Caring Ambassadors Hepatitis C Program Newsletter
www.HepCChallenge.org
September
2008
In The News
Important news regarding the HCV sequence
database
“Regretfully, NIH has decided to stop funding this project. The funding has been moved to the Viral Bioinformatics Resource Center, who will be maintaining a different HCV site at http://www.hcvdb.org.
Because of this, we can no longer maintain the work-intensive HCV immunology database. The HCV immunology database will remain accessible for the foreseeable future, but due to lack of resources, no new information will be added. We will display this information at the top of our immunology web pages. For new epitope information, users of this database can try the Immuno Epitope Database (http://www.immuneepitope.org).
The HCV sequence database is still being maintained, although not quite as diligently as before. The website will be tied even more closely to the HIV site, so that all new HIV tools will also be available for HCV. When we feel (or you let us know) that the annotation quality begins to significantly deteriorate, this site will be closed.” Read more…
Hepatitis outbreak could result in new laws
“The hepatitis C investigation has uncovered a lot of holes in Nevada’s health care system and some lawmakers want to see them fixed before public health is put at risk again. When the hepatitis C investigation began, one of the biggest flaws noticed was the lack of communication among the health district, the state health division and medical facilities.
Lawmakers on
the Legislative Committee on Health Care feel that closing those loopholes of
communication will drastically improve the system. Here are just a few of the
recommendations the health committee wants to make to legislators next year.” Read
more…
Larger liver transplant pool
“There’s good news for the 17,000 people on the liver transplant waiting list,
especially for those patients with hepatitis C. The majority of liver
transplants in the United States are for patients with hepatitis C, the most
common cause of the liver disease cirrhosis. To accommodate the large
transplant waiting list, many centers have expanded their donor criteria to
include older donors.
Some have been concerned hepatitis C patients would have poorer transplants outcomes as a result of the extended pool, but recent research shows organs from older patients are safe. Researchers at Washington School of Medicine in St. Louis found no differences in the one, three and five-year outcomes of patients with and without hepatitis C, who received organs from donors age 60 and older.” Read more…
Study disproves belief that hepatitis C blunts
HIV drugs
Impaired
immune response after antiretroviral therapy may be due to genetic factors
“A new study challenges the long-held belief that the hepatitis C virus (HCV)
impairs the immune system’s ability to restore itself after HIV patients are
treated with highly active antiretroviral therapy (HAART). Researchers at Wake
Forest University Baptist Medical Center focused on levels of CD4 cells -- the
immune cells that are attacked by HIV -- and whether CD4 cells can rebuild
after HAART is used to suppress HIV infection. For the study, the researchers
analyzed the medical records of 322 patients.
‘We’ve been observing that in some patients that are co-infected with hepatitis C, we were treating their HIV with HAART but didn’t always get very good restoration of CD4,’ lead researcher Dr. Marina Nunez, an assistant professor of infectious diseases, said in a Wake Forest news release. ‘Some studies have suggested it was because of the hepatitis C. This study says it’s not the presence of active hepatitis C replication.’” Read more…
Warfarin may prevent liver failure in
hepatitis C
The drug warfarin may help prevent liver failure in thousands of people
with Hepatitis C, according to new research.
“In a study published tomorrow (1 August) in the Journal of Thrombosis and Haemostasis, researchers show that warfarin reduces the scarring on the liver caused by Hepatitis C. This scarring, or fibrosis, replaces normal liver cells and can lead to cirrhosis of the liver and ultimately liver failure.
Following the new findings in mouse models, the Imperial College London researchers are now embarking on a clinical trial of warfarin as a treatment for people with Hepatitis C, funded by the Medical Research Council (MRC).” Read more…
New treatment therapy helps inhibit
hepatitis C
Two new studies examine the use of the nucleoside polymerase inhibitor,
R1626, to the standard therapy for hepatitis C.
“The first study shows that adding the treatment to standard therapy with pegylated interferon alpha plus ribavirin leads to a synergistic antiviral effect. In the search for new and better treatments, researchers have been testing R1626, which previously has been used to inhibit HCV replication in vitro.
