The Week in Review: Feb 3, 2017 – Feb 10, 2017

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Friday, February 10, 2017

News Recap

Liver Cancer
In the news this week was a story about why Toronto, Canada, is a liver cancer hotspot. More than a thousand deaths from liver cancer every year in Ontario — and most of these occur in the Greater Toronto Area. The reasons: Hepatitis B & C in the immigrant populations, and the lack of screening of Baby Boomers in Canada.  This is terrible, especially considering that the survival rate from liver cancer remains quite low. According to provincial statistics, only 24 per cent of patients will survive five years or longer. But when caught early, there is a high chance of cure. Doctors’ Notes: Why Toronto is a liver cancer hot spot.

Another study this week in the news drew attention to the fact that not all causes of liver cancer are the same.  In fact, although alcohol is known to be a cause of liver cancer in people with alcohol-induced cirrhosis, the incidence of cancer is much lower than in those with HCV-induced cirrhosis. Study results showed that, “the adjusted relative risk of HCC was increased two-fold to three-fold among people with viral and autoimmune/metabolic etiologies, compared to those with alcohol-associated cirrhosis.” Alcohol Induced Cirrhosis Found Less Likely to Cause Liver Cancer Than Previously Thought Compared to Virally Induced Cirrhosis.

And finally, in the news is a review article of a study in Gastroenterology: Apparently, patients treated with direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV)-related cirrhosis appear to have high rates of hepatocellular carcinoma (HCC): “If these findings are confirmed from other centers, studies are suggested to examine mechanisms of these findings,” Dr. Ashwani Singal from University of Alabama at Birmingham told Reuters Health. Dr. Singal recommends that we “be aware of this potential issue and consider more intensive HCC surveillance of HCV cirrhotics during and after HCV therapy.”  However, not all researchers are convinced this is the case.  You can read more here:  High Rates of Hepatocellular Carcinoma After Hepatitis C Treatment.

HIV-HCV Coinfection
Two studies from Europe this week on HCV in MSM: In the first study, researchers found an unexpectedly high rate of hepatitis C virus (HCV) infection in participants tested for it at baseline. The HCV prevalence seen was more typical of that seen in HIV-positive gay men rather than the much lower rates seen in HIV-negative men.  This is because HCV is known to be sexually transmitted in MSM who also have HIV. One unanswered question is whether this might in future lead to a general increase in HCV prevalence among the HIV-negative gay population, or whether PrEP users were a specific population that were untypical of other HIV-negative gay men.   High hepatitis C prevalence seen in Amsterdam PrEP study participants.

The second study noted a rise in reinfection of acute HCV among men with HIV who have sex with men (MSM). The reinfection incidence was 7.3/100 person-years, with some patients being reinfected up to 4 times!. Unlike PrEP therapy (Pre-Exposure Prophylaxis) which can protect against transmission of HIV in MSM who have unprotected anal sex, there is nothing that can prevent HCV, other than condoms. Rates of Hepatitis C Coinfection in Patients With HIV.

Finally?
There was yet another analysis of the high cost of treatment and whether or not the price will come down.  It is an interesting read. However, after all is said and done, all it really takes is willingness on the part of Big Pharma and governments to do the right thing.  This is moral choice.  Some say it is also a good economic choice, but I think it’s time we stopped looking at people this way!  Where has it gotten us? Will Hepatitis C Virus Medicaton Costs Drop in the Years Ahead?

Coming Up Next Week!