A research team at Montefiore Health System and Albert Einstein College of Medicine led by Alain Litwin, M.D., was awarded $14 million by the Patient-Centered Outcomes Research Institute (PCORI) to determine how best to treat hepatitis C among people who inject drugs (PWID), a group with a high rate of infection. A follow up portion of the study will also seek to understand why some patients develop resistance to therapies for the hepatitis C virus (HCV), which causes the damaging liver disease.
“This study has major implications for controlling hepatitis C infection and reinfection rates,” said Dr. Litwin, attending physician, internal medicine, Montefiore Health System and professor of medicine, Albert Einstein College of Medicine. “Unfortunately, people who inject drugs rarely get effective, safe treatments because there is a concern that they won’t take their medication or that they might become reinfected. Determining the best model of care will help us avert grave consequences of chronic infection for many people and reduce the spread of the virus in the communities we serve and beyond.”
The national, multi-site study, titled Patient-Centered Models of HCV Care for People Who Inject Drugs, will involve 1,000 PWID infected with HCV. Investigators will compare two models of care that have proven effective: directly observed treatment (DOT), where patients take medication in front of a staff member, and the Patient Navigator (PN) model, where patients take their medications home and receive support and education from public health workers. The research team will evaluate which model produces the best results and is preferred by patients.
Despite reports of expanding rates of injecting drug use in a new list of countries around the world, no new countries have established needle and syringe programmes in the last three years.
This is one of the headline findings of an exhaustive review of the state of harm reduction services around the world conducted by international NGO Harm Reduction International, presented at the 25th International Harm Reduction Conference (HR17) in Montréal last week.
The absence of any increase in the number of countries that report starting needle and syringe programming is significant. Katie Stone, Research Analyst with Harm Reduction International describes this problem:
Researchers at UCSF and their colleagues have found that Hepatitis C virus (HCV) infection among people who inject drugs remains high and stable in some North American cities but incidence has dropped and remained low in some Australian and European cities. These differences in HCV infection rates likely reflect differences in the level and timing of programs to increase access to sterile injecting equipment and medically assisted treatment for opioid dependence, two harm-reduction programs shown to prevent transmission of HCV.
The lead author, Meghan Morris, PhD, MPH, assistant professor of epidemiology and biostatistics at UCSF, and the team analyzed epidemiological data from eight similar cohort studies of participants who were recruited through community outreach and were HCV negative when they entered study.
At a time when cases of hepatitis C are on the rise in North Carolina due to the ongoing opioid epidemic, Triangle-based physicians and state officials have partnered on a new mentorship program to combat the liver disease.
The UNC School of Medicine, Duke University Medical Center and the N.C. Division of Public Health launched the Carolina Hepatitis Academic Mentorship Program (CHAMP) earlier this year. The program is currently providing “telementoring” services to roughly 30 primary care providers in the state, according to Dr. Michael Fried, professor of medicine and director of the UNC Liver Center.
“In North Carolina, acute Hepatitis C has increased 400 percent since 2009,” UNC stated in a release announcing the new partnership. “There are an estimated 110,000 people in the state living with chronic hepatitis C – a persistent liver disease that can lead to serious complications, including cirrhosis or liver cancer.”
DES MOINES, Iowa – The Department of Public Health says far more Iowans are testing positive for hepatitis C…and that’s a good thing.
The first report on hepatitis C infection in the state shows the number of diagnoses rose from 754 in 2000 to 2,235 in 2015. The number of people between the ages of 18 and 30 who tested positive for the disease has more than quadrupled since 2009.
But according to Randy Mayer, Chief of the IDPH Bureau of HIV, STD and Hepatitis, that’s actually a sign of progress.
Hepatitis C – the liver disease some doctors thought might one day be eradicated – is on the rise in Erie County.
And now the disease’s resurgence afflicts a new group: young white men and women living in suburban and rural communities.
It’s another unwanted byproduct of the heroin and opioid epidemic plaguing the region. Most are needle-using drug abusers. They are infecting themselves with a slow and insidious disease that, unchecked, can lead to irreversible liver damage, cancer and death.