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Lisa A. Raedler - One of the best experts on this subject based on the ideXlab platform.

  • once a day harvoni ledipasvir plus sofosbuvir a new oral combination for the treament of patients with genotype 1 chronic hepatitis c infection
    American health & drug benefits, 2015
    Co-Authors: Lisa A. Raedler
    Abstract:

    Hepatitis C virus (HCV) infection is the most common Blood-Borne Disease; approximately 3.2 million Americans and 130 million to 170 million individuals worldwide are infected with HCV.1,2 Chronic HCV infection has been called a silent epidemic; the Disease can remain quiescent for decades before clinically significant symptoms appear.3 Because many Americans who are currently living with HCV were infected before blood screening testing for HCV was performed, the prevalence of HCV complications is likely to rise as these individuals enter their 50s and 60s.4 Research indicates that by 2015, more than 3 million individuals will have HCV infection that has been present for 20 years or more.5 This will result in a significant increase in the incidence of advanced liver Disease, including cirrhosis, decompensated cirrhosis, and liver cancer.5,6 In addition to causing substantial morbidity and mortality, HCV is associated with significant financial consequences.3 A 2000 study estimated that between 2010 and 2019, the direct medical expenditures for HCV-related conditions will reach nearly $11 billion, the cost of morbidity from disability related to decompensated cirrhosis and hepatocellular carcinoma would reach approximately $21 billion, and the societal cost of premature mortality for patients aged <65 years will exceed $54 billion (in 1999 US dollars).7 In the early 1990s, single-agent interferon was the standard of care for patients with HCV infection. Single-agent interferon represented a significant therapeutic advancement, because until then there was no treatment available for HCV infection; however, single-agent interferon offered a sustained virologic response (SVR) rate of less than 10% in patients with HCV genotype 1, the most common HCV subtype.8 Interferon was then used in combination with ribavirin, increasing the SVR rate by another 14% to 22%.8 In the early 2000s, pegylated forms of interferon dosed once weekly were introduced. The combination of pegylated interferon with ribavirin increased SVR rates to more than 50% in patients with HCV genotype 1.9,10 However, HCV genotype 1 was less responsive than HCV genotype 2 and genotype 3.9,10 Because of this variability in HCV response, low response rates in common HCV subpopulations (ie, black patients, patients with cirrhosis), and side effects associated with interferon and ribavirin, there remained a need to develop novel antiviral therapies.8 The treatment options for patients with HCV have evolved significantly in the past few years. HCV is currently the only chronic viral infection that can be cured with antiviral therapy.8 Although the prevention of infection should be the primary goal of treatment for HCV, no HCV vaccine is available. Therefore, the goals of current anti-HCV approaches are to cure infection, to prevent complications, and to prevent the spread of this Disease to other individuals.8 In 2011, 2 first-generation protease inhibitors, telaprevir (Incivek) and boceprevir (Victrelis), also known as direct-acting antiviral drugs, were approved by the US Food and Drug Administration (FDA) for HCV genotype infection; both agents offer significant efficacy as measured by the SVR rates.11,12 In December 2013, the FDA approved sofosbuvir (Sovaldi) in combination with ribavirin—the first interferon-free, all-oral regimen—for the treatment of patients with HCV genotype 2 and genotype 3. In addition, sofosbuvir in combination with interferon and ribavirin is approved for the treatment of patients with HCV genotype 1 and genotype 4.13,14 Candidates for sofosbuvir therapy include patients with hepatocellular carcinoma who meet Milan criteria (ie, awaiting liver transplantation) and patients with HCV/human immunodeficiency virus 1 coinfection.13,14 In contrast to older combination regimens, sofosbuvir regimens require less treatment time: 12 weeks for patients with HCV genotype 1, genotype 2, and genotype 4; and 24 weeks for patients with HCV genotype 3.14 Interest and investment in novel therapies for HCV remain strong in light of the increasing incidence of HCV (and its costly complications), unmet patient needs, and the identification of new drug targets through clinical research and discovery.15 Efforts continue, with the goals of improving the pharmacokinetics and the tolerability of these agents, as well as determining treatment strategies––interferon-containing and interferon-free (all oral) regimens––that optimize outcomes.16

