Saturday, April 9, 2016

Hepatitis C Deaths Up Sharply Over Past Decade

In the News
APRIL 8, 2016

Hepatitis C Deaths Up Sharply Over Past Decade

By Gina Shaw

Because of new novel therapies that cure HCV, the statistics might surprise some. However, the new therapies will not affect death rates for years to come. Over the past 10 years, there has been an increasing number of aging baby boomers who have been living with untreated or suboptimally treated HCV, who have developed advanced liver disease and liver cancer. Those are the individuals who have been contributing to the increased death rates from HCV-related causes. In patients with decompensated cirrhosis or liver cancer, as many of these patients have, new therapies may cure their HCV, but they can’t cure their cancer. In addition, the study period only goes to 2013—the year sofosbuvir (Sovaldi, Gilead Sciences) was approved, according to said Jonathan Fenkel, MD, the director of the Hepatitis C Center at Thomas Jefferson University Hospital in Philadelphia, who was asked to comment on the findings.

Continue reading....

Editorial: ‘Fixing’ drug prices

Editorial: ‘Fixing’ drug prices
Herald Staff
Saturday, April 09, 2016

There is a breed of Massachusetts lawmaker who truly believes that there is a legislative solution to every problem

Yes, some life-saving drugs have started out being enormously expensive. Both the Health Policy Commission and Pioneer looked at the impact of the trailblazing drug Sovaldi, used to treat — and usually cure — hepatitis C, but at a cost of about $84,000 per course of treatment. The commission blamed the drug in part for a 13 percent hike in health care costs. But even at that price the drug was considered a bargain compared to, say, a liver transplant.

But, as Pioneer reported, when the federal government approved a second hep C treatment, the manufacturer of Sovaldi was forced

Continue reading....

Thursday, April 7, 2016

Veterans Groups Fight Stigma Associated With Hepatitis C; They say the virus was spread via a vaccination jet injector gun

Of Interest
April 6:
Elderly veterans with chronic HCV at increased risk for cirrhosis, HCC
Elderly veterans with hepatitis C virus infection had a higher risk for developing cirrhosis or hepatocellular carcinoma compared with younger patients, according to results from a retrospective cohort study.

Hepatitis C Treatment and Cirrhosis
Cirrhosis is a serious medical condition, and although it can remain stable for a long time, it can also go south quickly. Patients with hep C-related cirrhosis clearly need to be treated, and treated soon. This article will discuss some of the risks and benefits of hepatitis C treatment in cirrhotic patients.

Today In The News
April 7
See the results of VA wait-time probes in your state
Following the Department of Veterans Affairs' scandal in Phoenix in 2014, the VA inspector general launched more than 100 investigations at facilities across the country. Newly released reports from the probes reveal supervisors instructed schedulers to falsify wait times at VA medical facilities in at least seven states, and employees at 40 medical facilities in 19 states and Puerto Rico regularly “zeroed out” veteran wait times, which masked growing demand as new waves of veterans returned from wars in Iraq and Afghanistan and as aging Vietnam veterans needed more care.
View: VA wait-time probes in your state...

April 7, 20165:09 AM ET
Heard on Morning Edition
Zach Hirsch

In Case You Missed It

Veterans Groups Fight Stigma Associated With Hepatitis C

More veterans say the military gave them hepatitis C during the Vietnam War. They say the virus was spread via a vaccination jet injector gun, and the same gun was used on hundreds of soldiers.

Wednesday, April 6, 2016

JAMA Forum: We Can’t All Have It All: The Economic Limits of Pharmaceutical Innovation

JAMA Forum: We Can’t All Have It All: The Economic Limits of Pharmaceutical Innovation
By Austin Frakt, PhD on April 6, 2016
Even though US consumers spend 3 times more for hospital care than for medication, they are much angrier with pharmaceutical companies than hospitals for driving up the cost of health care. Drug companies raise this apparent inconsistency in an effort to defend their pricing practices. In so doing, however, they fail to appreciate why they’ve been targeted for so much opprobrium. Ironically, the industry’s biggest public relations problems may arise from its most effective and widely applicable innovations. 
In fact, we may have already have reached the point of confronting the fact that we cannot all have it all. New, expensive drugs for hepatitis C—Viekera Pak, Sovaldi, and Harvoni—severely stress budget-constrained programs like Medicaid and the Veterans Health Administration. Even at the steep discounts those programs receive, these treatments—though cost-effective—are indicated for such large populations that their aggregate cost would overwhelm budgeted resources. The day that life-extending $1 million “miracle” pill arrives (or the precision-medicine equivalent of a collection of drugs), we may look back on the current hepatitis C treatment funding problems nostalgically. As innovation continues, drug pricing and budgeting problems will only get worse.

