Monday, July 9, 2018

Promising new HIV vaccine candidate trialled in humans

Monday 9 July 2018 5:37PM (view full episode)

Researchers have been trying for decades to find a vaccine for HIV. Several candidates have made it through initial rounds of clinical trials, only to prove ineffective at generating an immune response in humans. But a new vaccine candidate is the fifth ever to make it through to the so-called 'phase 2b' trial stage.

Listen @ Health Radio, hosted by Dr Norman Swan with guest Dr Dan Barouch, professor of Medicine at Beth Israel Deaconess and Harvard Medical School in Boston.

The Health Report is a valued information source for professionals and students in the medical and health professions, as well as attracting a sizeable audience of general listeners seeking jargon-free, easy-to-understand information and analysis on health and medical matters.

Friday, July 6, 2018

Cabozantinib Ups Survival in Advanced Liver Cancer - Results Phase 3 Trial

News > Medscape Medical News > Oncology News
Cabozantinib Ups Survival in Advanced Liver Cancer
Roxanne Nelson, BSN, RN
July 05, 2018

The targeted agent cabozantinib (Cabometyx, Exelixis) could be a new treatment option for previously treated patients with advanced hepatocellular carcinoma (HCC), suggest results from a phase 3 trial.

As compared with placebo, treatment with cabozantinib resulted in longer overall survival and progression-free survival.

Median overall survival was 2.2 months longer for patients who received cabozantinib, and treatment was associated with a 56% reduction in the risk for progression or death.

The results were initially presented at the Gastrointestinal Cancers Symposium (GICS) 2018 and were reported by Medscape Medical News at that time. They have now been published in the New England Journal of Medicine. 

Free registration may be required

Monday, July 2, 2018

Coffee Drinkers Are More Likely To Live Longer. Decaf May Do The Trick, Too

Coffee Drinkers Are More Likely To Live Longer. Decaf May Do The Trick, Too 
July 2, 2018

Coffee is far from a vice.

There's now lots of evidence pointing to its health benefits, including a possible longevity boost for those of us with a daily coffee habit.

The latest findings come from a study published Monday in JAMA Internal Medicine that included about a half-million people in England, Scotland and Wales. Participants ranged in age from 38 to 73.

$20 blood test could help diagnose thousands of patients with hepatitis B in need of treatment

$20 blood test could help diagnose hepatitis B patients across Africa
Imperial College London
A simple $20 blood test could help diagnose thousands of patients with hepatitis B in need of treatment in some of Africa's poorest regions.

Researchers have developed an accurate diagnostic score that consists of inexpensive blood tests to identify patients who require immediate treatment against the deadly hepatitis B virus - which can lead to liver damage or cancer (1).

The score consists of two simple blood tests: one measuring presence of antigens, proteins produced by the virus, and another for enzymes produced by the liver in response, to accurately assess patients for treatment.

The score was found to be as accurate as existing methods for identifying the patients in need of immediate treatment but at a fraction of the cost, $20 compared to $100-500 for current tests.

It is also far more accessible than existing methods - such as liver biopsy or HBV DNA, a much more complicated blood sample analysis - which requires resources and laboratories that are not always accessible in sub-Saharan Africa.

Researchers from Imperial College London and Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, collaborating with the Pasteur Institute in Paris and other African and European institutions, used data from hundreds of hepatitis B patients in The Gambia who were part of the PROLIFICA (Prevention of Liver Fibrosis and Cancer in Africa) study.

Clinical data from more than 800 hepatitis B patients, who had been tested through the PROLIFICA programme, were used to develop this new score.

The tests were then validated with data from African patients in Senegal, Burkina Faso, Germany, France and the UK. The results are published in the Journal of Hepatology.

The new diagnostic test, called TREAT-B, was found to accurately identify HBV positive patients who require treatment in 85% of cases (called sensitivity), and could accurately identify those who do not need treatment in 77% of cases (called the specificity).

The scientists say that further research is needed but if the test is successful in larger studies it could be used widely to identify patients in need of hepatitis B treatment and refer thousands of people for life-saving treatment. The test could also be developed further to be implemented as a finger-prick test, similar to those used to detect HIV, to get quicker results.

The researchers also discovered that the diagnosis method worked at all stages of the disease - meaning that people in the early stages of liver disease without symptoms could also be screened and identified.

Imperial's Dr Maud Lemoine, co-author of the study, said: "These results show that this simple and inexpensive test could be an accurate way to diagnoses patients in need of hepatitis B treatment in countries with limited resources.

"This could potentially help diagnose and subsequently treat thousands of people across Africa."

Co-author, Yusuke Shimakawa from the Pasteur Institute said: "Once these results are validated by further studies, they could be potentially integrated into the WHO guidelines and local guidelines - and implemented in daily practice.

