The U.S. Department of Veterans Affairs was authorized to spend as much as $500 million for hepatitis C treatments through Oct. 1 as part of the emergency highway funding bill signed into law on Friday.
The spending could provide a short-term sales boost for Gilead Sciences Inc., which makes the hepatitis C treatments Harvoni and Sovaldi, and for AbbVie Inc., which makes a similar drug, Viekira Pak. Gilead sold $4.9 billion of its hepatitis C pills in the second quarter, while AbbVie sold $385 million of its treatment in the same period.
While the drugs provide a cure for the disease, which can cause liver damage to the point of needing a transplant, their prices have attracted a firestorm of criticism from politicians and insurers. List prices for the treatments are more than $83,000 for a 12-week course.
Read more...
Monday, August 3, 2015
Hepatitis C numbers up in Maine, Androscoggin County
Hepatitis C numbers are up in Maine, with Androscoggin County seeing some of the highest rates of acute cases in the state.
Experts say there are a variety of reasons for the increase, including a spike in heroin use — the hepatitis C virus is transmitted by blood and shared needles commonly spread it — and a new, dramatically more effective treatment that's made patients more willing to be tested.
"We are seeing people coming out of the woodwork to seek treatment for hepatitis C," Imad Durra, infectious disease specialist with Central Maine Infectious Diseases in Lewiston, said.
Read more...
Experts say there are a variety of reasons for the increase, including a spike in heroin use — the hepatitis C virus is transmitted by blood and shared needles commonly spread it — and a new, dramatically more effective treatment that's made patients more willing to be tested.
"We are seeing people coming out of the woodwork to seek treatment for hepatitis C," Imad Durra, infectious disease specialist with Central Maine Infectious Diseases in Lewiston, said.
Read more...
HealthWise: Hepatitis C and Nonalcoholic Fatty Liver Disease —Lucinda K. Porter, RN
Recently I saw a post from a patient who was cured of hepatitis C, only to find out that he had fatty liver disease. I felt bad for him, since now he has another liver disease to contend with, but then I thought it over. Fatty liver disease can be fixed, and the cure may help more than his liver—it may help him live longer and feel better.
Nonalcoholic fatty liver disease (NAFLD) is a metabolic disease that generally occurs in overweight patients. It may also occur in patients whose weight is normal, but because of prior excess weight, they developed insulin resistance, diabetes, or fat in the liver area, called visceral fat. NAFLD may also arise in people who eat a high fat, low-nutrition diet.
NAFLD is the most common liver disease, and it is increasing in prevalence and severity. Since fat impairs liver regeneration, NAFLD can lead to fibrosis and cirrhosis. NAFLD is the third most common risk factor for primary hepatocellular carcinoma. The American diet is so harmful, that children are developing NAFLD. If we keep on this course, NAFLD may overtake hepatitis C as the single most common reason for liver transplantation. Tragically, the prevalence of NAFLD is so great, that there has been a decrease in the number of viable livers that can be used for transplantation.
Hepatitis C appears to increase the risk of NAFLD. However, before blaming hepatitis C for fatty liver disease, keep in mind that the prevalence of hepatitis C in the U.S. is less than 2 percent, whereas the prevalence of NAFLD is 30 percent. This makes it hard for hepatitis C to be the sole link to NAFLD. An exception is in genotype 3, where there is clearly a higher risk for NAFLD.
As I stated, fatty liver disease can be fixed. You probably already figured out that good nutrition and maintaining a healthy weight is important, but did you know that physical activity could improve NAFLD? Exercise also improves insulin resistance as well as cardiovascular health. A few studies bear this out, but the question some of us have is, “What kind of exercise, how much, and how often?”
Let me state this in a way that I can relate to, “What is the least amount of exercise in both time and intensity that I can get away with, and still look my doctor in the eye and say I am a regular exerciser?”
In a retrospective analysis of obese middle-aged men (Hepatology April 2015), Sechang Oh and colleagues reported that moderate to vigorous physical activity had a dramatic effect. Those who engaged in ≥ 250 minutes a week of moderate to vigorous physical activity had the most improvement of NAFLD.
That is more than four hours of exercise weekly. Surprisingly, the exercise seemed to improve liver health, regardless of weight loss. Other research shows similar benefits. When it came to liver health, aerobic activity showed more improvement than resistance training.
What is moderate to vigorous physical activity?
There are various was to measure intensity. I prefer the concept of relative intensity. Using this method, people pay attention to how physical activity affects their heart rate and breathing. Intensity level is subjective. What may be intense for one person may be less intense for someone else. For instance, I don’t play tennis, but if I were to try, I would probably be huffing and puffing after the first serve. On the other hand, I do aerobic dance, and it takes me a bit of effort to raise my heart rate.
