Hepatitis C Weekly News

Chicago Marathon Runner Finishes Race Cancer-Free and With New Liver
“One year after delaying a liver transplant to run the 2023 Chicago Marathon, Batbayar Tserendorj has a new liver, is cancer-free and completed the 2024 race, according to Northwestern Medicine (NM). Last year, Tserendorj then age 60, was living with liver cancer and on the waiting list for a new liver. He had been diagnosed with liver cancer in early 2023, likely caused by chronic hepatitis B and D infections, according to Northwestern Medicine.”

Endoscopies at Vanderbilt exposed patients to HIV, hepatitis C
“Nashville-based Vanderbilt Health is notifying patients that they may have been exposed to hepatitis B, hepatitis C and HIV as a result of botched endoscopy procedures performed at a clinic located on the hospital’s main campus.”

Coincidence of HCV and chronic kidney disease-a systematic review and meta-analysis
“Conclusions – We found a strong correlation between HCV infection and a higher risk of chronic renal disease in general global population.”

UB researchers advocate for continuing fewer rules for telemedicine
“During the COVID-19 pandemic, the federal government loosened regulations that govern the use of telemedicine for patients, which are set to expire on Dec 31. With a few months to go, an extension is possible. Some UB researchers and clinicians believe that returning to pre-pandemic restrictions would have a profoundly negative impact on health care.”

Study Identifies Risk Factors for Liver Enzyme Elevation Following Hepatitis C Virologic Cure
“Key Takeaways – Higher pretreatment ALT and cirrhosis increase liver enzyme elevation risk in HCV patients post-virologic response. Male sex is linked to reduced odds of liver enzyme elevation after HCV treatment.”

With October Being Liver Awareness Month, an Opportunity to Acknowledge This Essential Organ
“It is time to celebrate researchers’ amazing identification of our the body’s big secret—liver cells! These silent miraculous unrecognized liver cells have been hiding inside our noncomplaining, liver.”

Pharmacy-Based Services Combat SUD, HIV, STI Syndemic-Related Harms
“Pharmacies can play a crucial role in access to care by providing harm reduction, sexually transmitted infection (STI), and hepatitis C virus (HCV) services, according to a new study published in the Journal of the American Pharmacists Association. The findings show that by offering patient incentives, pharmacies can increase testing and detection of infectious diseases among individuals who might not otherwise seek care.”

HCV Transmission: What Are the Trends in HCV Without Injection Drug Use?
“Hepatitis C virus (HCV) infection among individuals without a history of injection drug use (IDU) is “sizeable” despite the higher HCV rates among those with a history of IDU, according to study findings published in Liver International. The primary mode of HCV transmission is through IDU. However, transmission can occur in the absence of IDU, through sexual contact, household contact, occupational exposure, and dialysis or transfusion, among other means.”

HCV Linked to Increased Risk of Peripheral Artery Disease in Hemodialysis Patients
“Key Takeaways – HCV infection in ESRD patients on hemodialysis is linked to increased PAD risk, indicated by elevated baPWV levels. Higher HCV viral loads and genotype 1 are significantly associated with increased PAD risk in these patients.”

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First-Hand Insights into Treating Hepatitis C in Pregnancy
“At IDWeek, the session “Should HCV Be Treated in Pregnant Persons?” featured Catherine Chappell, MD, MSc, assistant professor at the University of Pittsburgh. Chappell, an obstetrician-gynecologist with training in reproductive infectious disease, family planning, and addiction medicine, discussed ongoing studies on direct-acting antivirals for treating hepatitis C in pregnancy.”

DOH Report Finds Earlier Death Associated with Hepatitis C
“HONOLULU – As part of Liver Cancer Awareness Month in October, the Hawai‘i Department of Health (DOH) has released a report that found hepatitis C was associated with death at an earlier age in Hawaiʻi. “Premature Deaths and Disparities Associated with Hepatitis C: The Hawaiʻi Hepatitis C Mortality Report,” analyzed mortality data from 2000 to 2021 to understand the burden of hepatitis C infections on local communities. The findings will guide efforts to improve liver health and reduce preventable deaths.

