E-Bulletin 15


Welcome to the latest edition of the Hepatitis Scotland e-Bulletin.


The Hepatitis Scotland e-bulletin can be an opportunity to share news, views, knowledge and experience throughout our national and sector wide contact list.  If you have any research, ideas, news or upcoming events that you would like to see featured in our e-Bulletin, please forward the details to david@hepatitisscotland.org.uk for consideration.


NHS Lothian issues warning over unlicensed tattoo artists

NHS Lothian is warning people about the dangers of using unlicensed tattooists.

It comes following the arrest of a 28 year-old man in Edinburgh for allegedly carrying out tattoo work without the proper qualifications and licences.


Dr Duncan McCormick, Consultant in Public Health Medicine, NHS Lothian, said: “Unhygienic tattoo equipment carries a risk of infection of blood-borne viruses including Hepatitis B, Hepatitis C and HIV. 


NHS Lothian press release.


Heppy Birthday!


September 11th 2012 - keep the date free in your diary! The North West Community Drama Group has put together another fun and heart warming production which will be performed as part of the GRAND week (Getting Real about Alcohol and Drugs).  


The drama group have already produced several informative plays dealing with issues around hepatitis C and this promises to be as good as any that have gone before.  The play is titled 'Heppy Birthday' and is being staged at 7pm on Tuesday September 11th in the Partick Burgh halls.


To get free tickets you can get in contact with Gordon Peacock on 0141 332 2520 or e-mail him at gordon.peacock@waverleycare.org; or call Irene Hunter on 0141 276 6220.


Heppy Birthday Poster

Mixed bag in Hep C drug trials


Promising results for Idenix pharmeceuticals experimental Hepatitis C drug IDX184 (announced in June)  and res ults for Achillion's Sovaprevir and ACH-3102 drugs (announced in August), contrasted sharply with the announcement by Bristol Myers Squibb on August 1st that their experimental Hepatitis C drug BMS-986094, had been halted in trials due to a serious safety issue.


Idenix's IDX184 was administered to 31 patients along with PegInterferon and Ribavirin. 9 of those patients continued therapy for an extended 12 weeks with different amounts of the new drug.  When they were tested 4 weeks later 8 had achieved a sustained virologic reponse.  Those who hadn't yet achieved SVR automatically entered the 36 week combination therapy treatment and results are awaited.


Achillion's chief scientific officer Milind Deshpande said in a statement. "The safety and tolerability seen to date with ACH-3102 ... lead us to believe we have an in-house portfolio of optimized compounds that can successfully create an all-oral, interferon-free regimen for the treatment of genotype 1 HCV,"  


Meanwhile Bristol Myers Squibb has halted trials of it's drug BMS-986094 after one of the patients on the trial suffered heart failure - in what the company called a serious safety issue


These reports serve to highlight that whilst promising steps are being taken in research into new treatments, set backs can occur at any stage in the process and as such we should perhaps approach new research with cautious optimism


Sourced from Reuters and the Wall St Journal.


Universal Hep B screening is cost effective in Lymphoma patients


A report published in the Journal of Clinical Oncology has said that screening patients with Lymphoma for Hepatitis B makes both financial and clinical sense.


The investigators found that universal screening for HBV before chemotherapy helped to reduce costs and morbidity as well as bringing about a small increase in survival rates.  Immunosuppressive therapies like chemotherapy can result in reactivation of HBV any time during or after chemotherapy, which in some cases can result in severe flare ups of hepatitis and even death.


Among patients with chronic HBV infection, the incidence and severity of reactivation can be reduced with the use of prophylactic nucleoside analogs, with lamivudine being the most widely studied. This forms part of a wider debate as to whether all cancer patients should be screened for hepatitis B.


Sourced from Medscape.


Some babies remain at risk of hepatitis B despite vaccination

Research in Taiwan has shown that babies born to mothers with the hepatitis B e-antigen are more likely to become carriers of the virus/develop chronic infection.  Around 10% of babies born to mothers with the hepatitis B e-antigen are likely to become carriers, despite rigorous vaccination procedures in the baby's first 12 months.


Chen Hui-ling, a pediatrician at National Taiwan University Hospital, said that because the HBV vaccine does not guaruntee full protection against the virus, it is important to keep track of high risk children.

Taiwan launched a nationwide vaccination programme in 1984 and this has since reduced the carrier rate in children from 15-20% down to just 1%.


Sourced from Focus Taiwan News.


