Can-Fite recruits patients for hepatitis C study
Can-Fite is also recruiting patients for a Phase I/II clinical trial for CF102
for treating liver cancer.
Globes' correspondent14 Jul 09 11:31
Can-Fite BioPharma Ltd. (TASE:CFBI) has obtained permission from the Ministry of
Health to begin recruiting patients for the Phase I/II clinical trial of the
company's drug CF102 for the treatment of type C hepatitis virus. The ethics
committee of the Rabin Medical Center (Beilinson Hospital) in Petah Tikva also
approved the trial.
The Phase I clinical trial of CF102, which was conducted in the US under US Food
and Drug Administration (FDA) guidelines, found that drug had a high safety
profile. The results made it possible to move onto the present trial, which will
test the drug's safety and effectiveness in patients with hepatitis C.
The company said that the current size of the hepatitis C treatment market is $3
billion, and that it is expected to growth to around $8.3 billion in 2012.
CF102, like Can-Fite's other lead drug candidate, CF-101, was found to be
effective when taken orally.
Can-Fite is simultaneously recruiting patients for a Phase I/II clinical trial
for CF102 for treating liver cancer, which is frequent among patients with
hepatitis.
Can-Fite is based on the scientific research of CEO Prof. Pnina Fishman.
Can-Fite's share rose 4.4% in morning trading to NIS 13.25
Published by Globes [online], Israel business news - www.globes-online.com - on
July 14, 2009

[Non-text portions of this message have been removed]

Hepatology. 2009 Apr 6. [Epub ahead of print]

Outcomes of a patient-to-patient outbreak of genotype 3a hepatitis C.

Mailliard ME, Capadano ME, Hrnicek MJ, Gilroy RK, Gulizia JM.

Department of Internal Medicine, University of Nebraska College of Medicine,
Omaha, NE.

Between March 2000 and July 2001, at least 99 persons acquired a hepatitis C
virus genotype 3a (HCV-3a) infection in an oncology clinic. This nosocomial HCV
outbreak provided an opportunity to examine the subsequent clinical course in a
well-defined cohort. This was a retrospective/ prospective observational study
of the short-term significant health outcomes of a large, single-source,
patient-to-patient HCV-3a outbreak. Outbreak patients or their legal
representatives consenting to study were enrolled between September 2002 and
December 2007. We measured history and physical examinations, medical records,
HCV serology, HCV RNA and genotype, liver enzymes, histology, response to
antiviral therapy, and liver-related morbidity and mortality. Sixty-four of the
99 known HCV-3a outbreak patients participated. During a 6-year period, six
patients developed life-threatening complications from liver disease, three
died, one received a liver transplant, and two
  were stable after esophageal variceal banding or diuretic therapy of ascites.
Thirty-three patients underwent antiviral therapy, with 28 achieving a sustained
viral remission. One patient acquired HCV-3a infection sexually from an outbreak
patient and was successfully treated. Eleven study patients died of malignancy,
including two that had achieved a sustained viral remission after antiviral
therapy. Conclusion: Our patient cohort had a nosocomial source and an oncologic
or hematologic comorbidity. Compared with previous HCV outcome studies, a
patient-to-patient HCV outbreak in an oncology clinic exhibited significant
morbidity and mortality. Attention is needed to the public health risk of
nosocomial HCV transmission, emphasizing infection control, early diagnosis, and
therapy. (HEPATOLOGY 2009.).
PMID: 19585621 [PubMed - as supplied by publisher]


[Non-text portions of this message have been removed]

Evaluation of semen variables, sperm chromosomal abnormalities and r
 
Mon Jul 13, 2009 3:23 am (PDT)



http://www3. interscience. wiley.com/ journal/12250225 4/abstract

BJU International
Published Online: 7 Jul 2009

Evaluation of semen variables, sperm chromosomal abnormalities and reproductive
endocrine profile in patients with chronic hepatitis C

Mohammad Reza Safarinejad, Ali Asghar Kolahi* and Shahrokh Iravani †

Urology and Nephrology Research Center and *Department of Health and Community
Medicine, Faculty of Medicine, Shahid Beheshti University (MC), and †Division
of Gastroenterology and Hepatology, Aja University of Medical Sciences, Tehran,
Iran

Correspondence to Mohammad R. Safarinejad, PO Box 19395–1849, Tehran, Iran.
e-mail: safarinejad@ uncr.ir

ABSTRACT
To evaluate reproductive endocrine profile, sperm chromosomal abnormalities, and
semen quality in patients with chronic hepatitis C.

PATIENTS, SUBJECTS AND METHODS
In all, 82 patients with chronic hepatitis C, aged 18–60 years, were recruited
for the study; 76 age-matched healthy male volunteers served as controls. All
participants provided a medical history and had a complete physical examination
and routine semen analysis. Two blood samples were drawn from each participant
at 15-min intervals to determine the resting levels of luteinizing- hormone
(LH), follicle-stimulatin g hormone (FSH), prolactin, testosterone, oestradiol,
and sex hormone-binding globulin. The hypothalamus- pituitary- testis axis was
assessed using the gonadotrophin- releasing hormone (GnRH) test. All
participants also received an injection of human chorionic gonadotrophin (hCG)
and serum testosterone was determined before the hCG injection and on the third
day afterwards. Conventional karyotype analysis and triple-colour fluorescence
in situ hybridization for chromosomes X, Y and 18 were conducted in all patients
and controls.

RESULTS
The mean basal serum levels for LH, FSH, and testosterone in patients with
hepatitis C was significantly lower than the mean for normal controls (P =
0.01). The injection of GnRH analogue did not yield significantly higher FSH and
LH levels in the patients than in normal controls (P = 0.001). In patients with
chronic hepatitis C, the mean total sperm count, motility and normal morphology
was significantly lower than in controls (P = 0.001). There was a significantly
greater frequency of disomy in men with chronic hepatitis C than controls for
chromosomes 18, X, and Y (P = 0.01).

CONCLUSIONS
Patients with chronic hepatitis C are at risk of showing sperm chromosomal
abnormalities, the incidence of which is higher in patients with more advanced
disease. Hypogonadotrophic hypogonadism is caused by the selective loss of
pituitary gonadotrophin function. Further studies are needed to replicate our
results.

------------ --------- --------- --------- --------- --------- -
Accepted for publication 8 April 2009
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1464- 410X.2009. 08720


[Non-text portions of this message have been removed]

FULL TEXT: http://www.spnefro. pt/RPNH/PDFs/ n3_2009/artigo_ 008.pdf

Port J Nephrol Hypert 2009; 23(3): 261-265
Advance Access publication 25 March 2009

Tubulointerstitial nephritis associated with hepatitis C virus infection

Ana Oliveira, Raquel Cabral, Susana Sampaio, Manuela Bustorff, Manuel Pestana

Department of Nephrology, Hospital São João. Porto, Portugal

Received for publication: 11/12/2008
Accepted in revised form: 20/03/2009

ABSTRACT

Chronic hepatits C virus infection is frequently
associated with extrahepatic diseases that in most
cases appear to be directly related to the viral infection.
Renal disease is one of the most common extrahepatic
manifestations. The disorder is predominantly
glomerular and includes membranoproliferati ve
glomerulonephritis, with or without associated mixed
cryoglobulinaemia and membranous nephropathy.
We report a case of a patient with hepatitis C
virus infection, with multiple extrahepatic manifestations
including monoclonal gammopathy, lower
limbs vasculitis, Sjögren’s syndrome and tubulointerstitial
nephritis. In this case, we describe a rare
renal manifestation of hepatitis C virus infection:
tubulointerstitial nephritis.


[Non-text portions of this message have been removed]

Hepatology. 2009 Apr 1. [Epub ahead of print]

Increased rate of death related to presence of viremia among hepatitis C virus
antibody-positive subjects in a community-based cohort study.

Uto H, Stuver SO, Hayashi K, Kumagai K, Sasaki F, Kanmura S, Numata M, Moriuchi
A, Hasegawa S, Oketani M, Ido A, Kusumoto K, Hasuike S, Nagata K, Kohara M,
Tsubouchi H.

Department of Digestive and Life-style related Disease, Health Research Human
and Environmental Sciences, Kagoshima University Graduate School of Medical and
Dental Sciences, Kagoshima, Japan.

