Ethnic disparities evaporate with DAA treatment of hepatitis C infections

Medical Economics

Hepatology,  Resource Center

Ethnic disparities evaporate with DAA treatment of hepatitis C infections

Mark Fuerst
Early diagnosis and treatment of hepatitis C virus (HCV) infections can prevent liver cancer and end-stage liver disease even in high-risk ethnic minorities, according to a new study.

There is a well-known ethnic disparity in the U.S. among HCV patients, with a higher risk of cancer, cirrhosis and long-term outcomes among Hispanic and Asian patients as compared to Caucasians. In the interferon era, studies showed Asians had the lowest rate of treatment, and African Americans and Hispanics were also less likely to receive care than Caucasians.

Continue reading.....

Managing the Fruits of HCV Cure: How Much Care do the Cured Need?

In case you missed it

The following article appeared in the January/February print edition of HCV NEXT, provided online at Healio. 

Editorial
Managing the Fruits of HCV Cure: How Much Care do the Cured Need?

The feature by Eric Lawitz, MD, very nicely encapsulates the revolutionary changes occurring within hepatitis C therapy over the past few years. As he explains, this extraordinary newfound ability to cure almost all patients with chronic HCV raises many questions about clinical outcomes.

We’ve felt strongly for years that it was unjust to deny therapy to patients who didn’t have “sufficiently advanced scarring of the liver to warrant treatment” — a cost-based position that was anathema to most clinicians and patients. Today, there’s a wealth of literature showing fibrosis progression stabilizes or reverses after achieving SVR. Even patients with cirrhosis may have regression of cirrhosis after SVR. But an additional dimension of HCV infection about which our knowledge has dramatically expanded is the potential for extrahepatic morbidity and mortality associated with HCV infection, and the opportunity to ameliorate or prevent such outcomes by effecting virologic cure — problems such as diabetes, atherosclerosis, renal disease, cryoglobulinemia, lymphoma and others.

Continue reading........

How do viruses such as HIV or hepatitis C, manage to outsmart their hosts' immune systems?

McGill University

How viruses disarm the immune system
Discovery of molecular mechanism could point toward new targets for treating patients

How do viruses that cause chronic infections, such as HIV or hepatitis c virus, manage to outsmart their hosts’ immune systems?

The answer to that question has long eluded scientists, but new research from McGill University has uncovered a molecular mechanism that may be a key piece of the puzzle. The discovery could provide new targets for treating a wide range of diseases.

Fighting off infections depends largely on our bodies’ capacity to quickly recognize infected cells and destroy them, a job carried out by a class of immune cells known as CD8+ T cells. These soldiers get some of their orders from chemical mediators known as cytokines that make them more or less responsive to outside threats. In most cases, CD8+ T cells quickly recognize and destroy infected cells to prevent the infection from spreading.

“When it comes to viruses that lead to chronic infection, immune cells receive the wrong set of marching orders, which makes them less responsive,” says Martin Richer, an assistant professor at McGill’s Department of Microbiology & Immunology and senior author of the study, published recently in the journal Immunity.

The research, conducted in Richer’s lab by graduate student Logan Smith, revealed that certain viruses persist by driving the production of a cytokine that leads to modification of glycoproteins on the surface of the CD8+ T cells, making the cells less functional. That maneuver buys time for the pathogen to outpace the immune response and establish a chronic infection. Importantly, this pathway can be targeted to restore some functionality to the T cells and enhance the capacity to control infection.

The discovery of this regulatory pathway could help identify new therapeutic targets for a variety of diseases. “We might be able to take advantage of the pathways induced by these signals to fight chronic viral infections by making the immune system more responsive,” Richer says. “The findings might also prove useful for diseases like cancer and autoimmunity, where T cells function is poorly regulated.”

Interleukin-10 Directly Inhibits CD8+ T Cell Function by Enhancing N-Glycan Branching to Decrease Antigen Sensitivity was published in Immunity

NIH - How to Find a Cancer Doctor

National Institutes of Health

How to Find a Cancer Doctor
Cancer changes your life and the lives of those around you. Finding the right cancer doctor (called an oncologist) and treatment facility is an important step to getting the treatment and support you need.

