Highlights from The Liver Meeting: 6 reports on viral hepatitis

This year’s The Liver Meeting provided many exciting updates for viral hepatitis care ranging from steps toward eliminating hepatitis C to improving hepatitis B treatment options through data on hepatitis D.

Healio Gastroenterology and Liver Disease presents the following reports on data shared at the meeting, which highlighted linkage to care for patients with HCV C, treatment for patients coinfected with HBV and HIV, a combination therapy for HDV, and new information on viral hepatitis rates among men who have sex with men.

‘Building bridges’ between PCPs, liver specialists for HCV led to 100% cure

The Hepatitis C Leaders in Primary Care program, or HELP-C, engaged primary care physicians to successfully screen and treat veterans with hepatitis C through comanagement with a specialist liver team, according to a study presented at The Liver Meeting 2019.

“Although all veterans with hepatitis C have been offered treatment in the VA system, some have remained untreated because they did not engage with our liver clinic, despite good adherence with their primary care providers,” Susan Zapatka, a nurse practitioner codirector at the Veterans Affairs Connecticut Healthcare System, said during her presentation. “Our aim was to expand HCV treatment access and to increase birth cohort screening by empowering primary care providers to become engaged in the process.” READ MORE

VIDEO: Surface antigen loss in HBV/HIV coinfection similar to HBV alone

In this exclusive video from The Liver Meeting 2019, Douglas T. Dieterich, MD, director of the Institute for Liver Medicine at the Icahn School of Medicine at Mount Sinai, discusses results of a study that showed that loss of surface antigen among individuals coinfected with HIV and chronic hepatitis B virus infection was similar to rates previously reported in patients with HBV monoinfection.

The researchers analyzed the OPERA cohort to identify individuals living with HIV and chronic hepatitis B virus infections – defined by at least two or more hepatitis B surface antigen (HBsAg) positive tests after first visit. Individuals with hepatitis C virus infection at any time during follow-up were excluded from the study. READ MORE

Combination therapy prevents HCV infection in non-viremic organ recipients

Hepatitis C infection was prevented or rapidly cured in transplant recipients who received organs from donors infected with the virus following combined treatment with ezetimibe and direct-acting antiviral therapy, according to study results presented at The Liver Meeting 2019.

“Unfortunately, most of you know that the opioid epidemic continues and, with that, an overdose crisis,” Jordan J. Feld, MD, MPH, FAASLD, from the University of Toronto University Health Network, said during a press conference. “What has been observed is that among potential organ donors, particularly those who died of overdose, the prevalence of hepatitis C has increased dramatically.” READ MORE

‘Quest for better HDV therapy’: triple combination reduces RNA in most

Triple combination therapy with lonafarnib, ritonavir, and Lambda for chronic hepatitis D appeared safe and tolerable for up to 6 months in most patients and led to high rates of RNA decline, according to data presented at The Liver Meeting 2019.

“Worldwide, approximately 15 to 20 million people are infected with delta hepatitis, and up to 80% of those patients may develop cirrhosis within 5 to 10 years,” Christopher Koh, MD, MHSc, FAASLD, from National Institutes of Health in Maryland, said during his presentation. “Patients with delta hepatitis are at a higher risk for hepatic decompensation, leading to death and the development of hepatocellular carcinoma compared with monoinfected hepatitis B patients.” READ MORE

VIDEO: Shorter duration Mavyret safe, effective in all HCV genotypes

In this exclusive video from The Liver Meeting 2019, Robert S. Brown Jr., MD, MPH, of Weill Cornell Medical College, discusses the results of the EXPEDITION-8 trial, which demonstrated that treatment with Mavyret over 8 weeks was effective and had a favorable safety profile in patients with treatment-naive chronic hepatitis C virus genotypes 1-6 and compensated cirrhosis.

“We know we have a plethora of medications to choose [from] with hepatitis C, but the new recommendations from our organizations are to choose a pangenotypic therapy that is safe and effective,” Brown told Healio Gastroenterology and Liver Disease. “Having a simple regimen is also critical if we’re going to achieve the WHO goals of HCV elimination by 2030.” READ MORE

New HCV infection less common in MSM initiating PrEP

New incidences of hepatitis C virus infection among men who have sex with men, or MSM, who are actively using pre-exposure prophylaxis for HIV prevention appeared to be less common than previously shown, according to data presented at The Liver Meeting 2019.

“There have been a number of studies showing that once pre-exposure prophylaxis for HIV became available, risk-taking associated with sexual transmission and previously associated with trying to reduce the risk of HIV transmission started to go down,” Jordan J. Feld, MD, MPH, FAASLD, from the University of Toronto University Health Network, said during a press conference highlighting the finds. “And so, PrEP clinics have reported high incidences of acute HCV infection both through sexual transmission and through drug use at the time associated with sex.” READ MORE