The Specialty Care Access Network-Extension of Community Healthcare Outcomes program, or SCAN-ECHO, is a telehealth-based program created by the Richmond Veterans Affairs in 2011 to increase specialty care to patients being considered for orthotopic liver transplantation.
According to Venkata Rajesh Konjeti, MD, and colleagues, the program was designed to transfer subspecialty hepatology and liver transplant knowledge to non-transplant providers. SCAN-ECHO was highly effective in identifying non-candidates for transplantation without further tests in a recent study conducted by Konjeti and colleagues.
“Our data indicate that a telehealth-based triage reduces futile transplant evaluations by approximately 60%,” Konjeti and colleagues wrote. “It is also possible that knowledge diffusion through SCAN-ECHO played a role in reducing referrals of transplant non-candidates.”
The last two years have seen a huge increase in hepatitis A (HAV) infections and more deaths than I’ve ever seen in all my years of advocacy. HAV is a preventable disease – check out our Easy C fact sheet to learn how to protect yourself and your loved ones. Click here
Patrick Garcia wasn’t completely surprised when he learned recently he had hepatitis C. Until a few years ago, he had experimented with numerous drugs, injecting heroin, methamphetamine, cocaine — you name it.
“I haven’t lived exactly a perfect life,” said Garcia, 43, whose mouth, hand and back were injured in a motorcycle wreck last year.
Medi-Cal, California’s public health program for the poor, paid for his post-accident care and the bloodwork that led to his hepatitis C diagnosis. But it wouldn’t pay for the pricey new medications that cure the disease.
Patients with hepatitis C genotype 1 through 4 who underwent liver transplantation had significantly high rates of sustained virologic response after treatment with Epclusa for 12 weeks, regardless of cirrhosis status, according to recently published data.
“Among HCV-infected liver transplant recipients, HCV recurrence emerges in nearly all patients,” Kosh Agarwal, MD, from Kings College Hospital, United Kingdom, and colleagues wrote. “Within 5 years posttransplant, cirrhosis related to HCV ensues in approximately 30% of patients with recurrent, chronic HCV infection and is associated with increased graft loss rates and death. In the setting of posttransplant immunosuppression, the rate of hepatic fibrosis is accelerated in HCV-infected patients compared to the pretransplant period.”
The study comprised 79 patients with HCV who underwent treatment with Epclusa (sofosbuvir/velpatasvir [SOF/VEL], Gilead Sciences) posttransplant, including 37 patients with genotype 1, three patients with genotype 2, 35 patients with genotype 3 and four patients with genotype 4.
The reduction in new hepatitis C virus (HCV) infections that has taken place in Scotland since 2008 is most likely due to increased provision of needle and syringe programmes and opioid substitution therapy, rather than a reduction in the number of people with hepatitis C as a result of increased treatment of HCV infection, a modelling study published in the journal Addiction reports.
Scotland launched a national action plan for HCV and a national drug and alcohol strategy in 2008, which led to expanded coverage of needle and syringe programmes and opioid substitution therapy. New HCV infections fell by approximately 50% between 2008 and 2015 in Scotland. The vast majority of new infections in Scotland occur as a result of sharing injecting equipment, so it is plausible that reducing the sharing of injecting equipment, by scaling up service provision and the number of people reached with clean equipment, could have an impact on new infections.
Until now, however, there has been little evidence to show the extent to which new HCV infections might be reduced by harm reduction measures and little opportunity to validate models of the HCV epidemic against robust epidemiological data.
Viral Hepatitis Updates from the HHS Office of HIV/AIDS and Infectious Disease Policy
Hepatitis Awareness Month may have come to a close, but there are many opportunities to bring awareness about viral hepatitis. With more than 4 million Americans infected with viral hepatitis, and the number of new infections growing, we are still losing ground in the battle against viral hepatitis. The opioid epidemic in particular is fueling increases in hepatitis C with new hepatitis C infections more than tripling between 2010 and 2016, increases in hepatitis B cases in nine states from 2015-2016, and outbreaks of hepatitis A that have sickened more than 2,500 starting in January 2017 and affecting mostly people who inject drugs and those who are homeless. Despite these setbacks, scientific advances and improvements in health care make it possible to win the fight against viral hepatitis and save lives. So how will you join the fight?
There is a role for everyone in the fight against viral hepatitis, and every effort is important. The first step is to understand what the epidemics look like in your community. The second step is to identify what resources and services your organization and your partner organizations provide that can contribute to improving viral hepatitis prevention, diagnoses, and care. Learning from other partners’ experiences and sharing your own is also an important part of this work.
Read a couple of our latest blog posts about this epidemic including ways to get involved:
We hope you can join us on Thursday, June 14 at 2 p.m. for an exciting Twitter #HepChat. Join the Hepatitis B Foundation, NASTAD and CDC’s Viral Hepatitis Program as we share Hepatitis Awareness Month outreach events and experiences. This will be a great opportunity to share your successes, challenges and lessons learned from your efforts. Visit the Hepatitis B Foundation’s website for more information.
Richard Wolitski, PhD, and 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
New Hepatitis C Clinic Is Model of Collaborative Practice Aimed at Eliminating Disparities. May 30, 2018. The HCV program, led by officers from the Commissioned Corps, is a model of collaborative practice between medical providers, pharmacists, laboratory services and case managers in the Great Plains Area. Click to learn more about the program.
Hepatitis in the News
Hepatitis B Update: Vaccination and Follow-Up – Sarah Schillie, a medical officer in the Division of Viral Hepatitis at the Centers for Disease Control and Prevention (CDC) discusses new recommendations for the prevention of hepatitis B. June 4, 2018.
Hepatitis Awareness Month: The Road Ahead – Hepatitis will be here every day in June, and for as long as I can see, UNLESS we change the trajectory. We can eliminate viral hepatitis, but we must keep the momentum going. May 31 ,2018.
Researchers behind a bold experiment to use hepatitis C-infected lungs for transplant say such organs could help address a critical shortage of donors and make “some good come out” of the increasing number of opioid-related deaths.
Ten patients have received donor lungs from individuals infected with hepatitis C, with eight of the transplant recipients testing negative for the virus following their recovery.
The other two patients have recently started a drug regimen to eliminate the virus.