Author Interviews, Hepatitis - Liver Disease, JAMA, University of Pittsburgh / 11.12.2014

Adeel A. Butt, MD, MS, FACP, FIDSA Vice Chair for Faculty Affairs Department of Medicine Hamad Medical Corporation, Doha, Qatar Adjunct Associate Professor of Medicine and Clinical and Translational Science University of Pittsburgh School of MedicineMedicalResearch.com Interview with: Adeel A. Butt, MD, MS, FACP, FIDSA Vice Chair for Faculty Affairs Department of Medicine Hamad Medical Corporation, Doha, Qatar Adjunct Associate Professor of Medicine and Clinical and Translational Science University of Pittsburgh School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Butt: Precise rate of progression of liver disease in Hepatitis C (HCV) infection is unknown because the precise time of infection with HCV is seldom known. Knowledge of liver disease progression is critical to determine the optimal time for treatment. We found that progression of liver disease starts early after acquiring HCV infection. This is more rapid than was previously thought. About 18% of HCV infected persons develop cirrhosis within 10 years of acquiring HCV infection, which is 3-fold higher than demographically similar HCV uninfected persons.
Hepatitis - Liver Disease, Mayo Clinic / 10.11.2014

Surakit Pungpapong, M.D. Transplant Hepatologist Associate Professor of Medicine Mayo Clinic, Jacksonville, Fla.Medical Research.com Interview with: Surakit Pungpapong, M.D. Transplant Hepatologist Associate Professor of Medicine Mayo Clinic, Jacksonville, Fla.   Medical Research: What is the background for this study? What are the main findings? Dr. Pungpapong: This study reports our multicenter experience from Mayo Clinic’s three sites using sofosbuvir and simeprevir with/without ribavirin for 12 weeks to treat hepatitis C genotype 1 recurrence after liver transplantation. We found that this all-oral interferon-free antiviral regimen was very well tolerated with minimal to mild side effects. It required minimal dose adjustment of immunosuppression and no episode of acute rejection occurred. Overall, sustained virologic response rate was very high, more than 90 percent.
Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease, NIH / 05.11.2014

MedicalResearch.com Interview with: Anita Kohli, MS, MD Clinician Investigator, Clinical Monitoring Research Program (CMRP) Leidos Biomedical Research, Inc. formerly SAIC-Frederick, Inc. National Institutes of Health Bethesda, MD 20892 Medical Research: What is the background for this study? What are the main findings? Dr. Kohli: We previously treated 60 patients with sofosbuvir and ribavirin for 24 weeks. Patients who relapsed after treatment were offered re-treatment with another regimen of directly acting antivirals alone. 13 patients who relapsed were treated with sofosbuvir and ledipasvir for 12 weeks. All patients achieved SVR12. This is the first report of re-treating patients who failed a regimen including sofosbuvir with another regimen incorporating this same antiviral.
Author Interviews, Heart Disease, Hepatitis - Liver Disease / 08.10.2014

MedicalResearch.com Interview with: Naga Pothineni, MD Division of Cardiology University of Arkansas for Medical Science MedicalResearch: What are the main findings of the study? Dr. Pothineni: Hepatitis C is a blood borne infection that is very common worldwide. Most pateints who contract hepatitis C develop a chronic form on infection that progresses to liver damage and eventually hepatocellular cancer. Coronary heart disease is a worldwide problem as well. There has been interest in chronic infections being a mechanism of progression of atherosclerosis and coronary heart disease. We wanted to study the association of coronary heart disease events in patients with hepatitis C. We conducted a retrospective study of around 24,000 patients of which around 10,000 were hepatitis C positive. Our study showed that patients who have hepatitis C have a higher incidence of coronary heart disease events (myocardial infarction) when compared to patients who are negative for hepatitis C. In our analysis, we found that hepatitis C positivity is an independent risk factor for coronary events after adjusting for traditional cardiovascular risk factors like age, hypertension, smoking and diabetes. Another interesting finding in our study was that patients with hepatitis C have lower levels of cholesterol compared to patients without hepatitis C. Low cholesterol levels in these patients do not seem to be protective against future coronary heart disease events.
Author Interviews, Hepatitis - Liver Disease / 06.08.2014

