Caring Ambassadors Hepatitis C Program

Monthly Literature ReviewCA_logo-blue

January 2009


In The News


Caring Ambassadors Program releases Hepatitis C Choices, 4th Edition
“The Caring Ambassadors Hepatitis C Program is pleased to announce the publication of the 4th edition of Hepatitis C Choices, a comprehensive book that addresses all aspects of hepatitis C and its treatment. In accordance with its mission to provide state-of-the-art information, Caring Ambassadors has sought out the most recent advancements on the various aspects of the disease and included these updates in the newest edition.’ We are extremely excited about the new chapters in the 4th edition that were authored by nationally renowned experts,’ said Lorren Sandt, Hepatitis C Program Director. ‘We have added important new information on mental health, hepatitis C in women and children, immunological research, and a number of other important topics that affect the hepatitis C community.’” Read more…


FDA approves comprehensive system to test donated blood for HIV, hepatitis B and hepatitis C

“The Food & Drug Administration (FDA) today approved a new nucleic acid test from Roche to screen donated blood for HIV-1 Group M RNA, hepatitis C RNA and hepatitis B DNA in a single, automated assay. The test, called the cobas TaqScreen MPX Test for use on the cobas s 201 system, is a qualitative in vitro test for comprehensive single-assay detection of HIV-1 Group M RNA, HIV-1 Group O RNA, HIV-2 RNA, hepatitis C virus RNA and hepatitis B virus DNA in human plasma. The test, which is not intended for use as an aid in diagnosis, is designed to further increase the safety of blood supplies by identifying infections earlier than traditional serology tests.” Read more…


Peg-Intron/Rebetol combination therapy approved for pediatric hepatitis C

“The FDA has approved Schering-Plough’s Peg-Intron (peginterferon alfa-2b) and Rebetol (ribavirin) combination therapy for the treatment of previously untreated chronic hepatitis C in children ≥3 years old. This approval was based on a clinical trial of 107 treatment-naïve children ages 3 to 17 years of age with chronic hepatitis C and compensated liver disease. The study showed a safe and efficacious result from the pediatric patient population. Peg-Intron and Rebetol combination therapy is already indicated for chronic hepatitis C in adults with compensated liver disease.”


New test can predict success of hep C drugs

“The genetic code of hepatitis C contains telltale patterns that reveal whether a patient will respond to the available drugs for the virus. Studying the viruses of 94 people infected with hepatitis C, the scientists found sections of code that were always linked to drug failure. And John Tavis of the Saint Louis University school of medicine and his team of researchers say that a genetic test could be deployed that would prevent unnecessary treatment.” Read more…


Program helps ex-inmates reintegrate


“The Hepatitis Support Network of Hawaii has established a program to help ex-offenders reintegrate into the community with social, health and economic services. Andy Botts, director of the Prisoner Reintegration and Family Reunification program, will see relatives of ex-offenders and prisoners from 9 to 11 a.m. on Mondays and Thursdays at 1286 Queen Emma St. The program started Dec. 18. Botts became involved with the Hepatitis Support Network after learning he had hepatitis C when tested in prison. He was treated and cured by Dr. Alan Tice, medical director of Infections Limited Hawaii. A nonviolent drug offender, Botts had been in and out of institutions, including five years in a Thai prison, a release from the network said. Botts will join with volunteers and faith-based and community organizations to help ex-offenders and their families.

"Costwise, a sensible approach to the management of nonviolent offenders would be better on the outside of a prison instead of inside," Tice said. He said treatment for infectious diseases such as hepatitis C "can change a person's perspective on life." Read more…


‘You feel like you’re talking to an angel’

“As a nurse who deals with liver disease — a particularly trying medical field with a steady drumbeat of dispiriting news — Martha Shea does everything but get away from it after hours. “I’m just passionate about what I do,” said Ms. Shea, 57, on a recent weekend in a moment of rare repose at her home in Wallingford.

Ms. Shea is described as tough but compassionate by patients she has seen over the years at the Veterans Affairs hospital in West Haven. She has worked there since 1979, first running a hepatology research lab and since 1987, as a nurse — now the nurse-manager of the hepatitis C resource center.” Read more…


Needle/syringe programmes and opioid substitution therapy should be widely available in prisons to help prevent HIV transmission.