Continue reading....

Hepatitis C in Limelight Again at Liver Congress

Medscape Medical News > Conference News

Hepatitis C in Limelight Again at Liver Congress
Miriam E. Tucker

 April 06, 2016

BARCELONA, Spain — Hepatitis C will top the agenda at the International Liver Congress (ILC) 2016, as it did last year, with presentations on treatment regimens for difficult-to-treat patients, the cost burden of the new direct-acting antiviral therapies, and real-world data.

"In hepatitis C, the big wave was 2 years ago. Now that we're beyond a 90% cure rate, it's a different landscape," said Laurent Castera, MD, who is secretary-general of the European Association for the Study of the Liver (EASL).

The cost of the new treatment regimens is a major problem, and a late-breaker study from Australia on an imported generic direct-acting antiviral treatment will likely draw a large audience. And several presentations of real-world data could provide reassurance that regimens proven highly effective in controlled clinical trials are achieving the same results in clinical practice.

"Hepatitis C still dominates the field, but the focus is shifting to difficult-to-treat patient groups, other genotypes, and a lot of real-life data," said EASL Vice-Secretary Tom Hemming Karlsen, MD, PhD.
Other hepatitis C trials will address regimens for difficult-to-treat patients, such as those infected with genotype 3, transplant patients, and patients who failed previous treatment with a direct-acting antiviral. There will also be discussions on post-treatment monitoring for patients with hepatitis B or hepatitis C, who could still be at risk for hepatocellular carcinoma.
Hepatitis C still dominates the field, but the focus is shifting to difficult-to-treat patient groups, other genotypes, and a lot of real-life data.  

A group from China will present results from a randomized trial comparing systematic transient elastography monitoring with liver biopsy in patients with hepatitis B. "The issue is whether the noninvasive method can assess regression of fibrosis and cirrhosis in patients treated for hepatitis C and hepatitis B," Dr Castera told Medscape Medical News.

With previous interferon-based treatment, "there was a significant decrease in hepatocellular carcinoma risk, but some risk persisted," he explained. "With the new direct-acting antivirals, we don't know. We anticipate that the risk might be even lower, but it's difficult to identify these patients. You still need to monitor all these patients, even though only a few will develop carcinoma."

"The point is, the story isn't over with the cure of the virus," Dr Karlsen explained.

Care delivery is now an issue. "How should hepatitis C care be administered? Is it done by hepatologists, or more broadly within the healthcare system? This is an interesting discussion that will emerge now that the regimens have become easier and easier," he reported.

Beyond Hepatitis C
Among the other late-breaker topics are phase 2 data on norursodeoxycholic acid for the treatment of primary sclerosing cholangitis, a first-in-class hepatitis B virus core inhibitor (administered alone or in combination with pegylated interferon), and a new oral therapy for patients with cirrhosis and high MELD scores at baseline.

One of three general sessions will examine several different antiviral regimens for chronic hepatitis B, a marker for mortality in nonalcoholic fatty liver disease, a genome-wide association study identifying risk loci for alcoholic hepatitis, and a phase 2 study of a bone marrow stem cell treatment for cirrhosis.

New EASL clinical practice guidelines on autoimmune hepatitis, nonalcoholic fatty liver disease, benign liver tumors, vascular liver disease, and liver transplantation will be presented during dedicated sessions at the congress. As well, updated hepatitis C treatment guidelines from EASL and from the World Health Organization (WHO) will be released.

Some of the guidelines will be issued jointly with other liver societies, and there will be two sessions held in conjunction with the WHO.

Dr Karlsen said he is most excited by the global outreach aspect of the congress, which began as strictly a European meeting but now welcomes more than 10,000 attendees from all over the world.

"There is a strong direction toward collaborative efforts among the major liver associations — European, American, Asian, and Latin American," he said. "You will see some very concrete output from that collaborative effort at a global level being presented and showcased at the meeting."

Much of the global cooperation was spurred by the advances in hepatitis C, but it has now expanded to include collaboration in other liver diseases, Dr Karlsen reported.

