Tuesday, September 19, 2017

Can Restricting Fructose Intake Reduce Fatty Liver Disease in Children?

Can Restricting Fructose Intake Reduce Fatty Liver Disease in Children?
Kristine Novak
Reducing dietary fructose for as little as 9 days decreases liver fat, visceral fat, and de novo lipogenesis and increases insulin sensitivity, secretion, and clearance in children with obesity and metabolic syndrome, researchers report in the September issue of Gastroenterology. These findings support efforts to reduce sugar consumption. Consumption of sugar

Read more

Only One-Quarter of Hepatitis C Patients Got Treatment Before Widespread DAA Use

Only One-Quarter of Hepatitis C Patients Got Treatment Before Widespread DAA Use
SEPTEMBER 19, 2017
Gail Connor Roche

Only one-quarter of patients worldwide with the chronic hepatitis C virus (HCV) received antiviral treatment before the widespread use of direct-acting antiviral (DAA) drugs, a review that considered almost 500,000 people has found.
          
But the authors conclude that treatment rates should improve in the interferon-free era, although the costs of DAA therapy could limit participation.
          
“The number of patients eligible for treatment will increase significantly as DAA therapies are recommended now in patients with decompensated cirrhosis,” Philip Vutien, MD, one of the study’s authors from Stanford University Medical Center, Palo Alto, California, said. “In addition, as DAA therapies are much better tolerated, we would expect patients and their providers to be much more willing to initiate treatment.”

Thyroid function starting at age 50 tied to life expectancy

Thyroid function starting at age 50 tied to life expectancy
Last Updated: 2017-09-18
By Anne Harding

NEW YORK (Reuters Health) - Low-normal thyroid function is associated with longer life expectancy in middle-aged people, according to data from The Rotterdam Study.

"At age 50, people with low-normal thyroid function live up to 3.5 years longer than those with high-normal thyroid function. Also, people with low-normal thyroid function live a longer life without cardiovascular disease (CVD) than those with high-normal thyroid function," Dr. Arjola Bano of Erasmus Medical Center in Rotterdam, the Netherlands, told Reuters Health by email.

The Rotterdam Study previously found that low-normal thyroid function was associated with an increased risk of diabetes or non-alcoholic fatty liver disease, while high-normal thyroid function was linked to an increased risk of atrial fibrillation or dementia, Dr. Bano noted. "The challenge for future research will be to integrate the associated risk of relevant adverse outcomes, in order to eventually define the clinically relevant normal ranges of thyroid function," she said.

Read the article, here...

Abstract
JAMA Intern Med 2017.

Monday, September 18, 2017

Costly drugs to weigh on U.S. employers' expenses in 2018: survey

Costly drugs to weigh on U.S. employers' expenses in 2018: survey
(Reuters) - U.S. employers are bracing for higher health care expenses in 2018 as spending on new drugs to treat diseases such as cancer, multiple sclerosis and hepatitis C is expected to rise more than 7 percent, according to consultancy firm Mercer.
Between 40 and 50 new specialty drugs are set to hit the market each year in the next five years, which could increase costs by $25 billion annually, Mercer said.

Sunday, September 17, 2017

Coverage OncLive - 2017 International Liver Cancer Association Annual Conference

Conference Website
2017 International Liver Cancer Association Annual Conference
September 15 - 17
Seoul, South Korea

Conference Coverage Available Online At OncLive 
http://www.onclive.com/conference-coverage/ilca-2017

Conference Multimedia
http://www.onclive.com/conference-videos/ilca-2017

Highlights
Study Shows DAAs Are Not Associated With Increased HCC Recurrence Risk
Angelica Welch
Published Online: Monday, Sep 18, 2017
Direct acting antivirals (DAA) are a novel and completely oral hepatitis C therapy that is associated with a high response rate. DAAs are used in most patients being treated for hepatitis C, including those with decompensated cirrhosis.