The overall mortality of patients infected with hepatitis C virus (HCV) has not
been fully elucidated. This study analyzed mortality in subjects positive for
antibody to HCV (anti-HCV) in a community-based, prospective cohort study
conducted in an HCV hyperendemic area of Japan. During a 10-year period
beginning in 1995, 1125 anti-HCV-seropositi ve residents of Town C were enrolled
into the study and were followed for mortality through 2005. Cause of death was
assessed by death certificates. Subjects with detectable HCV core antigen
(HCVcAg) or HCV RNA were considered as having hepatitis C viremia and were
classified as HCV carriers; subjects who were negative for both HCVcAg and HCV
RNA (i.e., viremia-negative) were considered as having had a prior HCV infection
and were classified as HCV noncarriers. Among the anti-HCV-positive subjects
included in the analysis, 758 (67.4%) were HCV carriers, and 367 were
noncarriers. A total of 231 deaths occurred in
  these subjects over a mean follow-up of 8.2 years: 176 deaths in the HCV
carrier group and 55 in the noncarrier group. The overall mortality rate was
higher in HCV carriers than in noncarriers, adjusted for age and sex (hazard
ratio, 1.53; 95% confidence interval, 1.13-2.07). Although liver-related deaths
occurred more frequently among the HCV carriers (hazard ratio, 5.94; 95%
confidence interval, 2.58-13.7), the rates of other causes of death did not
differ between HCV carriers and noncarriers. Among HCV carriers, a higher level
of HCVcAg (>/=100 pg/mL) and persistently elevated alanine aminotransferase
levels were important predictors of liver-related mortality. Conclusion: The
presence of viremia increases the rate of mortality, primarily due to
liver-related death, among anti-HCV-seropositi ve persons in Japan. (HEPATOLOGY
2009.).

PMID: 19585614 [PubMed - as supplied by publisher]


[Non-text portions of this message have been removed]

http://content. karger.com/ ProdukteDB/ produkte. asp?Aktion= ShowAbstract&
ArtikelNr= 225244&Ausgabe= 249235&ProduktNr =232833

Published: July 2009

Hepatocellular Carcinoma 11 and a Half Years after the Resolution of Chronic
Hepatitis C Virus Infection Successfully Treated with Interferon

Naoki Hotta, Minoru Ayada, Akihiko Okumura, Tetsuya Ishikawa, Ken Sato, Tomohiko
Oohashi, Yasutaka Hijikata, Shinichi Kakumu

Department of Internal Medicine, Division of Gastroenterology, Aichi Medical
University School of Medicine, Aichi, Japan

Case Rep Gastroenterol 2009;3:175-181 (DOI: 10.1159/000225244)

Abstract
A 41-year-old Japanese man had received successful interferon (IFN) therapy
against chronic hepatitis C in 1994. Since then, serum hepatitis C virus (HCV)
RNA had been negative, and aminotransferase levels had been continuously normal.
He had abstained from alcohol. However, his serum aminotransferase levels showed
slight elevation as his body weight increased gradually. He was diagnosed as
having fatty liver and diabetes mellitus. In January 2006, 11 and a half years
after the resolution of HCV infection, he was found to have a hepatic nodule 4.0
cm in diameter at liver S4/8 region by plain abdominal CT at an annual follow-up
examination. He was diagnosed as having hepatocellular carcinoma (HCC) by
angiography. The tumor was curatively resected and its histological diagnosis
was moderately differentiated HCC. Noncancerous lesion of the liver revealed
fibrosis of stage F2 and mild inflammation of grade A1 with mild steatosis. This
case suggests that all
  patients with chronic HCV infection should be followed as long as possible for
the potential development of HCC even after clearance of the virus.

Author Contacts
Dr. Naoki Hotta
Department of Internal Medicine, Division of Gastroenterology Aichi Medical
University School of Medicine, 21 Karimata Yazako, Nagakute-cho
Aichi 480-1195 (Japan)
Tel. +81 561 62 3311 ext. 2382, Fax +81 561 63 0796, E-Mail naokiki@aichi-
med-u.ac. jp


[Non-text portions of this message have been removed]

http://www.kpbs. org/news/ 2009/jul/ 06/hepatitis- c-epidemic- more-widespread-
hiv/

Hepatitis C: An Epidemic More Widespread than HIV
By Kenny Goldberg
Monday, July 6, 2009

There's a chronic liver disease that's ten times more infectious than HIV, and
more widespread. Hepatitis C is a virus that's spread through IV drug use, like
HIV. Left untreated, hepatitis C can cause life-threatening complications,
including liver cancer. In this first of a four-part series, KPBS Health
Reporter Kenny Goldberg takes a look at the epidemic of hepatitis C.
In 1997, Charlie Navarro began to feel tired and lethargic. He went to his
primary care doctor, who recommended a blood test.
Navarro was diagnosed with hepatitis C.
He thinks he became infected back in his college days, when he experimented with
shooting drugs.
"This was before we went to a concert, it wasn't in the back of an alley, or it
wasn't 50 or 60 times," Navarro remembers. "I was never addicted. All I tried
was once, or twice. And unfortunately, with the crowd I was with, we shared
needles."
Getting a transfusion or an organ transplant used to be major risk factors for
becoming infected with hepatitis C. But since 1992, all blood and blood products
in the U.S. have been screened for the virus.
"And that's why now, IV drug use is the main risk factor for contracting
hepatitis C," says Dr. Tarek Hassanein, liver specialist at UCSD. "And most of
the patients that we see now, are infected because of history of IV drug use,
even once or twice in their life", he says.
Hepatitis C is the most common blood-borne infection in the U.S. -- about four
million Americans have it. In San Diego County, more than 4,000 people are
infected.
The virus often doesn't cause symptoms, so it can linger undetected for years.
Hassanein says once a person becomes infected with hepatitis C, the virus
replicates and survives in the liver.
"The ongoing fight between the virus and the immune system leads to injury to
the liver," Hassanein points out. "We call it chronic injury because it’s
happening every day for 20, 30 years. The liver has the ability to regenerate.
But in the process of the fight, the liver needs to heal with scar tissue. That
scar tissue within 20, 30 years leads to what we call cirrhosis."
Once cirrhosis sets in, it's very difficult to reverse. That's why early
detection and treatment are crucial.
"So welcome to the hepatitis C instruction class. The purpose of this class
today is to educate you on what the disease is. We're gonna talk about how we
treat hepatitis C."
At UCSD Medical Center in Hillcrest, nurse practitioner Lisa Richards offers a
primer on the disease with a class of 12 patients.
All of them have the virus, and they're about to start up to 48 weeks of
treatment. The potential cure consists of taking two medications -- one by
mouth, and one that's self-injected.
The treatment causes painful, flu-like side effects. But about half of all
hepatitis C patients who complete treatment are cured. For those that aren't,
their liver slowly deteriorates. About one in five will need a liver transplant.
Nikki is among the unlucky ones. The Oceanside woman recently developed type 2
diabetes, because the hepatitis C also attacked her pancreas.
"I didn't know that I had hepatitis all these years, so I didn't know that I was
damaging another part of my body," Nikki says.
Nikki has been on a waiting list for a liver transplant for two-and-a-half
years.
Dr. Ajai Khanna is UCSD's director of abdominal transplantation. He says people
who need a new liver don't always get one in time.
"The number of patients waiting for liver transplantation with end stage liver
disease, they far outnumber the number of donors available," says Dr. Khanna.
"So, therein lies the problem. And that's why we lose patients on the waiting
list."
Khanna says even if someone does get a donated liver, the operation can cost
more than a quarter of a million dollars.
In contrast, there's a really cheap way to prevent the spread of hepatitis C.
We'll find about it in part 2 of this series.

[Non-text portions of this message have been removed]

http://www.nytimes. com/2009/ 07/07/health/ 07well.html? th&emc=th

Reasons Not to Panic Over a Painkiller

By TARA PARKER-POPE
Published: July 6, 2009

Few drugs are more ubiquitous than acetaminophen, the pain reliever found in
numerous over-the-counter cold remedies and the headache drug Tylenol.