"The hepatology arena has become very global. It's a healthy direction, to see the field moving concertedly, along with the other associations, all in the same direction. It makes me happy," he said.
Dr Castera has served on the speaker's bureau for Echosens, which manufactures the FibroScan elastography device. Dr Karlsen has disclosed no relevant financial relationships.

Tuesday, April 5, 2016

April HCV Newsletters: Greed and the Necessity for Regulation/Treatment Action Group

April Hepatitis Newsletters and Updates
Welcome to this months collection of newsletters, todays news, and updates from around the web.
Research - News
April 6
JAMA Forum: We Can’t All Have It All: The Economic Limits of Pharmaceutical Innovation
New, expensive drugs for hepatitis C—Viekera Pak, Sovaldi, and Harvoni—severely stress budget-constrained programs like Medicaid and the Veterans Health Administration.
Many baby boomers may be unaware they need screening for the hepatitis C virus, a small study suggests
Miriam E. Tucker
BARCELONA, Spain — Hepatitis C will top the agenda at the International Liver Congress (ILC) 2016, as it did last year, with presentations on treatment regimens for difficult-to-treat patients, the cost burden of the new direct-acting antiviral therapies, and real-world data.

"In hepatitis C, the big wave was 2 years ago. Now that we're beyond a 90% cure rate, it's a different landscape," said Laurent Castera, MD, who is secretary-general of the European Association for the Study of the Liver (EASL).
By Erika Miller, Cavarocchi – Ruscio – Dennis Associates, Consultants to AASLD Reports from Washington may be making you question what is in store for your research, your patients, and your practice. The NIH finally just saw funding increase, but promoting the Institute’s growth is a priority during the continuing debates on the fiscal health of this country. Your patients may be providing conflicting reports on their access to new lifesaving hepatitis C drugs, and at the same time, you may be struggling with meeting Medicare’s increasing quality reporting requirements that impact your reimbursement.
Aimed Alliance:Patients should know they have legal options to remove reimbursement barriers to treatments they need. 
April 5
April 5, 2016
Patients with hepatitis C virus infection who failed interferon-free therapy have an increased risk for hepatocellular carcinoma compared with patients who achieved…
The Utah Department of Health and the CDC say they now have 16 confirmed cases of Hepatitis C tied to an outbreak in Weber and Davis Counties, CBS affiliate KUTV reports.
More patients hospitalized with acute liver failure – often the result of acetaminophen overdose – are surviving, including those who receive a liver transplant and those who don’t, an analysis led by a UT Southwestern researcher shows.
April 3
A new study, worked on by B.C. researchers, says baby boomers living a sex and drug lifestyle in the 1960s aren't to blame for hepatitis C infections in their demographic.
In fact, the research suggests all baby boomers should be tested for the hep C virus because widespread hospital practices predating the 1950's likely led to many accidental transmissions.

April 1
Drugmakers say Japan R&D spending at risk after government forces price cuts
TOKYO (Reuters) - Global drugmakers said they could cut research spending in Japan due to new rules requiring them to slash prices on some blockbuster drugs, including Gilead Sciences Inc's highly effective but expensive hepatitis C drug, Sovaldi. (Source: Reuters: Health)
April Newsletters

Treatment Action Group is an independent AIDS research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS.
TAG works to ensure that all people with HIV receive lifesaving treatment, care, and information.
We are science-based treatment activists working to expand and accelerate vital research and effective community engagement with research and policy institutions.
TAG catalyzes open collective action by all affected communities, scientists, and policy makers to end AIDS.

April 2016
TAGline Spring 2016

Fair Pricing: Reclaiming Drugs for the Common Good
By Tim Horn
The way I see it, you can go down in history as the poster boy for greedy drug-company executives, or you can change the system—yeah, you.—U.S. Representative Elijah E. Cummings (D-MD)

Greed and the Necessity for Regulation
The story of U.S. drug pricing run amok isn’t just about corporate arrogance and avarice—it is also about government permissiveness and inaction
By Tim Horn, Erica Lessem, and Kenyon Farrow

PrEP Pricing Problems
A number of barriers to pre-exposure prophylaxis (PrEP) uptake, use, and adherence have been identified—cost shouldn’t be one of them
By James Krellenstein and Jeremiah Johnson

The Low Cost of Universal Access
Generic treatments for HIV, viral hepatitis, and cancer can be affordably—and profitably—mass-produced for broad, unobstructed availability
By Tracy Swan


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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.