No link between birth defects and antiretroviral use in pregnancy

A study published in the Journal of Hepatology (conducted in the US) has concluded that there are no links between use of antiretrovirals to treat chronic HBV during pregnancy and any birth defects.


Lead author Dr. Robert S. Brown Jr from the New York Presbyterian Hospital said  "It is reassuring" that pregnant women can take tenofovir or lamivudine and "there does not appear to be any increase in the birth defects." Comparisons were made between mothers who had been treated with antiretrovirals during pregnancy and population based control groups and no link was found. 


However, Dr. Brown did note that safety was a 'complex' term when it comes to medication during pregnancy and that it was obviously better not to have to take any medication during pregnancy. 

He said that "The data provide guidance for patients and practitioners who either need or want to begin these drugs in pregnancy as to their predicted safety," he said.


Pre-diabetes and HCV infection


A recent US study has looked at the links between pre-diabetic states and hepatitis C.  The study was the first to look at pre-diabetes (Impaired fasting glycaemia and Impaired glucose tolerance) in the HCV population using direct and dynamic measurements of insulin action.


Pre-diabetic states are highly prevalent in the HCV population.  Pre-diabetes is often referred to as a grey area between normal blood sugar and diabetic levels.  Hepatitis C may accelerate progression from pre-diabetic states onto overt or actual diabetes because the virus interferes with insulin signalling in the body.  These pre-diabetic states may also accelerate fibrosis of the liver in HCV patients, possibly warranting aggressive HCV treatment in these patients.


A seperate study also suggested that treating HCV improved insulin resistance in HIV co-infected patients.





Levels of Hepatitis C higher in certain injecting drug users


A study conducted by the Center for Disease Control in the USA, and published in the July issue of the Journal of Hepatology, has shown that among hepatitis c infected injecting drug users in the United States, blacks, males and those co-infected with HIV, have higher levels of hepatitis C in their bodies.


Dr. Thomas O'Brien, of the Division of Cancer Epidemiology and Genetics at the U.S. National Cancer Institute, noted that hepatitis C viral load predicts treatment response in people with chronic hepatitis C. The study looked at 1,700 black, hispanic and white injecting drug users.


Dr. O'Brien went on to say, "We know that the level of [hepatitis C virus] is an important predictor of treatment response and that these levels seem to be influenced by a number of demographic, clinical, viral and human genetic factors."


View the Journal of Hepatology Press Release on this article.


A good amount of shut eye may help kiss hepatitis B goodbye!


Research published in the August edition of SLEEP has indicated that getting less than six hours of sleep per night can significantly reduce the likelihood of the hepatitis B vaccination protecting people from the virus.


At present the vaccine works in around 85-90% of cases, with smoking, weight and age being factors in it's failure in some people. However, Aric A. Prather, Ph.D., of the University of Pittsburgh said, ""Based on our findings and existing laboratory evidence, sleep may belong on the list of behavioral risk factors that influence vaccination efficacy."


Regression analyses showed that shorter sleep durations was associated with lower secondary anti-body response independent of age, sex, body mass index or initial response to vaccination.  Neither sleep efficiency nor subjective sleep quality were significant predictors of antibody response.


Prather said in a statement. "While there is more work to be done in this area, in time physicians and other health care professionals who administer vaccines may want to consider asking their patients about their sleep patterns, since lack of sleep may significantly affect the potency of the vaccination."




Not enough being done for Hepatitis C Patients


On July 27th, on the eve of World Hepatitis Day 2012, Charles Gore wrote an emotive article featured here in the Huffington Post.  The article focused on a man named Jim who had been diagnosed with end stage liver disease and sent home to die, the doctors unable to treat his liver or offer a transplant due to the extent of the damage.


Charles highlights how the advanced stage of this man's liver disease, caused by hepatitis C, could only only have been a result of long term, undiagnosed infection.  His death may have been avoided if he had been diagnosed sooner, with good treatment options available.  Again this underlines the fact that hepatitis C is a silent infection, 'a fire without smoke' as Charles calls it, and that this is a major problem worldwide where we see huge under diagnosis of hepatitis C.


"We are not doing enough, because Jim is not an isolated case. There are tens of thousands of people in the UK like him, living with hep C but not knowing." - Charles Gore, President of the World Hepatitis Alliance and founder of the Hepatitis C Trust.


Read his full article here.



Hepatitis Scotland
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Telephone: 0141 225 0419
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