 months after initiation of an antidepressant.

All antidepressants can induce hepatotoxicity, especially in elderly patients and those who take multiple pharmaceutical agents. However, there is not enough evidence to draw "rigorous conclusions" about the prevalence and severity of antidepressant-induced liver injury, the investigators say.

Based on the evidence, the antidepressants associated with highest risk for hepatotoxicity are monoamine oxidase (MAO) inhibitors, tricyclic/tetracyclic antidepressants, nefazodone, bupropion, duloxetine, and agomelatine. Those with seemingly lower risks are citalopram, escitalopram, paroxetine, and fluvoxamine.

Life-threatening or severe drug-induced liver injury has been reported for some antidepressants, including MAO inhibitors, tricyclic/tetracyclic antidepressants, venlafaxine, duloxetine, sertraline, bupropion, nefazodone, trazodone, and agomelatine, Dr. Perlemuter and colleagues report.

Although no dose-response relationship has been clearly demonstrated, it is best to stick to the minimum effective dosages of antidepressants to reduce the risk for liver injury, they advise.

Use With Caution

Dr. Perlemuter and colleagues say that antidepressants with a higher potential for hepatotoxicity "should be used with caution in elderly patients, in patients with coprescriptions, and in patients with substantial alcohol use, illicit substance use, or evidence of chronic liver disease."

"Systematic pretherapeutic screening and regular assessment of hepatic enzymes during treatment may be useful for antidepressants with a high potential for hepatotoxicity and for patients with known risk factors," they add.

It is also important to tell patients taking an antidepressant about the possibility of liver abnormalities, to encourage them to report any clinical symptoms suggestive of liver problems, and to stop treatment if jaundice develops, the researchers say.

Antidepressants "should be discontinued immediately" in any patient with suspected drug-induced liver injury, they write.

Dr. Perlemuter has received travel funds from Janssen, Gilead, and Roche, consulting fees from Bayer, Biocodex, Physiogenex, and Servier, and royalties from Elsevier-Masson. The original article contains a complete list of author disclosures.

Am J Psychiatry. Published online December 20, 2013. Abstract

http://www.medscape.com/viewarticle/818512?src=rsshttp://www.medscape.com/viewarticle/818512?src=rss

2014 Going Viral - Viral Hepatitis Newsletters



January 2014

Hepatitis Newsletters


Welcome to 2014 folks, where did the year go? Once again we have an array of informative newsletters put together by incredible people completely devoted to HCV awareness and education.

**Updated Jan 11 to included Transplant Recipients International Organization
**Updated Jan 10 - NYC Hep C Task Force
**Updated Jan 7 - NIH News in Health
**Updated Jan 4 -  Hepatitis Foundation International.



TRIO is an independent, not-for-profit, international organization committed to improving the quality of life of transplant candidates, recipients, their families and the families of organ and tissue donors.
Through the TRIO Headquarters and a network of chapters, TRIO serves its members in the areas of: Awareness, Support, Education, and Advocacy. This TRIO web site is filled with information about these areas and our many programs, including local chapter contact information, so wander around these pages to learn more about TRIO or contact your local TRIO chapter. If you still don't find answers to what you are looking for, please email us at info@trioweb.org or call 1-800-TRIO-386. 

UNOS News


Full 3-part series: Too Risky to Transplant (3 prior articles in one place)
Categories
Categories 

This Months Newsletter

January Newsletter
Rose parade float - so how many TRIO members are in or help with that DLA float?
What do you think - of the redesigned TRIO web site . . .

In just a short time since the launch we have had thousands of visitors from all around the world visit the new web site.  How about you?  If you haven't already bookmarked the site, do it now at http://trioweb.org

Newsletter Archives

 Check Us Out On Twitter and Facebook



 

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

NYC Viral Hepatitis Monthly E-Newsletter
January 2014 NYC Hep ABC Newsletter

In This Issue

NY Hep C ‘Baby Boomer’ Testing Law

NYS Hepatitis C Testing Law. 2171 requires healthcare providers to offer hep C test to baby boomers.