April Newsletter

Hey Advocators,
This month’s HCV Advocate newsletter is full of valuable information about hepatitis C.

HealthWise – Hepatitis on the Hill by Lucinda K. Porter RN – Lucinda talks about the recent advocacy efforts in Washington D.C. to increase awareness and funding for viral hepatitis C and more importantly how people with hepatitis C can get involved.

Nutrition and Hepatitis C – I discuss the importance of nutrition to stay healthy and some tips to help with making healthy choices.

SnapShots – in this month’s column I discuss a new HCV testing model in emergency rooms and the current HCV perspectives among primary care medical providers.

What’s Up!
This month we have the following information and updates:
The primary election process is upon us, and before you know it the national elections will be here. In many ways, the upcoming elections are the most important ones of our time. If you are not registered –it’s time to do so. Don’t forget to exercise your right and obligation as a citizen of our great nation.
Easy C Treatment Guides – Genotype 3 and Genotype 4 discusses the approved treatments for these strains of hepatitis C in easy to understand language.

In Case You Missed It

March Mid-Month Newsletter

HCV Drugs by Alan Franciscus
Hepatitis C Book Review: “Undetectable” by Kim Goldberg
HCV Advocate Monthly Pipeline Update
Cryoglobulinemia – updated Fact Sheet
A Brief History of HCV updated Fact Sheet

Easy C Treatment Guides for Genotype 1 (updated) and Genotype 2 (new).

Click here, to read this issue

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Hepatitis B and C Public Policy Association
 The Hepatitis Public Policy Association aims to urge and facilitate the formulation of public policies at national and international level for the communication, prevention and management of the spread of viral Hepatitis B and C. The Association’s unique approach in furtherance of this aim is to gather together, and work in partnership with, the major stakeholders in the field of these diseases including regulators, patients, clinicians, public health and civil society communities and the private sector.

April 2016 – Newsletter

In This Issue
Page 1 - 2
The first EU HCV Policy Summit dedicated to the elimination of hepatitis C in Europe.  Note by Professor Angelos Hatzakis  Co-Chair, Hepatitis B&C Public Policy Association.
Page 3 - 7
Report of the 2016 EU HCV Policy Summit
Page 8 - 9
Manifesto  Hepatitis C Elimination in Europe Page 10 Hepatitis C-free Europe is possible by 2030 - Press release
Page 11 - 13
Highlights from EU HCV Brussels Summit Gallery
Page 14 
EASL Meeting announcement

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.

April 2016 Hep Free NYC Newsletter
In This Newsletter
Upcoming Events
Hep Free NYC Program of the Month
Training & Technical Assistance
Tools & Resources
Journal Articles & Reports 

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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.

GI & Hepatology Newsletter

April 2016 PDF ( 4.1MB) |

Birth-cohort HCV testing misses one-quarter of infections
Portal in ammation in ped NAFLD linked to fibrosis
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HepCBC Hepatitis C Education and Prevention Society

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.

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

ALF Celebrates 40 Years in the Community
2016 marks a milestone year as we celebrate our 40th Anniversary serving the liver community. Learn more about what we have planned here!

Liver Cancer Deaths on the Rise
New Comprehensive Study Shows Overall Cancer Deaths Down, With Liver Cancer as the Concerning Exception

Recently, the National Cancer Institute released its Annual Report to the Nation on the Status of Cancer. Alarmingly, the report shows that liver cancer-related death rates were highest among people who have had hepatitis B and C.

This is preventable. There has been a vaccine to prevent hepatitis B since 1991, and new drugs for hepatitis C can cure 90% of cases but many people do not know they have it. Hepatitis C can remain silent in a person’s body for decades with symptoms often emerging in late stages of liver disease.

In addition to hepatitis, non-alcoholic fatty liver disease increases the risk for liver cancer, and, for those already diagnosed, reduces the chances for survival. Researchers at last year’s International Liver Congress meeting reported that survival is shorter for patients with fatty liver disease who develop cancer than it is for patients with hepatitis B or hepatitis C who develop liver cancer.

In fact, fatty liver disease is emerging as a major cause of hepatocellular carcinoma in the United States; a recent study found that in a five-year period (2004 to 2009), the annual increase in hepatocellular carcinoma in fatty liver disease patients was approximately 5%.

