Viral hepatitis is known as the silent epidemic, because it is a disease that is both under-recognized and underdiagnosed. Hepatitis can result from infection with several different viruses, including hepatitis C virus (HCV). The Centers for Disease Control and Prevention estimates that nearly 3.2 million people are chronically infected with HCV and that nearly half are unaware of their infection. Untreated, hepatitis C infection can lead to liver cancer and death; yet, we have more tools than ever before to respond successfully to this epidemic. The availability of expanded coverage for preventive screening for hepatitis C under the Affordable Care Act and new therapies with cure rates over 90% are galvanizing consumer and provider awareness of this important public health issue.
One of the four goals of the national Viral Hepatitis Action Plan seeks to improve HCV testing and linkage to care for the estimated millions of Americans who are living with undiagnosed hepatitis C. The plan also seeks to ensure that individuals, who have been previously diagnosed with HCV— but are not in care— take steps to prevent damage from chronic, untreated HCV infection
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Friday, September 4, 2015
Thursday, September 3, 2015
Can vaccination contribute to hepatitis C elimination efforts? A Q+A with Nick Scott
In a recent research article published in BMC Medicine, Nick Scott and colleagues used a mathematical modeling approach to show that vaccination is likely to play a role in reducing hepatitis C prevalence. Here, Dr Scott answers our questions about the study, and explores whether vaccination could help to eliminate the infection.
Nick Scott is an Econometrician at the Burnet Institute in Melbourne, Australia. Since completing his mathematics PhD in 2012, he has been modelling infectious disease transmission among vulnerable populations to inform public health policy.
In most developed settings, new HCV infections and HCV-related liver disease occur among largely disjoint populations. New HCV infections primarily occur among people who inject drugs (PWID) through the sharing of injecting paraphernalia, but the slow progression to liver disease means that the burden of disease is increasingly occurring in an aging population.
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Nick Scott is an Econometrician at the Burnet Institute in Melbourne, Australia. Since completing his mathematics PhD in 2012, he has been modelling infectious disease transmission among vulnerable populations to inform public health policy.
In most developed settings, new HCV infections and HCV-related liver disease occur among largely disjoint populations. New HCV infections primarily occur among people who inject drugs (PWID) through the sharing of injecting paraphernalia, but the slow progression to liver disease means that the burden of disease is increasingly occurring in an aging population.
Read more.....
Repurposing of the antihistamine chlorcyclizine and related compounds for treatment of hepatitis C virus infection—S He et al.—Alan Franciscus, Editor-in-Chief
Source: Sci Transl Med. 2015 Apr 8;7(282):282ra49. doi: 10.1126/scitranslmed.3010286
Results and Conclusions
The article discussed how a common and cheap generic antihistamine drug—chlorcylclizine HCL—could be used to treat hepatitis C. In cell studies it was found that cholorcyclizine had antiviral effects against the hepatitis C virus. The antiviral effect was also synergistic with other hepatitis C drugs including telaprevir, boceprevir, sofosbuvir, daclatasvir, and cyclosporine and importantly without any toxic effect to cells.
The Bottom Line
There have been many medications that have been developed to treat certain conditions, some of their properties, and even some of the side effects help with other conditions. An example would be mirtazapine. It is approved to treat major depressive disorder, but one of the side effects is sleepiness. It was found that when taken in small doses in the evening that it helped to treat insomnia. Another example is propranolol that is approved to treat high blood pressure. Taken at a lower dose, off-label, it reduced anxiety in people who suffer from stage fright and other anxieties such as fear of public speaking.
Editorial Comment
It is way too early to tell if chlorcyclizine will be an effective therapy to treat hepatitis C. Chlorcylclizine with and without ribavirin is currently in a phase 1 clinical trial to treat hepatitis C. There is more information available about chlorcyclizine’s clinical trial information at www.clinicaltrial.gov. Type in “chlorcylclizine” or the trial identifier NCT02118012
It is being conducted by the National Institutes of Health Clinical Center.
Results and Conclusions
The article discussed how a common and cheap generic antihistamine drug—chlorcylclizine HCL—could be used to treat hepatitis C. In cell studies it was found that cholorcyclizine had antiviral effects against the hepatitis C virus. The antiviral effect was also synergistic with other hepatitis C drugs including telaprevir, boceprevir, sofosbuvir, daclatasvir, and cyclosporine and importantly without any toxic effect to cells.
The Bottom Line
There have been many medications that have been developed to treat certain conditions, some of their properties, and even some of the side effects help with other conditions. An example would be mirtazapine. It is approved to treat major depressive disorder, but one of the side effects is sleepiness. It was found that when taken in small doses in the evening that it helped to treat insomnia. Another example is propranolol that is approved to treat high blood pressure. Taken at a lower dose, off-label, it reduced anxiety in people who suffer from stage fright and other anxieties such as fear of public speaking.