This novel report was the first comprehensive analysis of hepatitis C death data for Hawaiʻi. The most important findings from the report include: People with hepatitis C die at a younger age than the general population. Most (88 percent) Hawaiʻi residents with hepatitis C-related deaths did not reach age 75, which was lower than the U.S. life expectancy in 2021. Many deaths occur before retirement age. Among Hawaiʻi residents with hepatitis C-associated deaths, more than 40 percent died before the average retirement age of 65 years (as compared to 23 percent for all causes of death). Progress is being made. Hepatitis C death rates were lower than the national average from 2017 to 2020, with 2.63 deaths per 100,000 in Hawaiʻi compared to 3.45 per 100,000 in the U.S. in 2020. However, disparities in death rates were observed for male and white residents in Hawaiʻi.

Revealing disparities in hepatitis C care for reproductive-aged women to break cycle of viral transmission
“Most pediatric cases of hepatitis C virus (HCV) infection are perinatal, meaning the virus is transmitted from birthing parent to child during pregnancy or birth, according to the Centers for Disease Control and Prevention. If left untreated, hepatitis C infection can lead to worse outcomes later in life, such as chronic liver disease, liver failure, and liver cancer. Identifying disparities in testing and treating hepatitis C among people of reproductive age with opioid use disorder can improve health outcomes for all birthing parents and children.”

Feasibility and Performance of a Point-of-Care Hepatitis C RNA Assay in a Community Supervision Cohort
“Progress toward hepatitis C virus (HCV) elimination in the US has been stalled by reliance on a multistep diagnostic algorithm to confirm viremia, reducing access to curative treatment.”

New Research Supports Universal HCV Screening Over Risk-Based Testing
“The study found 1.4 million people aged 12-59 with current HCV infection, including over 500,000 without injection drug use history.”

State Spotlight Series: Syndemic Approaches to Substance Use and Infectious Disease
“Governors and their teams are responding to a rapid rise in syphilis and congenital syphilis cases. The National Governors Association Center for Best Practices (NGA Center) is working to support states and territories in implementing a “syndemic” approach to this and other infectious diseases, recognizing that these outbreaks are intertwined with substance use. A syndemic refers to intersecting epidemics that are not only concurrent or sequential, but also have synergistic relationship, with overlapping or interactive risk factors, and often a context of shared social and behavioral risk factors and healthcare access gaps.”

An evolutionary concept analysis: stigma among women living with hepatitis C
“Stigma is a complex social phenomenon that leads to marginalization and influences the course of illness. In the context of hepatitis C virus (HCV), stigma is a well-documented barrier to accessing care, treatment, and cure. In recent years, HCV rates among women have increased, resulting in an urgent need to address stigma and its harmful effects. The purpose of this concept analysis was to investigate stigma in the context of women living with HCV using Rodgers’ evolutionary method.”

Pregnancy Outcomes in Patients With Hepatitis C Virus Infection
“Despite no increased odds of preterm birth or other adverse maternal outcomes in adjusted analyses, maternal HCV infection was associated with twofold increased odds of NICU admission and nearly threefold increased odds of SGA birth weight below the 5th percentile.”

HCV Testing Rates Among Perinatally Exposed Children Are Low, Racially Dependent
“Fewer than half of hepatitis C virus (HCV)-exposed children were tested for HCV, with lower testing rates among Black, Asian/Pacific Islander, and Hispanic/Latinx children. These results were published in the Journal of the Pediatric Infectious Diseases Society.”

‘I was living with hepatitis C without knowing for 20 years’ – why you should get checked
“Getting a tattoo on his right arm led Andrew Eadie to contracting a shocking disease that only revealed itself two decades later when he visited his GP for with a suspected chest infection. The GP referred him to the University Hospital of Wales where concerns were raised about the significant swelling on his stomach.”

DAA Marketing Payments From Manufacturers Linked to Physician Prescribing Patterns
“New research is calling attention to a significant association between pharmaceutical company marketing payments related to direct-acting antivirals (DAAs) and physician prescription patterns for hepatitis C virus (HCV) treatment.”

Breakthrough in Hepatitis C Research Offers Hope for Vaccine Development
“Researchers at the University of Copenhagen have identified a protein complex on the hepatitis C virus that facilitates cell infection, paving the way for potential vaccine development, SciTech Daily revealed yesterday.”

Patients at Washington dental clinic told to get tested for HIV, hepatitis
“People expect the dentist who cares for their teeth to keep their equipment sanitary. In Eastern Washington’s Spokane County, patients at a dental clinic received an alarming letter.”

