Painting by - Tiffany Sage

For anyone who has been diagnosed with a serious disease what follows is often fear of the unknown. As the weeks turn into months the realization sinks in that you have a heath crisis on your hands. Quickly you find yourself seeking out information, looking for the right answers and asking yourself a few familiar questions; What can I do to improve my condition? Can this disease be treated, if so, when should I start treatment, or should I wait ? 

For the millions of people who have been diagnosed with hepatitis C, the same questions need to be answered.  
 
The Disease
In 2012 Medscape reported:
Out of 100 people that contract the infection, 75–85 people will develop chronic infection, 60–70 people will develop chronic liver disease, five to 20 people will develop cirrhosis over the course of their chronic infection and one to five people will
die of complications including hepatocellular carcinoma (HCC).

Treatment
Treatment is not for everyone, only you and your physician will determine what path you should investigate. However, if you are considering treatment, then arm yourself with accurate information.

The thought of treatment can be overwhelming, you may even see the side effects of treatment as much more detrimental then the disease itself.  Or because the symptoms of hepatitis C manifest very slowly, it's easy to dismiss treatment because it appears that there is nothing to be treated. What ensues for some people living with hepatitis C is a lack of urgency to seek treatment. 

Worth The Wait? Or Treat Now?
MedPage Today -HCV Patients May Be Able to Delay Therapy
At the May 2012 DDW meeting researchers discussed the new HCV therapies under investigation suggesting HCV patients without significant fibrosis may want to wait for new drugs to be FDA approved before deciding to begin therapy.

Updated Dec 15 2012 
This website has compiled a collection of articles on the subject:
Treat HCV Now Or Wait

Provided below are helpful links to additonal information on HCV including: support, FAQs, diet, transmission, books, videos, disease progression, treatment with current direct-acting antivirals and investigational antivirals, HCV tests, news
and research.

Need Some Answers?
Updated 2012 
Best List Of HCV FAQs
Informational site providing resources, education, and support for the hepatitis C community.
168 Pages Of Hepatitis C FAQs

Need To Talk To Someone ?
Help is available, recently "Project Inform" announced the launch of a new national helpline, 877-HELP-4-HEP (877-435-7443), run by and for people affected by hepatitis C. The helpline operates Monday through Friday 9am to 7pm EST. To learn more, visit www.help4hep.org or email info@help4hep.org.

American Liver Foundation HelpLine Service Adds a Dedicated Hepatitis  C Specialist and Expands Hours
1-800-GOLIVER  (1-800-465-4837)

After  receiving a diagnosis of hepatitis C, everyone has questions. And there are  times you need someone to help sort through those questions and provide information.

To answer this need, the American Liver Foundation has added a  hepatitis C specialist and expanded the HelpLine hours.
 
Callers can now  reach someone at the Helpline from 9:00 AM to 7:00 PM Eastern time, Monday – Friday.
In addition, questions sent on e-mail to info@liverfoundation.org will be  promptly answered.

Best Books
Free From Hepatitis C
I also highly recommend the new book authored by  Lucinda K. Porter, RN called  Free from Hepatitis C:Your Complete Guide to Healing Hepatitis C

Curing Hepatitis C
Curing Hepatitis C, View Chapter 6: The Future of HCV Treatment-Beyond Triple Therapy
Chapter six of the new book "Curing Hepatitis C" written by Gregory T. Everson, M.D. is available for downloading.
*Curing  Hepatitis C will go on sale August 21, for more information on ordering the book  click here.

Multimedia
For the hands on reader check out the  Multimedia section of  the web site. This page contains udpated HCV educational podcasts, videos, and links. 

Educate Yourself
Education-related information
Includes CME activities in various media formats covering the following topics:
treatment regimens, resistance, current direct-acting antivirals, investigational antivirals, interferon alfa-free regimens, effects of HCV on the liver, diet,drug-drug interactions, and managing side-effects

Where Can You Find An Easy To Understand HCV Web Site With Accurate Information ?
HCV Advocate is the go to site for all your questions, filled with information, news, HeathWise articles, fact sheets, new drugs currently in the pipeline, clinical trials, and a monthly newsletter.

