"Hepatitis C virus (Hepatitis C Virus) infection is the most
common type of chronic viral hepatitis in the developed world. The
prevalence of antibody to Hepatitis C Virus (anti-Hepatitis C Virus) is 1.8% among the US population,
with 74% of antibody-positive individuals demonstrating chronic
infection with viremia. These prevalence rates suggest that approximately
3.9 million Americans have been infected with Hepatitis C Virus, and 2.7 million
are chronically infected.
Chronic hepatitis C impairs health- related quality of life,[5]
with natural history studies indicating that progression to cirrhosis
occurs in at least 25% of patients, generally over a 10- to 30-year
period. After the development of cirrhosis, hepatocellular carcinoma
occurs in 2% to 5% of these patients each year.[6] However, it is
important to keep in mind that most patients with chronic hepatitis
C have a relatively benign natural history without development of
progressive disease.
Chronic hepatitis C is responsible for 8,000 to 10,000 deaths per
year in the United States, and it is estimated that this death rate
could increase to 38,000 per year by the year 2010. It is now the
single most common indication for liver transplantation in the United
States and Europe.
The high prevalence and potential morbidity of Hepatitis C Virus infection makes
treatment of chronic hepatitis C one of the more urgent priorities
in infectious disease control.
Although current interferon-based combination therapy can achieve
sustained virologic response rates of up to 40%, the remaining 60%
of treated patients do not experience significant long-term benefits.
Clearly, better therapies are needed, especially for the interferon
nonresponders. Hepatitis C: Current and Future Treatment.
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Document Name & Link to Document
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Description
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File Size /Type**
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99% Pegasys Respond
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The first study evaluating the long-term effectiveness
of PEGASYSâ, peginterferon alfa-2a (40KD), a promising
new hepatitis C treatment, has found that 99% of patients
remain viral free when examined two to three years later.
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Atlas
of Liver Pathology: Vascular Alterations in the
Liver
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Diseases Affecting the Vasculature of the Liver
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Biopsychosocial Predictors of Health-Related Quality of Life
in Patients With Chronic Hepatitis C |
In 94
consecutive patients with chronic hepatitis C
attending a liver center, HRQOL was assessed by the Medical
Outcome Study Short Form Health Survey 36 (SF-36) and
by the German version of the Chronic Liver
Disease Questionnaire. The predictive effect on
HRQOL of disease-related worries measured by the
worry subscale of the Chronic Liver Disease Questionnaire,
psychiatric comorbidity (defined by at least one
Hospital Anxiety and Depression Scale German
Version Score  11),
the Child-Pugh score in case of cirrhosis,
interferon therapy, and active medical
comorbidities was assessed by a multiple regression
analysis. |
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Britain says it will pay hepatitis C victims
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Thousands of Britons infected
with the hepatitis C virus as a result of contaminated blood
products and transfusions are to receive compensation, Health
Secretary John Reid said on Friday.
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Culprits identified in Hepatitis B Liver Damage
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Injecting antibodies to two rogue chemokines
implicated in the chronic disease phase of Hepatitis B infection,
which follows the initial acute response, blocks much of the
secondary inflammation in the liver, claim US immunologists.
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Diagnosis,
management, and treatment of hepatitis C |
Set of guidelines and methods of treatment for each of the
various classifications of HCV |
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Difference
between PEG and Pegasys
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The two pegylated versions of interferon alfa
are not identical by RockyRacoon (WebMD), 6/2/00 09:48:35
The two pegylated versions of interferon alfa are not identical
by Harvey S. Bartnof, MD FDA approval for two pegylated versions
of interferon alfa * are expected this year.
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Disruption of Plasma Melatonin in Liver Cirrhosis
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To assess the 24 hr plasma melatonin profile
as a marker of the output rhythm from the circadian clock
and to study sleep diaries as reflection of subjective sleep
quality in patients with liver cirrhosis
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Evidence-Based Management of Hepatitis C: A Clinician’s
Guide to Pegylated Interferons |
The
hepatitis C story is an ongoing tale of discovery, with the
chapters on viral pathogenesis, patient risk stratification,
and treatment constantly in need of revision. This brief
symposium review highlights several key areas of current
interest in the diagnosis and management of chronic
hepatitis C infection |
482 kb pdf |
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Experimental drugs block Hepatitis C Virus
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New experimental compounds may help the body
fight off hepatitis C, researchers said Thursday. The research,
done by separate teams in the United States and Canada, also
led to new discoveries about how the body fights off infection.