Q&A: Panel Offers Actionable Steps Toward Hepatitis C Elimination
““It is rare to consider the elimination of any infectious disease,” Vincent Lo Re III, MD, MSCE, and colleagues noted in Clinical Infectious Diseases.”

US will let more people take methadone at home
“The first big update to U.S. methadone regulations in 20 years is poised to expand access to the life-saving drug starting next month, but experts say the addiction treatment changes could fall flat if state governments and methadone clinics fail to act.”

Extrahepatic Cancer Risk in Patients with Hepatitis C Virus Infection Treated with Direct-Acting Antivirals
“Chronic hepatitis C virus (HCV) infection is associated with an increased risk of extrahepatic cancers, particularly non-Hodgkin lymphoma. The introduction of direct-acting antivirals (DAAs) has revolutionized HCV therapy, resulting in high cure rates. However, concerns have been raised about potential effects on cancer risk. This review summarizes the current evidence on extrahepatic cancer risk in HCV-infected patients treated with DAAs.”

Welcome to the INHSU Prisons Hepatitis C Advocacy Toolkit   
“This toolkit provides guidance across three core areas that will support your advocacy efforts for the scale-up or implementation of prison-based hepatitis C testing, treatment and prevention services”

AI is Redefining the Hepatitis B and C Diagnostics Market, Set to Grow by USD 3.02 Billion from 2024-2028 with Rising Demand for Molecular Diagnostics – Technavio
“NEW YORK, Sept. 19, 2024 /PRNewswire/ — Report with market evolution powered by AI- The global hepatitis b and c diagnostics market size is estimated to grow by USD 3.02 billion from 2024-2028, according to Technavio. The market is estimated to grow at a CAGR of 8.09% during the forecast period. Growing demand for molecular diagnostics in diagnosis of HBV and HCV is driving market growth, with a trend towards advent of immunosensors in HBV and HCV diagnostic tests. However, low penetration of HBV and HCV diagnostic tests poses a challenge.”

Renal Manifestations of Chronic Hepatitis C: A Review
“Hepatitis C virus (HCV) has emerged as a major global health concern and, if left untreated, can lead to significant liver damage, including cirrhosis, decompensated liver disease, and hepatocellular carcinoma (HCC). Approximately 40% of patients with HCV infection experience extrahepatic manifestations, including renal involvement. HCV-related renal disease is of significant importance among patients with chronic kidney disease (CKD), leading to higher morbidity and mortality.”

Free Hepatitis C Screening and Testing coming to Houston
Eliot Davis, secretary of Houston Viral Hepatitis Task Force, shares what people can expect at The ElimiNATION Awareness Tour. You can attend the event on Wednesday, September 18 at Sunnyside Health and Multi-Service Center from 9 a.m. to 2 p.m. or on Saturday, September 21, at The Beacon from 7 a.m. to 12 p.m.

Economic Analysis of National Program for Hepatitis C Elimination, Israel, 2023
“In 2021, the Israel Ministry of Health began a national hepatitis C elimination program. Implementing a World Health Organization goal, Israel’s program involved targeted screening, barrier minimization, workup simplification, awareness campaigns, and a patient registry. We evaluated program costs for testing and treatment. By May 15, 2023, the program had identified 865,382 at-risk persons, of whom 555,083 (64.3%) were serologically screened for hepatitis C virus (HCV), which was detected in 24,361 (4.4%). Among 20,928 serologically positive patients, viremia was detected in 13,379 (63.9%), of whom 10,711 (80%) were treated, and 4,618 (96.5%) of 4,786 persons receiving posttreatment HCV RNA testing had sustained virologic response. We estimated costs of ₪14,426 (new Israel shekel; ≈$3,606 USD) per person whose HCV infection was diagnosed and successfully treated. The program yielded screening and treatment in almost two thirds of the identified at-risk population. Although not eliminated, HCV prevalence will likely decrease substantially by the 2030 target.”

Association between non-injection drug use and hepatitis C infection among HIV-negative men who have sex with men
“Among MSM with non-injection drug use, the subgroup of individuals who were ≥ 42 years of age and used multiple drugs (including heroin, speedball, methamphetamine, crack cocaine, and marijuana) had a high probability of HCV infection. Public health and education programs, as well as drug treatment and rehabilitation programs, should be developed for this high-risk subgroup of individuals to prevent HCV acquisition and transmission.”