The Links
HeathWise articles can be found in the HCV Advocate Newsletter
Fact Sheets , HCV Drug Pipeline , News Updates , Clinical Trials  , Hepatitis C

Support Online
HCV  Support
Med Help
WebMD® Hepatitis  Community
Links To HCV Support On Facebook and Twitter

Cirrhosis - Transplant Support
http://forums.delphiforums.com/liverfailure/start 
]
Next up, what about the disease progression of hepatitis C ?

By Alan Franciscus, Editor-in-Chief Of HCV Advocate

Disease progression

(HCV) is highly variable, which means that it is difficult to tell who will and who will not have severe HCV disease progression.In general about 80% of people with chronic hepatitis C will have a slow rate of disease progression
that may not lead to serious complication.

The other 20% of people with chronic hepatitis C will have severe disease progression that could lead to complications
such as severe fibrosis, cirrhosis, liver failure, liver cancer and death.
The question that has vexed us all is why some people with HCV have serious disease progression while others only have mild progression.

Although we are far from completely understanding and answering this important question there is information
available about some of the factors that will likely increase the risk for serious HCV disease progression.
This article will discuss the various factors that increase the likelihood of disease progression and steps we can all take to minimize these effects – at least for those factors over which we have some control.
,
ALT Levels
Alanine aminotransferase or ALT (previously called SGPT) is a chemical produced in the liver.

ALT levels are elevated when liver cells are inflamed, damaged, or destroyed by HCV, HBV, alcohol and certain drugs.Persistently elevated ALT levels are more of a sign that there is ongoing damage to the liver,and, if elevated over a
long period of time, indicate ongoing fibrosis progression. But it is important to know that people  with persistently normal ALT levels can also have fibrosis progression, although the risk is much lower.

Related - 2012 - Clinical Features of Hepatitis C Virus Carriers With Persistently Normal Alanine Aminotransferase Levels
,
Inflammation
The amount or degree of inflammation in the liver roughly correlates with the development of fibrosis and cirrhosis. The amount of inflammation can be reduced by taking HCV medical treatment and avoiding any substance that causes harm to the liver, such as alcohol, etc.
,
Fibrosis/Cirrhosis
Light, moderate, or severe scarring of the liver (fibrosis) can eventually lead to even more severe scarring of the liver called cirrhosis.

The damage caused by hepatitis C is not linear – this means that once fibrosis and cirrhosis start to develop, the progression of liver disease speeds up. In other words, it may take 10 years to progress from one degree or stage of liver damage to another, but the next increase in the amount of damage may take less time – say 7 years.

Progression to the next stage may only take 5 years and so forth. HCV treatment can help to reduce, slow down or stop the disease progression progress especially if HCV treatment is successful.

Lifestyle changes can also help the liver to stay healthy by maintaining a healthy weight, eating a healthy diet, avoiding alcohol and drugs, moderate exercise, stress reduction, etc.

Diet
Dr. Galati- Watch: Is there a Special Diet for Hepatitis C?

AGE
Age plays a critical role in HCV disease progression. The age at the time that someone acquired HCV plays an important role in disease progression – so the older you are when you acquire HCV the faster the disease progression.

This is because the body’s immune system doesn’t work as well to minimize the damage HCV causes. On the other hand,
if someone acquires HCV at an early age, as they get older the greater the chances of more severe disease progression due to the accumulation of damage over time.

For instance, some studies have found that people over 60 years old have a quicker disease progression and other studies have found that having HCV for 25 years or longer increases the chances of disease progression.

Related - HCV In Elderly Patients
,
Steatosis
Fatty liver or steatosis can contribute to lower HCV treatment response and a faster rate of HCV disease progression. The cause of steatosis in most people with HCV is a synergistic effect of thevirus, poor diet and lack of exercise. If you are HCV genotype 3, however, steatosis is most likely caused by the hepatitis C virus.
For example, in people with genotype 3 who are successfully treated with HCV medications steatosis has been found to be decreased or eliminated. This is not true of steatosis in people with HCV non-3 genotype.

For most people, steatosis can be prevented and even reversed by the simple, but not so easy, methods that we all struggle with – a healthy diet and exercise program.

We recommend that anyone who undertakes a diet and exercise program consult with a medical provider and experts in the field of diet and exercise.

Unfortunately,these tools are not available to everyone; but there are still many avenues and resources open to
become even healthier. On the internet there is a wealth of diet and exercise sites to help.

