Viral hepatitis in practice - 2017

Developing a community pharmacist-led hepatitis C care pathway
Andrew Radley
pp 1-4
Around 50,000 people living in Scotland are thought to have been infected with hepatitis C virus (HCV). An estimated 38,000 of those with HCV are suffering from chronic infection, equating to 0.8% of the Scottish population. The greatest risk of acquiring this infection in the UK is through injecting drugs. Individuals receiving opiate substitution therapy (OST), usually methadone or buprenorphine, form the single largest infected group, with research suggesting that around 40% of people receiving OST have HCV infection. Most of this patient group frequently visit a community pharmacy and many come into contact with a pharmacist every day of the working week. Therefore, most community pharmacists in Scotland will meet a person infected with HCV every day.
Comment: Find the undiagnosed and bring them into care
David J Bell
pp 2-2
This is my first time editing Viral hepatitis in practice and I am grateful to the editorial board and to Hayward Medical Communications for this opportunity, and to Alastair Miller for his excellent service in this role over the previous six years. I have always found Viral hepatitis in practice to be a useful resource on what is happening in the rapidly evolving field of viral hepatitis. The articles in this edition are all on hepatitis C (HCV), but each exploring different clinical issues.
Hepatitis C: where is the point of no return? Treating patients with decompensated liver cirrhosis
Mary Cannon and Kosh Agarwal
pp 7-10
Direct-acting antiviral (DAA) therapy has revolutionised the treatment of hepatitis C, conferring sustained virological response (SVR) rates of over 90% in the clinical trial setting. Real-world cohorts have replicated these numbers and have not only demonstrated that DAA therapy for hepatitis C is efficacious, but it is also well tolerated.
Viral hepatitis and cardiovascular disease
Salvatore Petta and Antonio Craxì
pp 11-14
Infections by hepatitis C (HCV) and hepatitis B (HBV) viruses account for a high proportion of cases of chronic liver disease worldwide and, consequently, are leading causes of liver-related morbidity and mortality. However, while there is limited data available regarding the potential association between HBV infection and extrahepatic clinical complications, there is growing evidence to suggest that HCV infection should no longer be considered ‘simple’ liver disease, but instead as a systemic infection that can lead to extrahepatic manifestations. In this emerging and complex landscape, mounting evidence highlights a link between HCV infection and increased risk of cardiovascular alterations (Figure 1 and 2). The prevalence of cardiovascular alterations has been reported in about 20% of veterans in the USA, and in about 30% of the HCV-infected Italian population. However, because both HCV infection and cardiovascular alterations are common in the general population, it is very hard to establish whether a simple association links these two conditions, or whether HCV is involved in increasing the risk of cardiovascular disease. This article will review the existing evidence for a link between HCV and cardiovascular disease.

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)