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Welcome
The National Nurses Advisory Council for Liver Wellness & Viral Hepatitis
(NNAC) was created to improve hepatitis related health outcomes by initiating
collaborative programs on three fronts:
- To promote education and prevention;
- To improve the quality of care given to patients;
- To serve as advocates for patients, researchers, and medical professionals.
By pursuing innovative programs and initiatives, the NNAC will help medical
professionals and their patients overcome the obstacles to positive treatment
outcomes. The NNAC will also help promote healthy lifestyle behaviors
to the public on the community level.
Emerging Research
New
Genetic Test Identifies High Risk VS Low Risk HCV Infected To
Evaluate Need For Early Or Delayed Treatment
Researchers
at five major medical centers helped confirm the reliability of a new
genetic test, the first of its kind that can identify patients who are
at high risk of developing cirrhosis from chronic hepatitis C
infection. This means high-risk patients could be directed toward
early treatment that is usually a long course of drug therapy, while low-risk patients might
delay treatment.
Read
More About it....
Outcomes
With or Without Transplant for HBV Patients
Survival
rates are similar among patients with hepatitis B who are
listed for liver transplantation, whether or not they have
hepatocellular carcinoma (HCC) according to a study led by Anna S. Lok,
MD at the University of Michigan. Of 279 patients enrolled between
November 2001 and June 2005, 183 had HBV with cirrhosis, and 96 had
HBV with HCC. Most were receiving antiviral therapy.
The
patients with HBV-HCC were older, more likely to be Asian and had less
severe liver impairment than patients with HBV-cirrhosis; 78%
underwent liver transplantation, compared to 51% of patients with HBV-cirrhosis.
Despite this difference, 5-year survival rates were similar: 73% of
the HBV-HCC group, compared to 78% of the HBV-cirrhosis group. The
5-year survival rates for patients who did not receive a transplant
were also very similar: 82% of the HBV-HCC group versus 79% of the HBV-cirrhosis
group. It should be noted that 71% of the patients in the HBV-HCC
group who had not been transplanted had received some form of HCC
treatment including surgical resection and the number of patients
alive without transplant 5 years after listing was very small (n=6).
Survival without transplantation was excellent and equal between the
two groups, with 5-year survival in patients not transplanted actually
better than the survival for the entire cohort.
HFI Launches Teens
to the Top Campaign Promoting Healthy Lifestyles
--7,500 School Nurses Receive New Teen DVD
In collaboration
with the
National
Association, of School Nurses (NASN),
the Hepatitis Foundational International
is launching TEENS to the TOP campaign.
The aim of the Teens
to the Top national
initiative is to make effective tools available to
nurses and teachers to enhance their efforts
to
help teens avoid liver
damaging activities and
to adopt healthier lifestyle
behaviors.
HFI provided over 7,500 NASN
members with a new teen DVD called Give Your
Liver a Break plus
a user friendly Foundation for Decision Making Teacher’s Guide to
fill the gap in information available in schools about the liver.
Hepatitis, HIV/AIDS, alcohol and other substance abuse
are ever present threats to young adults who lack basic information to
know “why” and “how” to protect themselves. Knowledge is the
key to prevention.
Teens talking to teens is an effective approach to reach
kids with non-threatening, liver wellness messages they
can relate to in their daily lives. The Give
Your Liver a Break DVD has an
upbeat rap session, toe tapping music and an animated Lennie the Liver
character conveying powerful and memorable messages to help kids make
informed decisions and avoid liver damaging activities.
“We
are delighted to co-sponsor Teens
to the Top
to fill the gap in teaching tools available to health
educators aimed at reducing the
tragic consequences related to teens participating in unhealthy
behaviors, ” said Amy Garcia, Executive Director of
NASN.
For more information about this campaign and ways to
participate, call HFI at 1-800-891-0707.
Teachers – Parents – Counselors – Ministers – Social
Workers – Law Enforcement Personnel
Please join Teens to the Top !