Doctors specialize in different types of cancer and treatment methods. It’s important for you to find a doctor with experience treating your type of cancer. You also need to feel good about the doctor you choose. You’ll be working with this person closely as you make decisions about your treatment.

Your primary care doctor can suggest cancer specialists. Or, you may be able to get a recommendation from a friend or family member. Also, your local hospital should be able to provide you with a list of specialists who practice there.

You can check with your local or state medical society, which may maintain a list of doctors in each specialty of cancer care. A nearby medical school may be able to suggest cancer specialists as well.

NIH’s Finding Health Care Services webpage provides a list of several online directories to cancer specialists. Visit www.cancer.gov/about-cancer/managing-care/services to find this and other cancer resources.

American Cancer Society
Cancer Help Line 800.227.2345
Choosing a Doctor and a Hospital
When you learn you have cancer, you want to make sure you get the best possible medical care and treatment. Choosing your doctor and treatment center will be one of the most important decisions you’ll make. There are many excellent cancer care centers in the United States, but how do you know where to look?
Continue reading...

American Medical Association
DoctorFinder 
DoctorFinder provides you with basic professional information on virtually every licensed physician in the United States. This includes more than 814,000 doctors.

American Society of Clinical Oncology (ASCO)
Find a Cancer Doctor
This international medical society represents cancer specialists in clinical research and patient care. They provide an oncologist directory, which is a database of ASCO members called - Find a Cancer Doctor. The Find an Oncologist Database is made available by ASCO as an informational resource for patients and caregivers. The database includes the names of physicians and other health professionals from certain ASCO membership categories who have given their permission to be identified publicly. Inclusion in the database is not an endorsement or a warranty by ASCO of the physicians or other health professionals in the database or the care they provide.

ASCO’s patient information website -- Cancer.Net (www.cancer.net)
ASCO’s Blog - https://www.cancer.net/blog

Liver Cancer
This is Cancer.Net’s Guide to Liver Cancer.
Use the menu to choose the Overview/Introduction section to get started. Or, you can choose another section to learn more about a specific question you have. Each guide is reviewed by experts on the Cancer.Net Editorial Board, which is composed of medical, surgical, radiation, gynecologic, and pediatric oncologists, oncology nurses, physician assistants, social workers, and patient advocates.
Continue reading.....

Cancer.Net Video:

Choosing an Oncologist, with John Sweetenham, MD

Watch this patient education video to learn more about types of oncologists, sources to help find an oncologist, what to consider at your first appointment, and more with Drs. Shelby Terstriep and Jyoti Patel.

Today is World Cancer Day 

Did you know chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) is the most common risk factor for liver cancer?  The only way to know your status is to get tested for hepatitis B and C, take a 5 minute Hepatitis Risk Assessment developed by the CDC and get a personalized report.

Medscape - Hepatitis C

Hepatitis C
Updated: Jan 29, 2018

Free registration may be required to view article 
Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD

Hepatitis C is an infection caused by the hepatitis C virus (HCV) that attacks the liver and leads to inflammation. The World Health Organization (WHO) estimates about 71 million people globally have chronic hepatitis C, with approximately 399,000 dying from this infection as primarily due to cirrhosis and hepatocellular carcinoma.
Continue reading........

Liver Cancer
2018: Hepatocellular carcinoma - Updated and evidence-based review

Seminar Hepatocellular carcinoma

Alejandro Forner, MD, MD Alejandro Forner
Published: 04 January 2018
DOI: http://dx.doi.org/10.1016/S0140-6736(18)30010-2
Hepatocellular carcinoma appears frequently in patients with cirrhosis. Surveillance by biannual ultrasound is recommended for such patients because it allows diagnosis at an early stage, when effective therapies are feasible. The best candidates for resection are patients with a solitary tumour and preserved liver function. Liver transplantation benefits patients who are not good candidates for surgical resection, and the best candidates are those within Milan criteria (solitary tumour ≤5 cm or up to three nodules ≤3 cm). Image-guided ablation is the most frequently used therapeutic strategy, but its efficacy is limited by the size of the tumour and its localisation. Chemoembolisation has survival benefit in asymptomatic patients with multifocal disease without vascular invasion or extrahepatic spread. Finally, sorafenib, lenvatinib, which is non-inferior to sorafenib, and regorafenib increase survival and are the standard treatments in advanced hepatocellular carcinoma. This Seminar summarises the scientific evidence that supports the current recommendations for clinical practice, and discusses the areas in which more research is needed....
Full-text article
Downloaded & shared by @HenryEChang via Twitter.
View Article: https://jumpshare.com/v/La5WS4Mn8Uwpi927nbeU

