According to the results of a study published in Morbidity and Mortality Weekly Report, the rate of hepatitis C virus (HCV) infection among pregnant women enrolled in Wisconsin Medicaid is rising. Further, approximately two-thirds of infants born to women with HCV during pregnancy were not tested for HCV according to recommendations.
To determine the proportion of pregnant women with HCV, researchers examined HCV-positive laboratory tests using Wisconsin Department of Health Services and Wisconsin Medicaid encounter data for 146,267 women who delivered at least one infant between 2011 and 2015.
Vertical transmission risk was assessed as high (evidence of viremia during pregnancy), possible (evidence of viremia before pregnancy), and unknown (anti-HCV antibody positive but no RNA results). To estimate the frequency of HCV testing for infants at high risk for vertical transmission, researchers assessed guideline-concordant testing among infants who were enrolled in Medicaid to at least 18 months of age.
It’s no secret Portland has a drug problem. Anyone who rides the MAX regularly or walks around downtown can see the area’s drug problem as plainly as the weather. Injectable drugs like heroin and methamphetamine are among the worst, not only because of the addictive propensity of the drugs themselves, but also because of the use and disposal of needles and overdose rates.
The biggest problem with heavy drug use in Portland is the city itself. According to NorthPoint Recovery, “In 2014, more than half of all heroin-related deaths in Oregon occurred in Multnomah County, in and around Portland…Deaths related to methamphetamine use are almost triple the number that occurred in 2001.”
Right now, Multnomah County has a sharps collection box on the East Bank Esplanade and a sharps exchange program for drug users, but how effective are they? What about those who use needles and throw them on the ground in parks and sidewalks? What about those who carry HIV or hepatitis C and share needles?
Treatment with direct-acting antiviral therapies, or DAAs, demonstrated similarly high rates of SVR for hepatitis C virus infection in patients with and without HIV coinfection, according to findings from a systematic review published in Hepatology.
“Because of low SVR rates associated with interferon-based therapies, the accelerated progression of HCV related liver disease, and barriers to receiving treatment, the FDA identified those infected with HIV and HCV co-infection as being a specific population with unmet medical needs,” Sammy Saab, MD, MPH, AGAF, FAASLD, professor of medicine and surgery in the division of digestive diseases and head of outcomes research in hepatology at David Geffen School of Medicine, University of California, Los Angeles, and colleagues wrote. “With the improvements in life expectancy afforded with treatment, in conjunction with superior SVR rates with DAA therapy, re-evaluation of whether coinfected individuals should be considered a special population among those infected with hepatitis C is warranted.”
Using clinical databases, researchers performed a systematic review of the treatment of chronic HCV infection in patients coinfected with HIV to determine whether using DAA agents addresses an unmet medical need and results in similar SVR rates as those seen among HCV-monoinfected patients. In their review, the investigators included studies dated between January 2004 and July 2017.
A team of Japanese researchers has identified a compound that inhibits the maturation of the hepatitis C virus without selecting for resistant strains.
AsianScientist (Dec. 19, 2017) – Scientists in Japan have discovered a compound that blocks the spread of hepatitis C virus (HCV). They published their findings in PNAS Plus.
Hepatitis C is caused by a highly infectious virus, affecting millions across the globe. While HCV can sometimes be fought off and cleared by the immune system during the first few months of acute infection, up to 80 percent of those with HCV develop a chronic infection. This can lead to serious liver illnesses, including inflammation, cirrhosis and hepatocellular carcinoma—the third leading cause of cancer death worldwide. While highly effective treatments for HCV have become available in recent years, drug-resistant viral strains can still lead to treatment failure for a sizable proportion of patients.
Ombitasvir/paritaprevir/ritonavir and dasabuvir with or without ribavirin (OPrD ± RBV) resulted in good adherence and high rates of sustained virologic response (SVR) among patients with hepatitis C genotype 1 and advanced fibrosis, according to recent real-world use data published in the Journal of Viral Hepatitis.
To evaluate the association of patient characteristics and SVR among those receiving OPrD ± RBV, researchers evaluated 403 adults with genotype 1 hepatitis C and advanced fibrosis, using data from an Israeli health plan database (71.0% treatment-naive; 95.6% 12-week regimen). Adherence was estimated based on a gap in medication fills of more than 14 days, and SVR was measured with viral testing at 12 weeks posttreatment.
Most participants were highly adherent and completed the treatment in the usual timeframe (86.4%). The remainder of patients completed treatment with a gap (8.2%) or purchased less than the recommended dose (4.7%).
Patients with hepatitis C genotype 1 who achieved sustained virologic response after direct-acting antiviral treatment had significant improvement or reversal of insulin resistance, according to a recently published study.
“Both experimental and clinical studies have demonstrated that HCV induces [insulin resistance (IR). Moreover, a close correlation between the viral load and IR was observed in genotype 1 infection, indicating a possible direct link between the two conditions,” Luigi E. Adinolfi, MD, from University of Campania, Italy, and colleagues wrote. “Our study demonstrated that HCV patients reaching SVR have a better glycemic control, thus it is possible to hypothesize that clearance of HCV in diabetic patients could improve the glucose homeostasis control.”
The researchers enrolled 68 patients with HCV genotype 1 and advanced fibrosis who underwent DAA therapy with simeprevir and sofosbuvir with ribavirin, ledipasvir and sofosbuvir with ribavirin, or ombitasvir/paritaprevir/ritonavir with dasabuvir and ribavirin. They also enrolled 65 control patients with HCV.