But last week, a federal advisory committee raised concerns about liver damage
that can occur with overuse of acetaminophen, and the panel even recommended
that the Food and Drug Administration ban two popular prescription drugs,
Vicodin and Percocet, because they contain it.
The news left many consumers confused and alarmed. Could regular use of
acetaminophen for pain relief put them at risk for long-term liver damage?
To help resolve the confusion, here are some questions and answers about
acetaminophen.
What prompted the committee to look at acetaminophen in the first place?
Every year about 400 people die and 42,000 are hospitalized as a result of
acetaminophen poisoning. When used as directed, the drug is not hazardous. But
acetaminophen is now in so many products that it is relatively easy to take more
than the recommended daily limit, now four grams.
“People often don’t know what products acetaminophen is in,” said Dr.
Lewis S. Nelson, a medical toxicologist from New York University who was the
panel’s acting chairman. “It isn’t that hard to go above the four-gram
dose. If you took a couple acetaminophen for a headache until you got to the
maximum dose, and then maybe later you take Tylenol PM and some Nyquil for a
cold. And your back hurts, so you take Vicodin — by now you’ve probably
gotten to a seven-gram dose.”
What did the panel recommend?
Besides a ban on Percocet and Vicodin, it called on the F.D.A. to lower the
total recommended daily dose of acetaminophen from the current level of four
grams, which is about 12 tablets of regular strength Tylenol. The new maximum
dose is likely to be 2.6 to 3.25 grams, equal to 8 to 10 regular pills.
The panel also recommended that “extra strength” doses — equal to two
500-milligram pills — be switched to prescription only, and that the largest
dose available over the counter be limited to two 325-milligram pills. It also
recommended that infants’ and children’s doses be standardized to prevent
errors.
As a precaution, should consumers switch to other types of over-the-counter pain
relief?
Emphatically, no. Every drug has risks and side effects, but over all the risk
of acetaminophen to any individual is low. Far more people are harmed by regular
use of aspirin and ibuprofen, which belong to a class of medicines called
nonsteroidal anti-inflammatory drugs, or Nsaids. By most estimates, more than
100,000 Americans are hospitalized each year with complications associated with
Nsaids. And 15,000 to 20,000 die from ulcers and internal bleeding linked to
their use.
By comparison, there are only about 2,000 cases of acute liver failure, and
about half of them are related to drug toxicity. Of the drug-induced cases, 40
percent are due to acetaminophen, and half of those are a result of intentional
overdose.
“Nearly everybody on the panel recognizes that from a public-health
perspective, ibuprofen is much more concerning than acetaminophen,” Dr. Nelson
said.
For users of Percocet and Vicodin, the picture is cloudier. Hydrocodone, the
narcotic in Vicodin, is not available as a single drug. Oxycodone, the narcotic
in Percocet, will remain available. But these ingredients are tightly
controlled, and prescriptions may require extra time and paperwork.
If I’ve been using a drug like Vicodin, should I be worried about long-term
liver damage?
The risks associated with acetaminophen overdose are acute or immediate liver
failure, not chronic liver disease. Even if you’ve been taking Tylenol or
other drugs with acetaminophen for years, there is no reason to worry about
long-term liver damage as long as you are using them as directed. (By
comparison, regular use of Nsaids like aspirin and ibuprofen can lead to chronic
gastrointestinal problems over time.)
An overdose of acetaminophen does not typically produce immediate symptoms.
Instead, drug-induced hepatitis is likely to develop within a week, leading to
loss of appetite, nausea, vomiting, fever and abdominal pain. Dark urine and
jaundice (yellowing of the skin and eyes) suggest a more serious case. Usually
the liver will recover once the drug is stopped or with medical treatment, but
many patients in acute liver failure will die without a transplant.
About 15 percent of liver transplants result from drug poisoning. In one study,
40 percent of drug-related liver transplants were due to acetaminophen, 8
percent to tuberculosis drugs, 7 percent to epilepsy treatment and 6 percent to
antibiotics.
What’s the main lesson from the panel review of acetaminophen?
Because acetaminophen is in so many products, consumers need to be vigilant
about reading labels, and they need to keep track of how much of the drug they
are ingesting daily.
“It would be a real shame if people in reading these stories got the idea that
acetaminophen is not safe,” said Dr. Paul Watkins, director of the Institute
for Drug Safety Sciences at the Hamner Institutes and the University of North
Carolina. “It’s totally safe when taken as directed. The problem is that
people end up unknowingly taking much more than recommended.”


[Non-text portions of this message have been removed]

http://www.kdvr. com/news/ kdvr-rose- hepc-folo- 070309,0, 410319.story

Patients flood hospital amid hepatitis C scare
Heidi Hemmat KDVR Investigative Reporter
July 3, 2009

DENVER - No time for a holiday at Rose Medical Center. Instead, it's all hands
on deck as hospital officials try to get the word out to 4,700 patients who may
have been exposed to hepatitis C.
Calls flooded a hospital hotline as nurses tried to answer their questions,
other patients arrived at the hospital first thing Friday morning to get tested.
"I just want to make sure I'm negative first of all," said a woman who fears
exposure but didn't want to give her name.
"I saw on line that the hospital was aware that the surgical tech was positive
for hepatitis C when they hired her, so I don't understand why they weren't
testing her on a regular basis for narcotics, they do random drug testing at my
job, so I don't quite understand why they let that happen."
This woman is one of 4,700 people who had surgery at Rose between October 2008
and April 2009 and came into contact with surgical tech Kristen Parker. The
former Rose employee is accused of swapping her own contaminated needles for
syringes filled with a powerful narcotic.
Rose Medical Center doctors say people infected with Hepatitis C usually have no
symptoms at all. But left untreated it could cause serious liver damage.
Parker also worked at the "Audubon Surgical Center" in Colorado Springs. That
medical facility is setting up its own hotline for concerned patients.
Rose patients who could have been infected will receive a letter within the next
72 hours.

The hot-line number for Rose patients is 303-329-7500.


[Non-text portions of this message have been removed]

Fri Jul 3, 12:40 am ET
DENVER – A former surgery technician may have exposed thousands of Colorado
patients to hepatitis C when she swapped her own dirty syringes for ones filled
with a powerful narcotic, federal authorities said Thursday.
Kristen Diane Parker faces criminal charges for allegedly making the swaps while
working at Audubon Ambulatory Surgery Center in Colorado Springs and Rose
Medical Center in Denver.
Authorities say Parker admitted to changing out syringes containing a saline
solution with ones filled with the painkiller Fentanyl. Parker injected herself
with the drug, according to a complaint filed Thursday in U.S. District Court in
Denver.
An affidavit by Mary F. LaFrance, an investigator for the U.S. Food and Drug
Administration, says at least nine surgery patients at Rose have tested positive
for hepatitis C, which is incurable. About 6,000 patients are being advised they
may have been exposed and need to be tested.
Hepatitis C is a blood-borne disease that can cause serious liver problems,
including cirrhosis or liver cancer. The illness is treatable, but there is no
cure. Symptoms can include nausea, diarrhea, fatigue, pain and jaundice.
Rose Medical Center officials told a news conference Thursday night they were
working with the Colorado Department of Public Health and Environment to
determine whether Parker was the source of the virus.
It could not be determined Thursday night whether Parker had an attorney.
Parker worked at Rose from Oct. 21, 2008, until April. Hospital officials say
she was suspended April 13, before they learned of the cases, and then fired.
She had failed a drug test by testing positive for Fentanyl.
Parker went to work for the Audubon surgery center shortly after being fired.
She worked there from May 4 until Monday, Dr. J. Michael Hall, Audubon's medical
director, told The Gazette in Colorado Springs.
If convicted of tampering with a consumer product and other charges, she faces
up to 10 years in prison and a maximum $250,000 fine on the most serious charge
of tampering.
___
Information from: The Gazette, http://www.gazette.com
(This version CORRECTS UPDATES with hospital news conference, comment from
Colorado Springs doctor. corrects that charges were filed Thursday sted Friday.)

[Non-text portions of this message have been removed]

FULL TEXT: http://www.turkgast ro.org/text. php?id=711

The Turkish Journal of Gastroenterology
2009, Volume 20, No 2, Page(s) 104-107

Awareness of hepatitis C virus transmission routes among patients, their
household contacts and health care staff: Does perception match the reality?


Arzu T�FT�K��1, �zlen ATU�2, Nurdan T�Z�N1
Department of 1Gastroenterology, Ac�badem University, School of Medicine, and
Department of 2Gastroenterology, Marmara University, School of Medicine,
�stanbul

Summary
Background/aims: The worldwide seroprevalence of hepatitis C virus infection is
around 3%. Since there is no effective vaccine, a major effort should be given
to counselling both HCV-infected patients and those at risk of infection. Our
aim was to determine the awareness of the transmission routes of hepatitis C
virus in health care staff (HC staff), HCV-infected patients and their household
contacts. Methods: A reliable and valid self-report inquiry consisting of 14
questions was completed by 397 HC staff (75 first-year, 75 last-year medical
students, 89 dentists, 71 pharmacists, 87 nurses), 68 HCV-infected patients and
62 household contacts. All subjects were asked about the various modes of
transmission of hepatitis C virus. Results: Ninetyseven percent of the HC staff,
85% of hepatitis C virus patients and 90% of household contacts were aware of
the parenteral transmission of hepatitis C virus. Ninety percent of HC staff,
54% of hepatitis C virus
  patients and 66% of household contacts admitted the role of sexual
transmission, with significant difference between the subgroups of HC staff (p


[Non-text portions of this message have been removed]

http://www.thenews. com.pk/daily_ detail.asp? id=186029

High rate of prevalence of hepatitis in Pakistan is mainly because of less
effective awareness campaigns
Thursday, July 02, 2009
Muhammad Qasim