Requires full diagnostic testing for those who screen anti-body positive and either follow-up health care or referral to a health care provider who can provide follow-up health care.

Takes effect January 1, 2014

Read the ‘Hep C Testing Law Dear Colleague Letter‘ from Governor Cuomo.

NYS HCV testing law FAQ_12-9-2013 (PDF). Hep C Testing Law: Frequently Asked Questions from the NYS Department of Health. 

Webinar | Hepatic Encephalopathy: The Patient Perspective. American Liver Foundation. January 23rd (7 PM - 9:30 PM ET).

Beyond the Hype: What Sofosbuvir Means—and Doesn’t—for Global Hepatitis C Treatment.
Open Society Foundations.

And more.......
Click here to start reading....

Subscribe to this Newsletter

Join Us






January Features

Avoiding Anemia Boost Your Red Blood Cells

Anemia is a common blood disorder that can leave you feeling exhausted and sluggish. Many types of anemia are mild and short term. But the condition can become serious if left untreated
for a long time.

Read more about anemia

Dealing with Dementia
When Thinking and Behavior Decline

Feeling forgetful and confused may be a normal part of life. But if thinking problems or unusual behavior start to interfere with everyday activities, these could be signs of a brain condition known as dementia.

Read more about dementia.

Find Us On Facebook






Hepatitis Foundation International (HFI)

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

Health-e Bytes™

Hepatitis Alert / Partners In Liver Wellness Newsletters

Click Here To Download Newsletter





Lifestyle...

— Obesity’s Impact on Kidneys
— Tighter Regulations Make for Safer Drugs
— Plain Soap and Water Still the Best

Grand Rounds...

— Understanding the Clinical Trial Process
— Reducing Viral Load — Saves Lives

In the Pipeline...

— Hepatitis C Phase III Drugs Treatment Pipeline

Helping Hands... Holiday Giving

Advocacy Alert: Legislation expanding hepatitis B and C education, testing and linkage to care services

T.I.PS. — Qualifying for SSI Disability with HCV; Free Consumer Action Handbook

Stay Updated







HCV Advocate

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

January 2014 HCV Advocate

In This Issue:

HCV Advocate's Top News of 2013
It is usually difficult to come up with the number 1 item and this year was no exception; so we decided that two different news items topped our list.....
Alan Franciscus, Editor-in-Chief

HEALTHWISE: New Hepatitis C Drugs: Disappointment or Hope?
Lucinda K. Porter, RN

Snapshots
Lucinda K. Porter, RN

HCV Advocate Eblast

Stay informed on the latest news...click here to register for email alerts

HEPATITIS B

HBV Journal Review

by Christine Kukka
HCV Advocate News & Pipeline Blog!

Be sure to check out the latest clinical trial postings at the HCV Advocate News & Pipeline Blog. Just click on the links to the Drug Companies below the banner to see which drugs are in trials right now, where the trials are, and how to register for one.

Connect With HCV Advocate






HepatitisWA

Perth, Australia

HepatitisWA (Inc) is a non-profit community-based organisation providing free services to the community. HepatitisWA aims to assist in obtaining the best possible care and support for people affected by hepatitis, reducing discrimination and stigma directed at people living with viral hepatitis and raising community awareness in relation to hepatitis.


The HepatitisWA Newsletter is a quarterly publication.

With each edition we endeavour to capture new developments in hep C treatment, management and other relevant topics.

This issue we cover the following:
• Ed's Story - Personal Perspective
• Going Viral - Viral Hepatitis News
• Hepatitis B Mapping Project - Feature
• Rising deaths from hep C spur New York city action - Community News
• Closer than you thINK - Feature
• Staying on track when eating out - Health & Lifestyle
• Sleep management and hepatitis C - Health & Lifestyle






HepCBC Hepatitis C Education and Prevention Society

HepCBC’s MONTHLY NEWSLETTER

January Newsletter (PDF)

The hepc.bull, has been “Canada’s hepatitis C journal” since the late 1990′s and has been published nonstop since 2001. The monthly newsletter contains the latest research results, government policy changes, activities and campaigns you can get involved in, articles by patients and caregivers, and a list of support groups plus other useful links.