Related - Natural Approaches to Hepatitis C and Liver Health

Marijuana
There have been some studies that have found that regular daily use of marijuana can significantly increase the risk of fibrosis progression. There is a caveat, however, about the data that has surfaced. The studies have been self-disclosure studies that are typically extremely difficult to gauge as to how truthful people may answer questions about how much they smoke.

But the most important factor is that it is impossible to measure the concentrations of THC (the active ingredient in marijuana) that the participants were smoking. Interestingly, the studies that report that daily marijuana causes significant
fibrosis progression also report that non-daily use of marijuana did not accelerate fibrosis progression. The bottom line – more is not better when it comes to many issues including using marijuana.
.
Cigarettes
I don’t think anyone these days would be surprised to learn that smoking cigarettes causes many health-related problems including increasing the chances of fibrosis progression and liver cancer.
.
ALCOHOL
Another no-brainer is that alcohol consumption can increase fibrosis and cirrhosis progression.

Excessive alcohol consumption – in and of itself – can lead to cirrhosis, liver failure and liver cancer. If both of the negative effects, alcohol and HCV, were combined I think it’s easy to see why people with HCV should avoid alcohol. If someone has trouble stopping, they should cut back on the amount of alcohol they drink and get help to stop.
There are many effective programs to help people stop drinking.

Metabolic Syndrome
In the last decade the relationship between metabolic disorders and fibrosis progression has been well-documented. Metabolic disorders are a group of conditions that increase the likelihood for cardiovascular disease and other health problems.

Components of metabolic syndrome include:
• Abdominal obesity
• High blood cholesterol and high triglycerides
• High blood pressure
• Insulin resistance
• State of inflammation caused by obesity, insulin resistance, etc.
• Prothrombotic state – increased platelets

Although there are different components that define metabolic syndrome they are also interconnected interconnected
especially with obesity.

Obesity and insulin resistance are the two factors that stand out as factors that increase fibrosis progression.

A simple tool to measure insulin resistance is the HOMA-IR– the higher the score, the higher the degree of insulin resistance.
The higher the HOMA-IR score, the more rapid fibrosis progression is.
.
Many of the factors of metabolic syndrome can be treated with lifestyle changes (diet, exercise, stress reduction) and medications to control diabetes, high blood pressure, cholesterol, etc.

Related - Hepatitis C increases risk of death from both liver disease and non-liver-related causes

Transmission Of Hepatitis C

How is hepatitis C spread? Who's at risk?

Hepatitis C virus (HCV) is transmitted through contact with an infected person's blood.

The following list outlines sources of hepatitis C transmission
.
-Sharing needles and syringes (IV drug abuse);
-Other possible risk behaviors: tattoos, body piercing, living and medical care in a developing country, folk medicine, intranasal cocaine;

Related - 2012 - Amateur tattoos carry hepatitis C risk

Related - IV User-Worried About HCV ? Check This Out

-Extensive surgical procedures

-Unknown--up to 5% of patients have no identifiable risk factors;

-Sexual transmission is rare; the risk of sexual transmission to an individual is probably less than 3% when a person is in a stable monogamous relationship;

-Vertical transmission from mother to baby

-Reused needles in a medical or health care setting.

Related: Hepatitis transmission risk needs to be studied in nail salons, barbershops

According to the CDC:
In a recent analysis of data from a national health survey, 55% of persons ever infected with HCV reported an exposure risk of either (IV drug use or blood transfusion before July 1992), and the remaining 45% reported no known exposure risk
(CDC, unpublished data, 2012).

Other potential exposures include ever having received chronic hemodialysis, being born to an HCV-infected mother,
intranasal drug use, acquiring a tattoo in an unregulated establishment, being incarcerated, being stuck by a needle (e.g., in health care, emergency medical, home, or public safety settings) and receiving invasive health-care procedures  (i.e., those involving a percutaneous exposure, such as surgery before implementation of universal precautions).

Related - Hepatitis C - The Risk And Free Home Confidential Testing 

Is hepatitis C transmitted sexually?

