World Hepatitis Day 2018: 6 recent reports on HCV treatment, outcomes

“Test. Treat. Hepatitis.” is this year’s World Hepatitis Day theme. The direct-acting antiviral era has seen a significant increase in the number of patients with hepatitis C clearing their infection. Along with this, public awareness of the disease and its highly effective cure has increased.

The following reports include data on treating HCV in the prison ‘microenvironment,’ further research that invalidated the link between DAA therapy and increased risk for hepatocellular carcinoma, and a report on a novel HCV ‘genotype 8’ discovered in four patients.

Treating HCV in prison ‘microenvironment’ reduces transmission

Growing evidence supports the overall benefits and cost-effective outcomes of testing for and treating hepatitis C in the prison “microenvironment,” according to a review of recent studies.

“The prison microenvironment is thought to be a promising location to intervene in the care of blood-borne transmitted diseases since this population carries a high prevalence of disease, commonly engage in high-risk behaviors, and could be readily accessible by providers for testing and treatment,” Joseph S. Redman, MD, PhD, and Richard K. Sterling, MD, MSc, FACG, from the Virginia Commonwealth University, wrote in their review. Read more

Research continues to invalidate link between DAA treatment, liver cancer

Results of a recent study provided continued confirmation that increased rates of hepatocellular carcinoma among patients treated with direct-acting antivirals compared with interferon correlated with patient characteristics such as age and liver function rather than treatment.

“Despite a lack of long term follow-up, there have recently been several alarming reports suggesting ‘unexpectedly high’ rates of HCC incidence under and following DAA regimens in cirrhotic patients,” Pierre Nahon, MD, from the Hospital Jean Verdier in France, and colleagues wrote. “However, this twofold increase in risk is modest, limited in time and can at least partially be explained by confounders linked to the specific profile of patients bearing higher risk factors for the development of liver cancer.” Read more

Novel ‘genotype 8’ surfaces among four patients with HCV

Researchers identified four patients with a novel hepatitis C genotype, according to study published in The Journal of Infectious Diseases.

Despite the genotype’s genetic distinction from previously identified HCV genotypes 1 through 7, all four patients achieved sustained virologic response with direct-acting antivirals. Read more

PAGE BREAK

Universal HCV screening in adults cost-effective, decreases prevalence

Results of recent study in France showed that universal screening was the most effective strategy and was cost-effective when treatment was initiated regardless of patient fibrosis stage.

“In Europe, recommendations for hepatitis C virus (HCV) screening still target only people at high risk of infection,” Sylvie Deuffic-Burban, MD, from the Université Lille in France, and colleagues wrote. “From an individual and especially from a societal perspective of HCV eradication, [universal screening] should be implemented. However, when recommending such strategy, rapid initiation of treatment after diagnosis is required.” Read more

Alcohol use disorder in HCV increases depression, inflammatory response

Hepatitis C with comorbid alcohol use disorder correlated with increased depression and anxiety, dysregulated cytokine expression, and compromised blood-brain barrier function, according to a recently published study.

“Like HCV infection, chronic alcohol use induces inflammatory responses that contribute to its adverse [central nervous system] and neuropsychiatric effects,” Jennifer M. Loftis, PhD, from the VA Portland Health Care System in Oregon, and colleagues wrote. “The aim of this study was to investigate how comorbid [alcohol use disorder (AUD)] contributes to abnormalities in inflammatory mediators and psychiatric impairments in Veterans with HCV.” Read more

Liver transplant indications changing, survival better in DAA era

The number of liver transplantations due to hepatitis C-related decompensated cirrhosis and hepatocellular carcinoma declined rapidly over the last 3 years while posttransplant survival has improved, according to data from the European Liver Transplant Registry.

“This study shows for the first time on a large scale the use of direct-acting antiviral drugs giving major improvement in HCV recipient survival,” Luca Saverio Belli, MD, from the Niguarda Hospital in Milan, Italy, and colleagues wrote. “This trend is expected to continue provided that current policies aiming to eradicate HCV infection in the population are maintained.” Read more