In This Issue

WHO TO TREAT FIRST?
With approval of protease inhibitors, so many people want to start treatment, that waiting lists have developed. A limited number of people can be started on treatment each week. At the recent meeting in Boston, the AASLD (American Association for the Study of Liver Diseases) discussed who should be treated first.

MICHAEL’S STORY
Editor: Michael is a long-time member of HepCBC. The CanHepC list and the HepCan list. He and I have been emailing frequently since 2004. He has volunteered for HepCBC and has provided caring support and information to many fellow Hep C sufferers in our community, both by email and in person. Perhaps you have spoken to him on the phone.

ROB’S STORY
Six years later, I knew I had to go back. He welcomed me and said, “I told you I’d see you later.” So I went on the meds, and experienced ALL the negative symptoms of the meds and wound up in the hospital for a week.

Larry Hagman
Larry Hagman, perhaps best known for his role as J.R. Ewing of the TV series “Dallas”, died November 23 at age 81. His death was caused by complications from throat cancer, although he suffered from Hep C and liver cancer, too.

HCV Support Groups in Canada

AND MORE!!

Stay Connected







Caring Ambassadors Hepatitis C

The Caring Ambassadors Hepatitis C Program (CAP-Hepatitis C) is a national non-profit organization devoted exclusively to meeting the needs of the hepatitis C community.

The Caring Ambassadors Program mission is to help improve the lives of those affected by long-term diseases through advocacy, information, and support.

CAP News

In The News

CAP Hepatitis C Literature Review

December Monthly Pubmed Review of the most relevant research on hepatitis C.

Abstract Index
CLINICAL TRIALS, COHORT STUDIES, PILOT STUDIES 1 - 5
BASIC AND APPLIED SCIENCE, PREC LINICAL STUDIES 5 - 13

HIV/HCV COINFECTION 13 - 18

COMPLEMENTARY AND ALTERNATIVE MEDICINE 18 - 19
MISCELLANEOUS WORKS 19 - 24
LIVER CANCER 24 - 30







GI & Hepatology News

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

January Issue - Please Check Back

Stay connected








American Liver Foundation

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

In accordance with the Foundation’s mission, the e-newsletter is disseminated to provide information about the prevention, treatment and cure of liver disease, as well as the organization’s research and advocacy endeavors.

Content includes updates about the Foundation’s educational and signature programs; an in-depth focus on specific types of liver disease, and profiles of liver patients’ and caregivers’ personal experiences

Recently Diagnosed with HCV?

If you or a loved one thinks you may be at risk or has been recently diagnosed with Hep C, we encourage you to go through this site to find information on risk factors, diagnosis, treatment and support.

January Newsletter - Check back

December Newsletter


INSPIRE: CONNECT WITH OTHER LIVER DISEASE PATIENTS

The Inspire.com website builds online health and wellness communities for patients and caregivers, in partnership with national patient advocacy organizations. In fact, Inspire.com has more than 80 exclusive national patient organization partnerships and over 300,000 members.

As we recognize the value of patient engagement, we have partnered with Inspire.com to create a global resource community focused on liver disease.

Take action now: Log on to www.inspire.com/groups/american-liver-foundation/ to become a member of the American Liver Foundation group, complete your profile, and join the specific liver disease discussions that interest you. The American Liver Foundation Inspire groups can also be accessed by clicking on the Inspire logo on our website’s home page: www.liverfoundation.org

ALF Website

The Hepatitis C: Diagnosis, Treatment, Support website

1-800-GOLIVER (1-800-465-4837)

In addition, questions sent on e-mail to info@liverfoundation.org will be promptly answered.

Join Our Mail List

Stay Connected

Check Us Out On Twitter and Facebook





Hepatitis C news, is an online community for those living with hepatitis C. Join us for news, views and features about hep C, read the real-life experiences of our guest bloggers, and learn about living well with the condition.

New In January

The effects of medical marijuana in treating hepatitis C
January 10th, 2014 Earlier this week New York became the 21st state to legalise marijuana for medical purposes. 