  • viekira pak ombitasvir paritaprevir and ritonavir tablets dasabuvir tablets all oral fixed combination approved for genotype 1 chronic hepatitis c infection
    American health & drug benefits, 2015
    Co-Authors: Lisa A. Raedler
    Abstract:

    Approximately 130 million to 170 million individuals worldwide, including 3.2 million Americans, are infected with chronic hepatitis C virus (HCV), making it the most common Blood-Borne Disease.1,2 Chronic HCV infection is a silent epidemic; the Disease can remain quiescent for decades before clinically significant symptoms appear.3 The prevalence of HCV and its complications are expected to rise as Americans who are currently living with HCV enter their 50s and 60s.4 Research indicates that by 2015, more than 3 million individuals will have HCV infection that has been present for 20 years or more, which will result in a significant increase in the incidence of advanced liver Disease, including cirrhosis, decompensated cirrhosis, and liver cancer.5,6 The Centers for Disease Control and Prevention estimates that for every 100 individuals infected with HCV, 1 to 5 will die from liver cancer or cirrhosis.1 In addition to causing substantial morbidity and mortality, HCV is associated with significant financial consequences.3,7 A 2000 study estimated that between 2010 and 2019, the direct medical expenditures for HCV-related conditions will reach nearly $11 billion, the cost of morbidity from disability related to decompensated cirrhosis and hepatocellular carcinoma would reach approximately $21 billion, and the societal cost of premature mortality for patients aged <65 years will exceed $54 billion (in 1999 US dollars).7 HCV is currently the only chronic viral infection that is curable with antiviral therapy. The goals of current anti-HCV approaches are to eradicate infection, to avoid complications, and to prevent the spread of HCV to others.8 In the early 1990s, single-agent interferon was the standard of care for patients with HCV infection. Single-agent interferon represented a significant therapeutic advancement, because until then there was no treatment available for HCV infection; however, single-agent interferon offered a sustained virologic response (SVR) rate of less than 10% in patients with HCV genotype 1, the most common HCV subtype.8 Interferon was then used in combination with ribavirin, increasing the SVR rate by another 14% to 22%.8 In the early 2000s, once-weekly pegylated forms of interferon were introduced. The combination of pegylated interferon with ribavirin increased SVR rates to more than 50% in patients with HCV genotype 1. However, HCV genotype 1 was less responsive than HCV genotype 2 or 3.9,10 Because of this variability in HCV response, low response rates in common HCV subpopulations (ie, black patients, patients with cirrhosis), and side effects associated with interferon and ribavirin, there remained a need to develop novel antiviral therapies.8 The treatment options for patients with HCV have evolved significantly in the past several years. In 2011, 2 first-generation protease inhibitors, telaprevir and boceprevir (also known as direct-acting antiviral drugs), were approved by the US Food and Drug Administration (FDA).11,12 Both agents offered significant efficacy in patients with HCV genotype 1 infection as measured by SVR rates.11,12 In December 2013, the FDA approved sofosbuvir (Sovaldi) in combination with ribavirin—the first interferon-free, all-oral regimen—for the treatment of patients with HCV genotype 2 or 3.13,14 In addition, sofosbuvir in combination with interferon and ribavirin is approved for the treatment of patients with HCV genotype 1 and genotype 4.13,14 Candidates for sofosbuvir therapy include patients with hepatocellular carcinoma who meet Milan criteria (ie, awaiting liver transplantation) and patients with HCV/HIV-1 coinfection.13,14 Sofosbuvir regimens require less treatment time than older combination regimens—12 weeks for patients with HCV genotype 1, 2, or 4; and 24 weeks for patients with HCV genotype 3.14 In October 2014, the FDA approved the fixed-dose combination capsule of ledipasvir and sofosbuvir (Harvoni) for the treatment of patients with HCV genotype 1 infection.15 This once-daily combination tablet was the first regimen approved for HCV genotype 1 without interferon or ribavirin.15 Interest in novel therapies for HCV remain strong in light of the increasing incidence of HCV (and its costly complications), unmet patient needs, and the identification of new drug targets.16 Efforts continue, with the goals of improving the pharmacokinetics and the tolerability of these agents, as well as determining treatment strategies––interferon-containing and interferon-free (all oral) regimens––that optimize outcomes.17

B Stanzeit - One of the best experts on this subject based on the ideXlab platform.

