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Top HCV reports for June 2017 focus on guides, screening

In the direct-acting antiviral era, researchers and medical professionals are continuing their efforts to eliminate hepatitis C by defining the most instrumental guides for screening, treatment and management.

Healio.com/Hepatology presents some of the highlights in HCV research data and formal reports for June 2017. The reports include EASL’s response to a controversial review of DAA studies, recommendations for the elimination of HCV from Georgetown University, the utility of electronic screening for HCV among the baby boomer generation, and a survey that identified gaps in current HCV and hepatitis B testing guides in Europe.

EASL responds to unfavorable DAA review

The European Association for the Study of the Liver responded with serious concern to a systematic review published by the Cochrane Group Review that stated direct acting antivirals “do not seem to have any effects on risk of serious adverse events [but] we could neither confirm nor reject that DAAs had any clinical effects.”

“The review examines the intervention in a clinical vacuum that fails to accept that DAA treatment to attain [a sustained virologic response] is a pivotal outcome of treatment, and does not accept the likelihood that an SVR will reduce the risks of long-term outcomes of hepatitis C,” EASL governing board members and board directors wrote in a recent editorial published online in Journal of Hepatology. “With this deduction comes responsibility. The uncertainty created by the ill-conceived Cochrane group’s conclusions and the attendant press publicity could grievously affect policy making, and constrain the gathering momentum for diagnosis, testing and linkage to care of individuals with hepatitis C. It will create dangerous confusion in the mind of patients treated or about to be treated and their families.” Read more

Experts release new recommendations for the elimination of HCV in the U.S.

A recent report from the O’Neill Institute for National and Global Health Law at Georgetown University provides key recommendations for the potential elimination of hepatitis C in the U.S., based upon an expert consultation of 35 diverse stakeholders, including HCV medical and non-medical providers, patient advocates, epidemiologists, and federal HCV policy and program staff.

“To eliminate HCV in the U.S., we must effectively monitor the epidemic and deploy critical public health and health care resources to prevent new infections, screen and diagnose cases, and treat all of those who are infected with the virus,” Sonia L. Canzater, JD, MPH, and Jeffrey S. Crowley, MPH, from Georgetown University wrote in their report. “While expanding access to care and treatment and bolstering the health care workforce are also critically important, these efforts will not be as effective as they could be if we do not have sufficient data to inform our efforts.” Read more

Urban clinic achieves high SVR rates in HCV/HIV coinfected patients

Patients with hepatitis C and HIV coinfection had high rates of sustained virologic response in an urban clinical setting with the use of standard nurse and pharmacist adherence support programs, according to results of a recent study.

“In this real-world cohort of predominantly black, inner city HIV/HCV coinfected patients, treated with oral [direct-acting antivirals], we observed high SVR rates (above 95%),” the researchers wrote. “Despite the high prevalence of psychiatric disease and addiction disorders, the observed SVR rate was similar to that observed in registration clinical trials. These HCV cure rates were consistently high regardless of race, cirrhosis status and HCV treatment experience.” Read more

Interferon-based SVR in HCV reduced risk for extrahepatic manifestations

Sustained virologic response following interferon-based antiviral therapy in patients with hepatitis C reduced the risk for extrahepatic manifestations, according to results of a recently published study. The researchers suggested this means greater impact from direct-acting antiviral treatments.

“In this large cohort study of HCV-infected U.S. veterans, we found that SVR reduces the risk of some HCV-associated [extrahepatic manifestations (EHM)], such as mixed cryoglobulinemia, glomerulonephritis, [porphyria cutanea tarda], [non-Hodgkin’s lymphoma], diabetes and stroke,” Parag Mahale, MBBS, PhD, MPH, from the National Cancer Institute, Maryland, and colleagues wrote. “These findings further strengthen the epidemiological evidence for their association with HCV infection. Furthermore, HCV-related EHMs carry a significant economic burden due to direct medical costs and indirect costs due to loss of productivity.” Read more

Electronic HCV screening intervention improves testing, linkage to care in baby boomers

An electronic health record clinical decision support tool significantly increased hepatitis C virus infection screening, as well as follow-up testing and linkage to care among baby boomers, according to recently published findings.

“The [CDC] and U.S. Preventive Services Task Force recommend a one-time hepatitis C virus screening for adults born between 1945-1965,” Jeffrey D. Klausner, MD, MPH, professor of medicine at the David Geffen School of Medicine, University of California, Los Angeles, and colleagues wrote. Read more

Survey finds gaps in HBV, HCV testing guides, outcome data

The European Center for Disease Prevention and Control recently published results of two semi-structured surveys that found a wide variation in existing national testing policy and lack of monitored data for hepatitis B and hepatitis C in the EU/EEA member states.

“The purpose of this work was to provide a baseline situation assessment to inform the guidance development process and to assess the availability and feasibility of collecting additional morbidity and mortality data from EU/EEA Member States,” the researchers wrote. “As a subsidiary objective, the availability of information to monitor the HBV and HCV epidemic was assessed against the core indicators defined in the WHO Regional Action Plan for viral hepatitis.” Read more