"There is great potential to diagnose more people and improve access to treatment.

Viral hepatitis is a major global health problem and in 2013 an estimated 1.45 million people died from the virus. It is the seventh leading cause of death worldwide and about half of deaths are attributable to the hepatitis B virus infection.

The hepatitis B virus infects around 250 million people worldwide, and is transmitted through blood and bodily fluids. In Africa, it is commonly transferred from mother to baby during birth or between children. However the virus causes no immediate symptoms, and can remain undetected in the body for decades until triggering severe complications such as liver damage (cirrhosis) and cancer.

The region most affected by hepatitis B is Sub-Saharan Africa, where around 80 million people are infected.

Sunday, July 1, 2018

Cost-effective universal screening for hepatitis C in France

Cost-effective universal screening for hepatitis C in France
It is currently recommended in Europe that screening for hepatitis C virus (HCV) should target people at high risk of infection. In France, public health data suggest that in 2014 approximately 75 000 people aged 18 to 80 were infected by HCV, but were unaware of their status. In at least one in ten cases, these people are at an advanced stage of the disease when diagnosed. Today's treatments of HCV infection are both highly effective and well tolerated, and cure the infection in a few weeks in over 95% of cases. In Professor Yazdan Yazdanpanah's Inserm research team, Sylvie Deuffic-Burban has developed a mathematical model that assesses the efficacy and cost-effectiveness of different screening strategies, including universal screening.

This study applied data from a 2004 InVS seroprevalence survey to 18- to 80-year-olds in France, excluding people with diagnosed chronic HCV infection. The researchers developed their analytical model using a combination of these seroprevalence data and findings from studies of the characteristics of people infected (age, sex, stage of the disease at diagnosis, alcohol intake, etc.), the natural progression of the disease, the efficacy of treatments, the quality of life of the patients treated, and the cost of treatment of infection. The screening strategies assessed targeted the following groups: the at-risk population only, all men aged between 18 and 59, all people aged between 40 and 59, all people aged between 40 and 80, and everyone aged between 18 and 80, ie, universal screening.

The modeling results show that universal screening is associated with better life expectancy adjusted for quality of life than other strategies. Universal screening is cost-effective if the patients tested for HCV infection are treated rapidly after diagnosis. Sylvie Deuffic-Burban points out that "Screening, on an individual basis, enables rapid treatment, which avoids the development of serious complications. In time, collective screening helps eliminate hepatitis C from a population that has been screened without restrictions." The results of this ANRS-funded study therefore argue in favor of universal screening for HCV in France, followed by immediate treatment of those diagnosed with HCV infection. Sylvie Deuffic-Burban concludes that "Although our model is unable to test the idea, the epidemiological similarities of HCV, HIV, and HBV suggest that universal and combined screening for these three viruses could be of particular interest."

Sources: Research Article
Assessing the cost-effectiveness of hepatitis C screening strategies in France
Sylvie Deuffic-Burban, Alexandre Huneau, Adeline Verleene, Cécile Brouard, Josiane Pillonel, Yann Le Strat, Sabrina Cossais, Françoise Roudot-Thoraval, Valérie Canva, Philippe Mathurin, Daniel Dhumeaux, Yazdan Yazdanpanah
Publication stage: In Press Corrected Proof
Published online: July 1, 2018

Article Source

Saturday, June 30, 2018

HepCure Webinar Series - Hep C & Fatty Liver, Treatment, Alcohol Use, Elderly Patients and More

Watch experts discuss important HCV related topics in this easy to access webinar series presented by HepCure.

June 26, 2018
Transplant & HCV
On Tuesday, June 26th, Dr. Thomas Schiano of Mount Sinai Medical Center presented on: “Transplant & HCV”
Watch, here….
Download Slides, here.....

June 19, 2018
Nonalcoholic Fatty Liver Disease and Hepatitis C
On June 19th Dr. Amon Asgharpour of the Icahn School of Medicine at Mount Sinai. Dr. Asgharpour presented “Nonalcoholic Fatty Liver Disease and Hepatitis C.”

Watch, here.….
Download Slides, here...…

Of Interest
Michael Carter
Published: 18 June 2018
Fatty liver improves rapidly after hepatitis C cure
Liver stiffness and liver fat (steatosis) in people with chronic hepatitis C virus (HCV) infection both improve significantly after treatment with direct-acting antivirals (DAAs) resulting in sustained virological response (SVR), investigators from Japan report in Alimentary Pharmacology and Therapeutics. Both measures of liver health were assessed six months after SVR. Improvement was associated with a reduction in ALT levels and an increase in platelet count.

On This Blog
June 18, 2018
Hepatitis C Weekend Video: NASH What Is It

July 1, 2018
In the July Issue of the patient-friendly HCV Advocate newsletter, Lucinda Porter, RN., writes a must read article about: Avoiding Fatty Liver.