Five tips for a healthy 2014

As we reach the New Year, it’s a good time to think about some simple steps that can be taken for a happier and healthier you

Read More...

Talking to friends and family about hep C

Finding out that you have hepatitis C can be a shock. You may experience a range of emotions, from disbelief to anger, sadness or fear.

While it might be tempting right now to pull away from friends and family, research has shown that the support of friends and family is vital when living with a medical condition. Don’t underestimate the value of simply having someone to talk to.

Read more..

Check out
Hepatitis C News YouTube Channel

Stay connected






The Hepatitis C Mentor and Support Group (HCMSG)

The Hepatitis C Mentor and Support Group (HCMSG) was founded to address the lack of awareness, support, and services for people living with Hepatitis C (including patients co-infected with other conditions such as HIV/AIDS and Hepatitis B), and patients in need of or living with liver transplants. To address these needs, we provide resources and services to foster the development and operation of successful support groups for Hepatitis C and co-infected patients. These services are provided to prospective and current support group facilitators FREE OF CHARGE. In the future, we will also provide one-on-one mentoring services to Hepatitis C and liver transplant patients.

Assistance Programs for Patients

A partial list of programs to help people who do not have insurance coverage or financial resources to pay for testing, medical care, and medications to treat and cure Hepatitis C.


HCMSG Blog

News and Updates

We welcome your suggestions on what you would like to see in upcoming issues and any stories you want to share.

We can be reached at hepatitisCmsg@gmail.com

Find Us On Twitter and Facebook






Canadian Liver Foundation

News Updates

Canadian Liver Foundation’s Newsroom
Liver in the News

Newsletter
Livewell is our e-newsletter exclusively for friends and donors of the Canadian Liver Foundation. Each issue highlights liver health issues, exciting research projects, upcoming events and includes profiles of our outstanding volunteers and donors.

The Livewell newsletter is distributed 4x per year. Please click here to fill in the form and we will be happy to add you to our subscriber list!

CLF updates you and interacts with you on all things liver


Stay Updated







Hep C Connections - Website

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

Newsletter


December 2013 -- Check back for - January Newsletter

The Flu and Hepatitis C: High Risk of Complications

As we enter the months when we see an increase in the number of flu cases, you should ask your doctor about the flu vaccination because it has been shown to reduce a patient's risk for hospitalization from complications associated with the flu such as pneumonia, bronchitis, sinus infections and ear infections. Patients with chronic hepatitis C, particularly patients with cirrhosis, that fall ill with the flu may be at an increased risk for serious complications compared to the general population.

Full Article

Sign Up For Online Monthly Newsletter

Connect On Facebook







ACP Internist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP

Current Issue - January 2014

Gastroenterology

Long-term view for chronic pancreatitis
By Terri D’Arrigo

Unlike acute cases of pancreatitis, chronic cases present with varying degrees and types of pain, and without other clinical indicators such as calcification or damage to pancreatic ducts. It’s best to refer to a gastroenterologist early to clarify the diagnosis, so the internist can better manage the patient.
More

Washington Perspective

Health reform’s winners and losers: by the numbers
By Robert B. Doherty

Breaking down the numbers offers insight into who stands to gain the most from the reforms provided by the Affordable Care Act. But the broader coverage offered under the law means that the country as a whole is better off.
More

ACP Blog

Reflections on a near-death experience

Now that it has been nearly two months since my cardiac arrest and resuscitation, I have finally found the leisure and the motivation to put fingers to the keyboard to gather some thoughts and feelings about it. Of course these include at least in part the sort of changes in attitude and philosophy people are commonly supposed to experience, but for the most part, my own experience seems different.
More

Follow ACP On Twitter



Bloggers Corner

Of interest this month;
Hepatitis C: Resolve to Make Small Steps for Big Gains

By Lucinda Porter, RN |Published January 1, 2014

“Small deeds done are better than great deeds planned.” ~Peter Marshall The healthier you are, the easier it is to live with hepatitis C. We all know that we are supposed to exercise, eat better, and maintain a normal...

