Note: The outbreaks of hepatitis C in dialysis centers is the reason the people who receive hemodialysis should be tested for hepatitis C and other blood-borne pathogens on a regular basis.
Dialysis – Hepatitis C Outbreaks by Setting ― United States, 2015
The number on the left is the number of people notified of potential exposure; the number on the right is the actual number of people who tested positive for hepatitis C.
Hepatitis C: Reported cases of acute HCV infection increased more than 2.9-fold from 2010 through 2015, rising annually throughout this period. Examining annual trends beginning in 2011, reported cases of acute HCV infection increased 44.3% from 2011 to 2012 (n=1,232 and 1,778 cases, respectively), increased 20.3% to 2,138 cases in 2013, increased 2.6% to 2,194 cases in 2014, and increased 11% to 2,436 cases in 2015. The increase in acute HCV case reports reflects new infections associated with rising rates of injection-drug use, and, to a much lesser extent, improved case detection (15). Several early investigations of newly acquired HCV infections reveal that most occur among young, white persons who live in non-urban areas (particularly in states within the Appalachian, Midwestern, and New England regions of the country) (16); trends in these states likely indicate an overall increase in HCV incidence throughout the country (15, 17).
States with the highest rate of new HCV infections (e.g., West Virginia, Kentucky, and Tennessee) did not receive CDC support for case finding during these reporting years (2011-2015).
After adjusting for under-ascertainment and under-reporting (2), an estimated 33,900 (95% CI=26,800–115,000) new HCV infections occurred in 2015.
Based on the data from national health surveys conducted in the 2003-2010 time period, approximately 3.5 million persons are currently infected with HCV (18).
Mortality among HCV-infected persons—primarily adults aged 55–64 years—increased during 2006-2010 (19, 20). In 2013, HCV associated deaths exceeded the combined number of deaths with 60 other infectious diseases as underlying causes (21).
CDC data indicate the number of HCV-associated deaths increased 10.9% from 2011 through 2014 and decreased 0.2% to 19,629 in 2015. Approximately one-half of all deaths in 2015 occurred among persons aged 55-64 years. However, deaths associated with HCV are largely underestimated; the only large U.S. study of deaths among persons with confirmed HCV infection indicated that only 19% had HCV listed anywhere on the death certificate despite 75% having evidence of substantial liver disease (20). To increase the proportion of persons with HCV who are tested and linked to recommended care including curative treatment for HCV (12, 13), CDC and USPSTF recommend one-time testing for HCV infection among all adults born during 1945–1965 and among others at increased risk for HCV infection (22).
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A major new insight into how Hepatitis B virus works could pave the way for new drug treatments for the infection, which is the major cause of liver cancer worldwide.
The team at the Universities of York and Leeds identified an “assembly code” in the genetic material of Hepatitis B virus that allows it to create a protective casing in which it can produce new infectious virus particles.
They found that the signal, generated by ribonucleic acid (RNA), helps viral proteins to overcome an ‘engineering problem’, assembling them into in a particular geometric pattern.
Patients with opioid use disorder are much more likely than the general population to have a host of other health conditions, including hepatitis C, post-traumatic stress disorder, and anxiety.
That’s according to a new analysis from health care company Amino, which culled data from the claims of 3.1 million privately insured patients between 2014 and 2016. It calculated the frequency of a slew of health conditions — from back pain to binge drinking — in patients diagnosed with opioid use disorder. Then, it compared those rates to the general patient population.
Here’s what it found.
Your buddy at the gym can’t say enough about the bodybuilding products he’s been taking to help build muscle mass and strength. You wonder, are they all safe to use?
According to CDR Mark S. Miller, Pharm. D., a regulatory review officer at the U.S. Food and Drug Administration (FDA), bodybuilding products that contain steroids or steroid-like substances are associated with potentially serious health risks, including liver injury. “Some of the liver injuries were life-threatening,” CDR Miller says.
CDR Miller was the lead reviewer assessing hundreds of adverse event reports made to the FDA from July 2009 through December 2016. Thirty-five reports showed evidence of serious liver injury.
