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New treatment in HCV

Rossella Letizia Mancusi, Massimo Andreoni, Daniela d'Angela, Cesare Sarrecchia, Federico Spandonaro
Between western European countries, the hepatitis C virus (HCV) endemic is highest in Italy. The main objective of this paper is to estimate the endemic diffusion of hepatitis C at the national level and by geographical area, with an extrapolation at the regional level and by uniform cohorts of subjects (by sex and year of birth). The secondary objective is a stratification by gravity of the estimated statistical figures to provide an overview of possible targets of the new anti-HCV treatments.PubMed and the Cochrane Library were searched for relevant Italian populations studies regarding HCV prevalence...
October 2016: Medicine (Baltimore)
Heather Bailey, Anna Turkova, Claire Thorne
PURPOSE OF REVIEW: Eastern Europe and Central Asia (EECA) has experienced large-scale epidemics of syphilis, hepatitis C virus (HCV) and HIV over the past few decades. Here, we review recent evidence on the epidemiology of and the response to these intersecting epidemics. RECENT FINDINGS: The HIV epidemic in EECA continues to expand, with new infections increasing by more than 50% between 2010 and 2015. HCV is now in the top 10 causes of death in EECA, with Russia accounting for more than half of the global burden of HCV infections, but access to direct-acting antivirals remains a major obstacle for control of the epidemic...
October 15, 2016: Current Opinion in Infectious Diseases
Charles Béguelin, Darius Moradpour, Roland Sahli, Franziska Suter-Riniker, Alexander Lüthi, Matthias Cavassini, Huldrych F Günthard, Manuel Battegay, Enos Bernasconi, Patrick Schmid, Alexandra Calmy, Dominique Braun, Hansjakob Furrer, Andri Rauch, Gilles Wandeler
BACKGROUND AND AIMS: Hepatitis delta virus (HDV) infection accelerates the progression of hepatitis B virus (HBV)-related liver disease. We assessed the epidemiological characteristics of HDV infection in the nationwide Swiss HIV Cohort Study and evaluated its impact on clinical outcomes. METHODS: All HIV-infected patients with a positive HBsAg test were considered and tested for anti-HDV antibodies. HDV amplification and sequencing were performed in anti-HDV-positive patients...
October 13, 2016: Journal of Hepatology
Zobair M Younossi, Haesuk Park, Douglas Dieterich, Sammy Saab, Aijaz Ahmed, Stuart C Gordon
BACKGROUND: New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. AIM: The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. DESIGN: A decision-analytic Markov model...
October 2016: Medicine (Baltimore)
Evelyn Stelzl, Hannah M Appel, Rochak Mehta, Ed G Marins, Jörg Berg, Christian Paar, Hanna Zurl, Brigitte I Santner, Harald H Kessler
BACKGROUND: Determination of the hepatitis C virus (HCV) genotype and discrimination between HCV subtypes 1a and 1b is still mandatory prior to anti-HCV treatment initiation. The aim of this study was to evaluate the performance of the recently introduced cobas® HCV GT assay (Roche) and to compare it to two comparator assays. METHODS: The cobas® HCV GT assay is based on primer-specific real-time polymerase chain reaction (PCR). For comparison, the TRUGENE® HCV 5'NC Genotyping Kit (Siemens) and the VERSANT® HCV Genotype 2...
October 14, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Maria Stepanova, Trevor Locklear, Nila Rafiq, Alita Mishra, Chapy Venkatesan, Zobair M Younossi
BACKGROUND: Chronic HCV infection is often considered a contraindication for receiving a heart transplantation. METHODS: From the Scientific Registry of Transplant Recipients, we selected all adults with and without HCV infection who underwent a single organ heart transplantation in 1995-2013; the mortality status was updated in September 2015. RESULTS: A total of 32,812 heart transplant recipients were included; N=756 (2.30%) HCV-positive...
October 14, 2016: Clinical Transplantation
Christoph Sarrazin, Vasily Isakov, Evguenia Svarovskaia, Charlotte Hedskog, Ross Martin, Krishna Chodavarapu, Diana M Brainard, Michael D Miller, Hongmei Mo, Jean-Michel Molina, Mark S Sulkowski
BACKGROUND:  Development of direct-acting antivirals in recent years has dramatically enhanced rates of viral eradication to >90% in patients with chronic hepatitis C virus (HCV) infection. To determine true treatment efficacy and to define the most appropriate retreatment, it is important to distinguish virologic relapse from reinfection where patients who achieve HCV eradication during treatment become infected with a new HCV strain posttreatment. METHODS:  Here, we investigated prevalence of late recurrent viremia (patients who achieved SVR12 but had detectable HCV RNA at follow up week 24) and used refined phylogenetic analysis of multiple HCV genes to distinguish virologic relapse from reinfection...