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Exploring
the Liver
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This through-the-skin biopsy method makes it
possible to get tissue via the laparoscope (intra-abdominal
telescope), or from the inside of the liver via a guided catheter
threaded through the jugular vein, or through the skin with
added accuracy using ultrasound or MRI guidance. A recent
article from Harvard in the New England Journal of Medicine
retraces these liver biopsy historical steps that I have lived
through
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Gastroenterology & Hepatology
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Description of Liver Disease
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Gene
Therapy may hold key to Hepatitis B
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Gene therapy that targets liver cells can halt
hepatitis B infection in mice, a new study shows.
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HCV On-Treatment Virologic Monitoring: Impact on Treatment
Decisions |
PowerPoint
Presentation |
Pdf 382v
kb |
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HCV-To
Treat or Not to Treat? That is the Question... |
The
difficult question of if and when to treat those infected with
Hepatitis C Virus (HCV) can be evaluated from a myriad of
perspectives, including public health concerns, risk/benefit
in corrections, legal issues, ethical issues, and personal
physician-patient responsibility |
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Hepatitis B Virus
infection: A comprehensive immunization strategy to eliminate
transmission in the US-Draft (Large
paper-increase download time) |
This document updates the immunization strategy to
eliminate hepatitis B virus transmission in the US, which was
published in 1991 and expanded in 1995. The document
also updates technical information on HBV vaccination of
infants, children, adolescents, and adults. |
2209 kb pdf |
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Hepatitis C: Epidemiology, Diagnosis and Treatment |
PowerPoint
Presentation |
620 kb |
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Hepatitis C: Facts for Today, hope for
tomorrow |
Power point
presentation |
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Hepatitis C infection and injection drug use: The role of
hepatologists in evolving treatment efforts |
The majority of incident infections with the hepatitis C virus
(HCV) are acquired through injection drug use practices. For
most injection drug users, drug use occurred in the past.
However, drug addiction is a chronic disease with a continuing
possibility of former drug users' relapsing back to drug use.
Injection drug users, both current and reformed, are at risk
for HCV and other infectious diseases, and they commonly
display co-morbidities associated with drug use, such as
psychiatric illnesses. |
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Hepatitis C Management |
Effective
treatment rests importantly on recognition of the attributes
that influence disease progression; they include host factors
such as age, obesity, comorbidities (eg, chronic renal
failure, coinfection with human immunodeficiency virus [HIV]),
and others. Viral properties such as genotype play an
important role in treatment choices and outcomes. A thorough
understanding of the pharmacology and pharmacodynamics of the
agents used in treatment and management of side effects is
also important. |
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Hepatitis C-new Test
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A study presented at this year's 51st American
Association for the Study of Liver Disease (AASLD) meeting
reported on results using a new Hepatitis C (Hepatitis C Virus) test which
utilizes a cutting-edge molecular diagnostics technology called
transcription mediated amplification (TMA).
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Hepatitis
C
vs. TRADITIONAL MEDICINE
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So-called "traditional medicine" did not exist
as we know it before the early1920's. Also known as "allopathic"
medicine, it is adversary based. It "wages war" on bacteria,
viruses and misunderstood processes in the body, and sometimes
even the body itself
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Hepatitis C-Post-exposure
Treatment
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Report on post-exposure management
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Hepatitis C Symptoms-Imagined or Real |
What is it
about hepatitis C that makes so many of us complain about
symptoms such as fatigue, nausea, body aches and pains, loss
of appetite, and mood swings? Are they real or imagined? |
16 kb pdf |
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Hepatitis
B report
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Hepatitis B is a global health concern despite
the availability of a vaccine.
Although vaccines for hepatitis B and hepatitis A are available,
they are
often not administered to at-risk individuals
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Hepatitis
C Informational |
Critical
issues in the treatment and management of Chronic Hepatitis C |
1,114 kb
pdf |
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Hepatitis C-Who
should get treated
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When Fran Kee learned he had been infected with
the hepatitis C virus, he decided to start the grueling, yearlong
treatment process, even though doctors said he could wait.
His blood tests showed extremely low levels of the virus,
and all but one of his liver enzyme readings were normal.