Editorial Comment
It is way too early to tell if chlorcyclizine will be an effective therapy to treat hepatitis C. Chlorcylclizine with and without ribavirin is currently in a phase 1 clinical trial to treat hepatitis C. There is more information available about chlorcyclizine’s clinical trial information at www.clinicaltrial.gov. Type in “chlorcylclizine” or the trial identifier NCT02118012
It is being conducted by the National Institutes of Health Clinical Center.
Wednesday, September 2, 2015
World Hepatitis Summit harnesses global momentum to eliminate viral hepatitis
2 SEPTEMBER 2015 ¦ GLASGOW - Participants at the first-ever World Hepatitis Summit will urge countries to develop national programmes that can ultimately eliminate viral hepatitis as a problem of public health concern.
“We know how to prevent viral hepatitis, we have a safe and effective vaccine for hepatitis B, and we now have medicines that can cure people with hepatitis C and control hepatitis B infection,” said Dr Gottfried Hirnschall, Director of the WHO’s Global Hepatitis Programme. “Yet access to diagnosis and treatment is still lacking or inaccessible in many parts of the world. This summit is a wake-up call to build momentum to prevent, diagnose, treat - and eventually eliminate viral hepatitis as a public health problem.”
Around 400 million people are currently living with viral hepatitis, and the disease claims an estimated 1.45 million lives each year, making it one of the world’s leading causes of death. Hepatitis B and C together cause approximately 80% of all liver cancer deaths, yet most people living with chronic viral hepatitis are unaware of their infection.
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“We know how to prevent viral hepatitis, we have a safe and effective vaccine for hepatitis B, and we now have medicines that can cure people with hepatitis C and control hepatitis B infection,” said Dr Gottfried Hirnschall, Director of the WHO’s Global Hepatitis Programme. “Yet access to diagnosis and treatment is still lacking or inaccessible in many parts of the world. This summit is a wake-up call to build momentum to prevent, diagnose, treat - and eventually eliminate viral hepatitis as a public health problem.”
Around 400 million people are currently living with viral hepatitis, and the disease claims an estimated 1.45 million lives each year, making it one of the world’s leading causes of death. Hepatitis B and C together cause approximately 80% of all liver cancer deaths, yet most people living with chronic viral hepatitis are unaware of their infection.
Read more.....
Tuesday, September 1, 2015
Attention: If you know of people who are suing or if you are suing, please contact me at alanfranciscus@hcvadvocate.org
There are many insurance companies that are denying coverage of HCV medications to only the sickest of patients. I am working on a brief article describing why people are filing lawsuits against these insurance companies. It will be a brief overview, and I will not be using names. I am looking for quotes from people who are suing or are thinking of suing insurance companies. For example, one person told me that to be turned down for the HCV medications wasn’t medically ethical or morally just and from a monetary standpoint they were angry because they had been paying their medical premiums their entire life. Now when they needed their insurance, the company bailed on them.
Huntington needle exchange program set to launch
HUNTINGTON, W.Va. — West Virginia’s first-of-its-kind syringe exchange program will launch Wednesday in Huntington and Cabell County.
“The community has recognized a need and demand of this service for some time and we’re just excited to be able to offer it,” said Michael Kilkenny, the physician director for the Cabell-Huntington Health Department.
The pilot project will involve education and treatment resources to make clean needles more readily available. There will also be efforts to stop the spread of infectious diseases, like hepatitis B and hepatitis C, by giving addicts points of contact within the health department.
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“The community has recognized a need and demand of this service for some time and we’re just excited to be able to offer it,” said Michael Kilkenny, the physician director for the Cabell-Huntington Health Department.
The pilot project will involve education and treatment resources to make clean needles more readily available. There will also be efforts to stop the spread of infectious diseases, like hepatitis B and hepatitis C, by giving addicts points of contact within the health department.
Read more.....
Consumer Reports Best Buy Drugs Booklet —Alan Franciscus, Editor-in-Chief
Coincidently, today I received a booklet in the mail from Needymeds.org titled “Consumer Reports Best Drugs for Less.” This little book is chock full of information about saving people money on drugs, gives examples of how much money you can save, provides information on the best choices on different medications, what drugs are safe split in half (and medications that should not be broken in half), generic drugs, reading drug labels, understanding drugstore services and much more health advice.
The booklet is free! It can be viewed and downloaded in English and Spanish at CRBestbuydrugs.org
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