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HCV guidelines

Nikolaos Papadopoulos, Ioannis Griveas, Eirini Sveroni, Vasiliki Argiana, Antonios Kalliaropoulos, Beatriz Martinez-Gonzalez, Melanie Deutsch
BACKGROUND: Hepatitis C virus (HCV) infection is still common among dialysis patients, but the natural history of HCV in this group is not completely understood. The KDIGO HCV guidelines of 2009 recommend that chronic haemodialysis patients be screened for HCV antibody upon admission to the dialysis clinic and every 6 months thereafter if susceptible to HCV infection. However, previous studies have shown the presence of HCV viraemia in anti-HCV-negative haemodialysis patients as up to 22%...
March 2018: International Journal of Artificial Organs
Aditya Simha, Camille Maria Webb, Ramakrishna Prasad, N Randall Kolb, Peter J Veldkamp
BACKGROUND AND OBJECTIVE: To determine whether family medicine program directors (PDs) experienced moral distress due to obstacles to Hepatitis C virus (HCV) treatment, and to explore whether they found those obstacles to be unethical. DESIGN: An omnibus survey by the Council of Academic Family Medicine's Educational Research Alliance was administered to 452 and completed by 273 US-based PDs. The survey gauged attitudes and opinions regarding ethical dilemmas in patient access to HCV treatment...
March 2018: Journal of the American Board of Family Medicine: JABFM
Julia L Marcus, Leo B Hurley, Scott Chamberland, Jamila H Champsi, Laura C Gittleman, Daniel G Korn, Jennifer B Lai, Jennifer O Lam, Mary Patricia Pauly, Charles P Quesenberry, Joanna Ready, Varun Saxena, Suk Seo, David J Witt, Michael J Silverberg
BACKGROUND & AIMS: Treatment with the combination of ledipasvir and sofosbuvir for 12 weeks has been approved by the Food and Drug Administration for patients with genotype 1 hepatitis C virus (HCV) infection; some patients can be treated with an 8-week course. Guidelines recommend a 12-week treatment course for black patients, but studies have not compared the effectiveness of 8 vs 12 weeks in black patients who are otherwise eligible for an 8-week treatment regimen. METHODS: We conducted an observational study of Kaiser Permanente Northern California members with HCV genotype 1 infection who were eligible for 8 weeks of treatment with ledipasvir and sofosbuvir (treatment-naïve, no cirrhosis, no HIV infection, level of HCV RNA <6 million IU/mL) and were treated for 8 or 12 weeks from October 2014 through December 2016...
March 10, 2018: Clinical Gastroenterology and Hepatology
Salvatore Petta, Luigi Elio Adinolfi, Anna Ludovica Fracanzani, Francesca Rini, Rosalia Caldarella, Vincenza Calvaruso, Calogero Cammà, Marcello Ciaccio, Vito Di Marco, Stefania Grimaudo, Anna Licata, Aldo Marrone, Riccardo Nevola, Rosaria Maria Pipitone, Antonio Pinto, Luca Rinaldi, Daniele Torres, Antonino Tuttolomondo, Luca Valenti, Silvia Fargion, Antonio Craxì
BACKGROUND AND AIM: Recent studies suggest an association between HCV infection and cardiovascular damage, including carotid atherosclerosis, with a possible effect of HCV clearance on cardiovascular outcomes. We aimed to examine whether HCV eradication by direct antiviral agents (DAA) improves carotid atherosclerosis in HCV-infected patients with advanced fibrosis/compensated cirrhosis. MATERIALS AND METHODS: One hundred eighty-two consecutive HCV patients with advanced fibrosis or compensated cirrhosis were evaluated by virological, anthropometric and metabolic measurements...
March 2, 2018: Journal of Hepatology
Martin Lagging, Rune Wejstål, Ann-Sofi Duberg, Soo Aleman, Ola Weiland, Johan Westin
AIM: Following the approval of two new therapeutic combinations within the European Union in 2017, the former Swedish recommendations for the treatment of hepatitis C virus (HCV) infection from 2016 were deemed in need of updating. MATERIALS AND METHODS: An expert meeting to this end was held in Stockholm, Sweden in October 2017. RESULTS AND CONCLUSIONS: An interferon-free combination of direct-acting antiviral agents is now recommended for all patients with chronic HCV infection, regardless of liver fibrosis stage, in order to limit morbidity and spread of the disease...
March 1, 2018: Infectious Diseases
L Ryom, C Boesecke, M Bracchi, J Ambrosioni, A Pozniak, J Arribas, G Behrens, Pgm Mallon, M Puoti, A Rauch, J M Miro, O Kirk, C Marzolini, J D Lundgren, M Battegay
BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management...