Scientists take final key step toward a hepatitis C vaccine
“Scientists have identified the protein complex that gives the hepatitis C virus the ability to bind and infect cells. This bit of cellular knowledge was an ongoing issue in the race to create a hepatitis C vaccine.”

Liver Cancer Screening Improved Survival for Adults Cured of Hep C
“Ongoing liver cancer screening for older people with cirrhosis after they are cured of hepatitis C virus (HCV) leads to improved overall survival rates, according to a Yale School of Medicine study.”

This ancient disease still kills 1 million people every year
“A new generation of drugs promised salvation from hepatitis B and C. What went wrong?”

NSW Dried Blood Spot HIV and Hepatitis C Testing Pilot: Mid-Point Evaluation, November 2016 – December 2020
“The NSW DBS Pilot improved the reach of HIV and hepatitis C testing for a range of priority populations and people who had not recently received testing. Overall, ten new HIV diagnoses were detected: nine via online self-registration and one via assisted registration in prison. No new HIV diagnoses were detected via assisted registration in community settings. There was low uptake of hepatitis C DBS testing via the online self-registration pathway, but in this arm of the study, the proportion of people with current hepatitis C infection among people who recently injected drugs was comparable to other settings. Prison settings accounted for a high proportion of hepatitis C DBS tests in the pilot and reported high treatment uptake. Treatment uptake for hepatitis C testing in the community is lower than in prison but comparable with standard of care and demonstrates success in expanding the reach of testing for priority populations. There are disparities in hepatitis C treatment uptake across settings.”

Q&A: Overlooked health issues that ‘need to be addressed’ in Asian communities
“Hepatitis B, diabetes, cancer, CVD, maternal mortality and suicide disproportionately affect AA and NH/PI populations. Physicians should know and routinely implement updated screening and vaccine guidelines to prevent AA and NH/PI health disparities.”

Even with HCV cure, surveillance for portal hypertension, HCC ‘should be mandatory’
“Sustained virologic response occurred in 81.8% of patients after the first DAA treatment course. Despite this, further decompensation occurred in 19% of patients and 2.9% developed hepatocellular carcinoma.”

HCV Monitoring in Low-Risk, Undiagnosed Blood Donors Reveals Ongoing Untreated Infections
“Despite being screened for hepatitis C virus (HCV) risk and having a lower prevalence of infection than the general population, findings from a recent study suggest blood donors mirror HCV trends in the general population and highlight the ongoing prevalence of untreated infections in groups less likely to have obvious risks for acquisition.”

Non-Invasive Tests Predict Liver Cancer Risk in Hepatitis C Patients After SVR
“A new study found transient elastography and the fibrosis-4 index offer acceptable predictive performance for the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV) who have achieved a sustained viral response (SVR).”

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Hepatitis C is now curable but eliminating the disease from Australia comes with large challenges

Opioid Overdose Patients in Central Missouri, United States, Have High Rates of Hepatitis C Infection and Limited Testing History
“Conclusion: There is a substantial burden of HCV among opioid overdose patients in central Missouri, United States, emergency departments, particularly among male patients and those aged 55-64. Universal HCV screening for individuals being observed following an overdose could detect many undiagnosed HCV infections.”

4-Week Glecaprevir/Pibrentasvir Regimen Effective and Well-Tolerated
“This study assessed the bioequivalence of a generic glecaprevir/pibrentasvir (G/P) formulation compared to the brand name version under fed conditions using a randomized, single-dose, crossover design. Results showed that the generic formulation is bioequivalent to the brand, with similar pharmacokinetic profiles and no adverse events reported. Additionally, recent research on a 4-week G/P regimen demonstrated high efficacy and good tolerability, further supporting the effectiveness of both the generic formulation and the shorter treatment duration for HCV.”

