Advanced Liver Disease among HIV-HCV Coinfected Individuals

2006-12-31 14:36:38

Advanced Liver Disease among HIV-HCV Coinfected Individuals
By Liz Highleyman
Studies to date have produced conflicting data about the incidence of liver
fibrosis progression in HIV-HCV coinfected individuals, whether this is more
rapid in coinfected compared with HCV monoinfected patients, and how chronic
liver disease is affected by antiretroviral therapy.
In a study presented at the 14th Conference on Retroviruses and Opportunistic
Infections last month in Los Angeles, researchers assessed the incidence and
characteristics of advanced end-stage liver disease -- or hepatic decompensation
-- and liver-related mortality in HIV-HCV coinfected patients receiving HAART.
The study included 1011 previously antiretroviral-naive coinfected participants
who started HAART at 5 hospitals in Spain.
Results
a.. After a median follow-up period of about of 5 years, 59 patients (5.83%)
developed hepatic decompensation and 69 (6.82%) died (1.36 per 100
person-years).
b.. Of the 69 total deaths, 30 (43%) were due to liver disease, 15 (22%) were
due to AIDS, and 24 (35%) were due to other causes.
c.. 39 of 953 patients (4.09%) without liver cirrhosis at baseline developed
hepatic decompensation, 20 of whom (2.1%) died due to liver failure.
d.. Categorized according to CD4 cell gain after starting HAART, the rates of
liver decompensation were:
a.. +
deaths;
b.. + 100-300 cells/mm3: 11 (3.55%) decompensations, 6 (1.94%) liver-related
deaths;
c.. + < 100 cells/mm3: 14 (7.14%) decompensations, 7 (3.57%) liver-related
deaths.
e.. The most common presentation of decompensated liver disease was ascites
(abdominal fluid accumulation), followed by hepatic encephalopathy and jaundice.
f.. Factors independently associated with the development of hepatic
decompensation were:
a.. age older than 33 years;
b.. female sex;
c.. CDC stage C HIV disease;
d.. baseline cirrhosis;
e.. CD4 cell gain of less than 100 cells/mm3;
f.. less than 60% of follow-up time spent with undetectable HIV viral load.
g.. Factors associated with death due to liver failure were:
a.. older age;
b.. smaller CD4 cell gain;
c.. lack of anti-HCV treatment;
d.. coinfection with hepatitis delta virus (HDV);
e.. baseline cirrhosis;
f.. hepatic encephalopathy.
Conclusion
"The overall rate of clinical progression of liver disease in HIV-HCV
[co]infected patients under HAART is relatively low," the investigators
concluded. "In spite of that, end stage liver disease is the main cause of death
in this population."
Hosp Univ de Valme, Seville, Spain; Hosp Univ Virgen del Rocio, Seville, Spain;
Hosp Univ Virgen de la Macarena, Seville, Spain; Hosp Virgen de la Victoria,
Malaga, Spain; Hosp Univ Reina Sofía, Cordoba, Spain.
PDF of poster
Link to study abstract
03/30/07
Reference
J A García-García, M Aguilar-Guisado, M Ríos-Villegas, and others (Grupo Andaluz
para el Estudio de las Enfermedades Infecciosas). Clinical Progression of
Hepatitis C Virus-related Chronic Liver Disease in HIV-infected Patients
Undergoing HAART. 14th Conference on Retroviruses and Opportunistic Infections.
Los Angeles, February 25-28, 2007. Abstract 934 (poster).
http://www.hivandhepatitis.com/2007icr/croi/docs/033007_g.html