Liver Cancer And HCV
Direct-Acting Antiviral Treatment & Decrease a Incidence of Liver Cancer

November 2017
Alan Franciscus
Did you know that people who were treated with direct-acting antiviral (DAA) medications….
*Were significantly less likely to die than the people who were untreated.
*Had at least a 20% decrease in liver fibrosis after 24-weeks of the completion of DAA therapy
*Experienced a 71% reduction in liver cancer risk after being cured with a DAA medication.

The studies on this blog looked at treatment with DAAs to find out if curing hepatitis C (HCV) with DAAs improved HCV disease progression and reduced the risk of liver cancer.

Continue reading........

Healio - December 8, 2017

Free registration may be required to view article 
Liver cancer incidence after HCV therapy linked to risk factors, not treatment
Li DK, et al. Hepatol. 2017;doi:10.1002/hep.29707.

Direct-acting antiviral treatment for hepatitis C did not correlate with an increased risk for hepatocellular carcinoma in a large cohort study of both treated and untreated patients with or without cirrhosis. Those with incident HCC after DAA treatment had higher risk factors at baseline. “There was no increased risk for HCC as a result of having received DAA therapy whatsoever,” Raymond T. Chung, PhD, director of Hepatology and Liver Center at Massachusetts General Hospital, told Healio Gastroenterology and Liver Disease. “The risk was related to their preexisting likelihood of developing HCC. The fact that HCC developed post-DAA, we think, is more likely to be an accident of timing than the idea that it's related to receipt of DAA — these persons were at risk for HCC whether they received DAAs or not.”

Continue reading........

In The News

World Hepatitis Alliance

Deaths from liver cancer nearly double since the 1990s, new figures reveal
Feb 1, 2018
Over the past two decades, deaths caused by liver cancer have increased by 80% , making it one of the fastest-growing causes of cancer deaths worldwide.

According to the Global Burden of Disease Study, the most comprehensive worldwide observational epidemiological study to date, 830,000 people died as a result of the disease in 2016 compared to 464,000 people in 1990. This makes liver cancer the second leading cause of cancer deaths worldwide, after lung cancer.

Primary liver cancer, the most prevalent liver cancer worldwide, can be attributed to heavy drinking and other lifestyle choices but is most commonly caused by long-term infection with the hepatitis B or hepatitis C virus. These viruses are a major public health challenge, affecting over 325 million people, worldwide.

Globally, two out of three liver cancer deaths are caused by hepatitis B or C. The Western Pacific and South East Asia regions record the largest numbers of people living with the viruses and also some of the highest cases of liver cancer deaths globally. In China alone, over 260,000 liver cancer deaths caused by hepatitis B and C were recorded in 2016, accounting for a third of the global liver cancer death toll.

According to the findings, the hepatitis C virus was responsible for 160,000 liver deaths in 2016. The USA was amongst the top three countries with the highest numbers, alongside Japan and China.

The American Cancer Society suggests this is because of the high rate of hepatitis C infection among baby boomers (born between 1945 through 1965), of which prevalence is approximately 2.6%, a rate 6-fold greater than that of other adults in the USA. Highly-effective cures for hepatitis C do exist which can halt progression to liver cancer, however only 3 of the 71 million people living with the virus globally, have accessed these life-saving treatments in the last two years.

The study also found that 350,000 liver cancer deaths were caused by the hepatitis B virus, of which China and India accounted for 80% of these. The high majority of these deaths could have been prevented if people received the hepatitis B vaccination after birth. Today, only 52% of countries provide the hepatitis B birth dose vaccine to newborns.

"What many people don't realise is the correlation between the sharp increase in liver cancer deaths and the hepatitis B and C viruses", said Michael Ninburg, President of the World Hepatitis Alliance. "The rise in deaths is ultimately a result of poor vaccination coverage, lack of routine testing and inadequate access to effective treatment".

