Tag Archives: Hepatiits C

Rope-A-Dope with Hepatitis C

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Methods: The authors developed an agent-based model (ABM) “simulating the dynamics of HCV transmission and demographic changes from 2006 to 2030, using data from Ontario, Canada.14 Predicted long-term health outcome effects for current HCV policies (status quo) and those following the implementation of various scale-up interventions were compared to the elimination goals set by the WHO.”

Key findings:

  • Under the current status quo of risk-based screening, we predict the incidence of CHC-induced decompensated cirrhosis, HCC, and liver-related deaths would decrease by 79.4%, 76.1%, and 62.1%, respectively, between 2015 and 2030
  • However, chronic hepatitis C (CHC) incidence would only decrease by 11.1% (WHO goal by 2030 is a reduction of 80%)

From the editorial:

“According to the study by Tian et al,3 the future incidence of HCV infection will be mainly related to HCV transmission, stressing the fact that harm reduction strategies, in addition to the highest treatment rate, are paramount to reducing the further HCV spread and reinfection risk, especially in marginalized populations. In high‐income countries, HCV treatment rates among people who use drugs remain inadequate due to a lack of simplified HCV testing, scale‐up of harm reduction‐based HCV treatment programs, and numerous additional barriers to HCV services.”

“It is not just a matter of time until high-income countries get rid of HCV infection. The ongoing mass screening campaign in Italy shows that having political will and financial coverage is insufficient to achieve the HCV elimination targets. In high-income countries, encouraging and convincing people to get tested is among the most challenging and underrated.”

My take: The development of highly effective HCV treatments has been a remarkable feat, reducing the rate of death and complications from HCV. Nevertheless, it has not brought about a big improvement in HCV transmission. To achieve this, it looks like a vaccine will be necessary. Until then, our fight against HCV is akin to the ‘rope a dope‘ boxing strategy –we are not getting a knock-out anytime soon against this opponent.

Related blog posts:

Canyonlands National Park, Utah

Treating Pediatric Hepatitis C Infections is Cost-Effective. Plus COVID-19 mRNA Vaccine Study

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E Greenaway et al. J Pediatr 2020; DOI:https://doi.org/10.1016/j.jpeds.2020.08.088. Free full text: Treatment of Chronic Hepatitis C in Young Children Reduces Adverse Outcomes and Is Cost-Effective Compared with Deferring Treatment to Adulthood

Methods: A state-transition model of chronic HCV was developed to conduct a cost-effectiveness analysis comparing treatment at age 6 years vs delaying treatment until age 18 years

Key findings:

  • After 20 years, treating 10 000 children early would prevent 330 cases of cirrhosis, 18 cases of hepatocellular carcinoma, and 48 liver-related deaths
  • The incremental cost-effectiveness ratio of early treatment compared to delayed treatment was approximately $12 690/quality-adjusted life-years gained and considered cost-effective

My take (=conclusion from authors): Delaying treatment until age 18 years results in an increased lifetime risk of late-stage liver complications. Early treatment in children is cost effective. Our work supports clinical and health policies that broaden HCV treatment access to young children.

Related blog posts:


FP Polack et al. NEJM Full text link: Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Published data on the Pfizer/BioNTech vaccine

Briefly Noted: E-Cigarette Use Increasing Rapidly in Kids & Gilead Profits

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From NPR (accessed 4/24/15): The statistical findings, published in this week’s issue of Morbidity and Mortality Weekly Report, come from the CDC’s National Youth Tobacco Survey. The latest survey found that the use of e-cigarettes increased from 1.1 percent in 2013 to 3.9 percent in 2014 among middle school students, and from 4.5 percent to 13.4 percent among high school students. That translates to a total of 450,000 middle school students now using e-cigs, alongside 2 million high school students.

Related blog post: Tobacco 21 & ENDing Combustible Tobacco Use | gutsandgrowth

 

Also, from NY Times, Gilead is making a lot of money on its Hepatitis C medications ,$4.55 billion in 1st quarter:

Sales of Gilead Sciences’ drugs to treat hepatitis C reached $4.55 billion in the first quarter, far exceeding already lofty Wall Street expectations but likely to focus attention once again on the overall costs to the health care system of the medicines.

Gilead said on Thursday that its new drug, Harvoni, had overall sales in the quarter of $3.58 billion, of which $3.02 billion was in the United States. This was the first full quarter of sales for Harvoni, which was approved in October.

Sales of Sovaldi, the older hepatitis C drug, fell to $972 million in the quarter from $2.27 billion in the first quarter of 2014 because it was supplanted by Harvoni. Combined, hepatitis C drug sales in the first quarter were double that of a year earlier.

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