HepCInfo Update 8.22 | CATIE - Canada's source for HIV and hepatitis C information

HepCInfo Updates

HepCInfo Update 8.22  

Welcome to CATIE's HepCInfo Update 8.22 for October 14 to October 27, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Hepatitis C treatment is highly effective in people who use drugs who receive multidisciplinary care

People with hepatitis C who have a current or past history of street drug use and were enrolled in multidisciplinary care had high hepatitis C cure rates, reported researchers from Vancouver, B.C. at the International Symposium on Hepatitis Care in Substance Users.

This study was a retrospective analysis of data from 185 people who had received hepatitis C treatment with direct-acting antiviral medications at the Vancouver Infectious Disease Centre.

Participants received treatment with DAA combinations. In addition to treatment, participants also received a multidisciplinary program of care that included support with mental health, substance use, social issues and other medical needs.

At the time of the report, 145 people had completed treatment and 139 people (95.8%) were cured. According to the researchers, “The new data support comprehensive policies to make people who use drugs a priority population for hepatitis C therapy regardless of disease stage.” (healio.com, September 2017)

Rapid liver injury in a large proportion of HIV-positive gay men with acute hepatitis C

Over a third of HIV-positive gay men developed significant liver fibrosis after an episode of acute hepatitis C virus (HCV) infection, reported researchers in the Journal of Viral Hepatitis.

The study participants were 178 HIV-positive gay men with acute hepatitis C who attended a clinic in Berlin, Germany.

A total of 213 cases of acute HCV were diagnosed in the participants between 2002 and 2013. Almost a fifth (18%) of cases were re-infections. Twenty-three people (11%) were spontaneously cured.

Of the men without spontaneous clearance, 153 (86%) initiated interferon-based treatment which lasted an average of 13 weeks. Of the people treated, 108 (71%) were cured from treatment. 

Prior to treatment, 160 (90%) of the men had no evidence of serious liver fibrosis. But after a mid-point of three years of follow-up, 69 people (39%) had fibrosis stage F2 or higher and 21 (12%) had cirrhosis. Older age and not being cured by hepatitis C treatment were both associated with significant fibrosis progression.

No patient developed decompensated liver disease or liver cancer.

According to the researchers, “Older men, chronic drinkers, and those with uncontrolled HCV RNA replication are at particularly high risk of fibrosis progression. This subgroup could warrant closer monitoring by non-invasive markers of fibrosis and should be considered for early treatment.” (infohep.org, October 2017)

Hepatitis C testing law increases screening among older adults in New York, U.S.

Hepatitis C testing among older adults increased by just over 50% in New York state following the implementation of a testing law in 2014 that required health care providers to offer hepatitis C screening to all patients born between 1945 and 1965, according to a report from the Centre for Disease Control and Prevention.

Canadian hepatitis C testing guidelines currently recommend against population-wide screening for older adults.

Data from 106 laboratories reported an increase of hepatitis C specimens from people born between 1945 and 1965 from 538,229 in 2013 to 813,492 in 2014 (51.1%).

According to New York Medicaid data (for people accessing government funded health care) the hepatitis C testing rate increased 52% from 2012 (8.4 per 1000 people) to 2014 (12.8 per 1000 people).

The percentage of people newly diagnosed with hepatitis C who were linked to care increased by 39.8% in New York state and by 11.2% in New York City after the 2014 testing law was implemented, compared with rates between 2011 and 2013.

According to the researchers, “Marked increases in the number of HCV tests performed and rates of testing were observed immediately after enactment of the law and remained steady over a 12-month period.” (healio.com, September 2017)

Straight to the source for new science

Direct-acting antiviral therapy outcomes in Canadian chronic hepatitis C telemedicine patients, Annals of Hepatology, November 2017

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