"Ahead of World Cancer Day, we are asking people go get tested for hepatitis B and C because that is a first vital step in prevention", said Raquel Peck, CEO of the World Hepatitis Alliance. "Together, we can stop cancer in its tracks".
http://www.worldhepatitisalliance.org/

The Lancet - Published: 30 January 2018

Tipping the balance in the fight against cancer – still a lot of work to do in order to bridge geographic and economic inequalities in cancer care.
Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries

Hep B reactivation common during direct-acting antiviral therapy for hep C

Reuters Health

Hep B reactivation common during direct-acting antiviral therapy for hep C

Last Updated: 2018-02-02
By Will Boggs MD
NEW YORK (Reuters Health) - Hepatitis B virus (HBV) reactivation is common in patients with chronic HBV and hepatitis C virus (HCV) coinfection receiving direct-acting antiviral (DAA) therapy, according to a systematic review and meta-analysis.

"It is important to identify patients at risk of HBV reactivation," said Dr. Johannes Vermehren from University Hospital Frankfurt, in Frankfurt am Main, Germany.

"HBsAg-positive patients who also have detectable HBV DNA should be closely monitored when treated for hepatitis C with direct antivirals. Alternatively, (nucleoside/nucleotide) prophylaxis may be justified in these patients," he told Reuters Health by email.

Continue reading article: http://www.chronicliverdisease.org/reuters/article.cfm?article=20180202Scie222294352

February 2018 Hepatitis Updates: Opioid Addiction, Newsletters & Can HCV Reactivate with Treatment of Non-hepatic Cancer

February 2018 Hepatitis Updates
Greetings, here is a recap of today's news, along with this months index of wonderful newsletters, publications, and blog updates; offering us invaluable information on the topic of viral hepatitis.

News Updates
MD Magazine
HCV Can Reactivate with Treatment of Non-hepatic Cancer

Hepatitis C virus (HCV) reactivation to occur in approximately 1 out of 5 patients treated for non-hepatic cancer, posing renewed risk for hepatic injury and possibly complicating the cancer treatment....

Here is the study, published last month in Hepatology “Hepatitis C virus reactivation in patients receiving cancer treatment: A prospective observational study”

HCV in Children Spikes as Substance Abuse Spreads

FEBRUARY 02, 2018

Kenneth Bender, PharmD, MA

A growing number of children are being hospitalized with hepatitis C virus (HCV) infection, coinciding with the increase in substance abuse in the US and the disproportionately greater rates in the northeast and southern regions.

Reuters Health
Hep B reactivation common during direct-acting antiviral therapy for hep C

Last Updated: 2018-02-02
By Will Boggs MD
NEW YORK (Reuters Health) - Hepatitis B virus (HBV) reactivation is common in patients with chronic HBV and hepatitis C virus (HCV) coinfection receiving direct-acting antiviral (DAA) therapy, according to a systematic review and meta-analysis.

"It is important to identify patients at risk of HBV reactivation," said Dr. Johannes Vermehren from University Hospital Frankfurt, in Frankfurt am Main, Germany.

"HBsAg-positive patients who also have detectable HBV DNA should be closely monitored when treated for hepatitis C with direct antivirals. Alternatively, (nucleoside/nucleotide) prophylaxis may be justified in these patients," he told Reuters Health by email.

HepCBC

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

Medscape

COMMENTARY

New Guidelines Provide a Clearer Path Forward for Abnormal Liver Tests

William F. Balistreri
February 01, 2018
Although several studies have examined the frequency of various causes of abnormal liver test results in the general population and the role of liver biopsy in diagnosis, to date no controlled trials have been performed to determine the optimal approach to evaluating patients.

Healio

8 recent reports on prevention, prediction of cirrhosis
February 2, 2018
Chronic liver damage known as cirrhosis has a variety of causes. What remains constant is its potential progression to liver failure. Researchers continue to seek…
View all headlines @ Healio

Healio - In the Journals
SVR for HCV with no advanced liver disease greatly reduces mortality risk

Backus LI, et al. Hepatol. 2017;doi:10.1016/j.cgh.2017.07.032.
January 30, 2018
Patients with hepatitis C without advanced liver disease who achieved sustained virologic response with direct-acting antiviral therapy had significantly reduced all-cause mortality rates compared with both treated patients who did not achieve SVR and untreated patients, according to a recently published data.