  • hepatitis c virus infection in iceland a recently introduced blood borne Disease
    Epidemiology and Infection, 1994
    Co-Authors: A Love, B Stanzeit
    Abstract:

    This study demonstrates a very high prevalence of antibodies to hepatitis C virus among Icelandic intravenous (i.v.) drug users. Of 152 identified i.v. drug users 95 (63%) were shown to have antibodies to the hepatitis C virus. In contrast the seroprevalence in the general Icelandic population is low, (0.2%). Almost all cases of hepatitis C virus infection in Iceland are due to i.v. drug use or to use of infected blood or blood products. Sporadic cases with unexplained modes of transmission, a significant portion of hepatitis C infections elsewhere, are virtually non-existent in Iceland. The results of this study are consistent with the hypothesis that the sporadic community-acquired cases could be caused by blood transfer due to bites from insect vectors such as mosquitoes which are not found in Iceland.

A Love - One of the best experts on this subject based on the ideXlab platform.

  • hepatitis c virus infection in iceland a recently introduced blood borne Disease
    Epidemiology and Infection, 1994
    Co-Authors: A Love, B Stanzeit
    Abstract:

    This study demonstrates a very high prevalence of antibodies to hepatitis C virus among Icelandic intravenous (i.v.) drug users. Of 152 identified i.v. drug users 95 (63%) were shown to have antibodies to the hepatitis C virus. In contrast the seroprevalence in the general Icelandic population is low, (0.2%). Almost all cases of hepatitis C virus infection in Iceland are due to i.v. drug use or to use of infected blood or blood products. Sporadic cases with unexplained modes of transmission, a significant portion of hepatitis C infections elsewhere, are virtually non-existent in Iceland. The results of this study are consistent with the hypothesis that the sporadic community-acquired cases could be caused by blood transfer due to bites from insect vectors such as mosquitoes which are not found in Iceland.

Caroline Leroux - One of the best experts on this subject based on the ideXlab platform.

  • interstitial lung Disease associated with equine infectious anemia virus infection in horses
    Veterinary Research, 2013
    Co-Authors: P Bolfa, Marie Nolf, Fabienne Archer, Christine Dolmazon, Caroline Leroux, Jean-françois Mornex, Cornel Catoi, Jean-luc Cadore
    Abstract:

    EIA (Equine Infectious Anemia) is a Blood-Borne Disease primarily transmitted by haematophagous insects or needle punctures. Other routes of transmission have been poorly explored. We evaluated the potential of EIAV (Equine Infectious Anemia Virus) to induce pulmonary lesions in naturally infected equids. Lungs from 77 EIAV seropositive horses have been collected in Romania and France. Three types of lesions have been scored on paraffin-embedded lungs: lymphocyte infiltration, bronchiolar inflammation, and thickness of the alveolar septa. Expression of the p26 EIAV capsid (CA) protein has been evaluated by immunostaining. Compared to EIAV-negative horses, 52% of the EIAV-positive horses displayed a mild inflammation around the bronchioles, 22% had a moderate inflammation with inflammatory cells inside the wall and epithelial bronchiolar hyperplasia and 6.5% had a moderate to severe inflammation, with destruction of the bronchiolar epithelium and accumulation of smooth muscle cells within the pulmonary parenchyma. Changes in the thickness of the alveolar septa were also present. Expression of EIAV capsid has been evidenced in macrophages, endothelial as well as in alveolar and bronchiolar epithelial cells, as determined by their morphology and localization. To summarize, we found lesions of interstitial lung Disease similar to that observed during other lentiviral infections such as FIV in cats, SRLV in sheep and goats or HIV in children. The presence of EIAV capsid in lung epithelial cells suggests that EIAV might be responsible for the broncho-interstitial damages observed.

