Article: Genotype from Punjab, India: Expanding classification of hepatitis C virus into 8 genotypes—S. M. Borgia, et. al.
Source: J Infect Dis. 2018 Jun 30. doi: 10.1093/infdis/jiy401. [Epub ahead of print]
Summary: Genotype 8, a newly discovered HCV genotype, was recently identified in Canada. The diversity of the HCV genotypes are classified by their genetic difference of at least 30% from the other HCV genotypes. The four patients with genotype 8 were originally from Punjab, India and were treated with HCV direct-acting antiviral medications. Good news! All four of the treated genotype 8 patients were cured.
Viral Hepatitis Updates from the HHS Office of HIV/AIDS and Infectious Disease Policy
Speaking of National Immunization Awareness Month, since 2017, CDC’s Division of Viral Hepatitis (DVH) has been assisting a number of state and local health departments with hepatitis A outbreaks which could have been prevented by vaccinating more at-risk adults. Since 2011, the number of reported acute new hepatitis A cases across the country has increased by 84% (1,298 in 2011 compared to 2,007 in 2016). Hepatitis A is a vaccine-preventable disease, with a safe and effective 2-dose hepatitis A vaccine given over 6 months.
Most recently, Kentucky and West Virginia have been experiencing hepatitis A outbreaks spread through person to person contact, that have occurred primarily among people who use drugs, and/or people who are homeless, and their close direct contacts. As of August 1, 2018, Kentucky state health officials confirmed that 1276 people have contracted the liver infection and in West Virginia, that number is 791. Compared to outbreaks before 2017, these have resulted in higher rates of hospitalization and deaths. There are ongoing hepatitis A outbreaks also occurring in Arkansas, Indiana, Missouri, Ohio, and Tennessee.
Federal partners have discussed the need to expand efforts and encourage the following actions:
Corinna Dan, RN, MPH Office of HIV/AIDS and Infectious Disease Policy U.S. Department of Health and Human Services
What’s New in the Blog
ORISE HIV & Viral Hepatitis Co-infection Fellowship Opportunity Now Available at HHS – August 7, 2018. An ORISE HIV and viral hepatitis co-infection fellowship opportunity is available in the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Health (OASH). Learn more and apply today!
Hepatitis in the News
3 deaths reported in waning Utah hepatitis A outbreak – A Utah hepatitis A outbreak has killed three people since spreading from San Diego last year, but it’s on the wane even as other states deal with similar outbreaks, health officials said Thursday. August 16, 2018.
Preventing Hepatitis A in West Virginia (Part 2) – Nurse director for the Berkeley County Health Department, Angie Gray, discusses the impact of a potential outbreak of Hepatitis A, as well as how the local harm reduction program is working to address this issue. August 7, 2018.
Note: Dan Biggs was an exceptional person who saved thousands of lives and changed the course of thousands more through his humane work as a harm reductionist. I had the honor of meeting Dan when I was in Chicago conducting a training workshop. Rest in peace. Alan
Dan Bigg didn’t worry about social norms or even the law when lives were at stake.
In the early 1990s, when he was a Chicago activist trying to stem the spread of HIV by distributing clean hypodermic needles, that activity was in a legal gray zone. He did it anyway.
A decade later, as heroin-related deaths began to surge, he pioneered the idea of putting the overdose-reversing medication naloxone into the hands of drug users and their loved ones. At the time, it was available only with a prescription, and some said making it readily accessible would encourage risky behavior. He did it anyway.
Liver disease researchers recently published internally validated models that estimated the risk for hepatocellular carcinoma following direct-acting antiviral therapy for hepatitis C based on the presence of cirrhosis and sustained virologic response outcome.
“These models, which are available as web-based tools, can help stratify patients according to HCC risk, and consequently, help determine an appropriate screening strategy based on a patient’s calculated risk,” George N. Ioannou, MD, from the University of Washington, and colleagues wrote. “A screening strategy targeting those who exceed a certain predetermined HCC risk may be more efficacious and cost-effective than the current ‘screen-all’ or ‘screen-none’ strategies which depend solely on cirrhosis status.”
Ioannou and colleagues collected data on 45,810 patients from the Veterans Health Administration who initiated DAA therapy between Jan. 1, 2009, and Dec. 31, 2015. Of those, 23% had cirrhosis and 74% achieved SVR. Most patients received DAA therapy alone (64%), while 22.5% received only interferon therapy and 13.5% received a combination.
Doctors are not screening Baby Boomers for hepatitis C at high rates, according to a new study; however, the implementation of electronic reminders could help solve the problem.
The US Centers for Disease Control and Prevention (CDC) recommends that all individuals born between 1945 and 1965 be screened for hepatitis C (HCV), as roughly three-quarters of the 3.2 million Americans infected with HCV were born in that time frame. Yet, a paucity of research exists to discern whether individuals in that age cohort are indeed being tested.
The new study looked at data from NorthShore University Health System, in Illinois, between 2010 and 2015. Of the 106,753 commercially-insured Baby Boomer outpatients seen over the 5-year time span, the overall HCV-antibody screening rate was 11.2%.
In their first treatment update since 2016, the World Health Organization (WHO) adopts a ‘treat all’ approach for hepatitis C, guided by the success of their HIV experience. A new era for hepatitis C
Every person living with chronic hepatitis C (HCV) should start treatment, no matter the disease stage, according to new advice from the World Health Organization (WHO) in updated HCV treatment guidelines released last month.
The guidance is set to usher in a new era for the 71 million people infected with HCV worldwide – much like ‘treat all’ did for HIV – fast-tracking access to new and effective direct-acting antivirals (DAAs) that can cure up to 90% of cases of chronic HCV.
Expanding testing in emergency departments for hepatitis C virus (HCV) beyond typical high-risk populations was found to be an effective measure to screen undiagnosed patients who may have otherwise gone without treatment, according to a study published in Academic Emergency Medicine.
The analysis, conducted in the emergency department at Boston Medical Center (BMC), expanded the facility’s monthly HCV screening rate by more than 6000% by screening for the virus whether or not patients had a perceived risk for the disease.
“Our findings indicate that if we had only tested the high risk birth cohort, there would have been 268 missed cases and 155 missed active infections,” lead author Elissa Perkins, MD, MPH, emergency medicine physician at BMC, said in a press release. “Physicians and patients should consider screening for HCV outside of the typical high-risk groups to ensure appropriate HCV diagnosis.”
On Sunday, August 12, Save One Life hosted the Wheels for the World Memorial Bike Ride and Picnic in Rye, New Hampshire to honor Barry Haarde, a beloved member of the bleeding disorder community in the United States and beyond. Barry, just 52, sadly passed away on February 17, 2018—a shock and great loss to all who knew him.
An avid cyclist, Barry spent the last six years of his life raising awareness about hemophilia and funds for his favorite charity, Save One Life, by biking each year across the United States. Save One Life, based in Groveland, Massachusetts, provides direct financial assistance to more than 1600 beneficiaries with bleeding disorders in 13 developing countries through child sponsorships, scholarships, micro-enterprise grants and support to bleeding disorder camps.
Barry recognized the great disparities in care for people with bleeding disorders in developing countries. Hemophilia, the most well-known bleeding disorder, is a condition where the blood doesn’t clot effectively due to a deficiency in one of 14 blood-clotting factors. When untreated, bleeds can cause extreme pain, joint deformities and even death. Of the estimated 400,000 people with hemophilia worldwide, 75% receive little to no treatment. Barry sponsored Mukesh, a boy in India, through Save One Life. But he wanted to do more. That was when he proposed a cross-country bike tour as a means to raise funds, and “Wheels for the World” was born.