World Hepatitis Alliance

Deaths from liver cancer nearly double since the 1990s, new figures reveal

Over the past two decades, deaths caused by liver cancer have increased by 80% , making it one of the fastest-growing causes of cancer deaths worldwide. According to the Global Burden of Disease Study, the most comprehensive worldwide observational epidemiological study to date, 830,000 people died as a result of the disease in 2016 compared to 464,000 people in 1990. This makes liver cancer the second leading cause of cancer deaths worldwide, after lung cancer.

How to Find a Cancer Doctor
Feb 4, 2018

Cancer changes your life and the lives of those around you. Finding the right cancer doctor (called an oncologist) and treatment facility is an important step to getting the treatment and support you need.

The International Agency for Research on Cancer (IARC) is the specialized cancer agency of the World Health Organization

World Cancer Day is 4 February.

Cancer kills 8.8 million people every year, and it's on the rise. Learn more about the European Code Against Cancer and 12 ways to reduce your cancer risk.

GI & Hepatology News

Baby boomers are the hepatitis C generation

Richard Franki Frontline Medical News
Publish date: February 2, 2018

Adults born before and after the boomers have much lower rates of hepatitis C–related hospitalizations.

infohep news

Harm reduction scale-up needed to eliminate HCV in people who inject drugs, European model predicts
Keith Alcorn / 01 February 2018
Elimination of hepatitis C among people who inject drugs in Europe will require simultaneous scale-up of direct-acting antiviral treatment, needle and syringe programmes (NSP) and opioid substitution treatment (OST)

NPR
Understanding The Struggle Against Opioid Addiction
NPR's Rachel Martin talks to Medicaid's former Chief Medical Officer Andrey Ostrovsky about his uncle's fatal drug overdose and his efforts to destigmatize opioid addiction.

Publications

NAM Publications

A new edition of our booklet HIV stigma & discrimination' is now available online. The booklet explains what stigma and discrimination are, makes some suggestions for how to deal with these problems and gives information about your legal rights. 

Treatment Action Group - TAG
We just released a great resource: Updated Training Manual for Treatment Activists: Hepatitis C and HIV Coinfection.
DOWNLOAD: Updated Training Manual, HCV & Coinfection with HIV - (in English)

The purpose of this Training Manual is to provide information for you and your community. This information can be used to advocate for access to prevention and diagnosis of, and care and treatment for, hepatitis C virus (HCV).

The manual is written by and for people who are not medical specialists. We're treatment activists who learned about HCV because it was a problem for people in our communities.

The primary goals of the Training Manual are to increase advocates’ knowledge about available HCV tests and treatments, particularly in the era of all-oral, highly effective direct-acting antiviral medications that treat all genotypes, and to jumpstart discussions on advocacy strategies that can be used to open up affordable access for more people with HCV.

We designed it to help you understand basic information about HCV and coinfection with HIV: how it's transmitted, how to prevent HCV, how people can find out if they have HCV, what happens to both HIV-negative and HIV-positive people who have HCV, testing and treatment options, drug-drug interactions, and other information used for making treatment decisions.

This Training Manual is organized into short sections, and each section can be presented and shared by a trainer or peer educator with a small group of people in one to two hours. There are discussion points and action steps at the end of each section. The discussion points are intended to start conversations about the key issues raised in each section. The action steps are intended to start conversations about how to translate the key issues into advocacy in the community and to allow participants to find solutions together.

In Case You Missed It - Journal Updates
Original Article: Glecaprevir–Pibrentasvir for 8 or 12 Weeks in HCV Genotype 1 or 3 Infection

Full Text Article: Shared and downloaded via Twitter by Henry E. Chang 

View all Journal updates on this blog, here.....

Newsletters

HCV Advocate
February Newsletter
Highlights
Hepatitis A (HAV) Overview
HealthWise – Love, Sex, and Hepatitis C
Alcohol

Recommended reading at HCV Advocate

A Guide to Understanding and Managing Fatigue – learn about how fatigue can affect the body and mind and how to manage it.
A Guide for Employers and Coworkers – Living with hepatitis C is not easy. This fact sheet is designed to help you to educate employers and co-workers, but it’s a tricky business at the very least. But disclosure could prove to be helpful for the person living with HCV.
Meditation – most of us live stressful lives. Living with HCV can be even very stressful. This fact sheet offers helpful tips on various meditation techniques.
Sleep – Everyone needs it and it is an important component of living well with hepatitis C.