15 Steps to Recovery from Hepatitis C Treatment

Be on guard NOT to jump right back into your normal routine or take on more than your ready for right after you finish treatment. Just because treatment is finished does not mean your body is recovered yet. Pace yourself and give your body time to rebuild

Stay warm, see you all soon.
Check back for updates

Newsboy Photo Credit - bangordailynews.com

Thursday, January 2, 2014

HCV treatment improves heart, renal outcomes in diabetics


HCV treatment improves heart, renal outcomes in diabetics

Last Updated: 2014-01-01 10:50:35 -0500 (Reuters Health)

By Reuters Staff

NEW YORK (Reuters Health) - Diabetics with hepatitis C who receive antiviral treatment have better renal and cardiovascular outcomes than patients whose infections go untreated, new findings show.

Hepatitis C virus (HCV) infection is known to cause insulin resistance and diabetes, Dr. Yao-Chun Hsu of China Medical University in Taichung, Taiwan and colleagues note. Eradicating HCV infection can improve insulin resistance, they add, but it's not clear how treating HCV might affect outcomes in patients with diabetes.

To investigate, Dr. Hsu and colleagues looked at data on nearly 2.3 million diabetic patients in the Taiwan National Health Insurance Research Database, identifying 1,411 patients with HCV who were receiving pegylated interferon plus ribavirin. The investigators matched them with 1,411 untreated controls and 5,644 diabetic patients without HCV.

As reported online in Hepatology, the cumulative incidence of end-stage renal disease (ESRD) between 2003 and 2011 was 1.1% for the treated HCV patients, 9.3% for the untreated HCV patients, and 3.3% for the diabetic patients without HCV (p<0.001).

Stroke risk was 3.1% for treated patients, 5.3% for untreated patients, and 6.1% for HCV-free patients (p=0.01).

Acute coronary syndrome occurred in 4.1% of treated patients, 6.6% of untreated patients, and 7.4% of the patients without HCV (p=0.05).

The multivariate-adjusted hazard ratio associated with treatment was 0.16 for ESRD, 0.53 for ischemic stroke, and 0.64 for acute coronary syndrome.

"These findings suggest that HCV infection may have a role in the pathogenesis of renal and cardiovascular complications among diabetic patients, and also implicate that treatment of concomitant HCV infection may improve clinical outcomes related to DM," Dr. Hsu and colleagues write.

They add, "The efficacy of anti-HCV therapy in ameliorating insulin resistance and restoring glucose homeostasis, which has been convincingly demonstrated in previous studies, may underlie the associations uncovered in our research."

The authors did not respond to a request for comment.

SOURCE: http://bit.ly/1dPStc2

Hepatology 2013.

Tuesday, December 31, 2013

Grading Pharma In 2013: Gilead's hepatitis C collaboration with Bristol had ethical issues

Grading Pharma In 2013: 16 Drug Companies Ranked

 
I gave one A+, to Bristol-Myers Squibb, based on its overall performance and its pioneering development of cancer drugs that work by priming the immune system. Gilead Sciences would have gotten one two were it not for the ethical issues surrounding its stopped collaboration with Bristol in hepatitis C, which I think hurt some patients. I am giving no Ds or Fs. There were no big drug disasters on a par with the recall of Merck’s Vioxx or Pfizer’s Bextra this year. Not even close. 
Companies are sorted by the letter grade I gave them, and, where there was a tie, by stock performance. Let me know what I got right – and what I got wrong. 
The Best Drug Companies 
1. Bristol-Myers Squibb CompanyMarket capitalization: $87 billionStock appreciation: +61.4%Grade: A+ 
Sure, the big-cap biotechs delivered better stock performance. But Big Pharmas don’t trade like this, and Bristol’s transformation, started under James Cornelius and continuing under current chief Lamberto Andreotti, has simply been amazing. (Former R&D head Elliot Sigal deserves credit, too.) Bristol is leading the way when it comes to cancer immunotherapy, which Science Magazine named as the breakthrough of the year. It’s smartly jettisoning its diabetes business to focus on what is working. And it is a player in hepatitis C............

