HepCInfo Update 8.1
Welcome to CATIE's HepCInfo Update 8.1 for December 10, 2016 to January 6, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.
New and noteworthy
People considering hepatitis C treatment want information on the potential harms and benefits of treatment, details of treatment regimens and basic information on hepatitis C-related liver disease, reported U.S. researchers in The Patient.
Limited research exists about the topics that people consider most important when making decisions about hepatitis C treatment.
The study involved two groups. The first group (45 people) listed all the information topics they thought would be important to reach a decision about treatment. The second group (57 people) ranked the importance of the topics identified by the first group.
The information needs identified by the first group included:
- harms of treatment: side effects, impact on quality of life, cost of therapy, worsening of hepatitis C and impact on wider health and other illnesses
- details of treatment regimens: length of treatment, information on specific medications, such as how they are taken and drug interactions
- benefits of treatment: cure, impact on long-term survival, potential improvements in other health conditions, hepatitis C symptoms and functioning
- basic information on hepatitis C and liver disease
The second group rated almost all of the topics (16/17) identified by the first group as “pretty important or extremely important” for making treatment decisions.
The most highly ranked topics, included:
- viral cure rate of the treatment
- effect of a viral cure on long-term survival and other health issues
- what side effects the treatment might cause
- how injured their liver is
- lifestyle changes that support liver health
- how the medication is taken
“The findings from this study demonstrate that patients with hepatitis C wish to consider a plethora of information to assist them to make informed decisions about their hepatitis C treatment options,” stated the researchers. (infohep.org, January 2017)
People with hepatitis C and HIV co-infection are at increased risk of liver disease, liver-related death, kidney disease, osteoporosis and bone fractures compared to people with HIV only, reported Swiss researchers in Clinical Infectious Diseases.
The study included 2500 HIV-positive participants who had been exposed to hepatitis C and 2500 HIV positive participants who had not been exposed to hepatitis C. Participants were from the Swiss HIV Cohort Study from 1994 to 2014.
Of the group that been exposed to hepatitis C, 540 people had spontaneously cleared hepatitis C, 1294 people had not been treated, 345 had been treated and cured and 281 people had been treated and not cured. The participants were followed for an average of 8.2 years.
When compared to people with HIV who did not have hepatitis C, the participants who were exposed to hepatitis C had an increased risk of:
- liver disease (6.79 times higher risk)
- liver-related death (8.24 times higher risk)
- kidney disease (2.43 times higher risk)
- osteoporosis/bone fracture (1.03 to 2.01 times higher risk)
The researchers recommend further studies with longer term follow up to determine the impact of being cured of hepatitis C on outcomes that affect parts of the body other than the liver, such as kidney disease and bone problems. (infohep.org, January 2017)
The experimental hepatitis C treatment glecaprevir and pibrentasvir showed high cure rates in people with severe kidney disease, reported researchers at the 2016 American Association for the Study of Liver Diseases (AASLD) Liver Meeting.
Glecaprevir is a protease inhibitor, and pibrentasvir is an NS5A inhibitor. They are combined in one pill that is taken once per day. This combination is not taken with ribavirin.
The 104 study participants had stage 4 or 5 chronic kidney disease; 82% were on kidney dialysis.
About 80% of participants were men and one-quarter were black.
About half had genotype 1 virus, 16% had genotype 2 virus, 11% had genotype 3 virus, 19% had genotype 4 virus and 1% had genotypes 5 and 6 virus.
Over half of participants had never been treated for hepatitis C (58%). Forty percent had been previously treated with an interferon- or sofosbuvir-based treatment.
Participants received glecaprevir and pibrentasvir once daily for 12 weeks. The cure rate was 98%.
Treatment was generally safe and well tolerated. The most common adverse events were itchy skin (20%), fatigue (14%) and nausea (12%).
According to the researchers, this study "demonstrates that a ribavirin-free glecaprevir/pibrentasvir regimen achieves a high [cure] rate in this population with severe renal impairment and end-stage renal disease on haemodialysis." (infohep.org, December 2016)
Straight to the source for new science
Reasons for missed appointments with a hepatitis C outreach clinic: A qualitative study, International Journal of Drug Policy, January 2017