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Post Info TOPIC: Healio/HCV Updates
Tig


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RE: Healio/HCV Mother to Infant Transmission
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Sadly, the rate of new infection is on an alarming rise. Still, the risk of vertical transmission is  low, as this article indicates. That isn’t a reason to dismiss the increased infections as no big deal. The simple fact that we’re seeing the infection rates rise, tells me we have a long road ahead. We are hoping to eradicate it by 2030, these numbers are going the wrong way. Thanks to Healio for content.

Mother-to-infant HCV transmission risk on the rise in Wisconsin

 

The proportion of pregnant women with hepatitis C virus infection who receive Medicaid in Wisconsin has risen dramatically, suggesting an increased risk for mother-to-infant transmission, according to an MMWR.

As HCV infection among women of child-bearing age increases both in the Midwest state and nationally, clinicians must step up diagnostics and surveillance, researchers wrote in the report.

“Enhanced identification through HCV screening during pregnancy and public health follow-up to monitor infants at risk for vertical transmission are needed,” Theresa Watts, MPH, of the University of Wisconsin School of Nursing, and colleagues said.

To assess the risk for vertical HCV transmission in Wisconsin, the researchers examined data from reports of infection in the Wisconsin Electronic Disease Surveillance System and childbirths among women on Medicaid in Wisconsin between 2011 and 2015.

During that period, HCV infection among pregnant women increased by 93% — from one in 368 pregnancies to one in 192. Out of 183 children born to women with evidence of HCV viremia, 34% were tested for the virus as recommended, the researchers said, and vertical transmission was reported in 4% of infants.

Watts and colleagues also cited prior research showing that, nationwide, one in 308 infants were born to women with HCV in 2014. The findings from Wisconsin and the United States as a whole call for improved surveillance, the researchers said.

They recommended following a recent position statement on notification of HCV vertical transmission issued by the Council of State and Territorial Epidemiologists. The statement, in part, recommends that all U.S. states and territories make it a notifiable condition.

“Adoption of this position statement by state and local health departments, along with enhanced identification of HCV among women of childbearing age, can improve care for HCV-infected women and infants at risk for HCV vertical transmission,” Watts and colleagues wrote. – by Joe Green

References: 

Council of State and Territorial Epidemiologists. Public Health Reporting and National Notification of Perinatal Hepatitis C Virus Infection. http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/2017PS/2017PSFinal/17-ID-08.pdf. 2017. Accessed October 26, 2017.

Watts T, et al. MMWR Morb Mortal Wkly Rep. 2017;10.15585/mmwr.mm6642a3.



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Tig


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RE: Healio/HCV Updates
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HCV clearance lowers liver cancer risk by 70% no matter drug of choice

 

WASHINGTON — Reaching sustained virologic response with direct-acting antivirals reduced the occurrence of hepatocellular carcinoma by 71%, but all treatments that cleared the virus saw a similar reduction in risk, according to a presenter at The Liver Meeting 2017. 

“Our results show that DAA-induced SVR is associated with a 71% reduction in HCC,” George N. Ioannou, MD, from the University of Washington, said in his presentation. “Eradication of HCV is associated with a similar reduction in HCC  irrespective of the regimen used to achieve that eradication.

Link to Healio article



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Thank you, Tig.  That is an extremely interesting article and among other things, confirms for me the fact that there is still a stigma attached to those affected by HepC.  For me, the emotional battle is just as difficult to overcome as the physical one.  I honestly have no idea how I contracted HepC, and know it's pointless to dwell on it, but can't help wondering how long I've had it and how I got it.



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64 y/o female, no idea how HEP C contracted

diag. 6/2017, GT 1a, VL 7.64 mil

Fibrotest-.41 (F1-F2) ; Actitest/Metavir 0.18; Apri: 0.266

Mutations detected: Q30H/Y, H58Q

Alt-33;  Ast-28

4 week:  VL<15; ALT-7 AST-11: 8 week: VL-UND, ALT-9, AST- 9

 Epclusa SOT 8-31-17; EOT 11-22-17

Lindsay

Tig


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I found some barriers to treatment that still exist. As individuals that complete treatment on these incredibly effective DAA’s, it’s important to get the word out, just how effective, and how easy the side effects profile is. People shouldn’t be afraid to start treatment! These aren’t the treatments from the recent dark ages of Interferon, Ribavirin and whatever else they could throw at you! They were awful drugs and difficult at the best of times. That was then and today is all about the new DAA’s! Effective, easy and getting more accessible all the time. Spread the word!  Credit to Healio.com for HCV Next.

Cost, fear of side effects key barriers to HCV treatment

 

Cost, insurance and apprehension of side effects were the leading barriers to hepatitis C treatment, according to results from a recent survey of individuals either cured or not cured of HCV.

