Hepatitis Scotland e-Bulletin, June 2, 2013


Scotland's action gets international gold

The Global Commission on Drug Policy have published a report on injection drug use and Hepatitis C in which Scotland's response has been hailed as an international model of best practice.

The report points out that harm reduction services - such as provision of sterile injecting equipment and opioid substitution therapy - have been proven to reduce the spread of blood-borne viruses in intravenous drug user populations, provided the services are accessible and delivered on the necessary scale.

Scotland's opioid replacement therapies are currently under review by an independent expert group, led by Chief Medical Officer, Sir Harry Burns, with their report expected in the near future.



A generic argument?

The GDPC report also looked at the high cost of HCV medications, noting that governments should "enhance their efforts to reduce the costs of new and existing hepatitis C medicines – including through negotiations with pharmaceutical companies to ensure greater treatment access for all those in need".

"Governments, international bodies and civil society organisations should seek to replicate the successful reduction in HIV treatment costs around the world, including the use of patent law flexibilities to make them more accessible".

With the likely very high cost of new drugs, and recent data suggesting that combinations of drugs from different companies may be a real "rescue therapy" for those in the greatest need, the straitened economic circumstance of health systems may benefit from new ways to negotiate on cost.

This is also relevant in light of recent Scottish research that highlights the difference in perceived quality of life a positive diagnosis can bring. Maintaining and improving efficient pathways from diagnosis to treatment becomes a greater priority as new testing practices increase the numbers of those diagnosed.

This Hepatitis C blog looks at the possibility that physicians may be tempted to prescribe both drugs together 'off label' once they have been approved, whilst highlighting some of the pitfalls to this course of action.


Sex and drugs and other events

Let's talk about sex and drugs in Scotland

This event is now fully subscribed.

Film Premiere launches Hepatitis C DVD's

Screening 6.30- 7.15, Thursday 6th June
Glasgow Youth Theatre, Old Sherriff Court, 105 Brunswick Street
Glasgow, G1 1TF

National premiere of a series of four short films exploring a broad range of social, educational and family issues commonly affecting people with viral hepatitis. The films were written and performed by the Glasgow North West Community Drama Group. They are intended for use with an accompanying educational pack so as to explore social care issues affecting people with Hepatitis C and how to respond to them.

If you are interested in attending please contact david@hepatitisscotland.org.uk. Limited places available.

World Hepatitis Day Event

- national family fun day at Scotstoun Leisure Centre in Glasgow

- five a side football and doubles badminton tournaments. 

- BBQ, a bouncy castle, open mic competition, creche and many other fun activities for all the family.

- Trained peer educators and staff will be on hand to speak with people and will also be conducting Community Action Research on the day.

View information pack and poster here.


Higher prevalence of BBVs in men injecting anabolic steroids

Dr. Vivian Hope of the London Health Protection Agency has presented new research on BBV prevalence among men who inject anabolic steroids to the BHIVA conference.

In the group of 395 injectors was a Hepatitis B prevalence of 8.8%, Hepatitis C prevalence of 5.5% and HIV prevalence of 1.5%. The findings suggest that prevalence of BBV infection may have increased since the last significant piece of research conducted in the mid 1990s.

View Dr. Hope's presentation here.


Accelerating to the finish?

Gilead was recently granted an accelerated review of Sofusbuvir by the European Medicines Agency, having already applied for approval to the FDA in the US. Janssen have also applied for marketing approval in Europe for Simeprevir.


Viral hepatitis and sex

This article features links to some recent research and discussion around sexual transmission and viral hepatitis. Most available research still points to HIV positive MSM as being most at risk from sexual transmission of Hepatitis B and C - however, there is ongoing discussion as to whether non HIV positive MSM may also be a risk group for hepatitis C transmission.

Hepatitis C infection in men who have sex with men: Cohort analysis.

Hepatitis C transmission among monogamous heterosexual couples.

For more information on sexual transmission risk of Hepatitis B and C please visit our respective webpages on this, listed below.

Sexual risk and Hepatitis B

Sexual risk and Hepatitis C



BHIVA hepatitis guideline consultation open until 1 July 2013

The guidelines are aimed at clinical professionals involved in and responsible for the care of adults with HIV and viral hepatitis coinfection, and at community advocates responsible for promoting the best interests and care of adults with coinfection.

Consultation link here


Targeted screening for Hepatitis C cost effective

Researchers at the University of Cincinnati have found that targeted screening of populations with a higher estimated prevalence of Hepatitis C may be cost effective. The research was published in the April 24th online edition of the journal Clinical Infectious Diseases. It indicated that targeted screening for populations with an estimated prevalence of higher than 0.84% could be cost effective. This work was supported in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp.

The United States FDA has previously advised Hepatitis C screening for the 'baby boomer' generation of people born between 1945 and 1965. There has also been recent discussion on whether to target screening other population groups such as MSM, in light of recent studies into prevalence within that community.



Hepatitis Scotland National Resource Index published

Hepatitis Scotland has just published a national index of viral hepatitis resources. This is a collection of all viral hepatitis resources published by statutory and non statutory organisations, as well as UK websites, which will be a live and regularly updated index for use of patients, the public and professionals.

If you are an organisation which publishes viral hepatitis information resources either in hard copy or online, and would like your resource included in this index, then please contact david@hepatitisscotland.org.uk

A gaps analysis of viral hepatitis resources in Scotland based on this index will be published later this year.



Vitamin D status may not predict SVR but is that the whole story

An Australian study has questioned the link between baseline Vitamin D status and achieving an SVR. Although appearing to show Vitamin D status may not be reflective of achieving SVR it does not disprove recent studies, highlighted in previous bulletins, which have shown a potentially large positive treatment effect when used in conjunction with pegylated Interferon and Ribavirin.


Study here (requires athens)


Hepatitis C treatment updates

Sofusbuvir shows high cure rates for Hepatitis C genotypes 2 and 3 among those who can't use interferon or were previous null responders - read more here.

Sofusbuvir cures 90% when combined with SOC - read more here.

Merck's experimental drug MK-5172 more effective than their protease inhibitor Victrelis.  - read more here.

Roche and Asceltis to work together on hepatitis C drugs for China - read more here

Liver Disease in Europe: A look at the main causes of liver disease in Europe - read more here.

Wide review of Hepatitis C treatment news - read more here or for those with athens access.



Hepatitis B updates

Adefovir for treatment of chronic Hepatitis B in heart transplant patients - read more here.

European Commission approves 6 in 1 paediatric vaccine - read more here.


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