The study group included 104 patients with HCV genotype 1. Twenty-one took 1500 mg of R1626 twice a day along with peginterferon alpha-2a. Thirty-two took 3000 mg of R1626 twice a day along with peginterferon alpha-2a. Thirty-one took 1500 mg of R1626 twice a day along with peginterferon alpha-2a and ribavirin. And 20 took the standard of care treatment of peginterferon alpha-2a with ribavirin. After four weeks, HCV RNA was undetectable in 29 percent, 69 percent, and 74 percent of patients in the respective study arms, compared to 5 percent of patients receiving the standard of care treatment. ‘The results of the present study show a marked increase in antiviral effect in patients when ribavirin is added to the combination of R1626 and peginterferon alfa-2a,’ the authors report.” Read more…
Vertex hepatitis C drug meets study goal
“Vertex Pharmaceuticals Inc. said late Thursday its hepatitis C drug candidate
telaprevir was both safe and prompted a response in patients during a midstage
study. Interim results from a Phase IIa clinical trial showed that twice-daily
and three-times-daily doses of telaprevir in combination with standard
hepatitis C treatments were effective in prompting a response. More than 80
percent of 160 patients had undetectable levels of hepatitis C after four-week
and 12-week periods. A complete analysis will be performed upon the conclusion
of this study in 2009, the company said.” Read more…
Pharmasset:
hepatitis C drug positive in early stage
“Pharmasset
Inc said preliminary results from an early-stage trial of its chronic hepatitis
C treatment showed that the dosage tested had greater safety potential and
could be carried forward into mid-stage studies, sending its shares up as much
as 12 percent. The data does not change the timeline of the drug, but implies a
very high efficacy rate, analysts told Reuters. The drug, R7128, was being
tested for a 1,000 milligram, twice daily dose in combination with two current
hepatitis C therapies, Pegasys and Copegus, in 31 treatment-naive patients
chronically infected with hepatitis C virus.” Read more…
Hep C
activist dies at 54
Feds denied Pillon-Trudeau hepatitis C
compensation weeks before her death Sunday
“Henry
Trudeau wipes a tear from his eye as he speaks about his common-law wife Janice
Pillon-Trudeau who died Sunday at the family home. Pillon-Trudeau believed she
contracted hepatitis C from a blood transfusion but never received compensation
from the federal government. As a nurse and hepatitis C activist, Janice
Pillon-Trudeau spent a lifetime helping others, but in the end could not help
herself.
Pillon-Trudeau died Sunday at 54 of
complications from hepatitis C -- which she contracted through tainted blood --
only seven weeks after the federal government deemed her not sick enough to
collect any of the $1 billion earmarked for people who contracted hepatitis C
from the blood system.” Read more…
Early
treatment is key to combating hepatitis C virus - Researchers publish research
results in on-line edition of Journal of Virology
“Canadian
researchers have shown that patients who develop a rapid poly-functional immune
response against hepatitis C virus (HCV) can eliminate the virus rapidly
without any treatment, according to a new study published in the Journal of
Virology.
The investigation was led by Dr. Naglaa Shoukry
and Dr. Julie Bruneau, who affiliated to both the Research Centre of the
Université de Montréal Hospital Centre and the Université de Montréal, as well
as researchers from the Institut national de la santé et de la recherché
scientifique (Montréal
branch) and Assiut University, Egypt. The study
found that patients who could not mount a rapid poly-functional immune response
became persistently infected and eventually lost any immune cells directed
against HCV. What’s more, the research team found that when early treatment was
administered within the first months following an infection, patients developed
a rapid poly-functional immune response against HCV and eliminated the virus rapidly
without any further treatment.” Read more…
High
prevalence of hepatitis C in Dutch HIV-positive gay men
“The prevalence of hepatitis C infection among
HIV-positive gay men attending a large Amsterdam sexual health clinic is 18%
and rising, reported Anouk Urbanus at the XVII International AIDS Conference in
Mexico City on August 7th.
Anonymous surveys were conducted at the clinic
in May 2007, November 2007 and April 2008. A total of 3125 people took part in
the survey, but almost four-fifths were heterosexual men and women, amongst
whom hepatitis C prevalence was low at 0.3%. Moreover, prevalence was also low
among HIV-negative gay men at 0.4% (2 of 532 men). However among HIV-positive
gay men, 18% had hepatitis C (28 of 157 men). Comparing the results between the
three surveys, prevalence rose from 15% to 17% and then to 21%. Just under a
third of these men were unaware of their infection.” Read more…
“Please
pay attention” to Hep C
Lone man markets message during Olympics
“For days now, Ten Xiaojun has stood beside a major street in Beijing — in the heart of the Olympic venues and under the watchful eye of security officials — and held up his placard, hoping to get noticed. Ten, a 30-year-old from Hunan Province — a plane flight away — believes Chinese officials should be doing more to educate the public on the perils of contracting Hepatitis C.” Read more…
Anesthesiologist
allegedly gives hepatitis
“A New York anesthesiologist has been suspended
and is accused in lawsuits of infecting patients with hepatitis B and C. City
Health Department officials found that Dr. Brian Goldweber sloppily used the
same syringe to give patients dosages from anesthesia vials already infected
with hepatitis. This ‘double dipping’ allegedly contaminated the contents and
helped spread the virus to at least 14 patients, the New York Post reported
Sunday. ‘This was a very serious outbreak -- and it was preventable,’ said Dr.