“Prisons should have needle and syringe programmes (NSPs), opioid substitution therapy (OST) and other preventive measures in place to prevent HIV transmission between inmates. These are the conclusions of a Review published in the January edition of Lancet Infectious Diseases, written by Dr Ralf Jürgens, a consultant for HIV/AIDS based in Quebec, Canada, and colleagues on behalf of WHO. The high prevalence of HIV infection and drug dependence among prisoners, combined with the sharing of injecting-drug equipment, make prisons high-risk environments for the transmission of HIV and also hepatitis C. The authors reviewed the effectiveness of interventions to reduce risky behaviour in this context. This Review forms part of a broader review of interventions to address HIV in prisons commissioned by WHO, together with the UN Office on Drugs and Crime, and UNAIDS, to guide countries in their efforts to scale-up towards universal access to HIV prevention, treatment and care by 2010.” Read more…


Study shows dramatic drop in needlestick risks for healthcare workers

“When working with needles, healthcare workers always have to be concerned about contracting a life-altering or even life-threatening infection from HIV, hepatitis B or hepatitis C. But after 20 years of intense regulatory and legislative activity and innovative changes to the design and handling of needles, U.S. healthcare workers are now significantly safer from needlestick injuries, according to a new study from the University of Virginia International Healthcare Worker Safety Center."Since the U.S. Needlestick Safety and Prevention Act was passed in 2000, American healthcare workers have benefited from an unprecedented level of protection from occupationally transmitted diseases," says Janine Jagger, M.P.H., Ph.D., director of the Center and co-author of the study published in the December 8 issue of the Journal of Infection and Public Health.” Read more…


Fresno County, Calif., officials approve needle-exchange program

“ The Fresno County Board of Supervisors in California on Tuesday approved a one-year needle-exchange pilot program, the Fresno Bee reports. Supervisors voted 3-2 in support of the program, which was proposed by County Health Officer Edward Moreno and will provide injection drug users with clean needles in an effort to curb the spread of HIV and other bloodborne diseases. Supervisors said that they understand concerns from some law enforcement officials about illegal drug use but that the county needs ways to reduce the spread of diseases such as HIV and hepatitis C. Volunteers have been illegally dispensing 6,000 to 8,000 clean needles each Saturday to IDUs in the county, according to advocate Dallas Blanchard, who has been distributing clean needles for about 13 years. According to the Bee, although these efforts have been tolerated by police, an official program previously had never been endorsed by the Board of Supervisors, which last voted against a needle-exchange program in 2006.” Read more…




Controversy of care

“A recent study, out of the University of California at Los Angeles offered a controversial, yet straightforward, answer to the legal and medical debate over standards of care for inmates with hepatitis C. The researchers concluded treating chronic hepatitis C in the prison population with interferon and antiviral drugs creates cost savings and improves the quality of life for all inmates, sick or not. If the medical community is starting to move in this direction, they’re not alone. An up-and-coming legal challenge is also looking to continue the momentum swing towards increased access to treatment. The law firm of Khorrami, Pollard & Abir is currently filing hundreds of individual lawsuits on behalf of California inmates against the California Department of Corrections and Rehabilitation for failure to properly treat inmates with hepatitis C. The firm expects the total number of plaintiffs to grow into the thousands. “This is an important problem nationally, it’s not just a California problem,” says Mark Ravis an attorney representing the inmates.” Read more…


Sixth Annual Hepatitis C Summit

“The Hepatitis C Task Force of Los Angeles brought the medical and prevention community together on November 21 to discuss the state of the hepatitis C epidemic in Los Angeles County.  Drug Policy Alliance (DPA) Southern California led the charge in prevention strategies for reducing the further outbreak of the disease at this Sixth Annual Hepatitis C Summit held at the California Endowment. Meghan Ralston, DPA’s Harm Reduction Coordinator, gave a highly energetic presentation about how pharmacies in the Los Angeles County are able to sell syringes without a prescription to those who need them.  The Disease Prevention Demonstration Project (DPDP) is a pilot program put together by Senate Bill 1159, the Drug Policy Alliance, California Endowment and the LA Department of Public Health to stop the ever increasing rates and spread of HIV and Hepatitis C.   DPDP has signed up over 300 pharmacies in the county and the number is still increasing, with new ground being broken for those in the Antelope Valley area.” Read more…