MedicalJagpreet Chhatwal, Ph.D. Assistant Professor Department of Health Services Research Houston, TX 77098Research.com Interview with Jagpreet Chhatwal, Ph.D. Assistant Professor Department of Health Services Research Houston, TX 77098 Medical Research: What are the main findings of the study? Dr. Chhatwal: The recent updates in hepatitis C virus (HCV) screening policy and ongoing therapeutic advances can make hepatitis C a rare disease in the US by 2036. However, more aggressive screening strategies are needed to further reduce the burden of disease. For example, 1-time universal screening further identify 487,000 chronic hepatitis C virus cases in the next 10 years, and can make hepatitis C a rare disease in the next 12 years.
Erasmus, General Medicine / 12.05.2014

Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The NetherlandsMedicalResearch.com Interview with: Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The Netherlands MedicalResearch: What are the main findings of the study? Dr. J van der Meer: The main finding of our study is that the prognosis of patients with compensated HCV-induced advanced liver disease can be adequately assessed by risk scores which merely include objective variables that are readily available in daily practice. Our analyses resulted in two separate prognostic scores by which the individual patient's risk of mortality or clinical disease progression (defined as occurence of Hepatitis C Cirrhosis (HCC), liver failure, liver transplantation or death) can be assessed.
Author Interviews, Hepatitis - Liver Disease / 17.04.2014

Jordan Feld MD MPH Toronto Western Hospital Liver Center University Health Network Sandra Rotman Centre for Global HealthMedicalResearch.com Interview with: Jordan Feld MD MPH Toronto Western Hospital Liver Center University Health Network Sandra Rotman Centre for Global Health MedicalResearch.com:  What are the main findings of the study? Dr. Feld: The SAPPHIRE 1 study was an international, large (631 patients) Phase 3 study of 3 direct acting antivirals combined with ribavirin for 12 weeks for the treatment of patients with genotype 1 hepatitis C virus (HCV) infection without cirrhosis.  The antivirals used were ABT-450, which is a protease inhibitor that is boosted with ritonovir to allow for once daily dosing along with ombitasvir (formally ABT 267), a potent NS5A inhibitor and dasabuvir (formerly known as ABT 333), a non-nucleoside polymerase inhibitor.  The ABT-450, ritonovir and ombitasvir were all co-formulated into a single tablet and dasabuvir was taken twice daily, as was ribavirin. The results of the study showed that the treatment is highly effective with 96% of patients achieving a sustained virological response (SVR) at 12 weeks after completing treatment.  SVR is a cure of HCV infection.  Importantly, patients with genotypes 1a and 1b had similar results with a rate of SVR12 of 95% in genotype 1a and 98% in genotype 1b.  These results were clearly superior to a historical control treatment with telaprevir combined with peginterferon and ribavirin.  Baseline factors were not predictive of outcome, including factors associated with non-response to interferon such as the IL28B genotype, baseline HCV viral load and older age.
Hepatitis - Liver Disease / 16.04.2014

Christophe Moreno, MD, PhD Directeur clinique, clinique d’Hépatologie Service de Gastroentérologie Hépatopancréatologie et Oncologie DigestiveMedicalResearch.com Interview with: Christophe Moreno, MD, PhD Directeur clinique, clinique d’Hépatologie Service de Gastroentérologie Hépatopancréatologie et Oncologie Digestive MedicalResearch.com: What are the main findings of the study? Dr. Moreno: The RESTORE study is an open label, phase 3 study, evaluating Simeprevir in combination with PegIFN and ribavirin in genotype 4 Chronic Hepatitis C patients, either naïve or treatment experienced. Results of this study demonstrated high efficacy of this combination, with an overall SVR rate of 65.4%. Efficacy is particularly high in treatment naïve and prior relapsers patients, with SVR rate of 82.9% and 86.4%, respectively. Moreover, treatment naïve patients and prior relapsers were eligible to a shorter treatment duration of 24 weeks if they met response-guided therapy (RGT) criteria (defined by an HCV RNA below 25 at week 4 and undetectable at week 12). 89.5% met RGT criteria. Of those, 94.1% achieved a SVR.
Author Interviews, Hepatitis - Liver Disease, NEJM / 12.04.2014