Sara Hayes, MPH
Sara Hayes

Hepatitis C in America was the third annual survey by Health Union and primarily included community members from HepatitisC.net. The survey design was to evaluate the community’s perceptions of HCV and HCV treatment, how those perceptions may have changed over time, and to engage newly diagnosed people.

“We find that these are a lot of the questions they want to be asked because they might not be asked these questions by anybody else and they like to see how they stack up against others,” Sara Hayes, MPHSenior Director of Community Development at Health Union, told Healio.com/Hepatology. “It’s nice to take a survey, see the results, and say, ‘Wow, I thought I was the only one experiencing this’ — to know that a large percentage of other people, in your community, are going through exactly what you’re going through.”

From May 3 to June 26, 2017, 296 individuals cured of their infection and 313 individuals with current HCV infection responded to the survey. Most respondents were women aged between 50 and 60 years, or the baby boomer generation.

While 62% of respondents were aware of HCV prior to their diagnosis, 33% were unaware of what the infection was. Of the 55% who knew how they were infected, 47% reported current or previous injection drug use.

Thirty-nine percent of the respondents received an HCV diagnosis due to a health care provider recognizing related symptoms. Other respondents received a diagnosis after routine medical exams (31%) or after they donated blood (14%). Fatigue was the most common symptom among both respondents who were cured (79%) and not cured (85%). Fatigue (70%), depression (69%) and anxiety (63%) affected respondents’ daily lives the most.

Barriers to treatment

Most of the respondents not cured said they actively seek out information on the latest treatments and play an active role in treatment decisions for their HCV. However, 52% of the uncured respondents have yet to receive treatment and 33% received treatment in the past but are no longer on treatment.

“Upon diagnosis, one of the top concerns that respondents had was how they were going to afford treatment in addition to how it would affect their body,” Hayes said. “There is a large percentage who reported they’re not sure what their next step is, and they don’t really have any plans. Anecdotally, based on what we see in the community, there are a lot of people who have a bit of hopelessness and feel they may never be able to access a life-saving cure for them.”

Respondents who have not yet received treatment said they are worried they cannot afford treatment (53%), their insurance provider denied coverage for HCV treatment (25%), they have not decided with their doctor what course to take (19%), or they are worried about the potential side effects of treatment (19%).

Of those who received HCV treatment, either cured or not cured, 28% stopped treatment early. The reason for 40% of those who stopped early was drug-related side effects. Overall, 148 respondents reported they had received treatment but were not cured.

“When treatment fails, there’s both an emotional and physical toll that it takes on people,” Hayes said. “It can be really brutal to go through a whole treatment regimen and really get your hopes up and then hear that you haven’t cleared the virus. There are some open-ended responses and one respondent wrote that when the virus came back after treatment, ‘I had never been so depressed in my life.’”

Education and awareness

Among 52% of the respondents who said they had never used manufacturer-sponsored financial support programs, 37% were unaware that those programs existed for HCV.

Most of the uncured respondents (69%) were interested in HCV clinical trials as means to benefit themselves (67%) and benefit others (60%), because it may be the only way they can receive treatment (55%), or because it may be the only way they can afford treatment (47%).

Educational topics that most interested respondents included complications related to HCV, long-term outcomes, related symptoms, new HCV treatments, and managing the infection.

Resources respondents turned to most often included health care professionals (62%), HCV-specific websites (56%), internet searches (46%), general health websites (28%), and social media outlets (26%).

Respondents also listed community as an important resource, as most of those cured (93%) said they still feel like they are part of the HCV community and 30% continue to engage in community activities such as support groups, liver walks, and work with the American Liver Foundation.

According to Hayes, while recent awareness efforts have been successful, she was concerned that a focus on risk factors, such as injection drug use, could affect outreach. “It’s important for both the general public and health care professionals to be aware that a risk factor someone had for a very short amount of time 30 years ago could influence what’s going on in their health today.

“It’s really an emotional battle that many are going through because there is still so much stigma that surrounds hepatitis C,” Hayes concluded. “If we could see people for who they really are, beyond just the condition or what the label represents to you, it’s important to really see people for what their struggle is and not necessarily what the condition represents.” – by Talitha Bennett

Reference: Health Union. Hepatitis C in America 2017 Findings. July 2017. Accessed October 11, 2017.



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Tig


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September Healio updates:

http://www.healio.com/hepatology/news/print/hcv-next

Tig



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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I pushed the LIKE button



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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 

Tig


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I just received this update and found a number of articles pertinent to our favorite subject!

http://www.healio.com/infectious-disease/hepatitis-c

Tig



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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