Shortened Protocol Can Prevent Infection in Recipients of HCV+ Organs
“A shortened antiviral protocol adding the dyslipidemic agent ezetimibe can prevent infection in solid-organ recipients who receive hepatitis C virus–positive organs, according to new research presented at The Liver Meeting 2023. The regimen, dubbed the “Toronto Protocol,” uses the current standard-of-care treatment glecaprevir-pibrentasvir (Mavyret, AbbVie) but cuts the course from eight weeks to eight days. It also adds ezetimibe, a cholesterol-lowering drug that has the unique ability to prevent HCV from entering cells (Nat Med 2012;18[2]:281-285). The first dose starts the day before organ transplantation and continues for one week, usually when the patient is still in the hospital recovering from surgery.”

Treatment with direct-acting antivirals found to improve HCV-related disease outcomes
“Hepatitis C virus (HCV)-related diseases such as chronic hepatitis C, liver cirrhosis, and liver cancers afflict a large number of people worldwide. A recent study from Korea University suggests that treatment with direct-acting antivirals (DAAs) improves liver disease-related clinical outcomes in patients with chronic HCV infection and reduces liver fibrosis-based disease burden. It further highlights that timely intervention with advanced antiviral therapies can have a positive impact on public health.”

FDA Accepts Nivolumab/Ipilimumab Application for First-Line HCC Treatment
“The FDA has accepted the supplemental biologics license application (sBLA) for nivolumab (Opdivo) plus ipilimumab (Yervoy) in the first line for patients with unresectable hepatocellular carcinoma (HCC). A Prescription Drug User Fee Act (PDUFA) target action date of April 21, 2025, has been set. The sBLA is supported by data from the phase 3 CheckMate -9DW trial (NCT04039607).”

Antiviral treatment combo leads to sustained HCV clearance in trial
“A two-month regimen of Atea Pharmaceuticals’ once-daily oral antiviral treatment for hepatitis C — a combination of bemnifosbuvir and ruzasvir — leads to sustained hepatitis C virus (HCV) clearance three months after the therapy’s completion.”

Study Demonstrates Patient, Graft Survival of HCV-Positive DCD Donor Liver Grafts
“Liver grafts from hepatitis C virus (HCV)-positive donation after circulatory death (DCD) donors have 1-year patient and graft survival comparable with donation after brain death (DBD) liver grafts from donors with or without HCV infection, according to findings from a recent study.”

Hepatitis C Virus Reinfection Among People Who Inject Drugs
“Long-Term Follow-Up of the HERO Study”

Martinez Receives Global Honor for Hepatitis Work
“The accolades for the work being done at the “La Bodega” hepatology clinic at the Erie County Medical Center continue to roll in.”

Chronic Hepatitis C Leaves Lasting Epigenetic Scars
“Hepatitis C is a silent yet formidable liver infection caused by the hepatitis C virus (HCV). Unlike its acute form, which often resolves on its own, chronic hepatitis C persists, potentially leading to severe liver damage, including cirrhosis and cancer. While groundbreaking advancements in direct-acting antiviral (DAA) treatments have revolutionized HCV management, achieving high cure rates, the battle isn’t entirely won. Emerging research indicates that the virus leaves a lasting imprint on the immune system, even after successful treatment.”

Liver stiffness becomes crucial indicator for post-treatment hepatitis C risk assessment
“Hepatitis C can be cured in almost all cases with modern medication. However, if advanced liver damage is already present at the time of cure, there is still a residual risk of liver cancer and complications of portal hypertension, such as abdominal fluid, bleeding from the digestive tract and confusion. New studies by an international research group coordinated by MedUni Vienna show that liver stiffness should be the primary indicator used to assess the risk after the end of treatment.”

U of A to run clinical trials for patients with hepatitis C and long COVID
“Infectious diseases specialist Vanessa Meier-Stephenson received $2,178,000 to lead a trial testing the safety and efficacy of a hepatitis C vaccine developed in the laboratory of Michael Houghton, director of the Li Ka Shing Applied Virology Institute and co-winner of the Nobel Prize in Physiology or Medicine.”

Risky Alcohol Use Does Not Impact HCV Treatment Efficacy But Is Linked to Cirrhosis
“Hepatitis C virus (HCV) treatment with direct-acting antiviral (DAA) therapy is equally efficacious in patients with risky alcohol use compared to those without, according to findings from a recent study. Results from OPERA-C, a prospective multicenter study conducted across 26 hospital-based liver clinics in Australia, showed equivalent rates of sustained virologic response (SVR) regardless of alcohol use. However, patients with risky alcohol use had greater rates of cirrhosis and more than one-third of patients with cirrhosis continued to consume alcohol, most of whom were not offered pharmacological therapy for alcohol dependence.”

