This is why support groups are so helpful.


By Kirsty Oswald, medwireNews
Reporter


08 April 2013


J
Viral Hepat 2013;
Advance online publication


medwireNews: Researchers have found poor levels of knowledge about hepatitis
C virus (HCV) among individuals with HCV mono-infection and HCV/HIV
co-infection.


Patients who were indifferent to the need for treatment or
reported feeling ashamed of their HCV-positive status scored particularly badly
in knowledge tests.


Mamta Jain (University of Texas Southwestern Medical Center,
Dallas, USA) and colleagues found that both mono- and co-infected patients
scored under 50% in a knowledge test, which assessed understanding of HCV
disease, transmission, and treatment.


Among 292 respondents recruited through outpatient clinics, many
reported fear about their infection, with 56.8% acknowledging that they were
scared about their HCV status, and 31.7% feeling stigmatized by
it.


Worryingly, 18.0% thought that HCV does not cause health
problems, 15.2% thought that they do not require treatment due to lack of
symptoms, and 20.7% said feeling ashamed prevented them from seeking
treatment.


Knowledge scores were significantly lower among the 26.6% of
patients who thought medication was unnecessary for HCV, than for those who did
not endorse this belief, at a mean of 15.1 vs 17.5 out of 34, with a similar gap
in knowledge between those who did and did not say they felt ashamed about HCV
(15.3 vs 17.2).


While knowledge levels were comparable between mono- and
co-infected patients, co-infected participants had more knowledge about HCV
treatment and about HIV, and perceived less stigma from HCV. The authors suggest
this may be due to their ongoing HIV care, and that these patients may perceive
their HIV-positive status as more stigmatizing than
HCV.


Additionally, 87 patients took an abridged version of the survey
before and after a 1-hour education session designed to improve knowledge and
attitudes regarding HCV. The authors found that while this did not lead to
changes in the respondents' attitudes, it did increase their mean knowledge
score from a mean of 17.2 to 23.3 points out of
34.


"However, re-education and ongoing support may be necessary to
maintain patients' knowledge level about HCV," say Jain and colleagues,
writing in the Journal of Viral
Hepatitis.


"There also remains a need to develop interventions that could
specifically modify attitudes towards HCV treatment," they
add.


Despite effective treatments, which can lead to high rates of
sustained virological response, many mono-and co-infected HCV patients fail to
get treatment, the authors explain.


"Future studies are needed to effectively change attitudes and
determine whether those changes will affect health behaviour among mono-infected
and co-infected populations," they conclude.


medwireNews (www.medwirenews.com
) is an independent clinical news service provided by Springer Healthcare
  Limited. 


To see links to resources and support groups please look at www.hepatitisCmsg.org
If you or your organization want to start a Hepatitis C, Co infection support group, please contact us to help get you started.
 

 HCV PROJECT


ABOUT TAG

Hepatitis C and the IL28B Gene


April 2013


What predicts response to hepatitis C virus (HCV)
treatment?

Many things help predict the likelihood of being cured (called sustained virological response or SVR) by pegylated
interferon (PEG-IFN) and ribavirin (RBV). Making sure to take all medications as
  prescribed (called adherence) will really increase the likelihood
  of SVR.
Two of the strongest SVR predictors are virus-related: the
amount of HCV in the bloodstream (called viral load) and the
strain of HCV (called genotype). For example, HCV genotype 1 is
harder to cure with PEG-IFN and RBV than genotypes 2 and 3. Medical issues (such
as being HIV-positive, having liver damage, and being overweight) can also make
HCV harder to cure.

PEG-IFN and RBV are less effective for African
Americans and people of African ancestry than people of other races and
ethnicities. Recently, researchers have discovered that this is mainly—but not
completely—due to an inherited (genetic) factor, the
interleukin-28B (IL28B) gene.


What is the IL28B gene?

Genes are working parts of our body inherited from our parents.
They determine eye, skin, and hair color as well as blood type, height, and
race. The IL28B gene is involved in the immune response to certain viruses,
including hepatitis C. There are three IL28B subtypes (called
genotypes): CC, CT, and TT. People with the CC genotype have a
stronger immune response to HCV infection than people with the CT or TT
genotypes (called non-CC genotypes). This immune response makes
people who have a CC genotype more likely to clear HCV without treatment (called
spontaneous viral clearance), within months of becoming infected.
People who have a CC genotype are also two to three times more likely to be
cured by PEG-IFN and RBV, regardless of race or HIV
status.