Hepatitis C outbreak: Infections prompt U.S. study 

“Congressional concerns about disease outbreaks in ambulatory surgery centers, including the hepatitis C outbreak at a Las Vegas endoscopy center, have prompted a nationwide study to determine what role the facilities play in the spread of health care-associated infections."There have been situations across the country that have raised concerns about the problems in those health care settings,'' said Cynthia Bascetta, director of health care for the federal Government Accountability Office, which is doing the study. The study, in the planning stage but expected to be complete by February, will determine to what extent data are available on the frequency and characteristics of health care-associated infections in ambulatory surgery centers.Instead of just looking at how many infections occurred in outpatient surgery centers, the study also will determine whether the facilities are following appropriate infection-control procedures, Bascetta said."One of the problems is that people aren't admitted into ambulatory surgery centers, so it is much harder to figure out what the source of an infection is if that person is being treated elsewhere,'' she said.Data will be collected from the Centers for Disease Control and Prevention, which conducts surveillance of disease outbreaks, and the Centers for Medicare and Medicaid Services, which regulates ambulatory surgery centers and monitors their infection-control policies.” Read more…


Health professionals need to raise hepatitis C awareness

“Awareness of hepatitis C among health professionals and the public needs to increase if diagnosis rates are to continue to improve, the Health Protection Agency (HPA) has said. Although diagnosis rates are increasing, there are still many infected individuals who remain undiagnosed, the HPA says. The HPA highlights the importance of coverage of hepatitis C, including GP's coverage to coincide with World Hepatitis Day. The report also stresses the role primary care can play in increasing diagnosis rates. ‘It is likely that many prevalent infections exist in individuals who have injected drugs in the past and are no longer in contact with drugs services, or in those who acquired their infections via other routes, like transfusion,' the HPA points out. ‘For this reason, targeted hepatitis C testing in primary care is also important.' It adds: ‘Individuals diagnosed in these settings often have the advantage of more stable lifestyles that enablethem to more easily tolerate and complete anti-viral therapy to clear their infections.'” Read more…

Human Genome's hep C drug is halfway home

“Human Genome Sciences  is halfway home. The company's hepatitis C drug, Albuferon, passed its first phase 3 trial test yesterday, but the harder test is yet to come. In a trial on patients infected with genotypes 2 and 3 of the hepatitis C virus, Albuferon worked just as well as Roche's Pegasys. (Genotypes refer to the virus's different genetic variations.) Fortunately, it didn't have to work better than Pegasys, because it's given every other week. The other interferon treatments, Pegasys and Schering-Plough's Pegintron, require weekly shots. Since injecting interferon causes unpleasant side effects, halving the number of injections should be a great selling point.” Read more…

Clinical Trials, Cohort Studies, Pilot Studies

The impact of diet on liver fibrosis and on response to interferon therapy in patients with HCV-related chronic hepatitis. Loguercio C, Federico A, Masarone M, et al. Am J Gastroenterol. 2008 Dec;103(12):3159-66. Epub 2008 Sep 11.

Peginterferon alfa-2a relapse rates depend on weight-based ribavirin dosage in HCV-infected patients with genotype 1: results of a retrospective evaluation. Zopf S, Herold C, Hahn EG, Granslmayer M. Scand. J. Gastroenterol. 2008 Dec 31:1-5. [Epub ahead of print]

PTPN22 C1858T polymorphism and the outcome of hepatitis C virus infection.

Montes-Cano MA, García-Lozano JR, Aguilar-Reina J, et al. Viral Immunol. 2008 Dec;21(4):491-4.


Impact of donor graft steatosis on overall outcome and viral recurrence after liver transplantation for hepatitis C virus cirrhosis. Briceño J, Ciria R, Pleguezuelo M, et al. Liver Transpl. 2009 Jan;15(1):37-48.

Does interferon use prior to liver transplant influence hepatitis C outcomes following transplantation? Smallwood GA, Devine R, Fasola C, et al. Transplantation. 2008 Dec 27;86(12):1795-8.


Genome-wide hepatitis C virus amino acid covariance networks can predict response to antiviral therapy in humans.

Aurora R, Donlin MJ, Cannon NA, Tavis JE. J Clin Invest. 2008 Dec 22. pii: 37085. doi: 10.1172/JCI37085. [Epub ahead of print]


A randomized study of extended treatment with peginterferon alpha-2b plus ribavirin based on time to HCV RNA negative-status in patients with genotype 1b chronic hepatitis C. Ide T, Hino T, Ogata K, et al. Am J Gastroenterol. 2009 Jan;104(1):70-5.


Four-week pegylated interferon alpha-2a monotherapy for chronic hepatitis C with genotype 2 and low viral load: A pilot, randomized study. Tsubota A, Satoh K, Aizawa M, et al. World J Gastroenterol. 2008 Dec 21;14(47):7220-4.