National Viral Hepatitis Roundtable

NVHR Newsletter

Save The Date - February 6, 2018

National Viral Hepatitis Roundtable NVHR
Engaging Active Drug Users About Hep C: From Testing Through Cure and Beyond
Tuesday, February 6, 2018, 12 pm Pacific/3 pm Eastern
Click here to register

Are drug users informing your agency’s programs and policies?
Do you know how to engage drug users?
What can be done to address concerns about adherence to hepatitis C treatment by people who use drugs?

We’ll discuss these questions and more during a webinar on February 6, 2018. The webinar will be hosted by the National Viral Hepatitis Roundtable, the Urban Survivor’s Union, the People’s Harm Reduction Alliance, and the Atlanta Harm Reduction Coalition. These groups are working collaboratively on the “More than Tested, Cured” project which addresses barriers to hepatitis C care faced by individuals who use drugs. The webinar will also include findings from interviews with participants and healthcare providers and suggested messaging to improve access to hepatitis C care. After the presentation, there will be time for questions and discussion.

The New York City Hepatitis C Task Force

Hep Free NYC Newsletters

British Liver Trust

All Newsletters

Blog Updates
HEPATITISC.NET

Managing Relationships with Hepatitis C 

By Editorial Team - February 1, 2018
How do you tell your friends and family or romantic partners you’ve been diagnosed with hepatitis C? Just the stigma of hepatitis C alone can make relationships challenging enough. Add in symptoms...

Is Your Doctor Speaking a Different Language? 

By Kimberly Morgan Bossley - February 1, 2018
Ever go to your appointment and feel like your doctor is speaking a different language? Many times, going in to see my liver doctor I would be sitting there waiting with a list...

Lost to Care living

By Daryl Luster - January 30, 2018
Lost to care is a phrase that is not commonly mentioned in the community or really anywhere else very much. What does it mean? In the context of hep C, it relates...

HEP Blog

Beginning Hep C Treatment

January 31, 2018

By Connie M. Welch

The preparation phase for treatment is very important. Knowledge is powerful. When patients prepare they are more likely to be proactive and handle treatment much easier.

When Hepatitis C Returns

By Lucinda K. Porter, RN

If your hepatitis was cured, but a new doctor tells you that you have hep C, should you panic? A look at what may be going on.

Hepatitis C Reactivation: What It Is and What It Isn’t

By Lucinda K. Porter, RN

Hepatitis C reactivation may occur in people receiving cancer treatment. However, hep C reactivation may not mean what you think it does.

On The Edge of a Smile

By Karen Hoyt
A glimpse at an easily overlooked tool for healing.

The Hepatitis B Foundation
Herbal Remedies and Supplements
Herbal remedies are not regulated or tested for efficacy, safety or purity. At best they are supportive, but sometimes they cause more harm than good.

Harvard Health Blog

This year’s flu season: Public health catastrophe or par for the course?

John Ross, MD, FIDSA

Posted February 02, 2018, 6:30 am

Are we headed toward a historically bad flu season? It’s too early to tell. This year, it could just be that flu season, which is usually at its worst in February, is peaking early. Hospitals across the United States have been flooded with flu patients. Matters have been made worse by national shortages of IV fluids in the wake of Hurricane Maria.

FDA Statement - Impact of saline shortages during this flu season
February 02, 2018
Statement from FDA Commissioner Scott Gottlieb, MD, on ongoing efforts to mitigate impact of saline shortages during this flu season
This year’s flu season has been particularly challenging, with a notable number of cases leading to hospitalization. The season started earlier than usual and seemed to spread across many states quickly. H3N2, the predominant strain of the influenza A virus this season, has led to health complications that are more severe than those seen during an H1N1-predominant season. We recognize that managing the thousands of flu-related hospitalizations has increased the demand for certain saline products – which are commonly used to both hydrate and deliver medications via intravenous routes. As we’ve shared over the past several months, across the country, there remains a shortage of IV saline bags, which have long faced supply issues. These supply issues were worsened by the impact of Hurricane Maria on the medical products manufacturing sector in Puerto Rico, which impacted small volume IV bags. Although the saline shortage is improving, this year’s worse-than-normal flu season and workarounds deployed by health care providers in the wake of this shortage have increased demand for saline and other products.