October 12, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Agostino Colli, Mirella Fraquelli, Daniele Prati, Alessia Riva, Alessandra Berzuini, Dario Conte, Alessio Aghemo, Massimo Colombo, Giovanni Casazza
INTRODUCTION: In a perspective of economic constraints the prioritizing of patients to IFN-free regimens is mainly based on the determination of liver stiffness by transient elastography (TE). Being a continuous variable the interpretation of TE results requires the identification of cut-off values, to date set to maximize diagnostic accuracy even if such values should be better based on more helpful outcome prediction endpoints. AIM: To define the TE cut-off values in different clinical scenarios, including new IFN-free regimens, and to balance the clinical benefits versus harms in treated and untreated patients...
2016: PloS One
Kerstin Herzer, Guido Gerken
Chronic hepatitis C virus (HCV) infection is one of the primary causes of hepatocellular carcinoma and liver transplantation (LT). Graft loss due to hepatitis C (HCV) recurrence is a serious problem after LT. Thus, the approval of interferon-free direct-acting antiviral (DAA) regimens has important implications in the LT setting. The findings of controlled trials have confirmed the safety and the excellent efficacy of most DAA combinations, and these findings have been confirmed by reports of high rates of sustained virologic response in the real-life setting...
August 2016: Visc Med
Elisabetta Degasperi, Flavio Caprioli, Omar El Sherif, David Back, Massimo Colombo, Alessio Aghemo
Inflammatory bowel diseases (IBD) require long-term administration of immunomodulatory treatments to maintain disease remission. Due to the high worldwide prevalence of hepatitis B (HBV) or C (HCV) virus infections, presence of concurrent hepatitis can be a relevant clinical issue to manage when treating IBD. Areas covered: The paper summarizes epidemiological data about IBD and HBV/HCV infection and reviews current knowledge about the natural history of HBV and HCV in the IBD setting, concentrating on risk of hepatitis reactivation during immunosuppressive treatment...
October 8, 2016: Expert Review of Gastroenterology & Hepatology
Marta Martin-Subero, Crisanto Diez-Quevedo
This paper aims to review the epidemiology and management of mental disorders in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients, the need for antiviral therapy in this specific population, and current treatment strategies for HIV/HCV patients with psychiatric and/or substance use disorders. This is a narrative review. Data was sourced from electronic databases and was not limited by language or date of publication. HIV infection has become a survivable chronic illness. Prevalence of HCV infection among HIV-infected patients is high ranging from 50% to 90%...
September 26, 2016: Psychiatry Research
Iain A Kaan, Geoffrey McCaughan, Tracey Jones
OBJECTIVE: To determine the likely current capacity of accredited treatment centres in treating hepatitis C (HCV) patients with Interferon free Direct Acting (DAA) Antiviral agents in Australia. METHOD: Data was collected from 22 centres before the introduction of DAA therapy - 11 sites from the Study 1 survey and an additional 11 sites from the Study 2 survey. The sites were selected based on consensus by viral hepatitis experts, in consultation with the NSW Agency for Clinical Innovation...
September 26, 2016: Internal Medicine Journal
H Becker, J T Stahmeyer, M P Manns, C Krauth, M Cornberg
Infections with hepatitis B-, C- and D- viruses have a significant health burden. In Germany, the seroprevalence of HBs-Ag is calculated with 0.6 % and of HCV-antibodies with 0.3 %. However, most patients are not diagnosed. Sequelae are liver-cirrhosis and hepatocellular carcinoma. Several S3-guidelines for the diagnosis and treatment of viral hepatitis have been established. However, implementation of guidelines is not easy to evaluate. To estimate the changes of medical knowledge and diagnostic procedures about viral hepatitis, 7 parameters of liver-diagnostics were elected to analyze the requirements profile in the years 2005 - 2011 in 4 German federal states...
October 6, 2016: Zeitschrift Für Gastroenterologie
Linda Henry, Zobair Younossi
We used published literature from 2013- 2016, to review data regarding the new all oral interferon and ribavirin free direct acting antiviral (DAA's) treatment regimens. Areas covered: Specifically, this paper will address DAA's clinical efficacy, their associated patient reported outcomes, their adherence to treatment, and their cost-effectiveness of treatment using studies from the United States. Expert commentary: The current data suggest that cure and elimination of HCV appears to be on the horizon; however, more research is needed to verify similar results from real world practices...