Sharon Balter, a city medical epidemiologist.” Read more…
County
needle exchange gets one more year
Board of Supervisors approves $100,000 for
program
“Yolo County’s needle exchange program, active for one year, has generated some controversy this summer because of reports that used syringes were showing up in public parks. Despite the concerns, the Yolo County Board of Supervisors voted 3-2 earlier this month to allow the needle exchange to continue into its second year at a cost of $100,000.” Read more…
Vertex
Pharmaceuticals to start phase 3 “REALIZE” trial with telaprevir in
treatment-failure HCV patients
“First HCV protease inhibitor in pivotal trial for this difficult to treat patient population Trial to enroll all major treatment-failure patient groups, including null responders, partial responders and relapsers Two telaprevir registration programs to address significant unmet need in treatment-naive and treatment-failure patients.” Read more…
Rapid
progression of liver fibrosis in HIV-positive gay men recently infected with hepatitis
C
“A US study has found that many HIV-positive gay men recently infected with hepatitis C virus have rapidly developed moderate-to-severe liver fibrosis. The study is published in the September 1st edition of the Journal of Infectious Diseases.
Most of the men became infected with hepatitis
C through unprotected sex and the infection was only diagnosed because the
patients had abnormal liver function tests. The study investigators suggest
that HIV-positive gay men should be regularly screened for infection with
hepatitis C, warning that ‘the implications of missing the diagnosis of acute
hepatitis C virus infection in these patients are grave.’” Read more…
Liver
transplant program established at Montefiore
“Area Residents Gain Access to High Quality Care
as State Approves Only Program in The Bronx
Patients who suffer from severe liver disease
and need a liver transplant will no longer have to seek that highly specialized
surgery and critically important follow-up care outside the borough of the
Bronx. Area patients and their families now have access to this high-quality
care locally, without having to travel long distances, as a result of the New
York State Department of Health’s approval of the first and only liver
transplant program in the Bronx, at Montefiore Medical Center (http://www.montefiore.org).” Read more…
Hep C
story saved my life
“For 23 years Lesley Jenkins
carried a virus that was slowly destroying her liver. Left untreated, it would
probably have killed her. Doctors repeatedly missed the lethal infection. They
told her she was overdoing things, it was arthritis and finally that she was
depressed. But Lesley had hepatitis C – and thanks to The Sun she is now clear
of the lethal bug. She insisted on a blood test for the disease after reading
our exclusive interview with Body Shop founder Dame Anita Roddick, who caught
hepatitis C from a blood transfusion.” Read
more…
16.1%
people tested positive for hepatitis (Rawalpindi, Pakistan)
“A free screening programme for the detection of
Hepatitis B and C, conducted in Rawalpindi, has yielded alarming results, as
16.1 percent of the total cases tested from general public were found affected
with the hepatitis virus.
Pakistan Green Task Force (PGTF) and Citi Lab jointly organized the programme in which almost 2,729 persons have, so far, been screened for hepatitis. Most of the cases visited the free camps to get themselves screened for hepatitis for the first time.” Read more…
Clovis
patients possibly exposed to hepatitis, HIV
Some instruments used last week may not have
been fully sterilized.
“Clovis patients must wait to
learn whether they’re infected. Fourteen
Clovis Community Medical Center patients -- some of whom were on the maternity
ward -- may have been exposed to hepatitis and HIV last week when doctors used
instruments that may not have been fully sterilized.
Although hospital officials say the risk of infection is remote, they have offered to test all the patients and doctors. So far, no infections have been found, said Michelle Van Valkenburg, director of communications for Community Medical Centers, which operates Clovis Community. She said she didn’t know how many remain to be tested or how many test results are pending.” Read more…
Life
inspires “reality” in Neal’s blues
“Blues player Kenny Neal has dealt
with enormous challenges in the past few years, from his hepatitis C diagnosis
in 2006 to the deaths of his brother, father, sister and drummer in rapid
succession. Now, the Louisiana
singer-guitarist is ready to get back to music with ‘Let Life Flow,’ his most
personal CD. It’s full of his homegrown ‘swamp blues,’ this time influenced by
his struggles.