With as many as 4 million Americans infected with hepatitis C (75% of them do not know they have it), plus the 30% of Americans who have some form of fatty liver disease (this number is poised to reach 50% by 2030), clearly there is cause for concern.

The American Liver Foundation is the country’s only nonprofit organization exclusively dedicated to promoting liver health, as well as education, support and research for the prevention, treatment and cure of liver disease.

Learn more about who we are and what we do here.
To read the report, click here.
To learn more about liver cancer, click here.
Visit Our Honor Wall!
Read the inspiring stories of others that have lived with and fought liver disease here. To share your own experience with the liver community, click here.

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Blogs Around The Web

By Daryl Luster - April 4, 2016
Recently, I have heard medical professionals and public health officials suggest that people can wait in their treatment because of how slowly the disease progresses. Has someone suggested this is accurate in...

Take the Health Information Experience Survey
By Editorial Team - April 3, 2016
Staying informed is crucial when managing a chronic condition such as hepatitis C, and the internet has made it significantly easier to learn right at home. But online resources are only helpful...

The Next Big Thing is…living
By Daryl Luster - April 2, 2016
The next big thing is a titillating title and I apologize for the grandiose tone, but I had to speak to the issue again of what’s next in hepatitis c and not...

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About Karen Hoyt
Karen Hoyt offers a no nonsense approach to living with Cirrhosis. A Hepatitis C treatment survivor, she created a liver loving diet and lifestyle that allows her to create awareness and advocate for her Best Friends at

Balancing Hepatitis and Health
My life has been spinning since being diagnosed with the Hepatitis C Virus. At first, I ran out of the hospital trying to get away from it. Then I spent the next 6 years coming to grips with what it meant to my future. I began the Liver Loving Diet. I went all out to get a dangerous treatment. I battled hepatic encephalopathy (HE). I continually treated portal hypertension, ascites, and bleeding varices. I had to work in order to maintain insurance. And what was that next thing? Oh Yeah – the liver cancer and transplant. Geez Louise. How did I go about balancing Hepatitis and Health? I’m still working on it. Here’s my current thoughts....

Dr. Kristine Novak is the science editor for Gastroenterology and Clinical Gastroenterology and Hepatology. She has worked as an editor at biomedical research journals and as a science writer for 15 years, covering advances in gastroenterology, hepatology, cancer, immunology, biotechnology, molecular genetics, and clinical trials. She has a PhD in cell biology and an interest in all areas of medical research.

Alcohol Consumption and Fatty Liver—A Double Whammy for Liver Cancer Risk
High to intermediate levels of ethanol consumption increase the risk for liver cancer in patients with fatty liver disease, researchers report in the April issue of Clinical Gastroenterology and Hepatology. Nonalcoholic fatty liver disease is a common cause of chronic liver disease associated with obesity, dyslipidemia, pituitary dysfunction, hypertension, sleep... 

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 are the go-to source for educational and social support for people living with hepatitis.

In Case You Missed It

HEP Spring 2016 – Special Issue
Also Available On: ISSUU

Pamela Anderson is cured of hep C                                   
In every issue of HEP, you'll find the hottest topics of interest to our readers along with cutting-edge health information.

  • Hear Her Roar
  • Pretty Woman
  • RIP Natalie Cole 
  • Hep C Fuels Health Care Spending
  • Gilead’s All-Genotype Hep C Drug
  • Three-Week Treatment?

  • Blogs At

    Greg Jefferys
    My Hep C Travel Diary, Hepatitis C Advocate
    An American Tale: My journey to get generic Harvoni
    I happened upon Greg Jefferys blog while online - researching Harvoni appeals in the US. I have been denied by my insurance twice in 2 years. I'm 61 years old, have treated 3 times unsuccessfully, but because I'm not "sick enough" my insurance won't cover the cost.
    David Pieper
    HIV/Hep C activist. Cured of Hep C.
    Hepatitis, Liver Disease Support Coach
    The reality of sexual transmission of hep C
    Sexual behaviour is clearly associated with recently acquired hep C in HIV/hep C co-infected gay men. We need much more discussion and openness to counter the limited knowledge around sexual transmission risks and the low level of hep C status disclosure.
    Connie M. Welch
    Passionate Encourager for Christ, Writer, Speaker, and Hep C Warrior
    Hep C Healthy Highlights Session 1
    Welcome to Hep C Healthy Highlights. This is an exciting day. Today we’re saddling up together to move toward better health and wellness in every area of our lives. You may have Hep C or you may have already received the cure. No matter where you are in your journey with Hep C, we all know our lives are filled with day to day busyness.  In spite of Hep C, we all have area’s we’d like to improve and goals to achieve, right?