In general, if you are doing moderate-intensity activity you can talk, but not sing, during the activity. If you are engaged in vigorous-intensity activity, you will not be able to say more than a few words without pausing for a breath.
According to the Centers for Disease Control and Prevention, examples of moderate-intensity activity are:
Examples of vigorous-intensity activity are:
Then there is the concept of duration. Perhaps 250 minutes a week is too much for you. Before you throw in the towel, bear in mind that any exercise is better than none. I don’t care if you are walking once around the table, it is better than sitting all the time. In fact, prolonged sitting is very unhealthy.
Prolonged sitting (eight to 12+ hours per day) increases risk of developing type 2 diabetes by 90 percent. It is also associated with increased premature death from cardiovascular conditions and cancer. The World Health Organization lists physical inactivity as the fourth-leading risk factor for death for people all around the world. It ranks up there with smoking.
When I first heard this, I thought, “I am screwed.” Writers sit a lot. Yes, I exercise every day, but I also sit a lot. After I was done whining, I set about to solve my sitting problem. I bought a stand-up desk, and set a timer to remind me to walk every hour. In addition to my regular workout, I added in a longer walk after dinner. I set a goal to stand during phone calls and commercials.
There are many other benefits of adding more physical activity in to your life. Last month, I talked about hepatitis C and the value of exercise for reducing chronic pain. Exercise helped alleviate arthritic and inflammatory pain, fibromyalgia, migraine headaches and back pain. Being active improves our sleep and our moods. We live longer, and the quality of our lives is better.
If you are new to exercise, be sure to talk to your medical provider before starting. Start slow and only do what feels comfortable. Most of all, do it. Find ways to battle every excuse. Make exercise a non-negotiable part of your life. It may be hard, but it is worth it.
Lucinda K. Porter, RN, is a long-time contributor to the HCV Advocate and author of Free from Hepatitis C and Hepatitis C One Step at a Time. Her blog is http://www.lucindaporterrn.com/
Resources
Source: http://hcvadvocate.org/news/newsLetter/2015/advocate0815.html#2
Nonalcoholic fatty liver disease (NAFLD) is a metabolic disease that generally occurs in overweight patients. It may also occur in patients whose weight is normal, but because of prior excess weight, they developed insulin resistance, diabetes, or fat in the liver area, called visceral fat. NAFLD may also arise in people who eat a high fat, low-nutrition diet.
NAFLD is the most common liver disease, and it is increasing in prevalence and severity. Since fat impairs liver regeneration, NAFLD can lead to fibrosis and cirrhosis. NAFLD is the third most common risk factor for primary hepatocellular carcinoma. The American diet is so harmful, that children are developing NAFLD. If we keep on this course, NAFLD may overtake hepatitis C as the single most common reason for liver transplantation. Tragically, the prevalence of NAFLD is so great, that there has been a decrease in the number of viable livers that can be used for transplantation.
Hepatitis C appears to increase the risk of NAFLD. However, before blaming hepatitis C for fatty liver disease, keep in mind that the prevalence of hepatitis C in the U.S. is less than 2 percent, whereas the prevalence of NAFLD is 30 percent. This makes it hard for hepatitis C to be the sole link to NAFLD. An exception is in genotype 3, where there is clearly a higher risk for NAFLD.
As I stated, fatty liver disease can be fixed. You probably already figured out that good nutrition and maintaining a healthy weight is important, but did you know that physical activity could improve NAFLD? Exercise also improves insulin resistance as well as cardiovascular health. A few studies bear this out, but the question some of us have is, “What kind of exercise, how much, and how often?”
Let me state this in a way that I can relate to, “What is the least amount of exercise in both time and intensity that I can get away with, and still look my doctor in the eye and say I am a regular exerciser?”
In a retrospective analysis of obese middle-aged men (Hepatology April 2015), Sechang Oh and colleagues reported that moderate to vigorous physical activity had a dramatic effect. Those who engaged in ≥ 250 minutes a week of moderate to vigorous physical activity had the most improvement of NAFLD.
That is more than four hours of exercise weekly. Surprisingly, the exercise seemed to improve liver health, regardless of weight loss. Other research shows similar benefits. When it came to liver health, aerobic activity showed more improvement than resistance training.
What is moderate to vigorous physical activity?
There are various was to measure intensity. I prefer the concept of relative intensity. Using this method, people pay attention to how physical activity affects their heart rate and breathing. Intensity level is subjective. What may be intense for one person may be less intense for someone else. For instance, I don’t play tennis, but if I were to try, I would probably be huffing and puffing after the first serve. On the other hand, I do aerobic dance, and it takes me a bit of effort to raise my heart rate.