Continue Reading @ Forbes

Friday, December 27, 2013

Top 10 Highlights From The Liver Meeting - A Future Without Hepatitis C


 Medscape Medical News from:
The Liver Meeting 2013: American Association for the Study of Liver Diseases (AASLD)

This coverage is not sanctioned by, nor a part of, the American Association for the Study of Liver Diseases.

Medscape Gastroenterology

Top 10 Highlights From The Liver Meeting
A Glimpse of the Future


William F. Balistreri, MD
December 27, 2013

Excerpt:

A Future Without Hepatitis C
The successful development of targeted therapies for patients with chronic hepatitis C virus (HCV) was clearly evident. Several companies are jockeying to be the first to offer an all-oral, interferon (IFN)-free strategy. On the near horizon is the promise that a cocktail of agents, constructed on the basis of synergistic mechanisms of action, will be available for clinicians to wisely, effectively, and safely treat patients with HCV infection. A major advance, in my opinion, is the validation of regimens that are devoid of IFN and, in some cases, ribavirin.
Chayama and colleagues[1] documented the safety and efficacy of an IFN/ribavirin-free, all-oral therapy with daclatasvir (60 mg once daily) and asunaprevir (100 mg twice daily) in IFN-ineligible, -naive, or -intolerant patients and in those who did not respond to standard treatment for HCV genotype 1b.
Daclatasvir is a novel NS5A replication complex inhibitor with pangenotypic antiviral activity. Asunaprevir is a potent NS3 protease inhibitor with antiviral activity against genotypes 1, 4, 5, and 6. This regimen was associated with high (87%) sustained virologic response (SVR) rates after 12 weeks in both groups of patients. Treatment with this dual therapy was well tolerated.
Another all-oral triple combination -- daclatasvir, asunaprevir, and BMS-791325 (a nonnucleoside NS5B inhibitor) -- achieved SVR rates > 90% in pilot cohorts of noncirrhotic patients with HCV genotype 1 infection. Everson and colleagues[2] evaluated this regimen in larger cohorts that included cirrhotic patients. Patients received a twice-daily regimen of daclatasvir (30 mg), asunaprevir (200 mg), and BMS-791325 (either 75 mg or 150 mg) for 12 weeks. This investigational combination, which likewise avoids the use of both IFN and ribavirin, allowed a high percentage (92%) of patients infected with HCV to achieve SVR, including 87% of cirrhotic patients. The most frequent adverse effects in both groups were headache, diarrhea, fatigue, and nausea.
Lawitz and colleagues[3] reported successful results with another strategy. They administered the investigational combination of ABT-450, an HCV NS3/4A protease inhibitor (150 mg, dosed with ritonavir 100 mg), with ABT-267, an NS5A inhibitor (25 mg). Both compounds have shown potent antiviral activity in vitro against HCV genotypes 1-4 and 6. This combination, given once daily for 12 weeks, reduced viral loads to undetectable levels 12 weeks after the end of treatment in 95% of treatment-naive patients and in 90% of patients who had been previously treated but did not respond. The regimen was generally well tolerated. There were no serious adverse events related to the study drugs, and no patients stopped treatment because of adverse events.
Other reported regimens included a once-daily combination of simeprevir plus sofosbuvir (2 novel agents that were recently approved by the US Food and Drug Administration), with or without ribavirin, in patients with cirrhosis and noncirrhotic HCV genotype 1 treatment-naive and previous null responders.[4] One study[5] reported the effect of sofosbuvir and ribavirin for the treatment of recurrent HCV infection after liver transplantation, and another study[6] reported that sofosbuvir and ribavirin can be administered before transplant to prevent recurrence of HCV infection after liver transplantation.