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Hepatitis C-Current
& Future Treatment
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Interferon alfa-2b, 3 million units tiw, plus
ribavirin, 1000 to 1200 mg daily for 6 to 12 months, has shown
an improvement of 2-fold or more for all measures of efficacy
when compared with interferon monotherapy. In the next year,
treatment of chronic hepatitis C will involve pegylated interferons,
either alone or in combination with ribavirin. Therapy in
3 to 5 years will likely be multidrug combinations, including
inhibitors of the hepatitis C virus (Hepatitis C Virus) protease, helicase,
or polymerase, with the aim of reducing serum levels or eradicating
Hepatitis C Virus RNA.
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Hepatitis
Report:
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The patient who has a liver disease wants (or
needs) to know about the natural history of the disorder so
as to plan for the future. The patient should be informed
regarding the likely consequences, important milestones, major
complications, and available therapies, all given with a large
measure of compassion and sensitivity.
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Hepatofugal Flow in the Portal Venous System:
Pathophysiology, Imaging Findings, and Diagnostic Pitfalls |
Hepatofugal flow (ie, flow directed away from the liver) is
abnormal in any segment of the portal venous system
and is more common than previously believed.
Hepatofugal flow can be demonstrated at
angiography, Doppler ultrasonography (US), magnetic
resonance imaging, and computed tomography (CT).
The current understanding of hepatofugal flow
recognizes the role of the hepatic artery and the
complementary phenomena of arterioportal and portosystemic
venovenous shunting. Detection of hepatofugal flow is
clinically important for diagnosis of portal
hypertension, for determination of portosystemic
shunt patency and overall prognosis in patients
with cirrhosis, as a potential pitfall at invasive
arteriography performed to evaluate the patency
of the portal vein, and as a contraindication to
specialized imaging procedures (ie, transarterial
hepatic chemoembolization and CT during arterial portography).
Hepatofugal flow is generally diagnosed at Doppler US
without much difficulty, but radiologists should
beware of pitfalls that can impede correct
determination of flow direction in the portal
venous system. |
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High-Dose Interferon Alpha-2b Prevents Chronic Hepatitis C
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Early treatment of acute hepatitis C
with a relatively short, high-dose regimen of interferon alpha-2b
prevents
the development of chronic infection in most patients,
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HIV and Hepatitis C-Coinfection Information Brochure |
Complications from hepatitis C are becoming one of the most
important medical issues facing HIV positive individuals |
17 kb pdf |
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How to
Enroll in a Drug Study
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There are several ways in which patients and
their physicians can learn of
clinical trials in which they may want to take part
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In a first, USC scientists show how Hepatitis C dodges
medicinal firepower |
“Hepatitis C is a ticking time bomb…It creates tremendous
social and health pressure, and is one of the most important
infectious diseases in this country.”
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175 kb pdf |
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Incidence
of seroconversion to hepatitis C
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To estimate the rate of seroconversion to positivity
for hepatitis C antibody in repeat blood donors in England
and to describe the probable routes of infection in these
donors.
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Overcoming Barriers to Prevention, Care, and Treatment of
hepatitis C in Illicit Drug Users |
Injection
drug users constitute the largest group of persons infected with
the hepatitis C virus in the united States, and most new
infections occur in IDUs. The prevalence of HCV antibody in
most studies of older IDUs is 80%-90%, and uninfected IDUs
generally become infected at rates of 10%-20%/year |
124 kb pdf |
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Physicians in the Management of Patients With Hepatitis C
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Approximately 4 million Americans are infected
with the hepatitis C virus (Hepatitis C Virus). Most patients with hepatitis
C have no symptoms until cirrhosis is established.
Thus, initial diagnosis and management of hepatitis
C rely on primary care physicians identifying and screening
high-risk individuals.
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Patients paying larger percentage for Medical Costs
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Faced with "rapidly rising" prescription drug
spending, which is climbing at about 15% per year, employers
and insurers have increasingly shifted the costs to patients,
who "may soon pay even more,"
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Quick Treatment for Hepatitis C cured if caught early
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Quick treatment after infection can almost always
cure hepatitis C, a condition that causes between 8,000 and
10,000 deaths in the United States each year, according to
a study released Monday.