In general, if you are doing moderate-intensity activity you can talk, but not sing, during the activity. If you are engaged in vigorous-intensity activity, you will not be able to say more than a few words without pausing for a breath.
According to the Centers for Disease Control and Prevention, examples of moderate-intensity activity are:
- Walking briskly (3 miles per hour or faster, but not race-walking)
- Water aerobics
- Bicycling slower than 10 miles per hour
- Tennis (doubles)
- Ballroom dancing
- Gardening
Examples of vigorous-intensity activity are:
- Race walking, jogging, or running
- Swimming laps
- Tennis (singles)
- Aerobic dancing
- Bicycling 10 miles per hour or faster
- Jumping rope
- Heavy gardening (continuous digging or hoeing)
- Hiking uphill or with a heavy backpack
Then there is the concept of duration. Perhaps 250 minutes a week is too much for you. Before you throw in the towel, bear in mind that any exercise is better than none. I don’t care if you are walking once around the table, it is better than sitting all the time. In fact, prolonged sitting is very unhealthy.
Prolonged sitting (eight to 12+ hours per day) increases risk of developing type 2 diabetes by 90 percent. It is also associated with increased premature death from cardiovascular conditions and cancer. The World Health Organization lists physical inactivity as the fourth-leading risk factor for death for people all around the world. It ranks up there with smoking.
When I first heard this, I thought, “I am screwed.” Writers sit a lot. Yes, I exercise every day, but I also sit a lot. After I was done whining, I set about to solve my sitting problem. I bought a stand-up desk, and set a timer to remind me to walk every hour. In addition to my regular workout, I added in a longer walk after dinner. I set a goal to stand during phone calls and commercials.
There are many other benefits of adding more physical activity in to your life. Last month, I talked about hepatitis C and the value of exercise for reducing chronic pain. Exercise helped alleviate arthritic and inflammatory pain, fibromyalgia, migraine headaches and back pain. Being active improves our sleep and our moods. We live longer, and the quality of our lives is better.
If you are new to exercise, be sure to talk to your medical provider before starting. Start slow and only do what feels comfortable. Most of all, do it. Find ways to battle every excuse. Make exercise a non-negotiable part of your life. It may be hard, but it is worth it.
Lucinda K. Porter, RN, is a long-time contributor to the HCV Advocate and author of Free from Hepatitis C and Hepatitis C One Step at a Time. Her blog is http://www.lucindaporterrn.com/
Resources
- Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity
- Medline Plus’s Exercise and Physical Fitness
Source: http://hcvadvocate.org/news/newsLetter/2015/advocate0815.html#2
Thursday, July 30, 2015
Eradicate hepatitis
By Sen. Mazie Hirono (D-Hawaii) and Rep. Mike Honda (D-Calif.)
Across our country and around the world, hepatitis B and C have taken countless lives and the numbers continue to explode. Regrettably, this rise is partially tied to the heroin epidemic in our country—since the 1990s the medical use and subsequent abuse of highly addictive opioids like Oxycontin has risen tremendously
The overuse of medication has caused too many Americans to succumb to addiction, and many turn to heroin. The rise in heroin use means that individuals are sharing needles as their need for the drug outweighs safety concerns.
The Center for Disease Control (CDC) estimates there were nearly 30,000 new hepatitis C infections in 2013, a 150 percent increase since 2010. The CDC also found an alarming rise in new infections among people under the age of 30, especially in rural areas.
Tragically, hepatitis infection, driven by drug abuse, threatens an alarming portion of an entire generation of Americans. We must do everything we can to help address heroin and opioid addiction.
Hepatitis C and hepatitis B are life threatening yet preventable diseases. Look at the story of Rob, of Hawaii. He met his wife Mei over 30 years ago when they were students at the University of Hawaii.
She is Chinese from Hong Kong, and he is Caucasian. In the over 30 years since they first met they’ve built a life in Hawaii. They have two kids in their 20s—both college educated and looking to build families and lives of their own.
Their life was great—until Mei suddenly became ill. Only weeks after first taking ill, Mei passed away from liver failure.
To add to this incredible tragedy, shortly before Mei’s passing they learned that not only Mei - but both of their children - had been infected by hepatitis B since birth.
For over 30 years, they’d never known that they were infected by hepatitis.
Hepatitis is 100 times more infectious than the HIV virus, and in the U.S. perinatal transmission, or being passed from mother to child immediately before or after birth, is one of the primary ways that people contract the disease. It’s a silent killer that slowly destroys the liver, often displaying no symptoms in those infected with the virus until it is too late – the liver is diseased, riddled with cancer, cirrhosis, or end-stage failure.