Werb Dan - One of the best experts on this subject based on the ideXlab platform.

  • Injection Drug Use Trajectories among Migrant Populations: A Narrative Review.
    eScholarship University of California, 2018
    Co-Authors: Melo, Jason S, Mittal, Maria Luisa, Horyniak Danielle, Strathdee, Steffanie A, Werb Dan
    Abstract:

    BACKGROUND:Dual epidemics of injection drug use and Blood-Borne Disease, characterized as "syndemics," are present in a range of settings. Behaviors that drive such syndemics are particularly prevalent among mobile drug-using populations, for whom cross-border migration may pose additional risks. OBJECTIVES:This narrative review aims to characterize the risk factors for injection drug use initiation associated with migration, employing a risk environment framework and focusing on the San Diego-Tijuana border region as the most dynamic example of these phenomena. METHODS:Based on previous literature, we divide migration streams into three classes: intra-urban, internal, and international. We synthesized existing literature on migration and drug use to characterize how mobility and migration drive the initiation of injection drug use, as well as the transmission of hepatitis and HIV, and to delineate how these might be addressed through public health intervention. RESULTS:Population mixing between migrants and receiving communities and the consequent transmission of social norms about injection drug use create risk environments for injection drug use initiation. These risk environments have been characterized as a result of local policy environments, injection drug use norms in receiving communities, migration-related stressors, social dislocation, and infringement on the rights of undocumented migrants. CONCLUSION:Policies that exacerbate risk environments for migrants may inadvertently contribute to the expansion of epidemics of injection-driven Blood-Borne Disease. Successful interventions that address emerging syndemics in border regions may therefore need to be tailored to migrant populations and distinguish between the vulnerabilities experienced by different migration classes and border settings

  • Identification of a Syndemic of Blood-Borne Disease Transmission and Injection Drug Use Initiation at the US-Mexico Border.
    eScholarship University of California, 2018
    Co-Authors: Rafful Claudia, Strathdee, Steffanie A, Jain Sonia, Sun Xiaoying, Garfein, Richard S, Cuevas-mota Jazmine, Magis-rodríguez Carlos, Smith, Laramie R, Werb Dan
    Abstract:

    BACKGROUND:Efforts to prevent injection drug use (IDU) are increasingly focused on the role that people who inject drugs (PWID) play in the assistance with injection initiation. We studied the association between recent (ie, past 6 months) injection-related HIV risk behaviors and injection initiation assistance into IDU among PWID in the US-Mexico border region. SETTING:Preventing Injecting by Modifying Existing Responses (PRIMER) is a multicohort study assessing social and structural factors related to injection initiation assistance. This analysis included data collected since 2014 from 2 participating cohorts in San Diego and Tijuana. METHODS:Participants were 18 years and older and reported IDU within the month before study enrollment. Logistic regression analyses were conducted to assess the association between recent injection-related HIV risk behaviors (eg, distributive/receptive syringe sharing, dividing drugs in a syringe, and paraphernalia sharing) and recent injection initiation assistance. RESULTS:Among 892 participants, 41 (4.6%) reported recently providing injection initiation assistance. In multivariable analysis adjusting for potential confounders, reporting a higher number of injection-related risk behaviors was associated with an increased odds of recently assisting others with injection initiation (adjusted odds ratio per risk behavior: 1.3; 95% confidence interval: 1.0 to 1.6, P = 0.04). CONCLUSIONS:PWID who recently engaged in one or more injection-related HIV risk behavior were more likely to assist others in injection initiation. These results stress the syndemic of injection initiation and risk behaviors, which indicates that prevention of injection-related HIV risk behaviors might also reduce the incidence of injection initiation