If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering a variety of the major hepatitis viruses.

Drug-drug interactions between direct-acting antivirals and antiretroviral therapy are frequently found among HIV/HCV-coinfected patients, according to a study in HIV Medicine.

Vaccine-induced immunity persisted for up to 15-17 years in 89.3% of participants after a primary hepatitis B vaccination in infancy, according to a Chinese study.

Key pretreatment viral resistant-associated variants (RAVs) for hepatitis C protease inhibitors are present in a major portion of the HCV/HIV coinfected population prior to therapy, a recent study found.

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A study of racial disparity in hepatitis C virus infection mortality found that Mexican Americans with chronic HCV had a mortality rate about seven times higher than that of HCV-negative individuals.

Acute hepatitis C virus infections are common in China, but a study in the Journal of Viral Hepatitis said the incidence of chronic HCV may be reduced among the high prevalence of chronic hepatitis B virus and IL28B genotypes associated with spontaneous clearance of HCV in Chinese populations.

Survival after hepatocellular carcinoma diagnosis is significantly worse in kidney transplant recipients compared to nontransplanted patients with hepatitis B virus and/or hepatitis C virus, a recent study found.

A high proportion of HIV-HCV-coinfected patients had chronic hepatitis C virus infection, according to a study of patients in South-East Asia. HCV genotype 1 was predominant, and 62% of patients had liver disease warranting prompt treatment.

Sofosbuvir plus ribavirin therapy achieved rates of sustained virologic response at 12 weeks post treatment of at least 90% and was well tolerated among treatment-naive patients with chronic genotype 1 or 3 hepatitis C virus infection in India, a recent study found.

A Spanish study found that, in patients with hepatitis C virus genotype 3 infection and cirrhosis, rates of sustained virologic response at 12 weeks post treatment were high with both sofosbuvir+daclatasvir and sofosbuvir/ledipasvir regimens, with few serious adverse events.

Chronic antigenemia in chronic HCV infection induces and maintains an antigen-specific T-bet+ B-cell, a study found, and antigen-driven T-bet expression may be a critical suppressor of B-cell activation in chronic HCV infection.

Methylation status of the IFN lambda-3 promoter region may be a useful parameter that identifies patients more likely to relapse following hepatitis C virus therapy, a recent study found, although continuing therapy for a sufficient duration can overcome this difference.

Early initiation of combination antiretroviral therapy for HIV-infected patients with and without hepatitis coinfections may mitigate or slow down some of liver fibrosis, a Chinese study found, but special attention should be given to those who are older, male, co-infected with HCV.

A study in a real-world setting found direct-acting antivirals to be safe and effective in elderly patients with hepatitis C virus-related advanced fibrosis/cirrhosis, but researchers said sustained virological response 12 weeks after the end of treatment was lower with worsening Child-Pugh-Turcotte class.

A combined HCV therapy of ombitasvir/paritaprevir/ritonavir±dasabuvir was found highly effective in a Spanish clinical practice study with an acceptable safety profile and low rates of treatment discontinuation.

A study in Hepatology found that HIV/HCV-coinfected and HCV-monoinfected adults had significantly less liver fat than uninfected adults, even after adjusting for demographic, lifestyle, metabolic factors, and hepatic fibrosis, suggesting that non-genotype 3 HCV infection may be protective against hepatic steatosis.

Liver stiffness is very accurate for predicting liver-related events in HIV-infected patients with chronic hepatitis C infection, according to a Spanish study.

A study in the journal AIDS found that HIV/HCV coinfection is associated with a greater homeostasis model assessment of insulin resistance, even after adjustment for demographic, lifestyle, and metabolic factors. The authors said sCD163, a marker of monocyte/macrophage activation which appears independent of intestinal epithelial damage and inflammation, partly explains this association.

Liver stiffness identifies HIV/HCV-coinfected patients with compensated cirrhosis with a very low risk of portal hypertensive gastrointestinal bleeding, according to a recent study, and as a result upper gastrointestinal endoscopy may be safely spared in patients with LS less than 21 kPa.

A systematic review found the introduction of universal mass vaccination in countries with intermediate endemicity for hepatitis A virus infection led to a considerable decrease in the incidence of hepatitis A in vaccinated and in non-vaccinated age groups alike.

A European study found HIV/HCV coinfected patients with a favorable virological response to PEG-interferon + ribavirin treatment had reduced risk of all-cause and liver-related death, while there was no difference in risk of non-liver-related death when comparing responders and non-responders.

rpizzi@frontlinemedcom.com

On Twitter @richpizzi

Hepatitis outlook: December 2016