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Researcher Says Disease Will Strain the State's Hospitals
and Transplant Units |
While
new cases of infection will decline in the future, Dr. Davis
and colleagues predict that more people who already have HCV
infection will experience progression of liver disease -- to
cirrhosis and hepatocellular carcinoma, for example. Chronic
HCV is the most common indication for liver transplantation in
the U.S., affecting 50 percent of all patients receiving liver
transplants. And, the disease frequently recurs following
liver transplantation, sometimes leading to cirrhosis and
liver failure a second time. |
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Recommendations for Prevention and Control of Hepatitis C
Virus (HCV) Infection and HCV-Related Chronic Disease |
These
recommendations are an expansion of previous recommendations
for the prevention of hepatitis C virus (HCV) infection that
focused on screening and follow-up of blood, plasma, organ,
tissue, and semen donors (CDC, Public Health Service
inter-agency guidelines for screening donors of blood,
plasma, organs, tissues, and semen for evidence of hepatitis
B and hepatitis C. MMWR 1991; 40 (No.RR-41); 1-17). The
recommendations in this report provide broader guidelines
for a) preventing transmission of HCV; b) identifying,
counseling, and testing persons at risk for HCV infection;
and c) providing, appropriate medical evaluation and
management of HCV-infected persons. Based on currently
available knowledge, these recommendations were developed by
CDC staff members after consultation with experts who met in
Atlanta during July 15-17, 1998. This report is intended to
serve as a resource for health-care professionals, public
health officials, and organizations involved in the
development, delivery, and evaluation of prevention and
clinical services. |
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Sharing of Drug Preparation Equipment as a Risk Factor for
Hepatitis C
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This study investigated the sharing of drug
preparation equipment as a possible route of hepatitis C virus
(Hepatitis C Virus) transmission.
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Statistics
and meaning of normal ALTs with Hepatitis C Virus+
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This article contains discussion of several
published studies which look at Hepatitis C Virus positive individuals with
normal ALTs (liver function test) and the relationship between
ALT levels and Hepatitis C Virus disease progression. Whether or not such
individuals should initiate Hepatitis C Virus treatment is discussed.
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Subject
Effectiveness of Hepatitis C Drug
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Patients being treated for the hepatitis C virus
-- a blood-borne disease that attacks the liver -- now can
learn earlier than ever before if they are likely to benefit
from an investigational drug therapy.
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TAKING A CHANCE AT LIFE: ASSESSING THE BENEFITS AND DETRIMENTS
OF HEPATITIS C TREATMENT TO DETERMINE WHEN IT IS MOST
REWARDING TO UNDERGO TREATMENT |
Deciding when to undergo treatment for Hepatitis C through an
assessment of the benefits and detriments |
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Transjugular Intrahepatic Portosystemic Shunt: Current Status |
The Transjugular Intrahepatic Portosystemic Shunt (TIPS) was
developed in the 1980s for treatment of complications of
portal hypertension. Once it was shown that the shunt could
be place with relative ease, TIPS was rapidly applied to the
treatment of many of the complications of portal hypertension. |
255 kb pdf |
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Treatment
options for Hepatitis B non-responders
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Thus, a large number of untreated patients with
HBeAg-positive CHB are left with severe liver necroinflammation
which persists for several years and results in an increased
likelihood of progression of liver damage to advanced stages
of fibrosis, cirrhosis and even development of hepatocellular
carcinoma (HCC), the most dire consequence in the natural
history of CHB.
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Treatment
denied to inmates
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In mid September, 1998 I became ill: fatigued
and weak, I thought I'd caught a bug. By late January, 1999
I'd been diagnosed as suffering from chronic hepatitis C and
was taken out of the prison to see a gastroenterologist at
a local hospital.
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Treatment of Chronic Hepatitis C
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Chronic infection with the hepatitis C virus
is extremely prevalent, averaging 1% to 2% of the world population.
Fortunately, recognition of potential risk factors, changes
in patterns of using injected drugs, and improved safety of
the blood supply have led to a dramatic decline in the incidence
of new hepatitis C virus infections in recent years.
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Treatment
of Hepatitis after Kidney Transplant
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This patient is the classic patient with acute
hepatitis due to Hepatitis C Virus infection. The most important thing we
need to know is the timing. It looks as if she clearly was
negative before transplantation and now is positive by both
virologic and enzymatic evaluation; therefore, she meets the
criteria for acute hepatitis
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Treatment
of Hepatitis B
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Hepatitis B remains a major worldwide public
health problem. Globally, there are 350 million carriers of
the hepatitis B virus (HBV) vs 370 million carriers of the
hepatitis C virus (Hepatitis C Virus). In the United States, 4.0 million
persons are positive for Hepatitis C Virus antibodies and 2.7 million of
these individuals are chronic carriers
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