Read about this serious extrahepatic manifestation of hepatitis C, click here
Read about this serious extrahepatic manifestation of hepatitis C, click here
Scientists from the University of Washington and the US Department of Veterans Affairs wanted to know whether the risk of liver cancer increased or decreased depending on which direct-acting antiviral (DAA) regimen was prescribed to a particular patient.
It’s the latest research in a series of studies looking at the complicated issue of DAAs, HCV infection, and cancer. Hepatitis C itself is a leading cause of hepatocellular carcinoma (HCC) and other liver cancers. Moreover, HCV can cause other conditions, such as cirrhosis, which in turn increase a patient’s risk of liver cancer.
On the one hand, DAAs help patients achieve sustained virologic response, which slows the progression of cirrhosis, and thus lowers the patient’s cancer risk.
1.Title: Inovio (INO) initiates phase 1 study on hepatitis C vaccine – Zacks Equity Research
Summary: Inovio Pharmaceuticals announced on September 4th, 2018 that it had begun a phase 1 study of the first hepatitis C vaccine—GLS-6150—to prevent hepatitis C (HCV) infection. The study is in collaboration with GeneOne Life Science. The study will enroll 24 patients previously cured of HCV. The clinical trial results are expected in 2019. Of note, Inovio also launched a phase I/II study of an HIV vaccine that targets all HIV strains that would control HIV without HIV antiretroviral medications. It’s a long shot for any drug to make it from phase 1 to an effective treatment or protective vaccine but it would be remarkable if these two vaccines proved to be effective.
2. Title: Transplantation of hepatitis C virus (HCV) antibody positive, nucleic acid test negative donor kidneys to HCV negative patients frequently results in seroconversion but not HCV viremia—M. E. de Vera, et. al.
Source: Am J Transplant. 2018 Jul 24. doi: 10.1111/ajt.15031. [Epub ahead of print]
Summary: The study looked at 32 patients who received a hepatitis C (HCV) antibody positive, HCV viral load negative kidney from deceased donors and underwent a kidney transplant. So far, all of the patients who received the HCV antibody positive kidneys became HCV antibody positive but remained HCV viral load negative.
3. Title: Cardiac transplantation from non-viremic hepatitis C donors—S. R. Patel, et. al
Source: J Heart Lung Transplant. 2018 Aug 17. pii: S1053-2498(18)31514-6. doi: 10.1016/j.healun.2018.06.012. [Epub ahead of print]
Summary: In 2017, 14 patients received hepatitis C (HCV) antibody positive, HCV RNA negative hearts from deceased donors and underwent a heart transplant. Over a period of 192 to 377 days, three patients developed HCV antibodies, but no patients tested HCV viral load positive.
4. Title: Cost-effectiveness of transplanting HCV-infected livers into uninfected recipients with preemptive antiviral therapy—E.D. Bethea, et. al.
Summary: In the study, the authors analyzed the costs and benefits of receiving an HCV viral load positive liver for transplantation. The patients who received the HCV positive liver were treated with 12-weeks of DAA therapy.
The cost-effectiveness was based on the model for end-stage liver disease (MELD). The higher the MELD score, the higher the severity of liver disease and the need for a liver transplant. The most substantial cost savings were in the people with the highest MELD score. However, even in patients with low MELD scores, there was a benefit to receiving an HCV-positive liver for transplantation.Share This Page
Universal 1-time screening for chronic hepatitis C virus (HCV) infection is cost-effective compared with no screening or with birth cohort-based screening alone, according to results published in Clinical Gastroenterology and Hepatology.
The researchers developed a Markov state transition model to estimate the effects of universal 1-time screening of adults age ≥18 years in the United States compared with the effects of the current guideline of screening adults born from 1945 through 1965.
They compared potential outcomes of universal screening or birth cohort screening followed by antiviral treatments for those with HCV infection compared with no screening. The researchers also measured effectiveness with quality-adjusted life years (QALY) and costs with 2017 US dollars.
Title: Lack of patient compliance in real-world practice negatively affects sustained viral response rates to direct-acting agent therapy for hepatitis C –M. C. Marshall, et. al.
Source: Dig Dis Sci. 2018 Aug 20. doi: 10.1007/s10620-018-5247-5. [Epub ahead of print]
Study Aims and Results: To assess patient compliance in taking hepatitis C (HCV) medications, completing therapy and with follow-up visits.
The authors retrospectively analyzed data of 261 genotype 1 treatment-naïve (never been treated) and treatment-experienced patients treated with Harvoni (ledipasvir plus sofosbuvir). Before beginning treatment, the patients were counseled on the importance of taking all of their medications, attending their laboratory appointments and returning for their post-treatment follow-up.
The cure rates of those who adhered to treatment vs. those who did not were 95% vs. 74% respectively. The cure rates in the treatment-naïve vs. treatment-experienced group were 68% vs. 86% respectively. In the entire study, 7% discontinued treatment early and 15% didn’t return for post-treatment follow-up. The treatment-naïve patients were less likely to return for post-treatment assessment compared to the treatment-experienced patients (28% vs. 11%).
Conclusion: In this retrospective analysis a significant number of people treated were noncompliant to DAA therapy despite being counseled on the importance of adherence. Treatment-naïve patients were less adherent than treatment-experienced patients.
Editorial Comments: At first, I was surprised by the study results, but after thinking it through I remembered that compliance with treatment is one of the most difficult issues of drug treatment. I think the bright spot in the study is in two areas:
Perhaps other tools like electronic reminders and further outreach to patients would have helped. Since this was an abstract, I don’t know all of the outreach efforts the investigators used.
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Hepatitis C coinfection can be eliminated in people living with HIV in the United Kingdom by 2021, the British HIV Association said today.
“The UK can be the first country to achieve microelimination of hepatitis C in those living with HIV, well ahead of WHO targets. We should seize this opportunity,” BHIVA said in a statement released today.
Speaking at last week’s British HIV Association Hepatology Highlights Meeting, Professor Graham Cooke of Imperial College, London, said that breaking down World Health Organization targets for hepatitis C elimination into microelimination targets for individual populations such as people living with HIV would help to drive progress towards the larger target of treating 80% of those eligible for direct-acting antiviral treatment by 2030.
Hepatitis C virus (HCV) infection is increasingly observed in younger patients. Maternal transmission is currently the main route of HCV acquisition in children, with 1 meta-analysis reporting a transmission rate of 5.8%.1 Each year in the United States, an estimated 29,000 HCV-infected women give birth to approximately 1700 infected infants.2
“Unfortunately, most likely those numbers will continue to understate the burden of maternal and perinatal HCV as long as screening for pregnant women remains risk-based and mechanisms to improve reporting remain unchanged,” wrote the authors of a review.3
“Universal screening for pregnant women is the first step to improving HCV perinatal surveillance and moving toward HCV elimination because risk-based screening is ineffective in identifying all exposed infants.”3
Hepatitis C is NOT just a liver disease-it affects the entire body. Check out our fact sheet that lists some of the more common and uncommon extrahepatic manifestations of hepatitis C. Click here to download