New and Noteworthy
Expanded harm reduction services decreased new Hep C infections in Scotland
Implementing comprehensive harm reduction services averted an estimated 1400 new Hep C infections in Scotland, reported researchers in PLOS ONE.
In 2008, the Scottish government expanded access to sterile injecting equipment, including needles, syringes, cookers, filters and water, and improved access to opiate substitution therapy (OST). Researchers examined the impact of these programs from 2008 to 2012 through surveys with 8000 people who inject drugs.
The research showed:
- Declines in the number of people injecting daily (63% to 49%)
- Decreases in sharing needles/syringes (15% to 8%), spoons (42% to 20%), filters (33% to 17%) and water (31% to 21%)
- Increases in people receiving OST (50% to 64%)
The estimated number of new Hep C infections declined from 1063 in 2008 to 566 in 2012. According to the researchers, “these data provide evidence of a downward trend in HCV incidence among people who inject drugs in Scotland.” (aidsmap.com, August 2014, in English)
High cure rates with interferon-free combination daclatasvir and asunaprevir
In a series of late-stage trials of daclatasvir (Daklinza) and asunaprevir for people with genotype 1b hepatitis C virus, cure rates ranged from 82% to 90%, reported researchers in The Lancet.
747 people participated in the trials in 18 countries.
For 24 weeks, participants who had never been treated received:
- daclatasvir once per day plus
- asunaprevir or a placebo twice per day
For 24 weeks, people who had previously been treated but did not respond to treatment and people who were interferon ineligible or intolerant received:
- daclatasvir once per day plus
- asunaprevir twice per day
Cure rates were:
- 90% for people who had never been treated before
- 82% for people who had previously been treated but did not respond to treatment
- 82% for people who were interferon ineligible or intolerant
“These results support the use of daclatasvir plus asunaprevir as an all-oral, interferon-free and ribavirin-free treatment option for patients with HCV genotype 1b infection, including those with cirrhosis,” concluded the researchers. (HIVandhepatitis.com, August 2014, in English)
Increasing testing and treatment with new medications could make Hep C a rare disease
Widespread Hep C testing and use of new Hep C medications could make Hep C a rare disease in 20 years, according to results from a mathematical modelling study published in Annals of Internal Medicine.
In the U.S., the Centre for Disease Control and Prevention (CDC), recommended that all adults born between 1945 and 1965 (baby boomers) be tested for hepatitis C. The researchers ran one model with all baby boomers being screened. Baby boomer screening was expected to identify 487 000 new cases of Hep C. They also ran a second model with all people being screened, known as universal screening. Universal screening could identify 933 700 new cases.
If all baby boomers were screened and treated with new Hep C medications that have cure rates of approximately 90%, the researchers estimated that the following liver related complications would be prevented by 2050:
- 124 200 cases of liver failure (decompensated cirrhosis)
- 78 800 cases of liver cancer (hepatocellular carcinoma)
- 9 900 liver transplants
According to the researchers, “new therapies for HCV infection and widespread implementation of screening and treatment will play an important role in reducing the burden of HCV disease.” (HIVandhepatitis.com, August 2014, in English)