‘Man, I had so much going on,’ says Neal, who is now cured of hepatitis. ‘I had been on the road for 30 years and, all of a sudden, I wasn’t able to play anymore. I took time off for treatment and couldn’t go out much. So I worked around the house and began putting a CD together about what I was going through. ‘I’m sharing what I’m going through and letting people know they’re not alone. And the response I’m getting back is amazing. People are opening up with their own problems, so it’s healing for them, too.’” Read more…
State
urges clinic’s patients to be tested for hepatitis C
“The state Department of Public
Health (NC) is asking people who
received a nuclear stress test at Scotland Cardiology in Laurinburg between
June 25, 2007, and Aug. 26, 2008, to get tested for the hepatitis C virus and
other infectious agents that may be transmitted through unsafe injection
practices.
A nuclear stress test involves injecting a radioactive substance into the bloodstream as a way to check for inadequate blood flow in the heart. A recent investigation of the clinic revealed that unsafe medical practices could have been used during the nuclear stress tests, possibly causing seven patients to acquire the disease. Dr. Matthew Block, a cardiologist at Scotland Cardiology and the city’s mayor, agreed to quit performing the procedure, which could have infected seven of his patients with hepatitis C, according to an Aug. 27 disciplinary order from the state medical board.” Read more…
New approach,
old drug show promise against hepatitis C, research shows
“The fight against the liver
disease hepatitis C has been at something of an impasse for years, with more
than 150 million people currently infected, and traditional antiviral
treatments causing nasty side effects and often falling short of a cure.
Using a novel technique, medical and
engineering researchers at Stanford University have discovered a vulnerable
step in the virus’ reproduction process that in lab testing could be
effectively targeted with an obsolete antihistamine.
The advance involves two new discoveries. One
is that a protein called NS4B is instrumental in binding some of the genetic
material, or RNA, and allowing the hepatitis C virus to replicate. The other is
that the former anti-itching drug clemizole hydrochloride could hinder that
protein, resulting in a tenfold decrease in virus replication with no apparent
harm to infected liver-like cells. Because the drug has already been used by
people, it is eligible for human testing.” Read more…
Clinical
Trials, Cohort Studies, Pilot Studies
Weight affect relapse rates in latinos with genotype 2/3 chronic hepatitis C (CHC) treated with peg IFN alfa-2a (Pegasys) 180 mcg/week and 800 mg daily of ribavirin for 24 weeks. Rodríguez-Torres M, et al. J Med Virol. 2008 Jul 22;80(9):1576-1580
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=18649339&dopt=Abstract
Diagnosis and clinical impact of occult
hepatitis B infection in patients with biopsy proven chronic hepatitis C: A
multicenter study. Sagnelli E, et al. J Med Virol. 2008 Jul
22;80(9):1547-1553
Chronic hepatitis C virus genotype 6 infection: Response to pegylated interferon and ribavirin. Fung J, et al. J Infect Dis. 2008 Sep 15;198(6):808-12.
Insulin resistance is a major determinant of sustained virological response in
genotype 1 chronic hepatitis c patients receiving peginterferon Alpha-2b plus
ribavirin. Chu CJ, et al. Aliment Pharmacol Ther. 2008 Aug 1; [Epub ahead
of print]
Efficacy and safety of peginterferon
alfa-2a/ribavirin in methadone maintenance patients: Randomized comparison of
direct observed therapy and self-administration.
