Viral hepatitis in practice - 2016

All aboard the BBV bus! Testing hard-to-reach patients in the community
Clare Phillips and Salim Khakoo
pp 1-5
Hepatitis C virus (HCV) is one of the main causes of liver disease worldwide, with an estimated global burden of 160 million infected individuals. In the UK, it is estimated that there are 214,000 infected people living with HCV. It is estimated that a substantial proportion (up to 80%) of people are undiagnosed and unaware of their disease status.
Comment: More diagnoses, please!
Alastair Miller
pp 3-3
We are now able to treat hepatitis C virus (HCV) infection effectively, simply and with relatively few adverse effects. This is a major shift that started in 2011, when directly acting antiviral agents became available. HCV is one of the so-called blood borne viruses (BBVs), which cause very few – if any – symptoms during the early years of chronic infection, but severe illness and death in later years. With increasingly effective and cost-effective antiviral therapies for all BBVs, the challenge now is to identify infected people in the early stages and intervene before chronic infection causes irreparable harm. The asymptomatic nature of early infection is not the only issue here: early diagnosis is also hampered by the fact that many infections occur among disadvantaged and marginalised groups, who are difficult to reach via traditional services.
Hepatocellular carcinoma in viral hepatitis: can we reduce the risk?
Daniel Galloway and Matthew Foxton
pp 6-8
Worldwide, hepatocellular carcinoma (HCC) remains the fifth most common malignancy in men and the eighth most common in women. This equates to more than half a million cases each year. Chronic infection with hepatitis B or C virus (HBV or HCV) is the main risk factor for the development of HCC worldwide, accounting for more than 80% of cases. In the UK, the exact proportion of HCC cases attributable to viral hepatitis is unknown, but may be as high as 40%.
Treatment options for hepatitis C virus infection – orals for all?
Emma Hathorn and David Mutimer
pp 10-13
The advent of directly acting antiviral agents (DAAs) in the treatment of hepatitis C provides a real opportunity to reduce the burden of end-stage liver disease and hepatocellular cancer that complicates chronic infection. Pegylated interferon combined with ribavirin (RBV) was considered the standard of care for managing hepatitis C virus infection since 2000, but its use was limited by significant side effects (neuropsychological effects, fatigue and flu-like symptoms) and low viral response rates. The first DAAs became available in clinical practice in 2011.
The British Liver Trust: a charity for adults with all types of liver disease
Vanessa Hebditch
pp 13-13
The British Liver Trust is the leading UK charity for adults with all types of liver disease, and its vision is to achieve the ‘best possible liver health for all’.
Strategies for diagnosing advanced hepatitis C virus infection
Jacqueline CM Paterson and John F Dillon
pp 14-15
Currently, in the UK, 214,000 individuals are chronically infected with hepatitis C virus, contributing towards the global count of 130–150 million infected people. Hepatitis C-related liver diseases cause 500,000 deaths a year worldwide.

Viral hepatitis in practice was previously supported by Gilead Sciences from 2015 to 2016, by Gilead Sciences and Janssen in 2014, by Gilead Sciences and Roche Products in 2013 and by Gilead Sciences from 2009 to 2012.

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ISSN 2041-1162 (Print)  ISSN 2045-7863 (Online)