HepCInfo Updates

HepCInfo Update 8.20  

Welcome to CATIE's HepCInfo Update 8.20 for September 16 to September 29, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Prisoner’s perspectives on hepatitis C treatment as prevention in the prison setting (second story in linked article)

People in prison expressed support for increasing hepatitis C treatment in prisons while raising concerns about the lack of hepatitis C prevention options in prison, reported researchers at the International Symposium on Hepatitis Care in Substance Users.

The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study is investigating the feasibility of a real-world trial of treatment as prevention (TasP) for hepatitis C for prisoners in Australian. Prior to treatment being given as part of the study, 32 people with a history of injection drug use from four prisons in Australia participated in qualitative interviews about the TasP study.

All participants had been screened for hepatitis C in the past six months: 16 participants were hepatitis C-positive, 14 were hepatitis C-negative and two were awaiting test results.

Many participants brought up the issue of prisoner movement undermining the effectiveness of TasP. They highlighted moves such as prisoners with hepatitis C moving between prisons and new prisoners with hepatitis C being brought into the prison and these people participating in injecting networks with people who have been cured of hepatitis C.

Participants also made suggestions for harm reduction measures that could support the TasP program and decrease hepatitis C re-infection, such as:

  • Education about hepatitis C and the ways it is transmitted
  • Increasing access to opiate substitution therapy
  • Access to prison needle and syringe programs

According to the researchers, “TasP in the prison setting is likely to reduce transmission rates. However, prisoners remain concerned about long-term effectiveness of TasP efforts (and treatments) without access to effective prevention measures.” (Healio.com, September 2017)

Menopause is linked to liver injury progression in HCV and HIV co-infection

Menopause is associated with increased liver injury development in women with hepatitis C and HIV co-infection reported researchers in Clinical Infectious Diseases.

Previous research exploring the impact of reproductive aging on liver injury progression has been limited by lack of adjustment for chronological ageing and an absence of longitudinal follow-up.

This study was based on the Women Interagency HIV Study (WIHS) cohort and included 405 American women with HCV/HIV coinfection who were not yet experiencing menopause. The study monitored the progression of menopause and liver injury for a mid-range follow up time of 9.1 years. One-fifth of participants took some form of hormone replacement therapy.

After adjusting for chronological age, the study found that liver injury was accelerated during menopause compared to before menopause (0.12 units/year faster). Liver injury was also faster after menopause compared to before menopause but this was not statistically significant.

According to the researchers, “the findings have important clinical significance, suggesting that [currently menopausal women] and post-menopausal women should be prioritised as candidates for HCV therapy using direct-acting antiviral agents (DAAs) to avoid further liver damage.” (infohep.org, August 2017)

Better blood sugar control in people with diabetes after hepatitis C is cured

Blood sugar levels fell significantly in people with diabetes who were cured of hepatitis C, reported researchers at The International Liver Congress in Amsterdam.

The Italian study included 122 people with hepatitis C and type 2 diabetes. The majority of participants were men (70%) and 30% were women. The average age of participants was 61 years.

Of this total, 101 (83%) people were cured of hepatitis C and 21 (17%) people were not cured or were not offered hepatitis C treatment. 

The participants were monitored for between 24 and 36 weeks, including before, during and after treatment.

Thirty-seven (37%) of people who were cured were able to decrease their diabetes medication after they were cured of hepatitis C. In the group of people who were not cured or not offered treatment, only one person was able to reduce their diabetes medication.

The overall results suggest that being cured of hepatitis C can improve the health of people with diabetes through better control of blood sugar.

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)

Straight to the source for new science

Long-term outcome of chronic hepatitis C virus infection in a real-world setting: The German LOTOS study, Liver International, July 2017.

Understanding experiences of and rationales for sharing crack-smoking equipment: A qualitative study with persons who smoke crack in Montréal, The International Journal of Drug Policy, October 2017.