Around the world, four hundred million people are living with hepatitis B or C. 1.4 million people die annually from complications due to viral hepatitis. In the United States, approximately 6 million individuals have hepatitis B or C, likely an underestimate. Both hepatitis B and C are the leading causes of liver cancer, and 65-75 percent of infected individuals do not know that they have either virus.
The difficulty with identifying the disease means that we do not have accurate data on infections. Without accurate data, we do not have a strong grasp of the scope of the problem. If we don’t take decisive action soon, our health care system will face a significant burden in decades to come.
We simply cannot handle the costs of the rampant spread of a disease whose complications are entirely preventable.
Stopping hepatitis has to be a three-step process.
First, people need to get tested, especially those in the Asian American and Pacific Islander communities, of which one in 10 will get hepatitis B.
Second, we need to make treatment options available to everyone regardless of income level.
And third, we must continue to invest in research on hepatitis to rid the world of the viruses once and for all.
This week, we recognized World Hepatitis Day, a day that President Obama declared by proclamation for the first time in the United States. This day was an opportunity to make a new commitment to educating people about the silent killers, helping prevent further infection rate spikes, identifying infected individuals, and providing them with proper medical care.
Working together, we can eradicate this preventable, treatable virus and save millions of lives.
Hirono is Hawaii’s junior senator, serving since 2013. She sits on the Armed Services; the Energy and Natural Resources; the Small Business and Entrepreneurship; and the Veterans’ Affairs committees. Honda represents California’s 17th Congressional District and has served in the House since 2001. He sits on the Appropriations Committee.
Source: The Hill
Across our country and around the world, hepatitis B and C have taken countless lives and the numbers continue to explode. Regrettably, this rise is partially tied to the heroin epidemic in our country—since the 1990s the medical use and subsequent abuse of highly addictive opioids like Oxycontin has risen tremendously
The overuse of medication has caused too many Americans to succumb to addiction, and many turn to heroin. The rise in heroin use means that individuals are sharing needles as their need for the drug outweighs safety concerns.
The Center for Disease Control (CDC) estimates there were nearly 30,000 new hepatitis C infections in 2013, a 150 percent increase since 2010. The CDC also found an alarming rise in new infections among people under the age of 30, especially in rural areas.
Tragically, hepatitis infection, driven by drug abuse, threatens an alarming portion of an entire generation of Americans. We must do everything we can to help address heroin and opioid addiction.
Hepatitis C and hepatitis B are life threatening yet preventable diseases. Look at the story of Rob, of Hawaii. He met his wife Mei over 30 years ago when they were students at the University of Hawaii.
She is Chinese from Hong Kong, and he is Caucasian. In the over 30 years since they first met they’ve built a life in Hawaii. They have two kids in their 20s—both college educated and looking to build families and lives of their own.
Their life was great—until Mei suddenly became ill. Only weeks after first taking ill, Mei passed away from liver failure.
To add to this incredible tragedy, shortly before Mei’s passing they learned that not only Mei - but both of their children - had been infected by hepatitis B since birth.
For over 30 years, they’d never known that they were infected by hepatitis.
Hepatitis is 100 times more infectious than the HIV virus, and in the U.S. perinatal transmission, or being passed from mother to child immediately before or after birth, is one of the primary ways that people contract the disease. It’s a silent killer that slowly destroys the liver, often displaying no symptoms in those infected with the virus until it is too late – the liver is diseased, riddled with cancer, cirrhosis, or end-stage failure.
Around the world, four hundred million people are living with hepatitis B or C. 1.4 million people die annually from complications due to viral hepatitis. In the United States, approximately 6 million individuals have hepatitis B or C, likely an underestimate. Both hepatitis B and C are the leading causes of liver cancer, and 65-75 percent of infected individuals do not know that they have either virus.
The difficulty with identifying the disease means that we do not have accurate data on infections. Without accurate data, we do not have a strong grasp of the scope of the problem. If we don’t take decisive action soon, our health care system will face a significant burden in decades to come.
We simply cannot handle the costs of the rampant spread of a disease whose complications are entirely preventable.
Stopping hepatitis has to be a three-step process.
First, people need to get tested, especially those in the Asian American and Pacific Islander communities, of which one in 10 will get hepatitis B.
Second, we need to make treatment options available to everyone regardless of income level.
And third, we must continue to invest in research on hepatitis to rid the world of the viruses once and for all.
This week, we recognized World Hepatitis Day, a day that President Obama declared by proclamation for the first time in the United States. This day was an opportunity to make a new commitment to educating people about the silent killers, helping prevent further infection rate spikes, identifying infected individuals, and providing them with proper medical care.