WHO releases global report, consolidated guidelines to tackle viral hepatitis
“The WHO “Global hepatitis report 2024: action for access in low- and middle-income countries” is the first consolidated WHO report on viral hepatitis epidemiology, service coverage and product access, with improved data for action.“

Study Finds One-Third of Eligible Patients Decline “Opt-Out” HIV, HCV Testing
“The study involved a retrospective, medical record review of adults seen at an internal medicine outpatient resident continuity clinic in South Carolina and found approximately one-third of eligible individuals declined HIV/HCV testing. Although non-Hispanic Black individuals were the least likely to decline testing among all race/ethnicity groups, notable sex disparities were observed among Black patients.”

Hepatitis C: A once incurable infection can now be cured with 8 weeks of medication
“Hepatitis C is a liver disease caused by the hepatitis C (“hep C”) virus. Left untreated, hep C can severely damage the liver, causing illnesses like cirrhosis and liver cancer. The good news is that hep C can be completely cured. We sat down with Amber Casey, HCV (Hepatitis C Virus) Program Manager with Public Health, to learn more.”

Martin Phillips remembered as a champion for hepatitis C sufferers
“Since his death last week tributes have flowed for Martin Phillipps, the late frontman of seminal New Zealand band The Chills. While his influence on New Zealand and the wider international music scene has been at the forefront of those tributes, his openness about living with hepatitis C has also been championed.”

The Interplay of Chronic Hepatitis C and COVID-19: Implications for Prognosis and Treatment
“Conclusion: Patients with CHC and SARS-CoV-2 infection have a substantial risk of severe outcomes. Early identification and management of these patients are crucial to improve their prognosis.”

Current HCV Screening, Treatment Strategies Projected to Fall Short of WHO Goals
“Projections from an agent-based model based on data from Ontario, Canada, suggest both current and prospective strategies may not meet World Health Organization HCV goals.”

Providence patients sue over concerns about possible HIV, hepatitis exposure
“Four people who underwent surgery at Providence Willamette Falls Medical Center in Oregon City filed a lawsuit after the hospital system warned the patients earlier this month that they may have been exposed to blood-borne diseases by an anesthesiologist who might not have followed “comprehensive infection control practices.””

Achieving SVR Improves Glycemic Control in Patients with Diabetes, HCV Infection
“Achieving sustained virologic response (SVR) with direct-acting antiviral (DAA) treatment leads to clinically significant improvements in glycemic control among patients with chronic hepatitis C virus (HCV) and type 2 diabetes, according to findings from a recent study.”

Hepatitis C falling in San Diego, but eliminating disease will take more work
“A big part of driving down number of infections has been more aggressive outreach to those at increased risk.”

CDA Foundation grants aim to help US hepatitis patients find doctors
“In its efforts to connect diagnosed but untreated hepatitis B or C patients with physicians, the Center for Disease Analysis (CDA) Foundation has awarded $1.8 million to 11 U.S. organizations in a second round of grant funding.”

Progress Toward the Elimination of Hepatitis B and Hepatitis C in the Country of Georgia, April 2015–April 2024
“Hepatitis B and hepatitis C are leading causes of cirrhosis and liver cancer and caused 1.3 million deaths worldwide in 2022. Hepatitis B is preventable with vaccination, and hepatitis C is curable with direct-acting antivirals. In 2015, in collaboration with CDC and other partners, Georgia, a country at the intersection of Europe and Asia, launched a hepatitis C elimination program to reduce the prevalence of chronic hepatitis C; at that time, the  prevalence was 5.4%, more than five times the global average of 1.0%.”

UC San Diego study shows link between fentanyl and hepatitis C
“Three years ago, Anthony Cooper was living in a tent when he overdosed on fentanyl. It was the first time he smoked it. “This is something new to me. I asked questions about it, and I was told it was something else,” he said. Cooper is 53 and has HIV. When he overdosed, he was surprised to find out he was positive for hepatitis C. The viral infection can cause cirrhosis or liver cancer if left untreated. “I kind of freaked out because I was like, I didn’t understand,” Cooper said. “I still don’t understand fully about hep C. I’m trying to learn.”