According to studies in the Journal of the American Medical Association, a low sexual transmission rate of hepatitis C was suggested. Of the 62 patients studied, none of the monogamous heterosexual partners had developed the hepatitis C antibody. In general, the probable risk of heterosexual transmission of hepatitis C is less than 3%.
It is recommend that all patients in a non-monogamous relationship use a condom or spermicide and patients in a monogamous relationship use a barrier method only if they are anxious or concerned about transmission.

All non-monogamous individuals should use safe sex practices.

For patients with hepatitis C, testing of spouses, babies and significant others is recommended by Centers for Disease Control(CDC). Please discuss these issues with your physician.

Related Dec 2012
Hepatitis C Sexual Transmission Is Rare among Monogamous Heterosexual Couples
Sexual  transmission of HCV among monogamous heterosexual couples: The HCV partners  study

Related - 2011 - Hepatitis C Transmitted by Unprotected Sex Between HIV-Infected Men
The Sexual Transmission of Hepatits C In The HIV Population

Is hepatitis C transmitted by breast milk to infants?

There is no substantial evidence that hepatitis C is transmitted through breast milk, however, a few studies have been performed that tested breast milk and very rarely is hepatitis C found in the breast milk--even using the most sensitive tests such as PCR. The CDC has issued a statement explaining that mothers who have HCV can breast feed, but should avoid it if there are sores around the nipple.

Can hepatitis C be transmitted to other members of my family (household contacts)?

There is a slight risk of hepatitis C transmission among household contacts, so family members should not share items such as razors or toothbrushes that may transmit blood or secretions. Women who have hepatitis C and are menstruating as well as men or women with hepatitis C and sores in the genital area should avoid sexual contact. The CDC recommends that spouses or partners of a hepatitis C patient be tested for hepatitis C.

Can a pregnant woman give hepatitis C to her baby?

A report in New England Journal of Medicine suggested a 7% transmission rate of hepatitis C from mother to child at birth. Though this is a high estimate, the possibility of transmission must be considered when a woman with hepatitis C is deciding whether to have children.

For infants who have received the hepatitis C virus from their mother, brief elevations of liver enzymes may occur, but no chronic liver disease has been reported. There have been no reports of cirrhosis in newborns, infants or child due to mother-to-child hepatitis C infection. It is recommended that all babies born to mothers with HCV be tested annually until age three with antibody tests.

Related - HCV In Pregnancy

Women with AIDS and hepatitis C are at high risk for transmitting the virus to their babies, and research has shown that these women consistently transmit the virus to their babies at birth.

Is hepatitis C transmitted by insects?

There is no documented transmission of hepatitis C through insects. The virus, however, is related to a group of viruses including yellow fever and Dengue, and those are known to have been spread by insects.

Related - Hey Can I Get Hepatitis C From.......

Exams and Tests

The following tests are done to help diagnose hepatitis C:
Learn more here

Related - Hey, I Have A Question About HCV Tests 

Sunday, May 20, 2012 

Hepatitis C Testing- the Fine Print 
Yesterday's blog focused on the CDC's new recommendation  for ALL BABY BOOMERS to be tested for Hepatitis C, regardless of their other  risk factors. The rational is to diagnose this often silent disease early, while  treatment can make the most impact saving lives and improving quality of lives. 

While hepatitis C is largely transmitted via IV drug abuse (which obviously  people can identify as a risk factor), there is a significant chunk- usually  quoted around 10%- of people who have NO KNOWN risk factors.

So what's the fine print about the testing?

First of  all, the Hep C test is a blood test (just a heads up for the needle-phobics out  there.) Mainly, however, the issues about testing surround the results.A negative result is wonderful-  there is extremely low chance that you have the disease and the test missed it,  because this is a very sensitive test.

A  positive result, however, leads to a much longer discussion. A  positive Hep C Antibody test (the screening test) cannot tell you how long you  have been infected.

More testing is now required.The next step will be to have a different blood test that measures "viral load"- actually looking for the amount of Hep C virus present in your system. 

Other blood tests will measure your liver "function" to see if it looks inflamed.  Your doctor may also test to determine the subtype of Hep C in order  to better advise you regarding the potential response to therapy.By the way, All positive tests for Hep C will be reported to the health  department. This should not to make you paranoid, as your insurance company will
obviously know as well, but simply something to note.