Working together, we can eradicate this preventable, treatable virus and save millions of lives.
Hirono is Hawaii’s junior senator, serving since 2013. She sits on the Armed Services; the Energy and Natural Resources; the Small Business and Entrepreneurship; and the Veterans’ Affairs committees. Honda represents California’s 17th Congressional District and has served in the House since 2001. He sits on the Appropriations Committee.
Source: The Hill
Following Spike in Hepatitis C Cases, Kentucky Considers Expanding Screenings for Virus
Officials at the state and local levels are in discussions about offering hepatitis C testing at all Kentucky county health departments.
Some local offices offered the tests last year as part of a pilot project, when Kentucky began to see a spike in hepatitis C cases related to intravenous drug use. The Centers for Disease Control and Prevention said in May that Kentucky’s rate of hepatitis C is seven times higher than the national average.
Deputy Commissioner Kraig Humbaugh, with the Kentucky Department of Public Health, says increased screening opportunities would be a way for health and addiction experts to reach out to those who need help.
Read more...
Some local offices offered the tests last year as part of a pilot project, when Kentucky began to see a spike in hepatitis C cases related to intravenous drug use. The Centers for Disease Control and Prevention said in May that Kentucky’s rate of hepatitis C is seven times higher than the national average.
Deputy Commissioner Kraig Humbaugh, with the Kentucky Department of Public Health, says increased screening opportunities would be a way for health and addiction experts to reach out to those who need help.
Read more...
Canada: Hepatitis C treatments skyrocket after pill-based drugs covered by B.C. plan
About 1,400 British Columbians have been treated for hepatitis C in the first four months since new anti-viral medications were covered by the province’s public drug plan — far above predictions.
The Ministry of Health expected 1,500 patients in the first full year for the pill-based medication.
Dr. Mel Krajden, medical head of hepatitis at the B.C. Centre for Disease Control, says the numbers reflect pent-up demand from patients seeking the latest treatments.
“A lot of people who are infected follow the literature on these drugs and they were waiting for the newer ones. It’s a whole group of people who realized these medications are more effective, better tolerated with fewer side effects and work over a shorter period of time,” Krajden said at a World Hepatitis Day event Tuesday in Vancouver.
- See more at: http://www.vancouversun.com/health/Hepatitis+treatments+skyrocket+after+pill+based+drugs+covered+plan/11249876/story.html#sthash.MT3sDoLJ.dpuf
The Ministry of Health expected 1,500 patients in the first full year for the pill-based medication.
Dr. Mel Krajden, medical head of hepatitis at the B.C. Centre for Disease Control, says the numbers reflect pent-up demand from patients seeking the latest treatments.
“A lot of people who are infected follow the literature on these drugs and they were waiting for the newer ones. It’s a whole group of people who realized these medications are more effective, better tolerated with fewer side effects and work over a shorter period of time,” Krajden said at a World Hepatitis Day event Tuesday in Vancouver.
- See more at: http://www.vancouversun.com/health/Hepatitis+treatments+skyrocket+after+pill+based+drugs+covered+plan/11249876/story.html#sthash.MT3sDoLJ.dpuf
Canada: Warning to all baby boomers: get tested for Hep C
A Saskatoon nurse predicts a surge of liver disease among baby boomers due to undiagnosed Hepatitis C.
“We’re going to see this huge wave of patients with end stage liver disease that are going to be dying from, potentially, liver cancer, kidney failure due to issues with their liver, and this is now the beginning,” said Lesley Gallagher, a Hepatitis C treatment support nurse with the Saskatoon Infectious Disease Care Network in Riversdale.
“We’re seeing it now, and we’re going to keep on seeing it.”
The number of Canadians with advanced liver disease is increasing, according to a 2014 study published in the Canadian Journal of Gastroenterology and Hepatology. More than 20 per cent of those who are infected with Hepatitis C will have significant complications from their disease by 2035, the study found.
Read more...
“We’re going to see this huge wave of patients with end stage liver disease that are going to be dying from, potentially, liver cancer, kidney failure due to issues with their liver, and this is now the beginning,” said Lesley Gallagher, a Hepatitis C treatment support nurse with the Saskatoon Infectious Disease Care Network in Riversdale.
“We’re seeing it now, and we’re going to keep on seeing it.”
The number of Canadians with advanced liver disease is increasing, according to a 2014 study published in the Canadian Journal of Gastroenterology and Hepatology. More than 20 per cent of those who are infected with Hepatitis C will have significant complications from their disease by 2035, the study found.
Read more...
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