Race and IL28B genotype

A person of any race or ethnicity could have any IL28B genotype,
but African Americans and people of African ancestry are less likely to have the
CC genotype than people of other races and
ethnicities.





Source: Thomas DL, Thio CL, Martin MP, et al. Genetic variation in
IL28B and spontaneous clearance of hepatitis C virus. Nature. 2009 Oct
  8;461(7265):798–801. doi: 10.1038/nature08463.



Although people with the CC genotype are more likely to be cured
by PEG-IFN and RBV, race still influences the likelihood of being cured. SVR
rates among people with the CC genotype are lower in African Americans and
people of African ancestry than in people of other races. Researchers have not
discovered other factors to explain the difference in SVR
rates.





Adapted from Ge D, Fellay J, Thompson AJ, et al. Genetic variation in
IL28B predicts hepatitis C treatment-induced viral clearance. Nature. 2009 Sep
  17;461(7262):399-401. doi: 10.1038/nature08309.


IL28B and new HCV drugs



Adding one of the new oral HCV drugs (called direct-acting
antiviralsor DAAs) to PEG-IFN and RBV or using a
combination of DAAs will increase SVR rates in people with non-CC genotypes,
regardless of race or ethnicity. It is still unclear whether IL28B genotype has
a strong influence on cure rates from DAAs without PEG-IFN, or which DAAs are
best for people with non-CC genotypes.

Regardless of your IL28B genotype,
it is important to get a viral load test 4 or 12 weeks after starting HCV
treatment, to see if it is working. People with an undetectable hepatitis C
viral load at 4 or 12 weeks are more likely to be cured, especially if they have
the IL28B CC genotype.


How can I find out my IL28B genotype?



You can take a blood test to learn your IL28B genotype (called the
IL28B genotype test). You only need to take this test once,
because your IL28B genotype never changes.


·       
IL28B genotype may determine the type—and possibly length—of your HCV
  treatment. It can be important information for treatment
decision-making.


·       
A person’s IL28B genotype should never be used to withhold HCV
treatment, since people with non-CC genotypes can also be cured.


·       
Soon, there will be more information about the best treatments for
people with non-CC genotypes. Check with your medical providers.

Medicare patients need hepatitis C tests, coalition
says


By Elise Viebeck - 04/03/13 10:52 AM ET



Medicare should promote screenings for hepatitis C given the
frequency of the virus among older patients, advocates said Wednesday.


The National Viral Hepatitis Roundtable, a coalition of health groups and
  medical providers, circulated a letter urging federal health officials to offer
  hepatitis C screenings as part of patients' first Medicare exam.



The advocates said baby boomers represent 75 percent of U.S. cases
of hepatitis C and that screening them for the virus could save more than
100,000 lives.


"The best way to identify [infected] individuals, so that they can
  benefit from care and treatment before developing late stage liver disease,
  liver cancer, and/or need a liver transplant, is to ensure everyone in the
  birth cohort have an opportunity to be tested," the roundtable wrote to federal
Health secretary Kathleen Sebelius.

"Testing everyone in this age range
removes stigma associated with the test, thus reducing barriers for the provider
and the patient," the group added.

The Centers for Disease Control (CDC)
recommended last year that every baby boomer get tested for hepatitis C, which
many people carry without knowing it.

The virus often has no symptoms at
the time of infection. It may be transmitted by sharing needles, or through a
bad blood transfusion or organ transplant.

Dr. John Ward, head of the
CDC's viral hepatitis division, said many older people who injected drugs in
their youth have unknowingly carried hepatitis C for decades.

"We had an
epidemic of hepatitis C transmission in the '70s and '80s, and we're now seeing
an epidemic of hepatitis C disease," he told
NPR last August.


The National Viral Hepatitis Roundtable is seeking additional
signatures to its letter before delivering it to Sebelius on May 1 for Hepatitis
Awareness Month.




Read more: http://thehill.com/blogs/healthwatch/medicare/291629-medicare-patients-need-hep-c-tests-coalition-says#ixzz2PuDuN4o4