Topic Highlights:

  • A Rapid Pace of Progress in Hepatology
  • Screening Specific Populations for HCV
  • Outcomes of Chronic HCV Infection
  • Reactivation of Hepatitis B Attendant to Immune Suppression
  • Insight Into the Mechanism, Diagnosis, and Treatment of NAFLD
  • Pathophysiology of Acute Liver Failure
  • Herbal and Dietary Supplement-Induced Liver Injury

  • Continue reading @ Medscape



    Thursday, December 26, 2013

    HCV Updates-HCV F1/F2 Treat Now Or Wait? and The best interferon-free combinations

    Hello Folks,
    I hope everyone had a festive and peaceful Christmas. This year my grandchildren were horribly sick with an "adenovirus" infection.

    After taking one very sick child to see their doctor, and the youngest child 24 hours later to the emergency room, some 48 hours after that Mr. and Mrs. Santa Clause were so sick the presents almost didn't make it under the tree. Our seasonal flu shot offered no protection against this nasty virus.

    The entire family is still recuperating from a sore throat, upper respiratory infection, ear infections and a few other complications. Oh my, it was so bad we postponed Christmas until this Saturday. My poor little babies.

    I just had to keep myself busy today, so for those of you with some free time over the holiday - here are a few updates.  

    News and Updates

    December 29
    People With HCV Die Decades Earlier Then Persons Without The Disease
    Recently, researchers set out to investigate the most frequent causes of death in people with viral hepatitis. In the study persons who shared the same cause of death were examined; one group of people with viral hepatitis and one without the infection. In the group of individuals with HBV or HCV, researchers found people died 22–23 years earlier than persons without the disease. Study results were released late in 2013, now the full text is available for viewing.

    Interferon-free combinations
    The best interferon-free combinations
    Based on the recent encouraging results from the widely studied IFN-free regimens in non-GT1 infection, it is possible that in the future, HCV may be the first chronic viral infection to be eradicated worldwide with one or more antiviral drug

    FDA warns consumers not to use muscle growth product
    Product marketed as a dietary supplement contains potentially harmful synthetic steroids
    The U.S. Food and Drug Administration is advising consumers to immediately stop using a product called Mass Destruction, marketed as a dietary supplement for muscle growth. The product is labeled to contain at least one synthetic anabolic steroid and has been linked to at least one reported serious illness.

    The FDA was alerted by the North Carolina Department of Health and Human Services of a serious injury associated with use of Mass Destruction. The report described a previously healthy 28-year-old male with liver failure requiring transplant after several weeks of product use. Liver injury is generally known to be a possible outcome of using products that contain anabolic steroids and steroid-like substances. The product’s ingredients are undergoing further analysis by the FDA.

    2014/HCV Multimedia: Videos and Podcast
    Three new videos from Lucinda Porter, RN., author and hepatitis C advocate.
    For people starting treatment Ms. Porter offers valuable tips on everything from the first time you inject (interferon), to keeping well hydrated during HCV therapy.

    Link
    Website and blog of Lucinda Porter, RN

    2014 - HCV F1/F2 Treat Now Or Wait?
    Topics Include:
    Genotypes 1-6
    Mixing and Matching Antiviral Agents

    Investment Commentary
    The Most Important New Drug Of 2013
    Gilead Sciences’ Sovaldi, for hepatitis C, was the most important new medicine approved this year. It heralds the hope that a viral disease that afflicts more than 3 million Americans, can be treated with a few pills– or even one – and that doctors and scientists may be able to dramatically reduce the toll of the infection, which can cause liver failure and death.

    Coffee, chocolate linked to improved liver health in HIV/HCV patients
    Patients coinfected with HIV and hepatitis C may experience a reduction in abnormal liver enzymes and an overall improvement in liver function with increased consumption of coffee and chocolate, a study determined.

    Cinnamon might help in nonalcoholic fatty liver disease

    By David Douglas
    NEW YORK (Reuters Health) - Cinnamon may help remedy lipid profiles and have therapeutic benefits in patients with nonalcoholic fatty liver disease (NAFLD), according to a new Iranian trial.

    2014-Hepatitis C Full Text Articles
    Comprehensive review of full text articles covering important aspects of hepatitis C and hepatitis B management.

    Hepatitis C Treatment Side-Effects: Interferon-Free and Triple Therapy
    Links with a quick summary highlighting common adverse events seen in triple therapy and interferon-free regimens.

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