Rawalpindi
A total of 7.4 per cent Pakistanis population is infected with hepatitis of
which 2.6 per cent are infected with hepatitis B while 4.7 per cent with
hepatitis C. Estimated cost of universal treatment of 11.34 million patients of
hepatitis in Pakistan amounts to more than Rs250 billion.
The high rate of prevalence of hepatitis in Pakistan is mainly because of less
effective awareness campaigns run in the past and poor preventive measures
adopted by our population. It is more alarming keeping the fact in mind that
hepatitis is a curable disease and prevention from it is possible.
Professor of Medicine at Rawalpindi Medical College and President-elect Pakistan
Society of Hepatology Dr. Mohammad Umar expressed this while speaking at a
seminar on hepatitis held here in a local hotel Wednesday.
Mir Khalil-ur-Rahman Memorial Society (MKRMS) organised the seminar in
collaboration with Pakistan Society of Hepatology and Pakistan Society of
Gastroenterology, with main objective of creating awareness among public about
treatment and prevention of hepatitis. The seminar was fourth of a series
organised on the subject by MKRMS.
In the seminar, Dr. Umar, Professor Dr. Hamamatul Bushra Khar of RMC, General
(r) Tasawwar Hussain, Professor Tashfeen Alam of Pakistan Institute of Medical
Sciences and Professor Saleem Qureshi elaborated different aspects of hepatitis
A, E, B and C and their complications.
Dr. Umar said that hepatitis, a disease known to mankind since 500 BC, could be
divided into two groups, hepatitis A & E and hepatitis B & C. “Hepatitis A & E
are mainly caused by consumption of unhygienic food and unsafe drinking water
while spread of hepatitis B & C is nothing to do with foodstuff,” he said.
He added that the spread of hepatitis A & E could easily be checked by creating
awareness among public on consumption of clean drinking water and hygienic food.
“Use of cut fruits from open markets, locally prepared ‘sharbats’, milk
and milk products on sale in unhygienic conditions and foodstuff from vendors
should be avoided not only to prevent hepatitis A & E but also to prevent
gastroenteritis.”
He said that safe drinking water is a must to avoid hepatitis. “Boiling of
water for drinking every time costs much, so we should adopt scientific rather
simple methods to make water germs free. You should add 100 grams of bleaching
powder to one litre of water and boil it. After boiling, store the concentrate
(boiled one) in a clean jar, and each time, add only three spoonfuls of the
concentrate in 10 litres of water to make it purified. Three spoons of
concentrate make 10 litre of water safe to drink without any further boiling,”
he explained the way of purifying drinking water without boiling each time.
Talking on causes of spread of hepatitis B & C, he said use of used syringes,
unsafe sexual relations, unscreened blood transfusions, shaving with
contaminated razor, tattooing, contaminated instruments of ‘footpath
dentists’, unsafe intravenous infusions, wastes in hospitals’ wards and
improper blood sample collection are among major factors contributing to spread
of the disease. “I believe that by adopting simple preventive measures, we can
control the spread of the disease,” he said.
He said that his team has developed a website — www.rawalianresearc h.org —
for providing guidelines not only to patients but also to junior doctors who
should be much careful while advising medication to patients. “Culture of
unnecessary medication, use of injection and blood transfusion should be
eliminated.”
While speaking on the occasion, Dr. Bushra Khar supported Dr. Umar’s point of
view on prevention and control of hepatitis in Pakistan. “Prevention and
control on a disease having more than seven per cent occurrence among population
is responsibility of the state yet without creating awareness among public the
problem could not be eliminated.”
She said that in Pakistan, the contamination increased with increase in
population. “Without controlling population, the problem could not be resolved
as we have meagre resources available in Pakistan.” She added that prevention
from hepatitis B is 100 per cent possible through administration of hepatitis B
vaccine that costs not more than Rs600.
General (r) Tasawwar Hussain while speaking to audience, however, presented a
new concept saying that the occurrence of hepatitis B & C has increased with the
increase in number of healthcare facilities across Pakistan. “It convinced me
to believe that unnecessary or unsafe pricking at the healthcare facilities is
one of the major causes of spread of hepatitis in Pakistan and it should be
discouraged religiously by medical professionals.”
Studies reveal that Pakistan is at number two around the globe where population
has maximum number of unnecessary injections. After the lectures from experts,
questions and answers session was held.


[Non-text portions of this message have been removed]

Gastroenterol Clin Biol. 2009 Jun 19. [Epub ahead of print]
[Hepatitis C: The recovery.]

[Article in French]

Marcellin P.
Inserm U773 CRB3, service d'h�patologie, universit� de Paris-7, h�pital Beaujon,
100, boulevard du G�n�ral-Leclerc, 92110 Clichy, France.

After the discovery of the hepatitis B virus in 1968 and of the hepatitis A
virus in 1973, many years were needed to identify the hepatitis C virus (HCV) in
1989. The discovery of HCV was a revolution for hepatology because of the
magnitude of the global burden related to HCV infection, a major cause of
cirrhosis and hepatocellular carcinoma. Therapy of hepatitis C has rapidly
evolved with currently nearly 60% of sustained virological response with the
combination of pegylated interferon plus ribavirin. In patients with sustained
virological response, viral eradication, corresponding to the cure of infection,
and regression of histological liver lesions have been demonstrated. Recently,
the availability of in vitro culture systems allowed to characterize viral
enzymes, potential therapeutic targets. A novel therapeutic era is open with the
protease and polymerase inhibitors, used as a first step in association with
pegylated interferon and ribavirin,
  both to increase efficacy and decrease the risk of resistance. Thanks to these
new molecules with a potent antiviral activity, one can reasonnably predict a
rapid improvement of treatments becoming more efficient and also better
tolerated with the progressive replacement of interferon and ribavirin by
combinations of these virus specific enzyme inhibitors.
PMID: 19541439 [PubMed - as supplied by publisher]


[Non-text portions of this message have been removed]

Hepatology. 2009 May 6;50(1):34-45. [Epub ahead of print]

Human immunodeficiency virus and hepatitis C infections induce distinct
immunologic imprints in peripheral mononuclear cells.

Kottilil S, Yan MY, Reitano KN, Zhang X, Lempicki R, Roby G, Daucher M, Yang J,
Cortez KJ, Ghany M, Polis MA, Fauci AS.
Laboratory of Immunoregulation, National Institute of Allergy and Infectious
Diseases (NIAID), National Institutes of Health (NIH), Department of Health and
Human Services (DHHS), Bethesda, MD.


Coinfection with hepatitis C virus (HCV) is present in one-third of all human
immunodeficiency virus (HIV)-infected individuals in the United States and is
associated with rapid progression of liver fibrosis and poor response to
pegylated interferon (IFN) and ribavirin. In this study we examined gene
expression profiles in peripheral blood mononuclear cells (PBMCs) from different
groups of individuals who are monoinfected or coinfected with HIV and HCV. Data
showed that HIV and HCV viremia up-regulate genes associated with immune
activation and immunoregulatory pathways. HCV viremia is also associated with
abnormalities in all peripheral immune cells, suggesting a global effect of HCV
on the immune system. Interferon-alpha- induced genes were expressed at a higher
level in PBMCs from HIV-infected individuals. HCV and HIV infections leave
distinct profiles or gene expression of immune activation in PBMCs. HIV viremia
induces an immune activated state; by
  comparison, HCV infection induces immunoregulatory and proinflammatory pathways
that may contribute to progression of liver fibrosis. Conclusion: An aberrant
type-I IFN response seen exclusively in HIV-infected individuals could be
responsible for the poor therapeutic response experienced by HIV/HCV coinfected
individuals receiving interferon-alpha- based current standard of care.
(HEPATOLOGY 2009;50:34-45. ).
PMID: 19551908 [PubMed - as supplied by publisher]


[Non-text portions of this message have been removed]

http://www.thecalif ornian.com/ article/20090630 /NEWS01/90630030 4

Hepatitis C, chlamydia increase in Monterey County
Deputy health officer says new data collection partially led to rise in case of
liver disease
By Leslie Griffy • lgriffy@thecaliforn ian.com • June 30, 2009

Hepatitis C infections increased by 27 percent, and chlamydia cases jumped 18
percent in Monterey County last year, according to a report released Monday by
the Health Department.