Stem Cells Speed Growth Of Healthy Liver Tissue

2006-12-31 10:32:51

Stem Cells Speed Growth Of Healthy Liver Tissue
Science Daily - For the first time, researchers have used adult bone marrow
stem cells to regenerate healthy human liver tissue, according to a study
published in the April issue of the journal Radiology.
When large, fast-growing cancers invade the liver, some patients are unable
to undergo surgery, because removing the cancerous tissue would leave too
little liver to support the body.
Researchers at Heinrich-Heine-University in Düsseldorf, Germany, used adult
bone marrow stem cells to help quickly regenerate healthy liver tissue,
enabling patients to eventually undergo a surgical resection.
"Our study suggests that liver stem cells harvested from the patient's own
bone marrow can further augment and accelerate the liver's natural capacity
to regenerate itself," said Günther Fürst, M.D., co-author and professor of
radiology.
In the study, researchers compared the results of portal vein embolization
(PVE), a technique currently used to help regenerate liver tissue, to a
combination of PVE and an injection of bone marrow stem cells into the
liver.
PVE blocks blood flow to the diseased portion of the liver and diverts blood
to the organ's healthy tissue, promoting liver growth. Bone marrow stem
cells extracted from the patient's hip bone and injected into the liver also
help the liver regenerate.
The study included 13 patients with large central liver malignancies who
were unable to undergo surgery because resection would leave less than 25
percent of their total liver volume.
Six of the patients underwent both PVE and injection of bone marrow stem
cells. Seven patients underwent only PVE. Computed tomography (CT) scans
were performed before and up to five weeks after PVE to determine the degree
of liver growth.
Patients who received the combination of PVE and stem cell injection had
double the liver growth rate and gain in liver volume, compared with those
who underwent PVE alone. As a result, the patients who received the combined
treatment were able to undergo surgery an average of 18 days sooner than
patients who received PVE only.
"Our research demonstrates that stem cells are a powerful adjunct to PVE for
patients undergoing surgical resection," said Jan Schulte am Esch, M.D.,
co-author and surgery staff member. "Based on our results, we also believe
that adult stem cell administration may be a promising therapy for
regenerating livers damaged by other chronic and acute diseases."
The researchers are currently embarking on a randomized controlled trial of
the therapy.
"Embolization and CD133+ Bone Marrow Stem Cells for Liver Regeneration."
Collaborating with Prof. Fürst and Dr. Schulte am Esch on this paper were L.
Benjamin Fritz, M.D., Ludger W. Poll, M.D., Stefan B. Hosch, M.D., Michael
Klein, M.D., Erhard Godehardt, M.D., Andreas Krieg, M.D., Britta Wecker,
Volker Stoldt, M.D., Marcus Stockschläder, Claus F. Eisenberger, M.D.,
Ulrich Mödder, M.D., and Wolfram R. Knoefel, M.D.
Note: This story has been adapted from a news release issued by Radiological
Society of North America.
http://www.sciencedaily.com/releases/2007/03/070327094518.htm

GPs Armed with New Hepatitis C Resource

2006-12-31 07:39:31

GPs Armed with New Hepatitis C Resource
29-Mar-07
The Department of Health's FaCe It campaign has launched this week a new guide
for primary care professionals providing essential information on the virus.
The Department of Health's FaCe It campaign has launched this week a new guide
for primary care professionals providing essential information on the virus.
With epidemiological surveillance suggesting that the majority of people in
England with hepatitis C may not be diagnosed, the leaflet aims to support GPs
in identifying and testing patients at risk of infection.
Developed in consultation with a professional panel, the leaflet provides GPs
with a handy and concise overview of hepatitis C from diagnosis to treatment,
recommending how patients with hepatitis C should be managed through testing,
diagnosis and referral to a specialist.
Most patients with hepatitis C will not realise that they have the virus as it
can take years or even decades for symptoms to appear. Antiviral drug therapy,
however, is effective at clearing the virus in the majority of people overall
and preventing progression to serious liver disease, which is why early testing
is being recommended for those patients at past or current risk of infection.
The launch of the new resource is timed to coincide with the latest hepatitis C
press and radio advertising campaign which encourages people to find out if they
could be at risk from hepatitis C. With this in mind, the availability of this
resource will help provide primary care professionals with the answers they need
to cope with the increasing numbers of enquiries.
Professor Howard Thomas, Clinical Professor, Imperial College London said:
"With the Department's advertising campaign and the recent announcement by Dame
Anita Roddick helping to raise awareness of hepatitis C, healthcare
professionals need to be better informed about the virus. GPs need accessible
information at their fingertips and the Hepatitis C quick reference guide for
primary care gets essential information into the hands of GPs in a quick and
straightforward manner. Because treatment is curative in the majority of cases,
it has never been more important to identify those infected."
Dr Martyn Wake, GP from Wimbledon commented,
"GPs have an important role to play in identifying and offering testing to
patients who might be at risk of hepatitis C infection so that they can be
referred to a specialist. We hope that this leaflet will be a useful tool for
GPs. Alertness in our profession will make a crucial contribution to ensuring
that more patients are diagnosed and treated."
The leaflet will be distributed to all GP practice managers this week and
complements a suite of hepatitis C resources including posters, patient leaflets
and a guide to the hepatitis C virus produced by the FaCe It campaign. All
materials can be ordered for free by contacting the Department of Health's
publications line (08701 555 455) or by fax (01623 724 524) or via email to
dh@... <mailto:dh@...
The Hepatitis C Information Line on 0800 451 451 (textphone 0800 0850859) is
open from 7am-11pm, 7 days a week for confidential information and advice for
both the general public and healthcare professionals.
http://www.healthcarerepublic.com/news/PressRelease/647252/GPs-Armed-New-Hepatit\
is-C-Resource/