If your screening test was positive but your viral load does NOT show any current presence of Hep C, and your liver enzymes are normal- you  will be considered to have recovered from a prior Hep C infection, and part of  the lucky 15-25% who do not progress to chronic disease. If your screening test is positive,  your viral load is elevated, but your liver enzymes are normal and you feel  fine- you may be a Hep C Carrier, and most people in this category do not  require immediate treatment.

Carriers are followed closely to be sure they are  not having silent worsening of disease (as measured by deteriorating blood tests  or symptoms), holding off on treatment until there has been a change.If your screening test is positive, your viral load is high,  and your liver enzymes are abnormal or you have significant symptoms, then you  will be heading to a liver specialist to discuss treatments. Though the  treatment for Hep C can be challenging, between 50-80% of patients have  sustained (successful) responses to treatment, depending on their subtype and how long the disease has been present.

BOTTOM  LINE
 Baby Boomers should talk with their doctors about getting tested for Hepatitis C, but recognize the results may initially create more additional questions than answers.
http://jillgrimesmd.blogspot.com/2012/05/hepatitis-c-testing-fine-print.html

Also See: Aug 3 2012 Challenges and issues in managing hepatitis C

The Tests

Diagnosis of HCV infection is based on the detection of  anti-HCV antibodies by enzyme immunoassay.

Anti-HCV test detects the presence of antibodies to the virus, indicating exposure to HCV. This test cannot distinguish between someone with an active or a previous HCV infection. Usually, the test is reported as "positive" or "negative." There is some evidence that if the test is "weakly positive," it may be a false positive. The Centers for Disease Control and Prevention (CDC) suggests that weakly positive tests be confirmed with the HCV RIBA test before being reported.

HCV recombinant immunoblot assay (RIBA) test is an additional test ordered to confirm the presence of HCV antibodies. In most cases, it can tell if the positive anti-HCV test was due to exposure to HCV (positive RIBA) or represents a false signal (negative RIBA). In a few cases, the results cannot answer this question (indeterminate RIBA). Like the anti-HCV test, the RIBA test cannot distinguish between a current or past infection.

Can you have a "false positive" anti-HCV test result?

Yes. A false positive test means the test looks as if it is positive, but it is really negative. This happens more often in persons who have a low risk for the disease for which they are being tested. For example, false positive anti-HCV tests happen more often in persons such as blood donors who are at low risk for hepatitis C. Therefore, it is important to confirm a positive anti-HCV test with a supplemental test as most false positive anti-HCV tests are reported as negative on supplemental testing.

Can you have a "false negative" anti-HCV test result?

Yes. Persons with early infection may not as yet have developed antibody levels high enough that the test can measure. In addition, some persons may lack the (immune) response necessary for the test to work well. In these persons, research-based tests such as PCR may be considered. . How long after exposure to HCV does it take to test positive for anti-HCV? . Anti-HCV can be found in 7 out of 10 persons when symptoms begin and in about 9 out of 10 persons within 3 months after symptoms begin. However, it is important to note that many persons who have hepatitis C have no symptoms..

Hepatitis C RNA assays to determine virus levels (called viral load)

Viral Load Test

How long after exposure to HCV does it take to test positive with Qualitative HCV RNA test =PCR?
It is possible to find HCV within 1 to 2 weeks after being infected with the virus

Unlike antibody tests, HCV RNA tests directly measure for the presence of the hepatitis C virus. HCV RNA tests may be qualitative or quantitative.

Qualitative HCV RNA tests are used to diagnose hepatitis C. Your doctor might choose to perform an HCV RNA test instead of the ELISA, especially if you are at high-risk for hepatitis C. The HCV RNA test will be positive in as little as 1 to 2 weeks after exposure.

A positive HCV RNA test means a person has hepatitis C infection.

Quantitative HCV RNA tests allow your doctor to determine exactly how much virus is in the blood. This is referred to as the viral load.

Related - HCV Viral Load Test  

The viral load is usually expressed as units per milliliter or copies per milliliter. In patients with chronic hepatitis C infection, viral loads vary widely from 50,000 to 5 million copies per milliliter. A higher viral load may not necessarily be a sign of more severe or more advanced disease but it does correlate with likelihood to respond to treatment. HCV RNA tests can also be used to monitor response to hepatitis C treatment. For example, if the viral load decreases during treatment, this suggests that treatment is working and should be continued, referred to as response guided treatment . Conversely, if the viral load remains the same, it suggests that the patient is not responding to treatment.