October 6, 2016: Expert Review of Pharmacoeconomics & Outcomes Research
M Holmström, A Nangarhari, J Öhman, A-S Duberg, A Majeed, S Aleman
INTRODUCTION: Hepatitis C virus (HCV) infection is common in patients with inherited bleeding disorders treated with clotting factor concentrates prior to the introduction of viral inactivation of these products. The long-term consequences of hepatitis C infection in Swedish patients are not fully understood. AIM: To examine the impact of HCV infection on liver-related morbidity and mortality in Swedish patients with inherited bleeding disorders. METHODS: We retrospectively collected data on 183 patients with inherited bleeding disorders infected with HCV who attended the Coagulation Unit at Karolinska University Hospital, Sweden...
October 5, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Yaohui Wang, Yinan Jiang, Jinxue Zhou, Wuhui Song, Jing Li, Mingli Wang, Jiuge Chen, Rui Xu, Jingjing Zhang, Fanni Ma, Youhai H Chen, Yuanfang Ma
Infection of hepatitis C virus (HCV) is associated with primary hepatocellular carcinoma (HCC). However, its underlying molecular mechanisms remain enigmatic. Tumor necrosis factor-α-induced protein 8-like 2 (TIPE2), a new negative regulator of immunity, plays significant roles in modulating inflammation and tumorigenesis. We hypothesized that TIPE2 might be involved in the development of HCV-induced HCC. To test this hypothesis, the expression of TIPE2 was determined by Western blot in the tumor and pericarcinomatous tissues collected from ten HCV-positive HCC patients; the interaction between TIPE2 and HCV-encoded non-structural proteins was analyzed by immunoprecipitation and immunofluorescence assays, and tumorigenesis and its mechanisms were studied in cell models and nude mice...
September 30, 2016: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Arnolfo Petruzziello, Samantha Marigliano, Giovanna Loquercio, Anna Cozzolino, Carmela Cacciapuoti
AIM: To review Hepatitis C virus (HCV) prevalence and genotypes distribution worldwide. METHODS: We conducted a systematic study which represents one of the most comprehensive effort to quantify global HCV epidemiology, using the best available published data between 2000 and 2015 from 138 countries (about 90% of the global population), grouped in 20 geographical areas (with the exclusion of Oceania), as defined by the Global Burden of Diseases project (GBD). Countries for which we were unable to obtain HCV genotype prevalence data were excluded from calculations of regional proportions, although their populations were included in the total population size of each region when generating regional genotype prevalence estimates...
September 14, 2016: World Journal of Gastroenterology: WJG
Pavel Lavitas, Mark Tesell, Tasmina Hydery, Bonnie C Greenwood, Mylissa Price, Kimberly Lenz, Paul Jeffrey
BACKGROUND: Breakthrough direct-acting antivirals set a new standard in the management of hepatitis C virus (HCV) with regard to cure rates and improved tolerability; however, the health care system is challenged by the cost of these medications. OBJECTIVE: To describe the effect of a comprehensive HCV medication management program on optimized regimen use, prior authorization (PA) modifications, and medication cost avoidance in a state Medicaid program. METHODS: This program consists of a 2-tiered prescriber outreach: (1) regimen outreach to promote optimized regimen selection and (2) refill outreach to support medication adherence...
October 2016: Journal of Managed Care & Specialty Pharmacy
Timothy P Gauthier, Eva Moreira, Chantal Chan, Alexandria Cabrera, Maribel Toro, Mara Z Carrasquillo, Mark Corentin, Elizabeth M Sherman
OBJECTIVES: To describe an innovative hepatitis C virus (HCV) care program and treatment outcomes resulting from pharmacist services. SETTING: Adult ambulatory care HCV clinic within the Miami Veteran Affairs Healthcare System. PRACTICE DESCRIPTION: Pharmacists with limited prescriptive authority are integrated into a medical hepatology care team. PRACTICE INNOVATION: Pharmacists screen patients with HCV infection for treatment eligibility, counsel patients upon treatment initiation, assess ongoing treatment success and toxicity through patient appointments, telephone calls, and the ordering of pertinent laboratory data, and provide oversight of all patients on HCV therapies...
September 22, 2016: Journal of the American Pharmacists Association: JAPhA
Mohamed El Kassas, Tamer Elbaz, Enas Hafez, Gamal Esmat
Hepatitis C virus is a hepatotropic virus that generally leads to chronic hepatitis and various harmful sequelae. The lone standard of treatment has been pegylated interferon and ribavirin, which produces a modest response and many side effects. However, a new era of management was declared with the introduction of various directly acting antiviral agents. Areas covered: Recent direct antiviral agents (DAAs) primarily target the non-structural proteins of the virus and affect its replication. These agents successfully achieve a sustained virologic response...
October 6, 2016: Expert Opinion on Drug Safety
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