HepCInfo Updates

HepCInfo Update 8.21 

Welcome to CATIE's HepCInfo Update 8.21 for September 30 to October 13, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Indigenous people bear a disproportionately high burden of hepatitis

Indigenous people are up to ten times more likely to have hepatitis B or C than the general population in their respective countries, reported researchers of a meta-analysis at the World Indigenous Peoples’ Conference on Viral Hepatitis in Alaska.

To determine rates of hepatitis C, data were gathered from 1991 onward from 11 countries, which included 23 specific Indigenous groups and 12 broad groups.

In Canada, hepatitis C rates were three times higher among Inuit, Métis and First Nations people compared to the general population.

Hepatitis C rates were also three times as high among Aboriginal and Torres Strait Islanders. Among American Indigenous peoples, the hepatitis C rate was 2.5 times higher.

There was no significant difference between Alaskan Indigenous people and the general population. 

Hepatitis B was found to be five times higher in Inuit, Métis and First Nations people than in the general Canadian population.

According to the researchers “for both HCV and HBV, disparities in access to health care, prevention and treatment, as well as higher rates of poverty, injection drug use and incarceration among Indigenous citizens are likely correlated with the higher rates of hepatitis infection”. (healio.com, Sept 2017)

People with HIV/HCV co-infection are at increased risk of cardiovascular disease

People with HIV/HCV co-infection are more likely to have a stroke or heart attack than people who only have HIV, reported researchers of a meta-analysis in the Journal of Viral Hepatitis.

There is a well-established link between HIV and cardiovascular disease. People with hepatitis C also have an increased risk of developing cardiovascular disease. It has been suggested that have HIV and hepatitis C could act together to further increase the risk in people co-infected with HIV and hepatitis C, however studies have shown conflicting results. To clarify this question, researchers performed a meta-analysis of this area of research.

The analysis included four studies, with a total of 33, 723 participants. The average follow up time for participants was between 2.3 and 7.3 years. Most participants were men and the mean age varied between 36 and 48 years. Studies were conducted in Canada, the U.S. and Spain.

Three of the four studies found a significant association between HIV/hepatitis C co-infection and cardiovascular disease risk.

After accounting for potential confounders, pooled estimates reported a 24% increased risk of stroke (HR=1.24) and a 33% increased risk of heart attack (HR=1.33) among participants co-infected with HIV and hepatitis C.

According to the researchers, “More research is needed to further quantify this association, determine potential mechanisms that underlie this association and evaluate whether treatment for HIV and HCV can reduce [cardiovascular disease] outcomes.” (infohep.org, October 2017)

Three or more cups of coffee a day halves mortality risk for people with HIV/HCV co-infection

Drinking three or more cups of coffee a day significantly decreases the risk of death from any cause for people with HIV/hepatitis C co-infection, reported researchers in the Journal of Hepatology.

Research has shown that elevated levels of coffee consumption in people with HIV/hepatitis C co-infection is linked to a reduced risk of insulin resistance and improved liver enzyme levels. However, researchers wanted to see if increased coffee consumption influenced mortality.

The 1028 participants were from a French nationwide study of people co-infected with hepatitis C and HIV (ANRS CO13 HEPAVIH). Data was collected over five years of follow up. The mid-range in age of participants was 49 years. Almost all participants were taking HIV treatment (95%) and 83% had an undetectable HIV viral load. At the end of study follow, just over half (53%) had not started hepatitis C treatment. Elevated coffee consumption was reported by 27% or participants.

After controlling for potential confounders, researchers found that drinking three or more cups of coffee halved the risk of mortality from any cause (hazard ratio = 0.5).

According to the researchers, “our findings indicated that elevated coffee consumption has a protective effect on all-cause mortality in patients with HIV-HCV, a population at specific risk of end-stage liver disease and greater risk of cardiovascular diseases and cancer.” (infohep.org, October 2017)

Straight to the source for new science

Perceived benefits of the hepatitis C peer educators: a qualitative investigation, Harm Reduction Journal, September 2017.