HepCInfo Update 8.24 | CATIE - Canada's source for HIV and hepatitis C information

HepCInfo Updates

HepCInfo Update 8.24  

Welcome to CATIE's HepCInfo Update 8.24 for November 11 to November 24, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Rate of hepatitis C cut in half in one year due to treatment in Spanish people with HIV

Between 2015 and 2016, the prevalence of hepatitis C in people living with HIV in Spain fell by 47%, from 22% to 11.6%, reported researchers at the European AIDS Conference in Milan, Italy.

This study included a random sample of 1,588 clients at 43 HIV treatment centres in Spain between October and November 2016. Of all the participants, 35% were men who have sex with men, 29.6% were people who acquired HIV through injection drug use. 

This sample was compared to previous samples from 2002, 2009 and 2015.

The proportion of people with hepatitis C also fell from 54% in 2002 to 34% in 2009 to 11.7% in 2016.

The decline in the rate of hepatitis C can partially be explained by a decrease of people in the sample who acquired HIV through injection drug use (55.2% in 2015 and 29.6% in 2016).

However, the study also found that the proportion of people who had ever received hepatitis C treatment rose from 23% in 2002 to 48% in 2009, 59.3% in 2015 and 74.7% in 2016. This resulted in 53.2% of people being cured.

According to the researchers, “Our findings show that the elimination of HCV among HIV-infected patients in Spain can be achieved in the short term once DAA-based-treatment is accessible to all co-infected patients.” (infohep.org, October, 2017)

Curing hepatitis C improves quality of life

People who were cured of hepatitis C with direct-acting antiviral (DAA) medications had sustained improvements in their quality of life, reported researchers at the 2017 Liver Meeting in Washington, D.C.

This study looked at people with hepatitis C who were cured through treatment with a sofosbuvir- based DAA regimen. There were 3,486 participants, of whom 60% were men. The average age was 55 years.

Health-related quality of life was evaluated before treatment (baseline) and every 24 weeks for up to 144 weeks using Short Form-36. This standardized measure assesses general health, physical health, mental health, pain, vitality, social functioning and role limitations due to emotional issues. They are combined into physical and mental health summary scores.

Compared to baseline measures, participants had significant improvements across all domains. The largest gains were in the vitality and general health domains. Increased health-related quality of life was maintained through three years of follow up.

The physical and mental health summary scores rose at the end of treatment and continued to increase after the participants were cured until they reached a plateau at or close to normal levels for the general population.

People with cirrhosis, depression, anxiety and fatigue had lower health-related quality of life scores. However, after adjusting for baseline levels, people with cirrhosis, depression, fatigue, insomnia and type 2 diabetes saw larger gains then people without these conditions.

According to the researchers, [These results show that] “treatment is not only about clinical benefit, but also the patient experience.” (HIVandhepatitis.com, October 2017)

Curing hepatitis C reduces liver cancer risk

People in this study who were cured of hepatitis C lowered their risk of liver cancer by 70%, regardless of if they were cured from treatment with direct-acting antiviral (DAA) medications or interferon-based treatment, reported researchers at the 2017 Liver Meeting in Washington, D.C.

The researchers examined data from the U.S. Veterans Affairs healthcare system on 62,354 people who were treated for hepatitis C a total of 83,000 times (some people were treated more than once). They looked for new cases of liver cancer not cancer recurrence.

Follow up continued until June 2017 and lasted for between two and 18 years.

The researchers identified 3,271 cases of liver cancer that were diagnosed at least 180 days after starting hepatitis C treatment.

After adjusting for potential confounders, being cured of hepatitis C was associated with a 68% decline in the risk of new liver cancer in people without cirrhosis and a 50% reduction in people with cirrhosis.

In 2016, several studies reported data suggesting that being cured from hepatitis C with DAAs was linked to a greater risk for liver cancer. Since then a systematic review and meta-analysis showed that people treated with DAAs do not have a higher risk of liver cancer. This study was unique in that it examined longer term follow up data from people who had taken interferon-based treatment or DAA treatment.

According to the researchers, "Eradicating hepatitis C will have a tremendous benefit in reducing liver cancer in individual patients and in the entire population." (HIVandhepatitis.com, October 2017)

Straight to the source for new science

First Nations hepatitis C virus infections: Six-year retrospective study of on-reserve rates of newly reported infections in northwestern Ontario, Canadian Family Physician, November 2017

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