Jan [HepCingles] Biospy Results

2006-12-31 01:01:36

so sorry Jan... I'm up for a minute here still hazy and swollen from that
stupid dye..... yuck you gonna feel a bit weird and sick...... please
don't forget to get yourself something to take along with to prevent yeast
infection....... they sell over counter now..... and Goji juice is
good....... oh are we having fun yet.....???????? ok enough for me
tonight..... Feel better.... I'm gonna!!!!!!! hugs, sally

Hepatitis C Symptoms, Illness, Diagnosis, TX

2006-12-30 21:54:39

Hepatitis C
Symptoms and illness
Diagnosis
Treatment
Hepatitis C virus was first identified in the 1980s. Although it is not
related to other hepatitis viruses, it can cause similar symptoms. It is
chiefly transmitted by blood to blood contact and so the main groups
affected have been injection drug users and recipients of blood and blood
products, e.g. haemophiliacs. People from these communities may also be
co-infected with HIV.
There is growing evidence that hepatitis C can be spread sexually. Though
the mechanisms are unclear, itÕs been suggested that the risk may relate
to sexual practices which involve contact with blood, most notably fisting
and rimming, and unprotected anal sex. Research involving heterosexual
couples has tended to find that the risk of transmission through sex is
low. However, this is still a controversial area and research is ongoing.
People infected with both HIV and hepatitis C may however be more likely
to transmit hepatitis C through sex, perhaps because they often have
higher levels of the virus in their genital fluids than HIV-negative
people.
It is currently estimated that 10% of children born to hepatitis
C-infected mothers will contract the virus; 25% for mothers who are also
HIV-positive.
Symptoms and illness
The effects of infection with hepatitis C vary. Less than 5% of people who
contract the virus develop acute hepatitis symptoms such as jaundice,
diarrhoea and nausea at the time of infection, and a significant minority
may experience no symptoms at any stage. For those who do, common symptoms
include extreme tiredness and depression.
It is not known what proportion of people with hepatitis C will develop
liver disease. A small proportion of people infected with hepatitis C will
manage to clear the infection. Approximately 85% of infected individuals
will go no to develop chronic or ongoing hepatitis C infection. Patterns
of disease progression seem to vary considerably from person to person.
Some individuals may never experience symptoms, others may begin to
develop symptoms like extreme tiredness and nausea ten to fifteen years
after infection and a significant minority develop serious liver disease.
The varying severity of hepatitis C may reflect differences between
hepatitis C strains. Other factors such as being male, alcohol use, older
age and having HIV may also speed-up hepatitis C disease progression.
It is thought that it takes on average 30 to 40 years to progress from
infection with hepatitis C to liver cirrohosis in people who have only
hepatitis C.
The prognosis of people co-infected with HIV and hepatitis C is unclear.
Recent studies suggest that HIV may hasten liver damage in co-infected
people, and that co-infected people may have a faster progression to AIDS.
Diagnosis
A blood test for antibodies to hepatitis C can tell you whether or not you
have been exposed to the virus, though a PCR (viral load) test may be used
to confirm infection. Liver function tests may give an indication of
whether hepatitis C has damaged your liver, though this can only be
accurately shown by a liver biopsy, in which a small sample of liver
tissue is removed.
HIV infection can make the diagnosis of hepatitis C more difficult as
infection may not show up on antibody tests in HIV-infected people.
Treatment
Current practice is to start treatment for hepatitis C only if liver
function is consistently abnormal. The goals of treatment are to normalise
liver enzymes (a marker of liver function); to lower hepatitis C viral
load; to improve liver inflammation; and to prevent progression to
cirrhosis or liver cancer.
Treatment or hepatitis C is not life-long and usually 24 or 48 week.
Currently three antiviral drugs are approved for hepatitis C:
interferon-alpha (which is given by injection), with or without an
anti-viral drug called ribavirin, and a new form of interferon called
pegylated interferon which is given with ribavirin. The British HIV
Association recommends that hepatitis C be treated with a combination of
pegylated interferon and ribavirin. Side-effects may be very severe,
though they tend to reduce as treatment goes on. They include high fevers,
joint pain, depression and low white cell count. Ribavirin should not be
taken at the same time as AZT, and canÕt be used during pregnancy.
The best approach to treating people co-infected with HIV and hepatitis C
is unclear. Most specialists advise treating the infection which is more
immediately life-threatening, and in the majority of cases that will be
HIV. However, treatment with some anti-HIV drugs, e.g. protease
inhibitors, may be problematic for people with liver damage and requires
very careful monitoring. There is some evidence that the restoration of
the immune system seen with successful anti-HIV therapy may temporarily
increase the risk of liver damage in people with hepatitis C.
---------...and the beat goes on......." Sonny Bono.....I will say of the L-rd,
He is my refuge andmy fortress: my G-d; in Him will I trust.Psalm