This type of treatment has now completely replaced interferon-based therapy for patients with hepatitis C, a therapy which was also associated with a decrease in hepatocellular carcinoma (HCC) incidence in 40% to 50% of patients.

Danielle Bucco
Published Online: Friday, Sep 15, 2017
“[At ILCA] we not only cover all of the clinical disciplines involved in the management of liver cancer but the presentations at this meeting include surgical oncology, transplant surgery, hepatology, interventional radiology, pathology, as well as medical oncology,” explained Richard Finn, MD, an associate professor of medicine at David Geffen School of Medicine at University of California, Los Angeles. “One of the most important things the audience will take away from the meeting is the latest data in not only systemic treatments, but also the role of treating hepatitis C in the setting of advanced and early-stage liver cancer. They will go home with some practice-changing observations.”

Danielle Bucco
Published Online: Saturday, Sep 16, 2017
Hepatocyte pERK-positive immunostaining and microvascular invasion were independent prognostic factors of recurrence-free survival (RFS) for patients with hepatocellular carcinoma (HCC) treated with adjuvant sorafenib (Nexavar); however, a predictive biomarker for recurrence was not uncovered, according to an analysis of the phase III STORM study presented at the 11th International Liver Cancer Association Annual Conference

Precision Screening May Improve Surveillance in HCC
Angelica Welch
Published Online: Saturday, Sep 16, 2017
“The highest rates of HCC are in east Asia and Africa, primarily driven by high rates of hepatitis B in those areas. While the incidence of HCC is lower in the United States and Europe, it is gaining a lot of attention because HCC has the largest increasing incidence among all solid tumors over the past 10 years as assessed by SEER,” said Singal, medical director of the Liver Tumor Program at UT Southwestern Medical Center. “Some projections have HCC becoming a top 5 cause of cancer-related death over the next decade in the United States. One of the key ways to curb this increased mortality is to increase rates of early tumor detection and curative treatment.”

Begin here..........

International Liver Cancer Association (ILCA) 
Patient information
What is liver cancer?
Liver cancer is defined by an abnormal and uncontrolled growth of cells within the liver. These altered cells progressively substitute the normal cells, collapsing the normal function of the liver, and invading other organs. These events irremediably lead to the death of the patients affected from this disease. We should distinguish liver cancer from benign tumors, that are also the result of an altered cellular growth, but they lack the invasiveness capacities of the malignant tumors (cancer). Therefore, the prognosis of benign tumors is excellent and in the majority of cases there is no need of treating them.
Continue reading...

Saturday, September 16, 2017

Deaths caused by viral hepatitis surpassed all chronic infectious diseases including HIV/AIDS, malaria and tuberculosis

Viral hepatitis kills more people than HIV, malaria or tuberculosis
Sept 15, 2017

World Hepatitis Alliance calls for immediate political action to counteract fatal trend

According to the Global Burden of Disease study released today, deaths caused by viral hepatitis have surpassed all chronic infectious diseases including HIV/AIDS, malaria and tuberculosis.

The study illustrates that in 2016, the total deaths caused by viral hepatitis, including liver cancer, acute cases, cirrhosis, hepatitis A, E, B, C and D account for 1.34 million deaths globally, exceeding tuberculosis (1.2 million), HIV/AIDS (1 million) and malaria (719,000).

These staggering death rates occurred despite recent advances in hepatitis C medications that can cure most infections within three months and the availability of highly-effective vaccinations for hepatitis B.

"It's outrageous, but not surprising, that the Global Burden of Disease Report found that deaths related to viral hepatitis have surpassed HIV, TB and malaria" said Charles Gore, President of the World Hepatitis Alliance. "This is largely due to a historic lack of political prioritisation coupled with an absent global funding mechanism".

The study shows that viral hepatitis remains amongst the top ten leading global killers which include heart disease, road accidents, Alzheimer's disease, amongst others. If we are to reverse this trend, immediate action must be taken at both a regional and national level.