Related - Testing Positive For Hepatitis C

On-Treatment Predictors of Response
Once hepatitis C virus (HCV) treatment is started, initial viral kinetics are helpful in predicting treatment outcome. Patients who have cleared the virus by Week 4 of therapy, whether with protease inhibitor (PI)–based triple therapy or with peginterferon/ribavirin alone, are very likely to achieve sustained virologic response (SVR). By contrast, those who still have detectable HCV RNA (virus) levels by Week 12 of therapy have very low likelihood of obtaining SVR

Viral Load - Familiar Treatment Terms

Response guided treatment-
Or viral load monitoring during treatment is intended to enable the physician to determine the duration of combination therapy based on a patients viral response.

Terms Used In Response guided treatment

(RVR)-Rapid Viral Response; Is an undetectable viral load four weeks into treatment. In SOC-standard therapy if you have an RVR your chance of cure is better than 78% and 92% and your doctor may recommend that you shorten your treatment.

(cEVR) Complete early viral response- Is an undetectable viral load 12 weeks into treatment. If you have a complete EVR you have a good chance of being cured .

(pEVR) Partial early viral response - A drop in viral load of at least 2-log (e.g. from 600,000 IU/mL down to 6,000 IU/mL) at 12 weeks of treatment, but still detectable virus in your blood. In people with genotype 1 the chance of viral clearance is low and treatment is generally stopped.

(non-EVR) Non-response- No significant drop in viral load in the first 12 weeks of treatment.

Related - Standardization  of Terminology of Virological Response in the Treatment of Chronic Hepatitis  C

What Is A 100-fold reduction in viral load ?

Changes in viral load are sometimes expressed in terms of logs: a 1-log change means a 10-fold increase or decrease; a 2-log change is a 100-fold increase or decrease.

What Is A 2 Log Drop?
Example: 2 log drop = 15,000,000 IU/Ml to 150,000 IU/mL; a viral load that starts at 15,000,000 IU/mL and does not decrease to 150,000 IU/mL or lower.

Terms Used To Define Patients

Naïve- No prior treatment/first time treating HCV.

Relapsers- People whose viral load drops to an undetectable level with treatment but rises again after treatment ends.

Partial responders- People who have at least a 2 log10 (100-times) drop in viral load, but do not reach undetectable levels in the blood by week 24.

Null responders- People who failed to reduce their viral load by at least 2 log10 (100 times) after 12 weeks of prior treatment, which is the currently recommended Food and Drug Administration (FDA) definition for clinical trials of investigational hepatitis C treatments.

Protocol for both Telaprevir and Boceprevir can be found by clicking on the link below:
A Practical Guide for the Use of Boceprevir and Telaprevir for the Treatment of Hepatitis C
Quick Facts Victrelis-boceprevir, Incivek-telaprevir

Genotype-Test

• Viral genotyping is used to determine the kind, or genotype, of the HCV virus present. There are 6 major types of HCV; the most common (genotype 1) is less likely to respond to treatment than genotypes 2 or 3.  Genotyping is often ordered before treatment is started to give an idea of the likelihood of success and how long treatment may be needed.

A better understanding of Genotypes

The following tests are done to identify and monitor liver damage from hepatitis C:

Liver function tests
Albumin level
Prothrombin time

A better understanding of Liver Function Tests

.Will I need a Liver Biopsy ?

Based on the abundant literature in chronic hepatitis C, alternative, non-invasive methods can now be used instead of liver biopsy in patients with chronic hepatitis C to assess liver disease severity prior to therapy at a safe level of predictability.

Related -  Liver Biopsy and Noninvasive Tests For Fibrosis

HEPATITIS C SYMPTOMS
.
When you are first exposed to the hepatitis C virus and become infected, you are said to have "acute hepatitis C". Most people have no symptoms of infection during this time.

In 70 to 80 percent of people, the infection becomes chronic. The word "chronic" implies that the infection will be prolonged, or even lifelong, unless you get treatment that cures the infection.

Many people with chronic hepatitis C have no symptoms, even if there is serious liver damage. Of those who do develop symptoms, the most common symptom is fatigue; other less common symptoms include nausea, lack of appetite, muscle or joint aches, weakness, and weight loss.

