HepCInfo Updates

HepCInfo Update 9.1 

Welcome to CATIE's HepCInfo Update 9.1 for November 25, 2017 to January 5, 2018. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

New and noteworthy

Getting tested for hepatitis C is linked to reduced drug use

Getting tested for hepatitis C antibodies is linked to reduced drug use among people who are taking opioid substitution therapy, reported Canadian researchers at the 2017 Liver Meeting in Washington, D.C.

For this study, the researchers examined the electronic health records from 43 addiction treatment clinics in Ontario from 2007 to 2013.

They looked at the records of 2406 individuals who received hepatitis C antibody testing during the study period and who had records of urine test results used to monitor drug use. Of these people, 527 (22%) tested positive for hepatitis C antibodies.

Testing positive for hepatitis C antibodies shows that a person has been exposed to the hepatitis C virus at some point. In order to determine if someone has a current hepatitis C infection they need to have a hepatitis C RNA test

Just over 60% of the individuals were men and the average age was 40 years.

Study participants who were positive for hepatitis C antibodies had a statistically significant 8.1% reduction in urine samples showing non-prescription opioid use. Participants who tested negative for hepatitis C antibodies had a 6.7% decrease.

After adjusting for potential confounders, people who tested positive for hepatitis C antibodies were 33% more likely to lower their use of non-prescription opioids compared to people who tested negative for hepatitis C antibodies.

According to the researchers, widespread testing of people who inject drugs "may reduce health consequences for the individual and reduce transmission in the community." (HIVandhepatitis.com, November 2017)

New recommendations address hepatitis C in pregnant people

The Society for Maternal-Fetal Medicine has released recommendations for the care of people who have hepatitis C and are pregnant, reported researchers in the American Journal of Obstetrics and Gynecology.

There is approximately a 5% risk of passing hepatitis C from a pregnant person to their unborn child.

The recommendations were created by reviewing evidence and best practices.

The recommendations include:

  • screening women at increased risk for hepatitis C for anti-hepatitis C antibodies at the first prenatal visit
  • conducting additional screening later in the pregnancy in women with new or persistent risk factors for hepatitis C, even if the first test results were negative
  • screening pregnant women with hepatitis C for other sexually transmitted infections
  • using direct-acting antiviral treatments only in the clinical trial setting or postponing hepatitis C treatment until after pregnancy
  • not performing caesarean delivery exclusively because a person has hepatitis C
  • avoiding episiotomy (an incision to enlarge the vaginal opening to allow the baby through), prolonged rupture of membranes, and internal fetal monitoring during labor
  • not discouraging breast-feeding
  • counseling all patients to refrain from alcohol

These recommendations were endorsed by the American College of Obstetricians and Gynecologists. (healio.com, November 2017)

A test-and-treat program reduces hepatitis C among Swiss HIV-positive gay men

A systematic policy of test-and-treat cured 99% of Swiss gay men with hepatitis C in eight months and reduced the prevalence of hepatitis C by almost two-thirds, reported researchers at the 16th European AIDS Conference (EACS 2017) in Milan, Italy.

The Swiss HIV Cohort is an ongoing multi-centre study of Swiss people with HIV. The study has seen a 20-fold increase in the prevalence of hepatitis C among men who have sex with men since 1996.

In an eight-month period between October 2015 and May 2016, all gay and bisexual men in the Swiss HIV Cohort were screened for active hepatitis C infection. Screening identified 177 men with chronic hepatitis C (4.8%), 30 of those people had new hepatitis C infections while 147 had been previously diagnosed.

All men with HCV genotype 1 or 4 were offered immediate treatment with Zepatier (elbasvir + grazoprevir) with or without ribavirin for 12 or 16 weeks.

Of the 177 people diagnosed with chronic HCV infection, 122 took part in the study and all but one were cured of hepatitis C.

Treatment was well tolerated. The most common side effects were fatigue, diarrhea, nausea, and itching. (HIVandhepatitis.com, October, 2017)

Straight to the source for new science

Declining HCV incidence in Dutch HIV positive men who have sex with men after unrestricted access to HCV therapy, Clinical Infectious Diseases, November 2017