Hepatitis C virus infection and primary Sjögren's syndrome: a clinical and serologic description of 9 patients. Ceribelli A, Cavazzana I, Cattaneo R, et al. Autoimmun Rev. 2008 Dec;8(2):92-4. Epub 2008 Aug 8.

Basic and Applied Science, Pre-Clinical Studies

Hepatitis C virus-specific T-cell gamma interferon and proliferative responses are more common in perihepatic lymph nodes than in peripheral blood or liver. Moonka D, Milkovich KA, Rodriguez B, et al. J Virol. 2008 Dec;82(23):11742-8. Epub 2008 Aug 20.

Peripheral blood gene expression profile associated with sustained virologic response after peginterferon plus ribavirin therapy for chronic hepatitis-C genotype 1.

Huang C, Chen H, Cassidy W, Howell CD. J Natl Med Assoc. 2008 Dec;100(12):1425-33.


Discovery of pentacyclic compounds as potent inhibitors of hepatitis C virus NS5B RNA polymerase. Habermann J, Capitò E, Ferreira MD, et al. Bioorg Med Chem Lett. 2008 Dec 13. [Epub ahead of print]


Debio 025, a cyclophilin binding molecule, is highly efficient in clearing HCV replicon containing cells, alone or when combined with Specifically Targeted Antiviral Therapy for HCV (STAT-C) inhibitors. Coelmont L, Kaptein S, Paeshuyse J, et al. Antimicrob Agents Chemother. 2008 Dec 22. [Epub ahead of print]


3D cultured immortalized human hepatocytes useful to develop drugs for blood-borne HCV. Aly HH, Shimotohno K, Hijikata M. Biochem Biophys Res Commun. 2008 Dec 25. [Epub ahead of print]


Generation of immune responses against HCV using dendritic cells containing NS5 protein-coated microparticles. Gehring S, Gregory SH, Wintermeyer P, et al. Clin Vaccine Immunol. 2008 Dec 17. [Epub ahead of print]

Role of the hepatitis C virus core+1 open reading frame and core cis-acting RNA elements in viral RNA translation and replication.Vassilaki N, Friebe P, Meuleman P, et al. J Virol. 2008 Dec;82(23):11503-15. Epub 2008 Sep 17.

Epidemiology, Diagnostics, and Miscellaneous Works


Hepatitis C in the elderly: Epidemiology, natural history, and treatment. Mindikoglu AL, Miller RR. Clin Gastroenterol Hepatol. 2008 Dec 10. [Epub ahead of print]

Fibrosis progression in African Americans and Caucasian Americans with chronic hepatitis C. Terrault NA, Im K, Boylan R, Bacchetti P, et al. Clin Gastroenterol Hepatol. 2008 Dec;6(12):1403-11. Epub 2008 Aug 19.

Sociodemographic trends in national ambulatory care visits for hepatitis C virus infection. Tsui JI, Maselli J, Gonzales R. Dig Dis Sci. 2008 Dec 23. [Epub ahead of print]

Reduced quality of life in patients with chronic viral liver disease as assessed by SF12 questionnaire. Svirtlih N, Pavic S, Terzic D, et al. J Gastrointestin Liver Dis. 2008 Dec;17(4):405-9.

Symptomatic acute hepatitis C in egypt: diagnosis, spontaneous viral clearance, and delayed treatment with 12 weeks of pegylated interferon alfa-2a. Sharaf Eldin N, Ismail S, Mansour H, et al. PLoS ONE. 2008;3(12):e4085. Epub 2008 Dec 30.

Laboratory evaluation of the UniCel DxI 800 analyser (Beckman Coulter) for detecting HBV and HCV serological markers.
Miedouge M, Legrand-Abravanel F, Lalanne C, et al. J Clin Virol. 2008 Dec 23. [Epub ahead of print]$=citationsensor

Differences between two real-time PCR-based hepatitis C virus (HCV) assays (RealTime HCV and Cobas AmpliPrep/Cobas TaqMan) and one signal amplification assay (Versant HCV RNA 3.0) for RNA detection and quantification.Vermehren J, Kau A, Gärtner BC, et al. J Clin Microbiol. 2008 Dec;46(12):3880-91. Epub 2008 Sep 17.

Diagnosis of acute hepatitis C virus infection and estimated incidence in low- and high-risk English populations. Brant LJ, Ramsay ME, Balogun MA, Boxall E, Hale A, Hurrelle M, Kaluba L, Klapper P, Lewis D, Patel BC, Parry J, Irving WL. J Viral Hepat. 2008 Dec;15(12):871-7. Epub 2008 Jul 10.