One such action is the scaling up of testing and diagnosis. Globally, only 5% of people living with viral hepatitis are aware of their condition, greatly increasing the chance of infecting others and missing the opportunity to access life-saving treatment. Because viral hepatitis has few noticeable symptoms, many people are either misdiagnosed or do not come forward for testing.

"World leaders and national decision-makers must heed these findings and note that with targeted funding, political prioritisation and specific interventions, hepatitis deaths can be avoided." said Raquel Peck, CEO of World Hepatitis Alliance.

Reducing hepatitis related deaths by 65% by 2030 is a key component of the World Health Organization's (WHO) Global Hepatitis Strategy. The Strategy, which was adopted by 194 governments, sets out a list of key targets, which, if achieved will eliminate viral hepatitis by 2030.

On 1- 3 November, hundreds of policymakers, patients, civil society and public health experts will gather at the World Hepatitis Summit, in São Paulo, Brazil to discuss how advance the elimination of viral hepatitis.

The three-day event, which is a joint initiative between WHO and the World Hepatitis Alliance, will focus on key ways to implement WHO's Global Hepatitis Strategy, with a specific focus on how to improve surveillance data, scale up testing and treatment at a national level, and support service delivery amongst vulnerable populations. The event will also encourage innovation in research and have a dedicated focus on sustainable financing for elimination, all of which are needed to eliminate viral hepatitis by 2030.

Find the full report here: www.thelancet.com/gbd

Future complications of HCV in a low-risk area - projections from the hepatitis c study in Northern Norway

BMC Infectious Diseases

Future complications of chronic hepatitis C in a low-risk area: projections from the hepatitis c study in Northern Norway
H. Kileng, L. Bernfort, T. Gutteberg, O.S. Moen, M.G. Kristiansen, E.J. Paulssen, L.K. Berg, J. Florholmen and R. Goll

https://doi.org/10.1186/s12879-017-2722-0
Received: 6 January 2017
Accepted: 8 September 2017
Published: 16 September 2017

Conclusion
"Based on the registration of patients with HCV in a low risk area, we estimate a relatively slow fibrosis progression within the first 20–25 years of infection, followed by an accelerated fibrosis progression, especially in subjects with HCV genotype 3. This may have important implications in the clinical management of patients infected with genotype 3. Furthermore, we estimate a gradual increase in future complications with an estimated peak around 2040. The projected scenario implies a substantial increase in HCV-related morbidity and mortality in the coming years. An increased number of patients need to be treated to have an impact on the future burden of HCV disease."

Full Text
View Online

Abstract
Background
Hepatitis C (HCV) infection causes an asymptomatic chronic hepatitis in most affected individuals, which often remains undetected until cirrhosis and cirrhosis-related complications occur. Screening of high-risk subjects in Northern Norway has revealed a relatively low prevalence in the general population (0.24%). Despite this, late complications of HCV infection are increasing. Our object was to estimate the future prevalence and complications of chronic HCV infection in the period 2013–2050 in a low-risk area.

Methods
We have entered available data into a prognostic Markov model to project future complications to HCV infection.

Results
The model extrapolates the prevalence in the present cohort of HCV-infected individuals, and assumes a stable low incidence in the projection period. We predict an almost three-fold increase in the incidence of cirrhosis (68 per 100,000), of decompensated cirrhosis (21 per 100,000) and of hepatocellular carcinoma (4 per 100,000) by 2050, as well as a six-fold increase in the cumulated number of deaths from HCV-related liver disease (170 per 100,000 inhabitants). All estimates are made assuming an unchanged treatment coverage of approximately 15%. The estimated numbers can be reduced by approximately 50% for cirrhosis, and by approximately one third for the other endpoints if treatment coverage is raised to 50%.

Conclusion
These projections from a low-prevalence area indicate a substantial rise in HCV-related morbidity and mortality in the coming years. The global HCV epidemic is of great concern and increased treatment coverage is necessary to reduce the burden of the disease.

Keywords Disease burden Fibrosis development Hepatitis C Markov modelling Natural course