March 1, 2018: HIV Medicine
M C Politi, N George, T Li, K M Korenblat, K J Fowler, C Ho, A Liapakis, D Roth, J Yee
Background: Recent advances in treatment have given patients with chronic kidney disease (CKD) access to safer and more effective medications to treat comorbid hepatitis C virus (HCV) infection. Given the variety and complexity of treatment options that depend on patients' clinical characteristics and personal preferences, education and decision support are needed to prepare patients better to discuss treatment options with their clinicians. Methods: Drawing on International Patient Decision Aids Standards guidelines, literature reviews, and guidance from a diverse expert advisory group of nephrologists, hepatologists, and patients, we will develop and test a HCV and CKD decision support tool...
2018: Pilot and Feasibility Studies
Antonio Olveira, Lourdes Domínguez, Jesús Troya, Ana Arias, Federico Pulido, Pablo Ryan, Laura María Benítez, Juan González-García, María Luisa Montes
Guidelines recommend evaluating persistent alteration of liver tests in HCV-infected patients after sustained virological response (SVR) and its influence on liver disease progression. We studied the prevalence, aetiology, associated factors, and evolutionary implications of persistent alteration of liver tests in HCV patients after direct-acting antivirals (DAA) -induced SVR. This was a prospective study of HCV-infected patients and SVR after DAA. Those with another previously diagnosed liver disease were excluded...
February 24, 2018: Journal of Viral Hepatitis
Cesare Mazzaro, Luigino Dal Maso, Luca Quartuccio, Michela Ghersetti, Marco Lenzi, Endri Mauro, Milena Bond, Pietro Casarin, Valter Gattei, Ivo Maria Crosato, Salvatore De Vita, Gabriele Pozzato
OBJECTIVES: To investigate the long-term effects and safety of new direct anti-viral agents (DAAs) in patients with hepatitis C virus (HCV)-related mixed cryoglobulinaemia (MC) without renal involvement. METHODS: The study enrolled 22 consecutive patients, 19 received sofosbuvir-based regimen and three patients received other DAAs, individually tailored according to latest guidelines. As of December 2016, the median length of follow-up was 17 months (range 13-21)...
February 13, 2018: Clinical and Experimental Rheumatology
Pierluigi Toniutto
Although clinical guidelines provide clear indications on the treatment of patients with chronic HCV related liver disease, there are still clinical situations in which clinicians experience and judgment remain essential in the proper patient management. These are mainly represented by antiviral therapy in patients with decompensated liver disease, especially if they are candidates for liver transplantation or with significant comorbidities and complex pharmacological therapies. Antiviral retreatment of patients who failed a regimen containing an NS5A protease inhibitor still appears to be a delicate context in which no solid recommendations are provided, especially in patients with HCV genotype 3 and decompensated cirrhosis...
January 2018: Recenti Progressi in Medicina
Rosa Zampino, Rita Lebano, Nicola Coppola, Margherita Macera, Anna Grandone, Luca Rinaldi, Ilario De Sio, Antonella Tufano, Gianfranca Stornaiuolo, Luigi E Adinolfi, Emanuele Durante-Mangoni, Gaeta G Battista, Alferio Niglio
Background/Aim: A reduction in portal vein inflow velocity seems to predispose to the emergence of portal vein thrombosis (PVT). Nonselective β-blockers (NSBBs), used to prevent variceal bleeding, may increase the development of PVT by reducing portal vein inflow velocity. In this retrospective case-control study, we evaluated the risk factors and clinical features of a first event of PVT in 130 cirrhotics, 19 (15%) with (PVT group) and 111 (85%) without PVT (non-PVT group). Patients and Methods: Patient evaluation and NNBB treatment were carried out according to the AASLD guidelines...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Stanislas Pol, Lucia Parlati
BACKGROUND & AIMS: The recommended combination of pangenotypic direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) associates the co-formulation of 2 or 3 second-generation DAAs. In the so-called "special populations" defined as patients with chronic kidney disease (CKD), HCV/HIV co-infection, HCV/HBV co-infection and an unsuccessful previous DAA regimen, these combinations have a high antiviral potency (sustained virologic response (SVR) > 95%), fair tolerance and a reduced pill burden...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Christophe Hézode
Direct-acting antivirals (DAAs) have transformed traditional treatment options for hepatitis C virus (HCV) infection. DAA combinations have been shown to be highly effective in reducing the burden of chronic HCV infection in clinical trials and have been recommended by the European Association for the Study of the Liver (EASL) treatment guidelines. This review examines the results of second-generation DAA combinations in real-life clinical practice in patients with genotypes 1-3 and in those co-infected with HIV (real-world data in genotypes 4-6 are rare)...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Laura Ambra Nicolini, Emanuela Zappulo, Claudio Viscoli, Malgorzata Mikulska
Infection with HBV and HCV represents a growing challenge in the management of patients with hematological malignancies. Recently, hepatitis E (HEV) was recognized as an endemic infection in developed countries and as an emerging health problem in immunocompromised patients. Areas covered: We reviewed the current knowledge on the impact of chronic viral hepatitis in the hematological setting. Epidemiological features, screening strategies and indications for treatment and monitoring have been explored and commented...