FDA
APPROVES NEW TREATMENT FOR CHRONIC HEPATITIS B IN ADULTS
The Food and Drug Administration (FDA) today approved
Tyzeka (telbivudine) for the treatment of adults with chronic
hepatitis B (HBV), a serious viral infection that attacks the liver
and can cause lifelong infection, scarring of the liver (cirrhosis),
and eventually liver cancer, liver failure, and death. Tyzeka is a new
molecular entity, which is a term used by the FDA to describe a
medication containing an active substance that has never before been
approved for marketing in any form in the United States.
For
more information, click here...
STATINS
ARE A HOT TOPIC
Preclinical studies indicate that some statins used to treat high
cholesterol (produced and excreted by the liver) either alone or in
combination with pegylated interferon have demonstrated activity against
HCV in laboratory cell cultures. Although the full story on whether or
not statins inhibit HCV replication in human beings is incomplete, some
physicians are ordering these drugs in combination with approved
medications. Dr. Raymond Koff, Clinical Professor of Medicine at the
University of Connecticut and HFI Board member, recommends that regular
monitoring of liver enzymes be done whenever statins are used, but
cautions that use of statins as treatment for hepatitis C is not an
approved use.
NIH HEPATITIS B MANAGEMENT
CONFERENCE REPORT
--By Dr. Raymond Koff Clinical Professor of
Medicine, University of
Connecticut School of Medicine
The biology of HBV infection and the role of cccDNA in viral clearance and
persistence received attention at the Workshop. Cytokine-induced pathways and hepatocyte necrosis and turnover are thought to be the major mechanisms needed to clear nuclear cccDNA and HBV DNA to produce a “virus-free” liver. Nonetheless, HBV appears to be capable of evading the innate immune response, acting as a stealth virus, although the responsible mechanisms remain ill-defined. Even many years after recovery from acute hepatitis B, HBV specific T-cells persist along with trace amounts of HBV DNA in hepatocytes. The progression from acute HBV infection to chronic infection may be due, at least in part, to insufficient CD4+ helper cells and a defective CD8+ repertoire. Therapy of chronic HBV infection was a major topic of discussion.
Although some investigators suggested that candidacy for treatment should be expanded, others suggested that controlled infections with normal serum ALT levels and low viral levels have an excellent prognosis (in the absence of cirrhosis) and do not necessarily need treatment unless ALT levels and viral load increases on prolonged follow-up. Considerable discussion on developing standard definitions of response to therapy and presenting viral levels as IU/mL rather than copies/mL was followed by reviews of efficacy and safety of FDA-approved and under review or under study antiviral therapies. These included interferons, lamivudine, adefovir, entecavir, telbivudine, and tenofovir. The importance of the emergence of resistance to oral antiviral therapies as a limitation on efficacy was highlighted in a number of presentations and discussions.
Although data are limited, there seemed to be a consensus that combining agents (interferons with an oral agent or two oral agents administered together) was unlikely to enhance efficacy beyond that seen with the most potent of the two drugs. The costs of therapy were identified and future therapies including new viral targets and immunotherapeutic approaches also were reviewed. Potential changes in FDA requirements for registration trials of HBV antiviral agents were described.
NNAC
FILLS A GAP IN PATIENT CARE GUIDELINES
Concerned nurses, members of the National Nurses Advisory
Council (NNAC) a program of the Hepatitis Foundation International
identified a major gap in NANDA International nursing diagnosis
guidelines.
Under the leadership of Kathy White, RN, BSN, HCV/HIV Coordinator
for the Nebraska Department of Health and Human Services and co-founder
of the NNAC, previously absent information on liver and hepatitis C
diagnoses were introduced and recently approved by NANDA International.
These guidlines will be included in NANDA's Nursing Diagnosis:
Definitions & Classification 2006-2007 Journal with a worldwide
distribution.
HCV VACCINE IN PHASE I CLINICAL TRIALS TESTING IN HUMANS
Chrion Corporation, a leader in hepatitis C research, is
collaborating with Saint Louis University School of Medicine to study
the safety and effectiveness of Chiron's investigational hepatitis C
vaccine. This Phase I clinical trial will be testing the vaccine in
humans for the first time.