Kris V. Kowdley, MD Director of Research & Director of the Liver Center of Excellence Digestive Disease Institute Virginia Mason Medical Center Seattle, WA 98111MedicalResearch.com Interview with: Kris V. Kowdley, MD Director of Research & Director of the Liver Center of Excellence Digestive Disease Institute Virginia Mason Medical Center Seattle, WA 98111 MedicalResearch.com: What are the main findings of the study? Dr. Kowdley:  A fixed-dose combination of ledipasvir and sofosbuvir in chronic Hepatitis C (HCV) genotype 1 patients without cirrhosis for 8 weeks without ribavirin was equally effective as the same combination with ribavirin added and also a 12 week combination of ledipasvir-sofosbuvir (without ribavirin).
Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease / 04.03.2014

Scott D. Holmberg, MD, MPH Chief, Epidemiology and Surveillance Branch Division of Viral Hepatitis.MedicalResearch.com Interview with: Scott D. Holmberg, MD, MPH Chief, Epidemiology and Surveillance Branch Division of Viral Hepatitis. MedicalResearch.com: What are the main findings of the study? Dr. Holmberg: Based on interview and testing of over 30, 000 National Health and Nutrition and Examination Survey (NHANES) participants from 2003 to 2010, 273 US residents or about 1%, are chronically (actively) infected with hepatitis C virus (HCV).  This translates to about 2.7 million chronic HCV-infected persons in the non-institutionalized population.
Author Interviews, Hepatitis - Liver Disease / 13.12.2013

Dr. Jason Grebely PhD The Kirby Institute University of South Wales, AustraliaMedicalResearch.com Interview with: Dr. Jason Grebely PhD The Kirby Institute University of South Wales, Australia MedicalResearch.com: What are the main findings of the study? Dr. Grebely: Although 20%-40% of persons with acute hepatitis C virus (HCV) infection demonstrate spontaneous clearance, the time course and factors associated with clearance remain poorly understood. This study investigated the time to spontaneous clearance and predictors among participants with acute HCV. Female sex, favorable IL28B genotype, and HCV genotype 1 were identified to be independent predictors of spontaneous clearance. This study provides important insights into factors affecting HCV viral control and offers guidance in clinical decision-making for the treatment of acute HCV infection.
Author Interviews, Chemotherapy, Gastrointestinal Disease, Hepatitis - Liver Disease, MD Anderson / 10.12.2013

Harrys A. Torres, MD, FACP Assistant Professor Director of Hepatitis C Clinic Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer CenterMedicalResearch.com Interview with: Harrys A. Torres, MD, FACP Assistant Professor, Director of Hepatitis C Clinic Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer Center MedicalResearch.com: What are the main findings of the study? Dr. Torres: The main findings of the study were that patients with hepatitis C virus (HCV) infection who were successfully treated with antivirals and attained sustained virologic response (SVR) did not have a relapse of HCV infection after receiving immunosuppressive chemotherapy for cancer. Patients in the study received different chemotherapeutic agents, including rituximab and systemic corticosteroids. Durability of SVR was maintained up to 14 years after chemotherapy in cancer patients.
Author Interviews, Hepatitis - Liver Disease, Lancet / 24.11.2013

Prof Eric Lawitz MD Vice President of Scientific and Research Development at The Texas Liver Institute Clinical professor of Medicine San Antonio University of Texas Health Science Center.MedicalResearch.com Interview with: Prof Eric Lawitz MD Vice President of Scientific and Research Development at The Texas Liver Institute Clinical professor of Medicine San Antonio University of Texas Health Science Center. MedicalResearch.com: What are the main findings of the study? Dr. Lawitz: Currently available treatments for HCV involve weekly injections of pegylated interferon and daily doses of oral antivirals that must be taken for up to a year.  These regimens are not only burdensome for patients, but are not always effective and can cause serious and debilitating side effects, including anemia. So there is a significant need for new tablet-based treatment regimens for HCV that eliminate interferon and ribavirin, are more effective, better tolerated and easier for patients to take.