Some patients facing a years-long wait for a kidney transplant are jumping ahead in line thanks to a startling experiment: They’re agreeing to an organ sure to infect them with hepatitis C
WASHINGTON (AP) — Some patients facing a years-long wait for a kidney transplant are jumping ahead in line thanks to a startling experiment: They’re agreeing to an organ almost sure to infect them with hepatitis C.
Knowingly transmitting a dangerous virus may sound drastic but two leading transplant centers are betting the strategy will save lives — if new medications that promise to cure hepatitis C allow use of organs that today go to waste.
LA JOLLA, CA — Oct. 24, 2016 — Researchers have been trying for decades to develop a vaccine against the globally endemic hepatitis C virus (HCV). Now scientists at The Scripps Research Institute (TSRI) have discovered one reason why success has so far been elusive.
Using a sophisticated array of techniques for mapping tiny molecular structures, the TSRI scientists analyzed a lab-made version of a key viral protein, which has been employed in some candidate HCV vaccines to induce the body’s antibody response to the virus. The researchers found that the part of this protein meant as the prime target of the vaccine is surprisingly flexible. Presenting a wide variety of shapes to the immune system, it thus likely elicits a wide variety of antibodies, most of which cannot block viral infection.
“Because of that flexibility, using this particular protein in HCV vaccines may not be the best way to go,” said co-senior author TSRI Associate Professor Mansun Law.
Since 2013, more effective drug therapies for treating hepatitis C have increased the rate at which our people are completing treatment that leads to a cure for the deadly virus. Joining a family of highly effective direct acting antiviral therapies available at ANMC is a newly licensed drug consisting of sofosbuvir and valpatasvir (Epclusa®, Gilead Sciences, Inc.). This is a fixed-dose combination tablet that covers six hepatitis C virus genotypes and is approved for use in persons with serious liver disease, most of whom had no treatment options available prior to this drug’s approval.
Through the Liver Disease and Hepatitis Program, ANTHC is currently supporting two programs to increase treatment rates for our people who are living with hepatitis C infection. First is the Hepatitis C Treatment strategic initiative, which has made the new treatment options available for the past three years. Through this initiative at ANMC, 270 patients have completed treatment with more than 95 percent completing treatment as prescribed by their provider. For patients who have completed treatment, 93 percent of them have been cured (i.e., no detectable virus in their blood, 12-weeks post-treatment completion). Statewide, outside of ANMC, more than 100 persons have received hepatitis C treatment.
Note: There is an excellent video embedded in the news story that explains the study- Alan
LEXINGTON, Ky. (Oct. 21, 2016) — With the rise in injection drug use, infectious disease has permeated through cohesive social networks in Appalachia, causing another dimension of devastation in the wake of the opioid epidemic.
About 15 years ago, a shift toward injection drug use behaviors occurred in rural Appalachia. These changes in drug use patterns signaled the potential for infiltration of blood-borne pathogens transmitted through shared needles. Increases in hepatitis C (HCV) infections have paralleled the increase in injection drug use behaviors among opioid users, with the rate of HCV infection in three Appalachian states tripling within six years.
With staggering rates of injection drug use and HCV in Appalachia, the National Institutes on Drug Abuse (NIDA) issued planning grants in 2016 to support researchers expediting and implementing solutions to the epidemic. Jennifer Havens, an epidemiologist in the University of Kentucky Center for Drug and Alcohol Research, was recently awarded two of the competitive planning grants to launch projects that will inform interventions and policies directed at opioid abuse across Appalachia. Havens has followed the simultaneous rise in injection drug use and HCV in Appalachia since 2004, accruing valuable data imperative for informing interventions and effective health policies.
Georgia’s hepatitis C elimination program, the first of its kind in the world, can provide information and experience that will assist similar goal-setting and programmatic efforts in other countries. The country of Georgia has one of the highest hepatitis C prevalence rates in the world, affecting 8% of the 3.7 million population. Georgia is the first country to take on the challenge of eliminating hepatitis C and has, as part of a comprehensive hepatitis C elimination plan, committed to treat and cure every hepatitis C-infected person in the country. In April 2015, in collaboration with CDC and other partners, Georgia embarked on a program to eliminate hepatitis C infection, subsequently defined as achieving a 90% reduction in prevalence by 2020. The initial phase of the program focused on providing free, curative HCV treatment to infected people with advanced liver disease. By April 2016, a total of 27,392 HCV-infected people registered for the program; 31% started treatment, 69% completed treatment, and 83% of those who completed treatment were cured of HCV.
MMWR News Synopsis for October 20, 2016 click here
In HIV-infected patients receiving antiretroviral therapy (ART), chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection is associated with an increased risk for non-Hodgkin’s lymphoma. The findings are published in Annals of Internal Medicine.
The incidence rate of non-Hodgkin’s lymphoma in HIV-infected persons is about 10 times higher than in the HIV-negative population, and is an important cause of AIDS and death, even for patients receiving ART. Growing evidence indicates that some infections increase the risk for non-Hodgkin’s lymphoma through chronic immune stimulation that occurs in immunocompromised patients. It is unclear whether chronic HBV and HCV infection promote non-Hodgkin’s lymphoma in HIV-infected patients.
The Substance Abuse and Mental Health Services Administration recently announced a new federal funding opportunity to address the opioid use and overdose epidemic and associated comorbidities in rural U.S. regions.
Funding will go towards research on comprehensive, integrated approaches to prevent opioid injection and related consequences, including substance use disorder, overdose, HIV, hepatitis C and associated conditions such as hepatitis B and STDs.
The initiative will focus on coal-impacted counties within Appalachia and other rural communities across the country.
Southeast Alaska has seen a nearly 500 percent increase in the rate of young adults with Hepatitis C in the last five years. Hepatitis C is the most common chronic blood-borne infection in the U.S. An estimated three and a half million people are infected in the U.S.
For many years it was mainly reported in older generations, the Baby Boomers, infected with blood transfusions and organ transplants done before blood screening became widespread in 1992. The infection can also be spread by sharing needles and intravenous drug use and health officials say that’s likely a factor in the spike in cases in adults age 18 to 29 in Alaska. Other parts of the state are also seeing a rise in young adults with Hep C, but Southeast has seen the biggest increase.