June 2018
Hepatitis C and Alcohol
On Tuesday, June 5th, Peter Hauser, MD, Director of the National VA Telemental Health Hub Long Beach presented on: “Hepatitis C and Alcohol”.

Watch, here...
Download Slides, here....

May 2018 - HCV Treatment
“Ace the Case” 

Program presented last month led by Dr. Douglas Dieterich of the Icahn School of Medicine at Mount Sinai. This webinar is patient based, with question and answer participation.

Late relapse in people with HCC
Chemo On HCV
Treating Patients with HCV & Depression & More....
Watch, here.....

HCV in the Elderly Patient
On May 29th, Dr. Roxana Bodin of Westchester Medical Center Health presented on: “HCV in the Elderly Patient”

Watch, here...
Download Slides here.....

Of Special Interest
"Innovation as Usual: Sustainable Financing for Viral Hepatitis Elimination" with Dr. Henry Chang. This webinar will discuss the global target to eliminate viral hepatitis as a major public health problem by the year 2030.
Watch, here.....
Download Slides, here...

Additional Topics
The HCV-Opioid Syndemic in Appalachia: Evidence from a Cohort of Rural Drug Users
Hepatitis C in Children and Adolescents
Cirrhosis & HCV

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HepCure Patient App
The patient app is a free resource for patients with hepatitis C, which allows them to track medication adherence, symptoms, and gain access to resources. It is available to download for free on iOS (App Store) and Android (Google Play) operating systems. While the app can be used by patients independently from the dashboard, it can also be linked with the provider dashboard. Providers can push lab data to patients and track treatment adherence and symptom data input by patients in real time.
Learn more here...…

Friday, June 29, 2018

Study May Lessen Controversy Over DAAs’ Relationship to Liver Cancer

Clinical Oncology News

Study May Lessen Controversy Over DAAs’ Relationship to Liver Cancer
Washington—Eradication of chronic infection with the hepatitis C virus with the new class of antiviral agents is associated with a 71% reduction in the risk for de novo liver cancer, according to a large retrospective cohort study involving the Veterans Affairs health care system.

The findings should provide some assurance for patients taking direct-acting antivirals (DAAs), according to lead study author George Ioannou, BMBCh, MS, the director of hepatology at Veterans Affairs Puget Sound Health Care System, in Seattle.

On This Blog
Liver cancer incidence after HCV therapy
This page offers an index of links to current data investigating the possible risk of developing liver cancer (hepatocellular carcinoma, or HCC) during and after direct-acting antiviral therapy in patients with hepatitis C.

Thursday, June 28, 2018

HCV clearance by direct antiviral therapy and occurrence/recurrence of hepatocellular carcinoma: still an issue?

HCV clearance by direct antiviral therapy and occurrence/recurrence of hepatocellular carcinoma: still an issue? 
Francesco Paolo Russo, Martina Tessari, Angela Imondi, Erica Nicola Lynch, Fabio Farinati

Hepatoma Res 2018;4:25. | | © The Author(s) 2018
Received: 4 May 2018 | First Decision: 15 May 2018 | Revised: 10 Jun 2018 | Accepted: 16 Jun 2018 | Published: 27 Jun 2018 

In conclusion, the risk reduction in hepatic decompensation as well as in HCC incidence in patients achieving SVR is the only proven evidence. The reports about the increased risk of HCC occurrence/recurrence in DAA treated patients are afflicted by selection and methodologic biases, that weaken the impact of these studies. We strongly believe that is mandatory to treat HCV-infected patients with DAAs but also to maintain an active surveillance for liver cancer as the guidelines suggest; the previously presented data must be considered with caution.

New regimens with direct-acting antivirals (DAAs) agents have changed both efficacy and safety of hepatitis C virus (HCV)-treatment, as almost all patients can be treated and cured at any stage of liver disease. The rates of sustained virological response to currently available combinations exceed 95% in real-life practice. However, conflicting results have been produced on the occurrence/recurrence of hepatocellular carcinoma (HCC) in patients with HCV-associated cirrhosis treated with DAAs. In this review we analyse the data available in the literature in order to elucidate the impact of DAAs on the risk of HCC occurrence in patients without previous history of tumor, and of recurrence after successful treatment of the tumor. Data on “de novo” HCC incidence were quite homogeneous, suggesting that the treatment with DAAs does not modify the risk of HCC developing during the first 6-12 months after HCV eradication. On the contrary, HCC recurrence rates after DAAs were extremely variable across different studies, reflecting a large heterogeneity in this clinical setting. The possibility that treatment with DAAs may favour tumour growth and spread in individual patients with active HCC foci is supported by some observations but remains unproven. 

Full-Text Article Open Access