In 2008, there were 989 reported cases of hepatitis C in the county, up from 777
in 2007.
The increase in the blood-borne virus that attacks the liver is partially
because of changes in the way it is reported, said Dr. Lisa Hernandez, deputy
health officer.
Now, when laboratories spot a positive case, they report it to health officials.
Before the 2008 change, epidemiologists relied on doctors to report the disease.
Health officials have long strived for a better accounting of the virus. The
Centers for Disease Control and Prevention estimates there were 17,000 new
infections in 2007, but only 849 cases of people sickened by the virus were
confirmed that year.
"We are starting to see the true burden of the disease," Hernandez said.
The hepatitis C virus causes cirrhosis and liver cancer. It's spread through
blood, including needle sharing. Often, infected people aren't symptomatic and
don't know they have the disease. But they can give it to others.
Hepatitis C today reminds Jim Smith, director of education and prevention at
John XXIII AIDS Ministries, of AIDS in the 1980s.
"There's not enough education. There's not enough hepatitis C testing. There's
not enough treatment," Smith said. "That's where hep. C is today."
Working with the county, the ministries will begin offering hepatitis screening
to high-risk groups this summer, he said. Even though some of those tested may
not have access to medical care, Smith believes the testing can slow the virus'
spread.
"The knowledge that they are positive could stop them from sharing syringes," he
said.


[Non-text portions of this message have been removed]

http://www.informap harmascience. com/doi/abs/ 10.1517/14656560 903066811



Summary
Expert Opinion on Pharmacotherapy
Posted online on 30 Jun 2009.

Antiviral therapy in compensated and decompensated cirrhotic patients with
chronic HCV infection

Angelo Iacobellis�† MD & Angelo Andriulli�
‘Casa Sollievo Sofferenza’ Hospital, Division of Gastroenterology, IRCCS,
viale Cappuccini 1, 71013 San Giovanni Rotondo, Italy +39 08 8241 0263; +39 08
8283 5411; a.andriulli@ operapadrepio. it
†Author for correspondence


Liver cirrhosis secondary to HCV infection is a chronic disorder that carries
high morbidity and mortality. Approved antiviral treatment for this condition at
present includes peginterferon in combination with ribavirin. Treatment is only
recommended for a well-compensated liver cirrhosis, whereas antiviral therapy is
commonly not implemented in cirrhotics with signs of liver decompensation, over
the concern that the use of peginterferon and ribavirin might expose patients to
severe treatment-related side effects. This review focuses on data available to
support both efficacy and safety of antiviral therapy in both compensated and
decompensated cirrhotic patients.


[Non-text portions of this message have been removed]

Hello I think I posted this article a couple of days ago and if so
sorry............our newest webpages are on Yahoo and the address is:
www.todayilive.org   so if you wish go there and send me your take on it to
this address: hepbegone@...  and if you write poetry or do art mail it to
me and we shall post it there.  Also wanted are good liver health recipees as
eating is so important to organs recovery.  If you have gone through treatment
once or more you really need to build back up the old body and eating is the
best way I can think of really.  We are asking if you wish to become involved
with our group so if so let us know ok?  thanks a mint 
tara




Over 600 Volunteer for Hepatitis C Test
Asma Ali Zain

28 June 2009
  Print E-mail DUBAI - Over 600 people have volunteered for blood tests to
assess if they have Hepatitis C as part of a UAE-wide campaign launched last
month.
The C WATCHER campaign will ascertain the risk factors through tests. Only test
results of those who volunteer will be revealed.
“There are three tests done to confirm if a person is suffering from Hepatitis
C,” said Sherief Rizk, business unit director at Hoffmann-La Roche, UAE.
The two final tests require a time gap between the tests, said Rizk.
The company is running the campaign in coordination with the Emirates
Gastroenterology Society in the UAE. The Hepatitis C virus is transmitted
primarily through blood or blood products. HCV chronically affects 180 million
people worldwide, which makes it over four times more prevalent than HIV,
according to the WHO.
It is a leading cause of cirrhosis, liver cancer and liver failure, despite the
fact that many patients can be cured.
Hepatitis C is an infectious disease transmitted through infected blood.
It damages the liver over a period of time and in some cases many of the
infected persons may not be aware of the fact they are carriers until permanent
damage has been done.
However, the UAE Ministry of Health has put on hold the decision to make the
disease deportable by law despite recently changing its medical testing
procedures for issuing work/residency permits. People can get tested for free at
partner laboratories and assess whether they fall within the disease’s risk
factors.
“Those who test positive for the disease will be given supported treatment,”
added Rizk.
About 180 million people worldwide are infected with Hepatitis C and is a
potentially serious condition if left untreated and can kill over a course of

20 years.
The campaign will run for a year and awareness activities will include booklet
distributions in medical institutions and main public areas. Queries can be made
on the toll-free number 8004038, the healthcare professional’s CME programmes
and the fund raising activities.
asmaalizain@ khaleejtimes. com
Are you at risk?
υDid you receive blood transfusion before 1992?
υ Have you ever received haemodialysis?
υ Do you have tattoos or body piercing done on you?
υ Have you shared items that might have had blood on them, such as razors, nail
clippers, scissors, toothbrush?
υ Is your sex partner or any other household member Hepatitis C positive?
υ Have you ever had any sexually transmitted diseases?
υ Have you had any contact with blood at your workplace, especially if you are
(or were) a healthcare worker, police officer or firefighter?
υDid your mother have Hepatitis C when you were born?

[Non-text portions of this message have been removed]

Decline in Male Sexual Desire, Function, and Satisfaction During and
Posted by: "Sheree Martin" shereemartin@... � mamablondie
Wed Jun�24,�2009 5:17�am (PDT)



Gastroenterology. 2009 Jun 12. [Epub ahead of print]

During and After Antiviral Therapy for Chronic Hepatitis C.

Dove LM, Rosen RC, Ramcharran D, Wahed AS, Belle SH, Brown RS, Hoofnagle JH;
Virahep-C Study Group.
Department of Internal Medicine, Division of Gastroenterology and Hepatology:
New York Presbyterian Medical Center, New York, NY.

BACKGROUND:: The recommended therapy for chronic hepatitis C, peginterferon and
ribavirin for 24 or 48 weeks, has many known adverse side-effects. AIMS:: To
evaluate the impact of antiviral therapy on male sexual health. METHODS:: As
part of the Study of Viral Resistance to Antiviral Therapy of Chronic Hepatitis
C (Virahep-C), 260 men treated with peginterferon alfa-2a and ribavirin
completed self-administered questionnaires concerning sexual desire, sexual
function, including erectile and ejaculatory function, and sexual satisfaction
before, during, and after treatment. RESULTS:: Before therapy, 37% of men
reported at least some degree of impairment in sexual desire, 44% reported
dissatisfaction with their sexual life, while 22% reported impairment in
erectile and 26% in ejaculatory function. During therapy, significant declines
were observed in all components of sexual health compared to pre-treatment. At
the end of therapy (24 or 48 weeks), an
  estimated 38% to 48% of men reported that overall sexual function was worse
than before treatment. African Americans reported less impairment in sexual
desire and satisfaction than Caucasians Americans during therapy. By 24 weeks
after treatment, sexual desire, and satisfaction improved and were comparable to
baseline levels. However, among men who received 48 weeks of therapy, the
estimated percentage of men reporting post-treatment erectile or ejaculatory
problems remained higher than baseline, though persistent erectile impairment
was limited to Caucasian Americans. CONCLUSIONS: : Sexual impairment is common
among men with chronic hepatitis C undergoing therapy with peginterferon and
ribavirin and should be considered as a potential side-effect of antiviral
therapy.

PMID: 19527724 [PubMed - as supplied by publisher]


[Non-text portions of this message have been removed]

http://www.newsinfe rno.com/archives /6968

VA Blasted at Hearing on Contamination Scandal
Date Published: Wednesday, June 17th, 2009


At yesterday’s hearing before a House Veterans Affairs (VA) committee, the VA
was roundly criticized for not increasing safeguards and improving procedures at
VA health facilities after shoddy colonoscopies and endoscopies were potentially
linked to the spread of dangerous, deadly pathogens.
Officials with the VA offered apologies and promised to make changes, and House
Veterans Affairs Committee Chairman Bob Filner (Democrat-Californi a), said that
VA Secretary Eric Shinseki would take disciplinary action, reported the AP.
Regardless, the fact remains that despite a nationwide scare, media attention,
and suspected links to HIV, hepatitis B, and hepatitis C, less than half of all
VA facilities were operating under appropriate procedures based on surprise
investigations spurred by the scandal, which broke months earlier, noted the
Associated Press (AP).
According to the VA, six veterans have tested positive for HIV, the virus that
causes AIDS; 34 have tested positive for hepatitis C, and 13 have tested
positive for hepatitis B, said the AP.
The surprise inspections were conducted last month reported the AP yesterday,
adding that less than half of the facilities were found to have had proper
training and guidelines in effect for endoscopic procedures, which include
colonoscopies; of serious concern, given that inspections were conducted after
the mistakes were made public and it was widely reported that the VA might be
responsible for the transmission of the deadly pathogens.
HIV and hepatitis B and C are spread by contact with infected body fluids,
especially blood. HIV—the human immunodeficiency virus—is the virus that
causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV
infection. Hepatitis B and C are liver diseases that can lead to cirrhosis or
cancer of the liver. Vaccines exist only for hepatitis B. HIV/AIDS and hepatitis
B and C can all be fatal.
The VA has admitted to the mistakes, which, it said, were caused by human error,
reported the AP, but says that it is unable to prove if the infections are
directly linked to VA procedures. The VA did warn nearly 11,000 veterans who
received care at three of its hospitals to undergo blood testing. Many believe
dirty equipment is to blame and, last month, the AP reported that other VA
patients were not warned about similar mistakes with the same equipment at more
than 12 other VA centers.
The shoddy tests were conducted as far back as five years ago and put VA
patients at risk because they were treated with equipment that was not
appropriately sterilized, thus exposing them to the bodily fluids of other
patients, noted the AP in a prior report. The VA acknowledged in its warnings
letters that the invasive procedures potentially exposed them to other
patients’ bodily fluids. Also, the VA admitted in late March that water tubes
and reservoirs it used in colonoscopies and endoscopies were rinsed—not
disinfected—between procedures, which could expose subsequent patients to
contamination.
VA assistant inspector general and review lead, John Daigh, said the findings
“troubled me greatly …. We think there are systemic issues,” quoted the
AP. “You certainly would think that after the initial discoveries and the
directive from the VA that medical directors would make sure that all of their
equipment and procedures were brought into line and yet this investigation shows
that many, many did not …There will be a public accounting of this
situation,” the AP quoted.