This flu season's hospitalizations are highest in nearly a decade
by Lena H. Sun February 2 at 2:17 PM

This year's flu season has now sent more people to the hospital with the illness than in nearly a decade, federal health officials said Friday. Nationwide during the past week, 16 more children died from the virus.

So far this season, influenza has caused the deaths of at least 53 children, rivaling that of the especially severe 2014-2015 flu season. Eighty percent of them had not had a flu shot....

Enjoy the upcoming weekend!

Tina

Photo Credit: Bygone Boys

Deaths from liver cancer nearly double since the 1990s, new figures reveal

World Hepatitis Alliance

Deaths from liver cancer nearly double since the 1990s, new figures reveal

Over the past two decades, deaths caused by liver cancer have increased by 80% , making it one of the fastest-growing causes of cancer deaths worldwide.

According to the Global Burden of Disease Study, the most comprehensive worldwide observational epidemiological study to date, 830,000 people died as a result of the disease in 2016 compared to 464,000 people in 1990. This makes liver cancer the second leading cause of cancer deaths worldwide, after lung cancer.

Primary liver cancer, the most prevalent liver cancer worldwide, can be attributed to heavy drinking and other lifestyle choices but is most commonly caused by long-term infection with the hepatitis B or hepatitis C virus. These viruses are a major public health challenge, affecting over 325 million people, worldwide.

Globally, two out of three liver cancer deaths are caused by hepatitis B or C. The Western Pacific and South East Asia regions record the largest numbers of people living with the viruses and also some of the highest cases of liver cancer deaths globally. In China alone, over 260,000 liver cancer deaths caused by hepatitis B and C were recorded in 2016, accounting for a third of the global liver cancer death toll.

According to the findings, the hepatitis C virus was responsible for 160,000 liver deaths in 2016. The USA was amongst the top three countries with the highest numbers, alongside Japan and China.

The American Cancer Society suggests this is because of the high rate of hepatitis C infection among baby boomers (born between 1945 through 1965), of which prevalence is approximately 2.6%, a rate 6-fold greater than that of other adults in the USA. Highly-effective cures for hepatitis C do exist which can halt progression to liver cancer, however only 3 of the 71 million people living with the virus globally, have accessed these life-saving treatments in the last two years.

The study also found that 350,000 liver cancer deaths were caused by the hepatitis B virus, of which China and India accounted for 80% of these. The high majority of these deaths could have been prevented if people received the hepatitis B vaccination after birth. Today, only 52% of countries provide the hepatitis B birth dose vaccine to newborns.

"What many people don't realise is the correlation between the sharp increase in liver cancer deaths and the hepatitis B and C viruses", said Michael Ninburg, President of the World Hepatitis Alliance. "The rise in deaths is ultimately a result of poor vaccination coverage, lack of routine testing and inadequate access to effective treatment".

"Ahead of World Cancer Day, we are asking people go get tested for hepatitis B and C because that is a first vital step in prevention", said Raquel Peck, CEO of the World Hepatitis Alliance. "Together, we can stop cancer in its tracks".

https://eurekalert.org/pub_releases/2018-01/wha-dfl013118.php

http://www.worldhepatitisalliance.org/

The Public and the Opioid-Abuse Epidemic

February 1, 2018
N Engl J Med 2018; 378:407-411
DOI: 10.1056/NEJMp1714529


Perspective
The Public and the Opioid-Abuse Epidemic
Robert J. Blendon, Sc.D., and John M. Benson, M.A.

Over the past year, the U.S. opioid-abuse epidemic has gained enormous visibility. President Donald Trump has identified it as a “public health emergency,” and a national commission and a commission of state governors have issued recommendations for action.1,2 This concern stems from the fact that in 2016 more than 11 million Americans misused prescription opioids, and opioid-related deaths have more than quadrupled since 1999.3,4

To determine what the public believes should be done to address the epidemic, we examined data from seven national polls conducted in 2016 and 2017. Many of the findings may surprise people who have been following this issue in professional journals and the media.

Continue to article: http://www.nejm.org/doi/full/10.1056/NEJMp1714529?query=TOC