ALCOHOL AND VIRAL HEPATITIS
Many epidemiologic studies have reported a higher than average
occurrence of hepatitis viral infections in alcoholics, specifically
hepatitis B and C viral infections. These infections can occasionally
lead to chronic infections and can contribute to the progression of
liver disease in alcoholic patients.
Several studies in urban areas have reported that alcoholics have
an increased prevalence of hepatitis B infection, as determined by the
presence of three blood markers: hepatitis B surface antigen ([HB.sub.s]
Ag), hepatitis B surface antibody (anti-[HB.sub.s]), and hepatitis B
core antibody (anti-[HB.sub.c]) (see Figure 1) (Chopra et al. 1980;
Mills et al. 1981; Goudeau et al. 1981; Basile et al. 1981; Boron et
al. 1986; Jacobson et al. 1992). Across these studies, the percentage
of alcoholics positive for any one of these markers ranged from 10
percent to 40 percent.
For more information, click here...
RAPID ORAL TEST FOR HCV ON THE WAY--NOT ON THE US MARKET-- YET
OraSure Technologies is teaming up with Schering-Plough to develop and
market the first Oral test to detect hepatitis C virus (HCV)
antibodies. Ease of testing for HCV will be a major step forward in
efforts to identify infected individuals. Hopefully, the development
will be accelerated by this collaboration between these two companies.
Encouraging individuals to assess their past risk behaviors that may
have exposed them to hepatitis C and to seek testing has been a
challenge. Making testing easier will enhance public health
initiatives to identify those who are HCV infected.
Once aware of their infection, individuals should stop drinking
alcohol, lose weight if they are overweight, and lead a healthy
lifestyle. Medical evaluation is essential to determine the extent of
liver damage and to consider treatment options.
Estimates of the number of unidentified hepatitis C infected
individuals is in the tens of thousands and probably many more.
Call the Hepatitis Foundation International at 800-891-0707 to obtain
more information and referral to liver specialists.
WHEN KNOCKING OUT THAT HEADACHE
-- YOU MAY BE KNOCKING OUT YOUR LIVER
The Food and Drug Administration cautioned millions about overdosing
on acetaminophen, found in Tylenol. The Hepatitis Foundation
International has been alerting the public over the years about the serious
liver damage that can occur by overdosing of Tylenol and combining
this drug with alcohol.
Warning labels are often so small they are hard to read. Many individuals
neglect to read them and assume that this and other drugs are
"safe". The FDA has proposed sterner
warning labels for acetaminophen, aspirin and ibuprofen cautioning
millions of Americans who take these over the counter pain relievers
on a regular basis of potentially serious side effects.
Liver damage and even death can occur when taking more than recommended for these drugs
on a regular basis and at shorter intervals than stated on
the label.
Tylenol liquid for infants is three times as strong as the elixir for
older children. Extreme caution is recommended when babies spit out
some of the medication and additional amounts are given. Overdose in
babies and young children may cause serious liver damage, coma, and
even death.
ABBOTT
HBV SCREENING TEST APPROVED BY FDA
New fully automated blood screening system for hepatitis B
improves the safety and simplifies screening of blood and organ donors.
Approved by the Food and Drug Administration, Abbott Laboratories'
system automates two tests previously handled manually. The new system
will reduce the potential for operator error and resists tampering in
processing 15 million units of whole blood per year for the hepatitis B
antigen.
CHRONIC HEPATITIS IN CHILDREN
American researchers have reported in the Journal of
Pediatric GI and Nutrition (2005) that chronic hepatitis C virus
(HCV) infection produces milder damage in children than in adults. With
duration of infection, HCV-RNA level, and genotype being equal, children
present lower serum ALT levels and less severe liver disease that adults
infected with HCV.
DRUG ALERT LIST
The American Association for the Study of Liver
Diseases (AASLD) web site hosts a list of drugs that have caused cases
of serious hepatic problems suspected to be associated with substances
prescribed, dispensed or used as reported by the FDA MedWatch.
To view this list, click
here...
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