    Lucinda K. Porter, RN
    Author, Hepatitis C Advocate, Health Educator
    What Hepatitis C Treatment Used to Feel Like
    Last Friday was my favorite non-Federal holiday – April Fools' Day. I love to laugh, so an entire day dedicated to tomfoolery is my kind of day. I think the entire month of April should be devoted to laughter.

    View all blog entries, here.
    In The Spotlight

    Long Riders - Join our adventure

    LONG RIDERS mission: Riding the entire Pacific Crest Trail for Hep C awareness, testing and treatment. Overcoming the stigma.

    When Vic Ferrari was in the darkest hours of his battle with hep c he made a promise: if he survived he would ride horseback from Mexico to Canada. At that moment the ride was simply Vic’s motivation to beat hep c. When tests showed Vic had been cured, we realized that Vic’s simple promise was going to grow into an ambitious mission: To create a social media program that will document the challenges of a hepatitis C survivor's equestrian ride of the entire 2,650 miles of the Pacific Crest Trail in order to educate, inspire and empower those who are suffering from Hepatitis C to get tested, treated and cured.

    Get involved

    Watch - Long Riders Video

    Stay connected on Twitter and Facebook

    Updates Around The Web

    Digestive Diseases and Sciences
    Correspondence pp 1-1/ First online:

    Treatment of Dual Genotype Chronic Hepatitis C: Case Series
    Lokesh K. Jha
    Affiliated with Sanford Center for Digestive Health, Sanford School of Medicine, University of South Dakota, Jorge Gilbert
    Affiliated with Sanford Center for Digestive Health, Sanford School of Medicine, University of South Dakota
    Dear Editor,
    There has been a lot of progress in the treatment of chronic hepatitis C in the last 2 years, but so far, there is no study on treatment of dual genotype chronic hepatitis C as dual genotypes are rare [1]. It is also challenging to get treatment medication approved by insurance company for these kinds of patients.
    We have so far treated three patients with chronic hepatitis C dual genotype.
    1. 1.
      A 60-year-old male with liver cirrhosis (confirmed with liver biopsy) secondary to chronic hepatitis C genotypes 1a and 2, treatment naïve: He was treated with 16-week course of sofosbuvir/ledipasvir and ribavirin 600 mg BID. He did not have any side effects due to medication. He did have some issues with interruption of treatment while waiting for refill on his prescription after he completed 12 weeks of treatment. His HCV RNA before starting treatment was 2143667. HCV RNA was undetectable at 4 and 12 weeks. He was able to achieve SVR 12.
    2. 2.
      A 73-year-old female with chronic hepatitis C, genotypes 1b and 3 with stage 2 fibrosis on liver biopsy: She previously had genotype 1 and had relapse when she was treated with interferon and ribavirin, and also developed interferon-associated Graves’ disease. Eight years later when directly acting antivirals became available, repeat hepatitis C genotype showed that she has genotypes 1b and 3. She did not have any risk factors for hepatitis C reinfection after prior treatment. She was treated with sofosbuvir 400 mg daily (total duration 24 weeks), simeprevir 150 mg daily (total duration 12 weeks), and Ribavirin 400 mg BID (total duration 24 weeks). She tolerated the medication without any side effects, and there was no interruption in the treatment. Her HCV RNA before starting the treatment was 4760000. HCV RNA was < 15 at 4 weeks, undetectable at 6 and 12 weeks. She was able to achieve SVR 12.
    3. 3.
      A 55-year-old male with liver cirrhosis (seen in CT scan) secondary to chronic hepatitis C, genotypes 1a and 2, treatment naïve: He was treated with 16-week course of sofosbuvir/ledipasvir and ribavirin 600 mg BID. He tolerated the medication without any side effects, and there was no interruption in the treatment. His HCV RNA before starting treatment was 6460000. HCV RNA was undetectable at 4 and 12 weeks of treatment. He was able to achieve SVR 12.
    Although dual genotypes of chronic hepatitis C are rare, these patients can also be successfully treated with newer directly acting antiviral agents.

    1.AASLD/IDSA HCV Guidance: recommendations for testing, managing, and treating hepatitis C. http://​www.​hcvguidelines.​org/​.