[Non-text portions of this message have been removed]

http://www.scienced aily.com/ releases/ 2009/06/09061610 3209.htm

Good News For Some Hard-to-treat Hepatitis C Patients

ScienceDaily (June 24, 2009) — In a multi-center trial led by a Saint Louis
University researcher, investigators found that a new combination therapy of
daily consensus interferon and ribavirin helps some hepatitis C patients who
have not responded to previous treatment. The findings, published in the June
issue of Hepatology, offer a new option for hepatitis C patients, and may be
effective even for those patients with factors that make their condition
difficult to treat.

"This represents an important advance for difficult to treat hepatitis C
patients who have failed to respond to traditional therapy," said Bruce Bacon,
M.D., director of the division of gastroenterology and hepatology at Saint Louis
University School of Medicine and co-director of the Saint Louis University
Liver Center .
About 4 million people in the U.S. have been infected with hepatitis C; an
estimated 10,000 to 12,000 people die from complications each year in this
country. Hepatitis C is caused by a virus, transmitted by contact with blood,
and may initially be asymptomatic. For patients who develop chronic hepatitis C
infection, inflammation of the liver may develop, leading to fibrosis and
cirrhosis (scarring of the liver), as well as other complications including
liver cancer and death.
For patients with chronic hepatitis C, the prognosis varies. About half fully
recover after an initial course of pegylated interferon and ribavirin anti-viral
therapy that may last from six months to a year.
The remaining patients, known as non-responders, may improve but the virus is
not eliminated. These patients are at greatest risk for worsening, and
subsequent treatments have shown limited effectiveness for this group. In
addition, those with genotype 1 (a particular genetic variation of the virus),
those with high baseline virus levels, those with advanced liver disease and
African American patients are all less likely to respond well to treatment.
The study looked at 515 patients at 44 different sites. Patients were given
either one of two doses of daily consensus interferon and ribavirin, or no
treatment.
For patients with less severe liver damage who had shown some response to
initial treatment, the success rate was above 30 percent. The overall results
showed that, for patients who had been unresponsive to initial treatment,
consensus interferon and ribavirin worked for about 7 percent of patients given
the lower dose and about 11 percent of patients given the higher dose of
consensus interferon and ribavirin.
"This study shows that select patients who have failed to respond to prior
therapy are candidates for retreatment with consensus interferon and ribavirin,"
Bacon said.
The study was funded by Valeant Pharmaceuticals and 3 Rivers Pharmaceuticals.

------------ --------- --------- --------- --------- --------- -
Journal reference:
. Daily-Dose Consensus Interferon and Ribavirin: Efficacy of Combined Therapy
(DIRECT). Hepatology, June 2009


[Non-text portions of this message have been removed]

Over 600 Volunteer for Hepatitis C Test
Asma Ali Zain

28 June 2009
  Print  E-mail  DUBAI - Over 600 people have volunteered for blood tests to
assess if they have Hepatitis C as part of a UAE-wide campaign launched last
month.
The C WATCHER campaign will ascertain the risk factors through tests. Only test
results of those who volunteer will be revealed.
“There are three tests done to confirm if a person is suffering from Hepatitis
C,” said Sherief Rizk, business unit director at Hoffmann-La Roche, UAE.
The two final tests require a time gap between the tests, said Rizk.
The company is running the campaign in coordination with the Emirates
Gastroenterology Society in the UAE. The Hepatitis C virus is transmitted
primarily through blood or blood products. HCV chronically affects 180 million
people worldwide, which makes it over four times more prevalent than HIV,
according to the WHO.
It is a leading cause of cirrhosis, liver cancer and liver failure, despite the
fact that many patients can be cured.
Hepatitis C is an infectious disease transmitted through infected blood.
It damages the liver over a period of time and in some cases many of the
infected persons may not be aware of the fact they are carriers until permanent
damage has been done.
However, the UAE Ministry of Health has put on hold the decision to make the
disease deportable by law despite recently changing its medical testing
procedures for issuing work/residency permits. People can get tested for free at
partner laboratories and assess whether they fall within the disease’s risk
factors.
“Those who test positive for the disease will be given supported treatment,”
added Rizk.
About 180 million people worldwide are infected with Hepatitis C and is a
potentially serious condition if left untreated and can kill over a course of

20 years.
The campaign will run for a year and awareness activities will include booklet
distributions in medical institutions and main public areas. Queries can be made
on the toll-free number 8004038, the healthcare professional’s CME programmes
and the fund raising activities.
asmaalizain@...
Are you at risk?
υDid you receive blood transfusion before 1992?
υ Have you ever received haemodialysis?
υ Do you have tattoos or body piercing done on you?
υ Have you shared items that might have had blood on them, such as razors, nail
clippers, scissors, toothbrush?
υ Is your sex partner or any other household member Hepatitis C positive?
υ Have you ever had any sexually transmitted diseases?
υ Have you had any contact with blood at your workplace, especially if you are
(or were) a healthcare worker, police officer or firefighter?
υDid your mother have Hepatitis C when you were born?

[Non-text portions of this message have been removed]

http://www.scienced irect.com/ science?_ ob=ArticleURL& _udi=B75JW- 4WCWF88-B&
_user=10& _coverDate= 02%2F28%2F2009& _rdoc=10& _fmt=high& _orig=browse&
_srch=doc- info(%23toc%2313161% 232009%239996499 98%231143079% 23FLA%23display%
23Volume) &_cdi=13161& _sort=d&_ docanchor= &_ct=15&_ acct=C000050221& _version=
1&_urlVersion= 0&_userid= 10&md5=2e2166ff4 b7dafe2c52e73bf7 3fda57b

Rheumatic Disease Clinics of North America
Volume 35, Issue 1, February 2009, Pages 111-123
Infections and Rheumatic Diseases

Hepatitis C–Associated Rheumatic Disorders

Dan Buskila MDa,
aDivision of Internal Medicine, Department of Medicine H, Soroka Medical Center,
Faculty of Health Sciences, Ben Gurion University, Beer Sheva, P.O.B 151, Israel
84101

Available online 27 May 2009.

Hepatitis C virus (HCV) is an important causative agent of liver diseases.
However, HCV infection is also associated with numerous hematologic, renal,
dermatologic, rheumatic, and autoimmune disorders. These include arthralgia,
arthritis, vasculitis, sicca syndrome, myalgia, and fibromyalgia. The purpose of
this article is to review the prevalence and spectrum of rheumatic disorders and
autoimmune phenomena in HCV-infected patients. It evaluates and current
treatment options including nonsteroidal anti-inflammatory drugs, low-dose
corticosteroids, hydroxychloroquine, methotrexate, penicillamine, combined
antiviral therapy, cyclosporin A, anti–TNF-a agents, and rituximab. It
concludes that larger, controlled studies are needed to establish further the
treatment indications, efficacy, and safety of these agents.