In addition to liver injury, anabolic steroids have been associated with serious reactions such as severe acne, hair loss, altered mood, irritability, increased aggression, and depression. They have also been associated with life-threatening reactions such as kidney damage, heart attack, stroke, pulmonary embolism (blood clots in the lungs), and deep vein thrombosis (blood clots that occur in veins deep in the body).
These bodybuilding products are promoted as hormone products and/or as alternatives to anabolic steroids for increasing muscle mass and strength. Many of these products make claims about the ability of the active ingredients to enhance or diminish androgen, estrogen, or progestin-like effects in the body, but actually contain anabolic steroids or steroid-like substances, synthetic hormones related to the male hormone testosterone.
Bodybuilding Products May Contain Steroids
Cara Welch, Ph.D., a senior advisor in FDA’s Office of Dietary Supplement Programs, explains that many of these bodybuilding products sold online as well as in retail stores, are labeled as “dietary supplements.” “In fact,” she says, “many of these products are not dietary supplements at all; they are illegally marketed, unapproved new drugs.” FDA has not reviewed these products for safety, effectiveness, or quality before these companies began marketing.
CDR Jason Humbert, a regulatory operations officer in FDA’s Office of Regulatory Affairs, says that potentially harmful, sometimes hidden ingredients in products promoted for body building continue to be a concern. “The companies making these products are breaking the law by exploiting an easily accessible marketplace to get these products to consumers,” he says. “In the end, it’s consumers who are put in harm’s way by taking dangerous ingredients from products promoted as having miraculous results or making empty promises, and who may not understand the risks.”
Some who use bodybuilding products engage in “stacking,” using multiple products (including stimulants or products providing false assurances of liver protection) to enhance results or “gains.” These combinations may put consumers at greater risk for serious and life-threatening reactions.
What to Do
If you’re taking any body building products that claim to contain steroids or steroid-like substances, FDA recommends that you stop taking them immediately because of the potentially serious health risks associated with using them, CDR Miller says. The agency also recommends that you:
- Talk to your health care professional about any body building products and/or ingredients you have taken or are planning to take, particularly if you are uncertain about those ingredients.
- Talk to your health care professional if you are experiencing symptoms possibly associated with these products, particularly nausea, weakness or fatigue, fever, abdominal pain, chest pain, shortness of breath, jaundice (yellowing of the skin or whites of the eyes), or brown or discolored urine.
FDA Taking Regulatory Action
In addition to issuing warning letters, CDR Humbert says, the agency can pursue other regulatory or enforcement actions against sellers of these illegal products. However, this can be challenging, particularly when sellers operate exclusively online. “Firm names or websites often are easily changed, or products can be relabeled in an effort to evade authorities and scam consumers,” CDR Humbert says.
The FDA encourages consumers and health care professionals to report adverse events or serious side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program (MedWatch).
This article appears on the FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.
June 20, 2017
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LIVER CANCER is the second most leading cause of cancer-related deaths worldwide and has an incidence of approximately 850,000 new cases. Mortality owing to liver cancer has increased in the past 20 years and latest estimates also indicate that global health burden of this disease will continue to grow.
With little or no symptoms at onset, HCC is also defect to detect and patients are diagnosed only at an advanced stage, severely impacting overall survival chances. Overall 5-year survival rate for advanced HCC is less than 5%, further proof that the disease is deadly.
Talking at Singapore event on Liver Cancer Awareness organized by Bayer, Prof Josep M. Llovet, emphasized on the co-relation of Hepatitis B (HBV) and Hepatitis C infections (HCV) to HCC incidence. He mentioned that about 400 million people are infected with HBV globally, with 0.2% having chronic hepatitis and 2% having cirrhosis per year, thus running the risk of developing into HCC. Further, there are 170 million people worldwide infected with HCV, with 0.3% having chronic hepatitis and 3-7% having cirrhosis per year, again running the risk of developing into HCC as a result.
Today, with the use of PrEP, Treatment as Prevention (TasP), and the growing confidence in what it means to have an undetectable viral load, we have a new sense of sexual liberation for both HIV-positive and negative people.
This is opening the doors to new pleasures and risks. We are more sexually active with each other across the sero-divide (between HIV-negative and HIV-positive men) than ever before.