    Clinical Care Options

    Getting Up to Speed on HCV Therapies; experts discuss HCV before, during and after treatment.
    Free registration is required, view video module, here.

    Medscape Gastroenterology
    A Focus on Hepatitis C: Outcomes
    Dr William Balistreri completes his three-part series on hepatitis C with a discussion about possible outcomes and a glimpse into the future of treatment.

    Conference Coverage @ NATAP
    APASL: Sofosbuvir and Ledipasvir/Sofosbuvir for the Treatment of Patients With Chronic Genotype 6 Hepatitis C Virus Infection: Integrated Analysis of Phase 2 and Phase 3 Studies - (04/01/16)

    APASL: Sofosbuvir/Velpatasvir Fixed-Dose Combination for the Treatment of HCV in Patients With Decompensated Liver Disease: the Phase 3 ASTRAL-4 Study - (04/01/16)

    Impact of Sustained Virologic Response in Hepatitis C Therapy
    The following article appeared in the March print edition of HCV Next available online at Healio;
    Stevan A. Gonzalez, MD, MS
    Although questions remain regarding the appropriate treatment strategy for patients with decompensated liver disease and those awaiting liver transplantation, it is clear that achievement of SVR is beneficial to virtually all patients. As more patients achieve this endpoint, we must also be attentive to which individuals will require ongoing surveillance after SVR, including surveillance for HCC in those with cirrhosis and managing comorbidities that could influence fibrosis progression such as fatty liver disease and obesity. Ultimately a greater understanding of these potential cofactors will be important in optimizing long-term outcomes and preserving the benefits of viral eradication.
    Healthy You

    Coffee Linked to 26% Drop in Colorectal Cancer Risk
    Regular coffee drinking was inversely correlated to colorectal cancer risk, supporting proposals of a protective effect.

    Check back for updates....


    Sunday, April 3, 2016

    New research says hep C epidemic not caused by 1960s sex and drug lifestyle

    New research says hep C epidemic not caused by 1960s sex and drug lifestyle

    Peak of hep C infection epidemic actually occurred in 1950, not 1965 as previously thought

    By Karin Larsen, CBC News Posted: Apr 03, 2016 7:00 AM PT Last Updated: Apr 03, 2016 7:00 AM PT

    A new study, worked on by B.C. researchers, says baby boomers living a sex and drug lifestyle in the 1960s aren't to blame for hepatitis C infections in their demographic.
    In fact, the research suggests all baby boomers should be tested for the hep C virus because widespread hospital practices predating the 1950's likely led to many accidental transmissions.

    The findings suggest an increase in medical procedures post World War II and inadequate hospital sterilization of reusable needles and syringes are the culprits.

    Continue reading...

    Getting Up to Speed on HCV Therapies - Experts discuss HCV before, during and after treatment.

    Good day folks, if you have been diagnosed with HCV and either considering treatment, on treatment or have completed treatment you may benefit greatly from viewing this easy to follow video program over at Clinical Care Options.

    The presentation; "Getting Up to Speed on HCV Therapies"offers a look see at various HCV patient scenarios. Experts discuss the use of current HCV therapies before, during and after treatment.

    As an example in the first video "Treatment for HCV" a noncirrhotic 50-year-old genotype 1a patient who would prefer to be treated with sofosbuvir/ledipasvir is reviewed. In the second module it's all about pre-treatment considerations in patients taking other medications. Next up an overview of adherence during treatment and finally in the post-treatment section "Cure" is defined. In addition experts discuss the benefit of SVR in relation to reducing liver-related mortality in persons with advanced liver damage. Closing with the importance of follow up care, testing, liver wellness, and alcohol use.

    Sit back and view experts; Sherilyn C. Brinkley, MSN, CRNP; Elizabeth K. Goacher, PA-C, MHS; Jennifer Katzianer, PharmD, BCPS; and Andrew J. Muir, MD, discuss the following topics

    • Considerations Influencing Choice of Oral Therapy for HCV Infection
    • Pretreatment Support for HCV-Infected Patients
    • On-Treatment Management of HCV Therapy
    • Posttreatment Care Following HCV Cure
    During the presentation participants can easily skip follow up questions by clicking the "NEXT" button located at the bottom of the page or click on the "Table of Contents" to continue with the activity.

    Free registration is required, begin here, view video module, here.