HepCInfo Updates

HepCInfo Update 8.23  

Welcome to CATIE's HepCInfo Update 8.23 for October 28 to November 10, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Light alcohol use is not linked to increased liver injury in women with HIV and hepatitis C co-infection

Women co-infected with HIV and hepatitis C with light or moderate alcohol use experienced little to no increase in liver injury, reported researchers in Clinical Infectious Diseases.

The study participants were 686 women who were enrolled in the Women’s Interagency HIV Study, an ongoing study of women living with HIV in the U.S. Each women received follow up visits every six months where they were interviewed about alcohol use and information was collected on kidney function, liver enzymes and HIV viral load. Participants were followed for a mid-range of ten years.

Nearly half of participants (315) reported no alcohol use. Just over one quarter (185) reported light alcohol consumption (defined as one to three drinks per week). Seven percent (48) reported moderate use (four to seven drinks per week). One-fifth of women (137) reported heavy drinking (stratified into eight to 14 drinks per week and more than 14 drinks per week).

The majority of participants had no liver injury at the beginning of the study (mid-range FIB-4 score of 1.4).

Drinking more than 14 drinks per week was associated with significant acceleration of liver injury (0.25 FIB-4 units per year) compared to no drinks per week. Drinking eight to 14 drinks per week was linked to minimal acceleration of liver injury (0.04 FIB-4 units per year).

According to the researchers, “Women with HIV/HCV infection should be counseled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression”. (healio.com, September 2017)

Many people with HCV who inject drugs not aware of effectiveness of current HCV medications

Most people who inject drugs were not aware of currently available highly effective hepatitis C treatments, reported Scottish researchers at the International Symposium on Hepatitis Care in Substance Users.

From 2015 to 2016, researchers surveyed 2,623 people who attended needle and syringe programs to assess the awareness of new direct-acting antiviral medications and their cure rates among people who inject drug and to determine the factors associated with awareness.

The majority of participants (2,361, 90%) had not received hepatitis C treatment but 79% (1865) of these people were aware that there is treatment for hepatitis C treatment.

However, only 17% (446) of participants were aware that new hepatitis C treatments were highly effective.

Most participants (530, 60%) responded that the chances of a cure with treatment was low or less than 40%.

Awareness of DAA effectiveness was higher among people who had ever attended a clinic (odds ratio = 9.76) or had been diagnosed but never attended a clinic (odds ratio = 3.91) or had been tested but did not have hepatitis C (odds ratio= 2.55) compared with those who had never received a test.

According to the researchers, “Increased efforts to raise awareness of new HCV therapies among [the most affected] populations will be required as treatment is scaled-up in the future”. (healio.com, September 2017)

Maviret safe and effective for HCV treatment in people with chronic kidney disease

Treatment with Maviret resulted in high hepatitis C cure rates in people with chronic kidney disease, reported researchers in the New England Journal of Medicine.

The 104 participants received 12 weeks of treatment with Maviret. Maviret consists of two medications, glecaprevir, a protease inhibitor, and pibrentasvir, an NS5A inhibitor. The two drugs are combined into one pill, three of which are taken once per day. It is approved in Canada for people with all genotypes (1,2,3,4,5 and 6 virus).

The average of participants was 57 years. The majority of participants had never been treated before (60 or 58%) and most participants had severe kidney disease (90 people or 86%). Participants had all hepatitis C genotypes with over half having genotype 1 virus.

The cure rate was 98% (102 out of 104 participants). The most common side effects were itchy skin, fatigue and nausea.

According to the researchers, “Treatment with glecaprevir and pibrentasvir for 12 weeks resulted in a high rate of sustained virologic response in patients with stage 4 or 5 chronic kidney disease and HCV infection.” (healio.com, October 2017)

Straight to the source for new science

Support of supervised injection facilities by emergency physicians in Canada, The International Journal of Drug Policy, November 2017