February 8, 2018: Expert Review of Anti-infective Therapy
Nancy Reau, Francis Vekeman, Eric Wu, Yanjun Bao, Yuri Sanchez Gonzalez
Despite guideline recommendations, access to hepatitis C virus (HCV) treatment is frequently restricted, with some payers approving therapy for only those with advanced disease or cirrhosis. However, delaying potentially curative treatment until the development of advanced liver disease may have costly consequences in terms of both hepatic complications and extrahepatic manifestations (EHMs) of HCV. Using a large claims database from the United States, we measured the risks and medical costs of 20 EHMs and investigated the role of treatment in different stages of liver fibrosis for mitigating the clinical and economic burden of these EHMs...
July 2017: Hepatology Communications
Sofia R Bartlett, Jason Grebely, Auda A Eltahla, Jacqueline D Reeves, Anita Y M Howe, Veronica Miller, Francesca Ceccherini-Silberstein, Rowena A Bull, Mark W Douglas, Gregory J Dore, Patrick Harrington, Andrew R Lloyd, Brendan Jacka, Gail V Matthews, Gary P Wang, Jean-Michel Pawlotsky, Jordan J Feld, Janke Schinkel, Federico Garcia, Johan Lennerstrand, Tanya L Applegate
The significance of the clinical impact of direct-acting antiviral (DAA) resistance-associated substitutions (RASs) in hepatitis C virus (HCV) on treatment failure is unclear. No standardized methods or guidelines for detection of DAA RASs in HCV exist. To facilitate further evaluations of the impact of DAA RASs in HCV, we conducted a systematic review of RAS sequencing protocols, compiled a comprehensive public library of sequencing primers, and provided expert guidance on the most appropriate methods to screen and identify RASs...
July 2017: Hepatology Communications
Iryna B Zablotska, Christine Selvey, Rebecca Guy, Karen Price, Jo Holden, Heather-Marie Schmidt, Anna McNulty, David Smith, Fengyi Jin, Janaki Amin, David A Cooper, Andrew E Grulich
BACKGROUND: The New South Wales (NSW) HIV Strategy 2016-2020 aims for the virtual elimination of HIV transmission in NSW, Australia, by 2020. Despite high and increasing levels of HIV testing and treatment since 2012, the annual number of HIV diagnoses in NSW has remained generally unchanged. Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV infection among gay and bisexual men (GBM) when taken appropriately. However, there have been no population-level studies that evaluate the impact of rapid PrEP scale-up in high-risk GBM...
February 2, 2018: BMC Public Health
Hirsh D Trivedi, Steven C Lin, Daryl T Y Lau
The emergence of direct-acting antiviral (DAA) therapies and noninvasive measures of liver fibrosis has streamlined the management of patients with chronic hepatitis C virus (HCV) infection. DAA therapy is associated with a significantly higher rate of sustained virologic response (SVR) compared to interferon-based therapies. Concomitantly, validated noninvasive measures of fibrosis allow evaluation of patients for therapy without an invasive liver biopsy. Noninvasive measures of fibrosis can be classified as serologic tests or imaging modalities...
October 2017: Gastroenterology & Hepatology
Kelly Safreed-Harmon, Kristina L Hetherington, Soo Aleman, Hannu Alho, Olav Dalgard, Tove Frisch, Magnus Gottfredsson, Nina Weis, Jeffrey V Lazarus
BACKGROUND AND AIMS: In the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden), the prevalence of chronic hepatitis C virus (HCV) infection is relatively low in the general population, but is much higher among people who inject drugs (PWID). We conducted an exploratory study to investigate the extent to which these countries have policies supporting key elements of the public health response that is necessary to achieve the global goal of eliminating HCV as a public health threat...
2018: PloS One
Hoang Bui Huu, Nhuong Ha Thuc, Hoa Pham Thi Le, Thuy Do Thi Thanh, An Luong Bac, Claudio Tiribelli, Patrizia Pontisso, Andrea Gallotta, Laura Paneghetti, Giorgio Fassina
Viral hepatitis infection is a major global issue and a leading cause of liver disease and associated deaths. Over time, patients infected with hepatitis B (HBV) or C virus (HCV) develop cirrhosis and, eventually, hepatocellular carcinoma (HCC). For this reason, they need to be constantly monitored. Current Asian guidelines recommend the determination of serum alpha-fetoprotein (AFP) together with liver ultrasounds every six months to detect HCC nodules. However, both methods have several limitations, and other biomarkers have been studied for monitoring cirrhosis, including SCCA-IgM, an immune-complex formed by Squamous Cell Carcinoma Antigen and IgM...
January 30, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
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