HepCInfo Updates

HepCinfo Update 8.19 

Welcome to CATIE's HepCInfo Update 8.19 for September 2 to September 15, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Improvements in energy and mental health in people cured of hepatitis C

In a small German trial, fatigue and symptoms of depression greatly decreased in people treated and cured of hepatitis C, reported researchers at the International Liver Congress 2017 in Amsterdam.

Twenty-five people received treatment with either Harvoni, Holkira Pak or sofosbuvir and ribavirin. Five participants served as a comparison group.  The trial included 14 men and 15 women with most having a moderate level of liver injury. Participants were on average in their mid-50s.

By the end of treatment, 70% of participants reported a lack of fatigue. There was no change in fatigue in the comparison group. 

Symptoms of depression also improved significantly in treated people but did not change in the control group.

Overall, the results of this analysis suggest that DAAs have a positive and persistent effect on fatigue and mood. This may be because DAAs quickly reduce production of hepatitis C and then help eliminate this virus from the body.

CATIE’s Treatment Update 221 reported on several other important hepatitis C-related findings from the International Liver Congress 2017. Read the full report here.

(catie.ca, July 2017)

Cirrhosis a possible risk factor for not being cured of hepatitis C in people with HIV co-infection

People with HCV/HIV co-infection who also had cirrhosis were 3.5 times more likely not to be cured from hepatitis C treatment than co-infected people without cirrhosis, reported researchers in Open Forum Infectious Diseases.

Study participants included 1,505 people with hepatitis C treated at nine clinics in Germany. Of the total, 349 patients (23%) were co-infected with HIV and 1,156 (77%) had only hepatitis C. In addition, 431 patients (29%) had liver cirrhosis. The mid-range in age was 52 years.

After adjusting for potential confounders, liver cirrhosis was the only factor significantly associated with not being cured of hepatitis C (odds ratio, 3.5).

According to the researchers, “this [research] highlights the need for early initiation of [direct-acting antiviral (DAA)] therapy in HCV/HIV co-infected patients before the onset of higher liver fibrosis/cirrhosis to allow for optimal rates of viral eradication and to substantially reduce morbidity and mortality in this patient population. (Healio.com, August 2017)

Incentives increase hepatitis C treatment initiation in people who inject drugs

People who inject drugs who were offered incentives such as peer mentoring or cash, initiated hepatitis C treatment more often than people offered the usual hepatitis C care, reported researchers at the International Symposium on Hepatitis Care in Substance Users 2017 in New York.

The study included 144 people with HIV and hepatitis C co-infection who use injection drugs from the CHAMPS study. All participants had genotype 1 virus and had not been treated for hepatitis C before.

Participants were offered one of three interventions:

  1. Usual care, which consisted of an HIV clinic-based nursing model and pharmacy support (36 people)
  2. Usual care and peer mentor support from someone with HIV who had been through hepatitis C treatment and peer mentor training (54 people)
  3. Usual care and cash incentives connected with attendance in the program (54 people)

The primary measurement was how many people initiated hepatitis C treatment within eight weeks of enrolling in the study.

In the usual care group, 24 of 36 (67%) of participants enrolled in the study. In the group that received usual care and peer support, 45 of 54 (83%) of participants enrolled in the study. For the group that received the cash incentives, 41 of 54 (76%) of the group initiated treatment.

Of the 110 people who started treatment, 88 people (80%) were cured of hepatitis C and ten people were not cured. Twelve people did not complete the course of treatment.

The researchers recommend the addition of peer mentorship, cash incentives and other novel interventions to improve the hepatitis C care cascade. (Healio.com, September 2017)

Straight to the source for new science

Premature ovarian senescence and high miscarriage rate impair fertility in women with hepatitis C virus infection, Hepatology, September 2017

High prevalence of willingness to use direct‐acting antiviral‐based regimens for hepatitis C virus (HCV) infection among HIV/HCV coinfected people who use drugs, HIV Medicine, October 2017