According to a study published in Hepatology, small dense LDL cholesterol independently predicted cardiovascular disease events among liver transplant recipients, according to a study published in Hepatology.
“The present study employs detailed lipoprotein sub-particles to link specific proteins with CVD outcomes using a prospective cohort and provides valuable information that can be readily incorporated into clinical practice to hopefully improve clinical outcomes,” Mohammad B. Siddiqui, MD, from the Virginia Commonwealth University, and colleagues wrote. “The generation of the atherogenic [small dense LDL cholesterol (sdLDL-C)] likely results from insulin resistance, exposure to chronic immunosuppression and fatty liver after LT.”
The researchers included 130 liver transplant recipients in the study. The primary etiologies for liver transplantation included hepatitis C, nonalcoholic steatohepatitis and alcohol-related cirrhosis. The prevalence of cardiometabolic conditions at baseline included diabetes (35%), hypertension (82%), and dyslipidemia (40%).
Alcohol and other substance-use problems take enormous psychological and societal tolls on millions of Americans. Now a study from the Massachusetts General Hospital (MGH) Recovery Research Institute shows that more than a third of individuals who consider themselves in recovery from an alcohol or other substance use disorder continue to suffer from chronic physical disease. The study, published online March 20 in the Journal of Addiction Medicine, is the first to look at the national prevalence of medical conditions that are commonly caused or exacerbated by excessive and chronic alcohol and other drug use among people in addiction recovery.
“The prodigious psychological, social and interpersonal impact of excessive and chronic alcohol and other drug use is well characterized,” says lead and corresponding author David Eddie, PhD, research scientist at the Recovery Research Institute. “Less well appreciated is the physical disease burden, especially among those who have successfully resolved a significant substance use problem.”
Incorporating data from the landmark 2017 National Recovery Survey, the current study examined information from a nationally representative sample of more than 2,000 U.S. adults describing themselves as in recovery from problems with the use of alcohol, cannabis, opioids, stimulants or other drugs. Of these, 37 percent had been diagnosed with one or more of nine alcohol- and drug-exacerbated diseases and health conditions: liver disease, tuberculosis (TB), HIV/AIDS or other sexually transmitted infections (STIs), cancer, hepatitis C, chronic obstructive pulmonary disease (COPD), heart disease and diabetes. The presence of these diseases was shown to be associated with significant reductions in participants’ quality of life, and all are known to reduce life expectancy.
As state administrators throughout Appalachia grapple with mounting health care costs, a new resource is offering assistance to policymakers by taking lessons from success stories outside of the health sector.
The study examines successful policies outside the health care sector that states, including those in the Appalachian region, have adopted to improve their communities’ health and well-being outcomes while reducing health care costs. Among those included are universal pre-kindergarten, rapid rehousing legislation and housing rehabilitation loans and grants, syringe-exchange programs and tobacco and alcohol taxes.
MINNEAPOLIS (AP) – Minnesota inmates with chronic hepatitis C infections have gained access to expensive drug treatment following a class-action lawsuit settlement.
Five inmates infected with the virus sued the Minnesota Department of Corrections in 2015, accusing the agency of withholding medication that has a 95 percent cure rate, the Star Tribune reported. The “direct acting antiviral” drugs, which were first approved by federal regulators in 2013, range in price from $26,400 to more than $100,000 per patient and have fewer side effects than older treatments.
The state agency has argued that providing the drug would overwhelm the state’s corrections budget.
Twelve weeks of combination Sovaldi and NS5A inhibitors without ribavirin was a reliable therapy with high rates of sustained virologic response for recurrent hepatitis C after liver transplantation, according to a study published in Hepatology.
“Liver recipients with HCV recurrence have always been considered as a difficult-to-treat population,”Pauline Houssel-Debry, MD, from the Pontchaillou University Hospital in France, and colleagues wrote. “Previous HCV treatment post-LT, progression of fibrosis on the graft, a high HCV viral load, and the immunosuppressive therapy implemented had originally prompted clinicians to choose treatment for 24 weeks with [ribavirin] in order to improve SVR12 rates. However, the availability of [direct-acting antivirals] should change these dogmas.”
The study comprised 512 LT recipients treated with Sovaldi (sofosbuvir, Gilead Sciences) and NS5A inhibitors with or without ribavirin. Most patients had HCV genotype 1 (70.1%) while 18.2% were infected with genotype 3.
WASHINGTON, DC – The U.S. Department of Veterans Affairs announced it is on track to eliminate the hepatitis C virus, or HCV, in as few as two months, in all veterans willing and able to be treated.
As of March 3, nearly 116,000 veterans started all-oral hepatitis C medications in VA, of which 96,654 veterans completed treatment and have been cured.
“As the largest single provider of HCV care in the U.S., this is terrific news because it means we are within striking range of eliminating hepatitis C among veterans under the care of the veterans Health Administration,” said VA Secretary Robert Wilkie. “Diagnosing, treating and curing hepatitis C virus infection among veterans has been a significant priority for VA.”
Antiviral drugs, including therapies for hepatitis C virus (HCV) and HIV, remained the most consistently costly drug group by Medicaid spending over a 4-year study period, according to a recent Kaiser Family Foundation analysis.
The analysis examined Medicaid outpatient prescription drug utilization in terms of prescriptions and spending before rebates over the 2014 to 2017 period.
Medicaid outpatient spending before rebates increased from $45.9 billion in 2014 to $63.6 billion in 2017, growing a total of 39%, according to the analysis. Overall, spending on outpatient services increased by 21% in 2015 and an additional 11% in 2016, but grew more slowly in 2017. However, the study authors noted that they anticipate this spending to grow faster than other Medicaid services over the next 10 years. Additionally, utilization grew from 621.7 million prescriptions in 2014 to 752.9 million in 2017, increasing a total of 21% over the study period.