Hepatitis C elimination: a Public Health Perspective
AbstractPurpose of reviewHepatitis C virus (HCV) infection is a principal cause of morbidity, mortality, and economic burden, and the global elimination of HCV is now considered a public health objective. Globally, an estimated 71 million have chronic HCV infection with an estimated annual mortality of 3,99,000.Recent findingsThe 69th World health Assembly has endorsed the global HCV elimination strategy by 2030, which is made possible because of all oral, cost-effective, efficacious, generic direct-acting antivirals. The public health strategy targets not only diagnosed chronic hepatitis C patients but also asymptomatic undiagnosed HCV-infected individuals, persons living with human immunodeficiency virus (HIV), post-transplant, thallasemia, persons who inject drugs, and the pediatric population.SummaryMobilization of state-sponsored HCV elimination programs in a global coalition against HCV has taken root in Egypt, India, Georgia, Mongolia, China, Australia, and Brazil. This review summarizes current HCV elimination initiatives in terms of medical progress, barriers to HCV elimination, and current gaps in knowledge and social outreach from the public health perspective.
Nature Reviews Gastroenterology &Hepatology, Published online: 20 August 2019; doi:10.1038/s41575-019-0203-1Preventing the development of hepatitis C in uninfected transplant recipients
In conclusion, our data show how oncogenic and tumor-suppressive drivers of cellular senescence act to regulate surveillance processes that can be circumvented to enable SnCs to elude immune recognition but can be reversed by cell surface-targeted interventions to purge the SnCs that persist in vitro and in patients. Since eliminating SnCs can prevent tumor progression, delay the onset of degenerative diseases, and restore fitness; since NKG2D-Ls are not widely expressed in healthy human tissues and NKG2D-L shedding is an evasion mechanism also employed by tumor cells; and since increasing numbers of B cells express NKG2D ...
Conditions: Liver Transplant; Complications; Hepatitis C Intervention: Sponsor: Yale University Recruiting
Previous studies suggest that direct-acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection permits transplantation of HCV-viremic donor organs in uninfected recipients. This opportunity may expand donor pool. We assessed the impact of utilizing HCV nucleic acid test-positive (NAT+) donor hearts on heart transplant (HTx) waitlist time and transplant rate.
The field of heart transplantation continues to evolve, with major changes in allocation systems, and increasing use of extended-criteria donor hearts, including hearts from donation after circulatory death (DCD) donors, hearts supported with ex-vivo perfusion, and hearts from hepatitis C viremic donors. Use of such non-traditional donor hearts has made transplantation available to a larger number of recipients, but the demand continues to outpace the supply. Given this persistent donor heart shortage, much attention has been given to the topic of donor-recipient size matching.
i RSB Abstract Recurrent hepatitis C (HCV) after liver transplantation (LT) is an important cause of morbidity and mortality. Antiviral treatment is recommended to avoid unfavorable outcomes. Direct-acting antivirals (DAA) have transformed HCV treatment, with higher efficacy and fewer side-effects than interferon-based therapies traditionally used. To evaluate DAA treatment outcomes at a Brazilian transplant unit, data of patients who finished HCV treatment at the Liver Transplant Unit of the University of Campinas were analyzed. Treatment consisted of sofosbuvir, daclatasvir, and ribavirin, for 12 or 24 weeks, ac...
Conclusions: This study identified risk factors associated with common perioperative complications of liver transplantation. These factors may assist practitioners in risk stratification and may form the basis for further investigations of potential interventions to mitigate these risks. PMID: 31378055 [PubMed - as supplied by publisher]
Abstract BACKGROUND: Direct-acting antivirals have changed the landscape of hepatitis C virus (HCV) care. While transplantation with HCV-positive donor organs is increasing, little is known about providers' attitudes toward this topic. The aim of this study is to determine providers' attitudes toward HCV-positive kidney transplantation. METHODS: Willing transplant and nontransplant nephrologists, transplant surgeons, and mid-level providers completed an online survey from April through May 2018. The survey asked about HCV knowledge and willingness to transplant HCV-positive antibody, nucleic acid testing-posi...
Conclusion The profile of RTx with HCV has changed over the last 20 years. Despite a decrease in the prevalence of HCV, new clinical challenges have emerged, such as more advanced age and a higher prevalence of cirrhosis.
ConclusionOur study demonstrated that liver transplant patients with a recurrence of hepatitis C who are initiating ribavirin combined with a sofosbuvir-daclatasvir direct-acting antiviral regimen may be at risk of lower tacrolimus concentrations because of probable ribavirin-induced anaemia and higher fibrosis score, although there are no effects on cyclosporine levels.Trial registrationNCT 01944527