[Non-text portions of this message have been removed]

http://www.springer link.com/ content/mu333k75 0070163l/

Journal Digestive Diseases and Sciences
Publisher Springer Netherlands
ISSN 0163-2116 (Print) 1573-2568 (Online)
Category Original Article
DOI 10.1007/s10620- 009-0833- 1
Subject Collection Medicine
SpringerLink Date Wednesday, June 10, 2009

Original Article
Increased Oxidative Stress, Decreased Total Antioxidant Capacity, and Iron
Overload in Untreated Patients with Chronic Hepatitis C

Danielle Venturini1, Andr閍 Name Colado Sim鉶1, D閏io Sabbatini Barbosa1,
Edson Lopes Lavado2, Victor Emanuel Soares Narciso3, Isaias Dichi3 and Jane
Bandeira Dichi3
(1) Department of Pathology, Clinical Analysis and Toxicology, University of
Londrina, Londrina, Paran�, Brazil
(2) Department of Physiotherapy, University of Londrina, Londrina, Paran�,
Brazil
(3) Department of Internal Medicine, University of Londrina, Avenida Robert Koch
no. 60 Bairro Cervejaria, Londrina, Paran�, Brazil

Received: 7 October 2008 Accepted: 30 April 2009 Published online: 10 June 2009


Abstract
The aim of this study was to determine oxidative stress in patients with
untreated chronic hepatitis C (CHC), relating the obtained results with iron
status and disease activity markers. Two groups (CHC patients and controls) were
studied. CHC patients presented significantly higher values than the control
group in some parameters: ALT, AST, GGT, iron, ferritin, and transferrin
saturation, and also in tert-butyl hydroperoxide initiate chemiluminescence and
thiobarbituric acid-reactive substances (TBARS) as well as lower values in total
radical-trapping antioxidant parameter (TRAP). TBARS showed a significant
correlation with serum AST and with transferrin saturation, whereas TRAP
correlated inversely with serum albumin. Serum ferritin correlated with ALT and
GGT, whereas serum iron did so with GGT. In conclusion, lower antioxidant
capacity, higher levels of pro-oxidants activity, and iron overload occur in
untreated patients with CHC. This greater
  oxidative activity could play an important role in pathogenesis and evolution
of hepatitis C and thus further investigations.


[Non-text portions of this message have been removed]

http://www.eurekale rt.org/pub_ releases/ 2009-06/slu- gnf061509. php

Public release date: 16-Jun-2009
Contact: Carrie Bebermeyer
bebermcl@slu. edu
314-398-5279
Saint Louis University

Good news for some hard-to-treat hepatitis C patients

SLU researcher tests new treatment for virus
ST. LOUIS – In a multi-center trial led by a Saint Louis University
researcher, investigators found that a new combination therapy of daily
consensus interferon and ribavirin helps some hepatitis C patients who have not
responded to previous treatment. The findings, published in the June issue of
Hepatology, offer a new option for hepatitis C patients, and may be effective
even for those patients with factors that make their condition difficult to
treat.
"This represents an important advance for difficult to treat hepatitis C
patients who have failed to respond to traditional therapy," said Bruce Bacon,
M.D., director of the division of gastroenterology and hepatology at Saint Louis
University School of Medicine and co-director of the Saint Louis University
Liver Center .
About 4 million people in the U.S. have been infected with hepatitis C; an
estimated 10,000 to 12,000 people die from complications each year in this
country. Hepatitis C is caused by a virus, transmitted by contact with blood,
and may initially be asymptomatic. For patients who develop chronic hepatitis C
infection, inflammation of the liver may develop, leading to fibrosis and
cirrhosis (scarring of the liver), as well as other complications including
liver cancer and death.
For patients with chronic hepatitis C, the prognosis varies. About half fully
recover after an initial course of pegylated interferon and ribavirin anti-viral
therapy that may last from six months to a year.
The remaining patients, known as non-responders, may improve but the virus is
not eliminated. These patients are at greatest risk for worsening, and
subsequent treatments have shown limited effectiveness for this group. In
addition, those with genotype 1 (a particular genetic variation of the virus),
those with high baseline virus levels, those with advanced liver disease and
African American patients are all less likely to respond well to treatment.
The study looked at 515 patients at 44 different sites. Patients were given
either one of two doses of daily consensus interferon and ribavirin, or no
treatment.
For patients with less severe liver damage who had shown some response to
initial treatment, the success rate was above 30 percent. The overall results
showed that, for patients who had been unresponsive to initial treatment,
consensus interferon and ribavirin worked for about 7 percent of patients given
the lower dose and about 11 percent of patients given the higher dose of
consensus interferon and ribavirin.
"This study shows that select patients who have failed to respond to prior
therapy are candidates for retreatment with consensus interferon and ribavirin,"
Bacon said.

###
The study, Daily-Dose Consensus Interferon and Ribavirin: Efficacy of Combined
Therapy (DIRECT) was funded by Valeant Pharmaceuticals and 3 Rivers
Pharmaceuticals.
Established in 1836, Saint Louis University School of Medicine has the
distinction of awarding the first medical degree west of the Mississippi River.
The school educates physicians and biomedical scientists, conducts medical
research, and provides health care on a local, national and international level.
Research at the school seeks new cures and treatments in five key areas: cancer,
liver disease, heart/lung disease, aging and brain disease, and infectious
disease.


[Non-text portions of this message have been removed]

http://www3. interscience. wiley.com/ journal/12231044 3/abstract? CRETRY=1&
SRETRY=0

Alimentary Pharmacology & Therapeutics
Volume 30 Issue 1, Pages 37 - 47
Published Online: 8 Apr 2009
2006 The Authors Journal compilation 2006 Blackwell Publishing Ltd

Meta-analysis: surveillance with ultrasound for early-stage hepatocellular
carcinoma in patients with cirrhosis

A. SINGAL*, M. L. VOLK*, A. WALJEE*, R. SALGIA*, P. HIGGINS*, M. A. M. ROGERS†
& J. A. MARRERO*
*Division of Gastroenterology and †Division of General Medicine, Department of
Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Correspondence to Dr J. A. Marrero, Division of Gastroenterology, Department of
Internal Medicine, University of Michigan, 3912 Taubman Center, SPC 5362, Ann
Arbor, MI 48109, USA.
E-mail: jmarrero@umich. edu
Copyright Journal compilation © 2009 Blackwell Publishing Ltd

ABSTRACT
Background A majority of studies investigating the accuracy of ultrasound for
detecting hepatocellular carcinoma (HCC) do not reflect how this test is used
for surveillance vs. diagnosis.

Aim To determine the performance characteristics of surveillance with ultrasound
for the detection of HCC, particularly early HCC as defined by the Milan
criteria.

Methods A systematic literature review using the

MEDLINE and SCOPUS databases yielded six studies that evaluated the accuracy of
ultrasound for HCC at any stage and 13 studies that were specific to early HCC.

Results Surveillance ultrasound detected the majority of tumours before they
presented clinically, with a pooled sensitivity of 94%. However, ultrasound was
less effective for detecting early HCC with a sensitivity of 63%.
Alpha-fetoprotein provided no additional benefit to ultrasound. Meta-regression
analysis demonstrated a significantly higher sensitivity for early HCC with
ultrasound every 6 months than with annual surveillance. Current studies have
limitations such as verification bias and are of suboptimal quality.

Conclusions Surveillance with ultrasound demonstrates limited sensitivity for
early HCC, although this may be improved by testing at 6-month intervals.
Currently available evidence evaluating surveillance ultrasound has significant
limitations and future studies are necessary to determine optimal surveillance
methods for early HCC.

------------ --------- --------- --------- --------- --------- -
Publication data Submitted 8 January 2009 First decision 30 January 2009
Resubmitted 16 February 2009 Resubmitted 1 April 2009 Accepted 2 April 2009 Epub
Accepted Article 8 April 2009
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365- 2036.2009. 04014


[Non-text portions of this message have been removed]

Am J Gastroenterol. 2009 Jun 9. [Epub ahead of print]

Peginterferon Plus Ribavirin for Chronic Hepatitis C in Patients With Human
Immunodeficiency Virus.

Gluud LL, Marchesini E, Iorio A.
[1] Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical
Intervention Research,

Rigshospitalet, Copenhagen, Denmark [2] Department of Internal Medicine,
Gentofte University Hospital, Hellerup, Denmark.

OBJECTIVES:The aim of this study was to assess the effects of peginterferon plus
ribavirin for chronic hepatitis C in patients with human immunodeficiency virus
(HIV).

METHODS:Trials were identified through manual and electronic searches.
Randomized trials comparing peginterferon plus ribavirin with other antiviral
treatments for patients with chronic hepatitis C and HIV were included. The
primary outcome measure was virological response at the end of treatment and
after>/=6 months (sustained). Intention-to- treat meta-analyses including data
on all patients who were randomized were carried out.