Related -  Symptoms .

Treating Hepatitis C
Hepatitis  C–What Are Your Treatment Choices: New Webinar
Approved Treatments for Hepatitis C

Whats New?
HCV Drugs In Development
New Drug PipelineHepatitis C Treatments In Current Clinical Development Download PDF

2012
Hepatitis C Drug Development Goes from Pony  Ride to Rocket Launch
The in depth report includes the following topics;  HCV drug resistance, DAA drug-drug interactions, nucleosides and nucleotide  polymerase inhibitors, HCV protease inhibitors, the next generation of drugs,  HCV quad therapy, genotypes 1-4,
interferon free therapy and much more....

Index Of Current Hepatitis C Drugs In Development
Links to available information on this website

Interferon Free ?

Gilead Begins Single Pill Hepatitis C Study for 2014 Approval
July 2012/ Gilead Sciences Inc. (GILD) (GILD) said it plans to start a combination study of  two drugs in a single pill to treat hepatitis C by the end of the year, putting   it on track to request U.S. regulatory approval for the medicine in 2014.

Direct acting antivirals for the treatment of chronic hepatitis C: one pill a day for tomorrow 
The end of the beginning for hepatitis C treatment 
Interferon Free Therapies

New FDA Approved Treatments For Hepatitis C

Patients’ Expectations About New HCV Direct-Acting Antivirals Often Unrealistic
FDA Transcripts Telaprevir/Boceprevir April Advisory Committee Meeting

Telaprevir FDA Approved
FDA Approves Telaprevir/Incivek For Hepatitis C

Boceprevir FDA Approved
Vicrelis/Boceprevir IS NOW FDA Approved May 13 2011

Medication Guides
Prescribing Information for INCIVEK including the Medication Guide.
VICTRELIS™- Boceprevir: Prescribing Information and Medication Guide
Peginterferon alfa
Ribavirin

Patient Assistance Program
INCIVEK/Telaprevir and VICTRELIS (Boceprevir) Patient Assistance Programs

Telaprevir-Incivek and Boceprevir-Victrelis - Side Effects
Standard therapy-Pegylated Interferon Alfa and Ribavirin is used along with both protease inhibitors, information on adverse effects of standard therapy are also included

Clinical Trials
To learn more about Hepatitis C virus clinical trials or to find out if a study is enrolling patients in your area, please click here.

Clinical Trial Updates
ClinicalTrials.gov: updated in the last 30 days
.
Questions for a specialist.
It's important to keep an open dialogue with your doctor, especially when it comes to understanding your treatment options, and how your body is responding to the therapy.
.
The following list of questions may be helpful to print and take to your appointment:

What is my genotype and how does it impact my therapy?
What is my viral load and how does it impact my therapy?
What are my expected outcomes with treatment?
What are my expected outcomes without treatment?
Do I have any other conditions that will complicate treatment?
What changes should I make in my everyday life?
What is the most important information I need to know before starting treatment?
What should I do next?
.
A specialist can help determine whether treatment is right for you.
Ask your doctor to recommend one today; your chances for recovery may be better than you think.

What Is A Hepatologist ? What Is A Gastroenterologist?

Hepatitis C-Related Conditions
Conditions associated with the hepatitis C virus

Links To More Information
These links will take you to the premier Hepatitis C sites and keep you informed with breaking news, clinical studies, new drugs, podcasts, newsletters, support, personal experiences and more. 

A Few Updates

2012
On The Blog - Updated Daily
New HCV targets for antiviral therapy
HCV In The  News

Articles
Hepatitis C Therapy in Non-genotype 1 Patients: The Near Future
What is Killing People With Hepatitis C Virus Infection?

2011
Chronic hepatitis C doubles the normal risk of dying early from any cause, a new study shows.
Prevalence and Challenges of Liver Diseases in Patients with Chronic Hepatitis C Virus Infection

What About Liver Health?
Advance Liver Disease What Every HCV Treater Should Know
Hepatitis C and Liver Health-Getting It Right In 2012
Hepatitis C - Five Ways You Can Take Care of Your Liver 
AASLD-The Mediterranean Diet Improves Liver Health

Getting Ready For Treatment
Treating Hepatitis C; Improving Your Shot At A Cure