Bonkovsky HL, et al. Am J Gastroenterol. 2008 Aug 5; [Epub ahead of print]
Safety of anti-tumor necrosis factor-alpha therapy in patients with rheumatoid arthritis and chronic hepatitis C virus infection. Ferri C, et al. J Rheumatol. 2008 Aug 1; [Epub ahead of print]
IFN-alpha-induced motor slowing is associated with increased depression and fatigue in patients with chronic hepatitis C. : Majer M, et al. Brain Behav Immun. 2008 Aug;22(6):870-80
Basic and Applied Science,
Pre-Clinical Studies
Detection of hepatitis C virus in thyroid tissue from patients with chronic HCV infection. Bartolomé J, et al. J Med Virol. 2008 Jul 22;80(9):1588-1594
Risk assessment of hepatocellular carcinoma in chronic hepatitis C patients by transient elastography. Masuzaki R, et al. J Clin Gastroenterol. 2008 Aug;42(7):839-43
Early interferon therapy for HCV rescues poly-functional long-lived CD8+ memory t cells. Badr G, et al. J Virol. 2008 Jul 30; [Epub ahead of print]
Impaired HCV specific effector CD8+ T cells undergo massive apoptosis in the peripheral blood during acute HCV infection and in the liver during the chronic phase of infection. Radziewicz H, et al. J Virol. 2008 Jul 30; [Epub ahead of print]
Induction of broad CD4+ and CD8+ T-cell responses and cross-neutralizing antibodies against hepatitis C virus by vaccination with Th1-adjuvanted polypeptides followed by defective alphaviral particles expressing envelope glycoproteins gpE1 and gpE2 and nonstructural proteins 3, 4, and 5. Lin Y, et al. J Virol. 2008 Aug;82(15):7492-503
Very low hepatitis C antibody levels predict false-positive results and avoid supplemental testing. Contreras AM, et al. Transfusion. 2008 Aug 1; [Epub ahead of print]
Altered natural killer cell subset distributions in resolved and persistent hepatitis C virus infection following single source exposure. Golden-Mason L, et al. Gut. 2008 Aug;57(8):1121-8
HIV/HCV
Coinfection
Serum concentrations of ribavirin and pegylated interferon and viral responses in patients infected with HIV and HCV. Nicot F, et al. J Med Virol. 2008 Jul 22;80(9):1523-1529
Hepatitis C virus seropositivity in a South African cohort of HIV co-infected, ARV naïve patients is associated with renal insufficiency and increased mortality. Parboosing R, Paruk I, Lalloo UG J Med Virol. 2008 Jul 22;80(9):1530-1536
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=18649335&dopt=Abstract
Role of hepatitis B virus, hepatitis D
virus and other determinants on suppression of hepatitis C viraemia in HIV
infected patients with chronic HCV infection: A longitudinal evaluation. Antonucci
G, et al. Scand J Infect Dis. 2008 Jul 23;:1-7
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=18651264&dopt=Abstract
Effect of treatment with efavirenz on neuropsychiatric adverse events of interferon in HIV/HCV-coinfected patients. Quereda C, et al. J Acquir Immune Defic Syndr.2008 Sep 1;49(1):61-3.
Complementary
& Alternative Therapy
Effects of silymarin on hepatitis C virus and haem oxygenase-1 gene expression in human hepatoma cells. Bonifaz V, et al. Liver Int. 2008 Aug 7; [Epub ahead of print]
Epidemiology,
Diagnostics, and Miscellaneous Works
Quality of life in hepatitis C virus infection: assessment of rural patients living in north-western New South Wales. Gunasekera S, Fraser J, Alexander C. Aust J Rural Health. 2008 Jul;16(4):213-20
Age-related lymphocyte and neutrophil levels in children of hepatitis C-infected women. Pembrey L, Newell ML, Tovo PA., Pediatr Infect Dis J. 2008 Sep;27(9):800-807.
Chronic liver disease among two American Indian patient populations in the southwestern United States, 2000-2003. Bialek SR, et al. J Clin Gastroenterol. 2008 Aug;42(7):949-54
Drug treatment clients’ readiness for hepatitis C treatment: implications for expanding treatment services in drug and alcohol settings. Treloar C, Holt M., Aust Health Rev. 2008 Aug;32(3):570-6
Occult hepatitis C virus infection among hemodialysis patients. Barril G, et al. J Am Soc Nephrol. 2008 Aug 6; [Epub ahead of print]
Effect of different types of smoking and synergism with hepatitis C virus on risk of hepatocellular carcinoma in American men and women: Case-control study. Hassan MM, et al. Int J Cancer. 2008 Aug 7;
Physicians’ and nurses’ views on infected health care workers. Kagan I, Lee Ovadia K, Kaneti T Nurs Ethics. 2008 Sep;15(5):573-85
Evaluation of an automated, highly
sensitive, real-time PCR-based assay (COBAS Amplipreptrade mark/COBAS
TaqMantrade mark) for quantification of HCV RNA. Sarrazin C, et al. J Clin
Virol. 2008 Aug 7; [Epub ahead of print]
Syndecan 1 (CD138) serum levels: a novel biomarker in predicting liver fibrosis stage in patients with hepatitis C. Zvibel I,et al. Liver Int. 2008 Aug 6; [Epub ahead of print]
Sustained clearance of serum hepatitis C virus-RNA
independently predicts long-term survival in liver transplant patients with
recurrent hepatitis C. Kornberg A, et al. Transplantation. 2008 Aug
15;86(3):469-73
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=18698252&dopt=Abstract