RESULTS:Seven randomized trials were eligible for inclusion. The patients
included had chronic hepatitis C and stable HIV and were not previously treated
with interferon or ribavirin (treatment naive). The mean dosages were 180 or 1.5
mug/kg once weekly for peginterferon and 800 mg daily for ribavirin. The
treatment duration ranged from 24 to 48 weeks. Peginterferon plus ribavirin
increased the proportion of patients with an end-of-treatment or sustained
virological response compared with interferon plus ribavirin or peginterferon
alone. In subgroup analyses of trials comparing peginterferon plus ribavirin
with interferon plus ribavirin, the proportion with a sustained virological
response was 26% (109 of 423) for patients with genotype 1 or 4 and 57% (130 of
230) for genotype 2 or 3. Several adverse events occurred, including fatal
lactic acidosis and liver failure, but there were no significant differences in
mortality rates between treatment groups.

CONCLUSIONS: Peginterferon plus ribavirin may be considered for treatment-naive
patients with HIV and chronic hepatitis C. Adverse events should be monitored
carefully.

Am J Gastroenterol advance online publication, 9 June 2009; doi:10.1038/
ajg.2009. 311.

PMID: 19513022 [PubMed - as supplied by publisher]


[Non-text portions of this message have been removed]

CDC 06-19-09

CANADA: "Whyte Avenue Tattoo Shop Closed over Health Concerns"
Edmonton Sun (06.18.09):: Sun Media
Alberta Health Services has shuttered an Edmonton tattoo parlor and is advising
its recent customers to be tested for blood-borne diseases. Zipp's Tattoo &
Museum, 10028 Whyte (82) Ave., was closed by authorities on June 5. Infractions
cited on the closure order include: instruments used on clients were not in
clean or sterile condition; inadequate antiseptic treatment prior to procedures;
and the operator reported he had recently been tattooing animals in the
business. "The lack of standard sterilization practices of reusable instruments
and safety precautions can cause a risk for disease transmission of hepatitis B,
hepatitis C, and HIV," health authorities said. "Anyone who has had any body art
or piercing done at Zipp's Tattoo & Museum since January 2009 is asked to call
780-413-4977 for further advice." Outside the local calling area, telephone
866-408-5465.

[Non-text portions of this message have been removed]

http://www.theleafc hronicle. com/article/ 20090613/ NEWS01/90613002/ Veterans+
split+about+ VA+medical+ care

Veterans split about VA medical care

By ANN WALLACE • The Leaf-Chronicle • June 13, 2009

Congressional hearings this week will investigate how veterans undergoing
certain surgical procedures were exposed to HIV and hepatitis contamination at
three veterans hospitals in Florida, Georgia and Tennessee.

Response from local veterans is a mixed bag - some are satisfied with their
medical care at veterans hospitals and others are not.

Veterans Dale Hatfield and John Stevenson continue to have the utmost confidence
in the quality of medial care provided at veteran’s hospitals.

Gery Ezell relies on VA hospitals for diagnostic testing, but prefers civilian
medial care for any needed surgery.

And Carl Hoy calls almost 15 years of VA medial care “pitiful.”

Several Montgomery County veterans receive their primary medical care through VA
hospitals in Nashville and Murfreesboro.

The Alvin C. York Veterans Hospital in Murfreesboro has been linked to
situations where cross-contamination occurred for some veterans receiving
endoscopic and colonoscopy procedures.

Letters from the VA were recently mailed to thousands of veterans asking them to
be tested for possible HIV or hepatitis.

The Veterans Administration issued a June 1 report
indicating 25 veterans have tested positive for hepatitis at Murfreesboro with
one for HIV.

Subsequent testing at the Miami hospital reflects 11 have tested positive for
hepatitis with three for HIV. And the Augusta, Ga. veterans hospital has
recorded nine positive cases for hepatitis and two for HIV.

For more about this story - read tomorrow's edition of The Leaf-Chronicle.


Next Pageundefined
Previous PageAnn Wallace cover education and religion. She can be reached at
245-0287 or by e-mail at annwallace@theleafc hronicle. com


[Non-text portions of this message have been removed]

http://news. brisbanetimes. com.au/breaking- news-national/ kids-with-
hepatitis- go-without- treatment- 20090614- c73m.html

Kids with hepatitis go without treatment

Danny Rose
June 14, 2009

Many Australian children with hepatitis are going without the medicines they
need because of a "head in the sand" approach by health authorities, new
research has found.
The NSW-based study found only six per cent of kids with hepatitis were referred
to a specialist clinic after state health authorities were notified of their
cases.
Dr Edward O'Loughlin, of The Children's Hospital at Westmead, reviewed the cases
of 1,700 children notified to NSW Health as having hepatitis C or hepatitis B.
He found fewer than 110 of the children had been referred on to a specialist
clinic for treatment, and none of those with hepatitis C were put on necessary
anti-viral drugs.
"A majority of these kids aren't receiving appropriate treatment," Dr O'Loughlin
said.
"And we rang our colleagues and spoke to them in the different states... It's
very similar all around Australia."
Dr O'Loughlin's study took in all children with hepatitis who were notified to
NSW Health from 2000 to 2007. Many more children would be living with the
condition across the country, he says.
Despite this, he says, hepatitis-related health programs and clinics often made
no provision for children.
The drugs approved to treat hepatitis C are not listed for use by patients under
18 on the Pharmaceutical Benefits Scheme.
Young people with hepatitis infections in Australia are often the children of
migrants or injecting drug users.
Dr O'Loughlin says he knows of only one Melbourne hospital treating hepatitis C
children on a "compassionate" basis.
If the condition goes untreated, hepatitis infections can cause death or serious
illness through liver fibrosis, cirrhosis and liver cancer.
"Because (health authorities) are burying their head in the sand over this, we
really have no idea what's going on out there in the community," Dr O'Loughlin
says.
"We think what we're seeing is just the tip of the iceberg."
Dr O'Loughlin is calling for the establishment of a coordinated healthcare
service for children with chronic hepatitis in Australia.
His research is published in the Medical Journal of Australia.


[Non-text portions of this message have been removed]

Cannabis Science: Can Cannabis-Based Drugs Slow The H1N1 "Swine Flu" Pandemic?14
Jun 2009���

The World Health Organization declared a swine flu pandemic Thursday, raising
its pandemic warning from phase 5 to 6, making swine flu the first global flu
epidemic in 41 years. Now that H1N1 "Swine Flu" has been elevated to pandemic
status, with reports of outbreaks in Asia, the Middle East and Europe, San
Francisco, USA-based Cannabis Science Inc. (OTCBB: CBIS) CEO Steven Kubby urges
public health officials around the world to "take medical cannabis seriously."

According to the company, which specializes in cannabis research and development
for medical purposes, the world may have at its disposal a means of combating
the affects of this deadly disease. Dr. Robert J. Melamede, Director and Chief
Science Officer for CSI reports, "Research into use of whole cannabis extracts
and multi-cannabinoid compounds has provided the scientific rationale for
medical marijuana's efficacy in treating some of the most troubling diseases
mankind now faces, including infectious diseases such as the flu and HIV,
autoimmune diseases such as ALS (Lou Gehrig's Disease), multiple sclerosis,
arthritis, and diabetes, neurological conditions such as Alzheimer's, stroke and
brain injury, as well as numerous forms of cancer."

Dr. Melamede went on to say, "The high lethality of some strains of flu can be
attributed to the excessive inflammatory response driven by Tumor Necrosis
Factor (TNF). Endocannabinoids are nature's way of controlling TNF activity.
Phytocannabinoids can mimic the natural endocannabinoids to prevent excessive
inflammatory immune responses."

Upon hearing that WHO had elevated the swine flu to pandemic status, CSI's CEO
Steve Kubby said, "Governments all over the world ought to seriously consider
the advantages of medical cannabis."

On Wednesday, WHO said 74 countries had reported nearly 27,737 cases of swine
flu, including 141 deaths. There are over 90 confirmed cases in the United
States, with reports of infections in 11 states, and one U.S. fatality, a 23
month old child in Texas. Symptoms include a high fever, body aches, coughing,
sore throat and severe respiratory congestion.

Chief Science Officer for CSI Dr. Melamede believes the potential for
cannabinoids that naturally prevent excessive inflammatory immune responses is
enormous. He stated, "Based upon recent discoveries regarding the role that
endocannabinoid system plays in maintaining human health, we may have a unique
solution to the looming threat posed by deadly influenza strains that we
believe, if implemented, could save millions of lives."

Source
Cannabis Science, Inc.
________________________________

Article URL: http://www.medicalnewstoday.com/articles/153776.php
Main News Category: Swine Flu
Also Appears In:��Public Health, �Alcohol / Addiction / Illegal Drugs, �Flu /
Cold / SARS, �
________________________________

Any medical information published on this website is not intended as a
substitute for informed medical advice and you should not take any action before
consulting with a health care professional. For more information, please read
our terms and conditions.
Save time! Get the latest medical news headlines for your specialist area, in a
weekly newsletter e-mail. See http://www.medicalnewstoday.com/newsletters.php
for details.
Send your press releases to pressrelease@...

[Non-text portions of this message have been removed]