HepCInfo Update 8.2
Welcome to CATIE's HepCInfo Update 8.2 for January 7, 2017 to January 20, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.
New and noteworthy
The two combinations of peg-interferon and ribavirin available in Canada, known by the brand names Pegetron and Pegasys will be discontinued this year. Pegetron will be discontinued on September 30th, 2017 and Pegasys will be discontinued on Feb 28th, 2017.
Peg-interferon will still be available on its own through one of the manufacturers and ribavirin is currently being sold separately through other manufacturers, so it is still possible to acquire the combination if necessary.
The second phase of a New York City patient navigator program was able to connect over three-quarters of participants to a medical clinic, have one-third start hepatitis C treatment, and have nine out of 10 of them cured, reported researchers in Clinical Infectious Diseases.
The second phase of the Check Hep C project took place between March 2014 and January 2015. It was based out of four community organizations in neighbourhoods where hepatitis C was relatively common. The second phase was modified based on lessons learned from the first phase.
The second phase of the project focused on ensuring patient navigators helped to provide:
- A hepatitis C risk assessment
- Health education
- Treatment readiness
- Medication adherence counselling
- Medication coordination with pharmacies and insurance coverage
The patient navigators provided accompaniment to medical appointments, alcohol counselling, health education and motivational interviewing.
Of the 388 total participants, 77% (299) were connected to a medical clinic, where 33% (129) of the total participants started hepatitis C treatment and 91% (119) were cured.
Participants who were in a study location that also provided clinical care were twice as likely to be designated as treatment eligible than participants who were at study locations where they had to be referred out for clinical care.
According to the researchers, “Check Hep C successfully supported high-need participants through hepatitis C care and treatment, and [cure] rates demonstrated the real-world ability of achieving high cure rates using patient navigation care models.” (catie.ca, January 2017)
People with hepatitis C who were cured through treatment had lower rates of liver-related complications and fewer deaths compared to people who were not cured from treatment, reported researchers at the 2016 American Association for the Study of Liver Diseases (AASLD) Liver Meeting.
The study included the records of 1032 people with hepatitis C from the Danish Database for Hepatitis B and C (DANHEP) and Danish national health registries from January 2002 to December 2013.
A total of 550 participants took hepatitis C treatment and 42% (232) were cured. The study period ended before direct acting antivirals were available, so participants likely took peg-interferon and ribavirin. First generation protease inhibitors were also available in the final years of the study.
Compared to participants who were cured from treatment, participants who were not cured from treatment were:
- four times more likely to develop liver cancer
- five times more likely to develop liver failure
- just over three times more likely to die from any cause
"Liver-related morbidity and mortality [were] high among patients with chronic hepatitis C and cirrhosis in Denmark," the researchers concluded. "[Being cured] was associated with reduced morbidity and mortality." These findings, they added, underscore the "urgent need to cure patients with chronic hepatitis C." (HIVandhepatitis.com, January 2017)
Straight to the source for new science
Short-duration treatment with elbasvir/grazoprevir and sofosbuvir for hepatitis C: A randomized trial, Hepatology, December 2016