U.S. Pharmacy Errors: Unreported Epidemic? Watch 20/20 Friday night

2006-12-30 08:49:31

"20/20" went undercover on a four-month investigation to examine what some
industry experts fear is an unreported epidemic of pharmacy errors at fast
growing chain drug stores. While pharmacists are supposed to check every
prescription that is sold, busy pharmacies sometimes rely on pharmacy
technicians -- often high school students -- to actually fill those
prescriptions.
http://abcnews.go.com/2020/
U.S. Pharmacy Errors: Unreported Epidemic?
March 29, 2007 11:40 AM
Rhonda Schwartz and Avni Patel Report:
Walgreens never told federal or state authorities that one of its pharmacists
had made a mistake on a prescription that led to devastating brain damage in a
suburban Chicago infant.
Because it didn't have to.
Neither the federal government nor 46 of the 50 states have any law requiring
that drug stores report prescription errors, even in cases involving serious
injury or death.
While some fear there is an unreported epidemic of pharmacy errors, there are no
reliable figures to gauge the scope of the problem. And that's the way the
industry seems to like it.
"I don't think it should be publicized," said Mary Ann Wagner, the senior vice
president of the National Association of Chain Drug Stores, in an interview to
be broadcast Friday on "20/20."
She says the industry fears the public won't understand the difference between
minor and major errors, and that the figures could be used to punish drug
stores.
In the suburban Chicago case, the pharmacist mistakenly put a medicine for adult
diabetes in filling a Phenobarbital prescription for four-month-old Alexandra
Gehrke.
Alexandra's mother, Tracey Gehrke, says the medicine was intended as a
precaution against seizures in her prematurely-born daughter but actually
triggered severe seizures.
"I was poisoning my baby, and I didn't know it," she told "20/20."
A jury ordered Walgreens to pay the family $21 million in damages, but the
Gehrkes say neither the company nor the pharmacist ever offered an apology for a
mistake that forever altered their daughter's life.
Alexandra cannot walk, talk or feed herself, although she is expected to have a
normal life expectancy.
"You hurt people, and you don't apologize?" Tracey Gehrke asked.
The pharmacist who admitted responsibility for the error, William Zaeske,
continues to work at Walgreens and is now a pharmacy manager at another store
near the one where the prescription error happened.
Zaeske declined to answer questions from "20/20" about how the error occurred.
In a statement, Walgreens said, "We deeply regret the few errors that have
occurred among the more than 500 million prescriptions we fill each year at our
5,600 pharmacies."
As the country's biggest pharmacy chain, Walgreens recently reported record
profits.
It says it has invested nearly $1 billion in "redundant pharmacy safety systems"
and training over the last 10 years.
For the full investigation, watch "20/20" Friday at 10 p.m. EDT.

Re: [HepCingles] Rick

2006-12-30 07:43:50

Thanks Rick, I really needed to hear this..... I've been having a very
rough time lately..... and this lifted my spirits... many thanks.... Sally
---------...and the beat goes on......." Sonny Bono.....I will say of the L-rd,
He is my refuge andmy fortress: my G-d; in Him will I trust.Psalm

 Husband and wife

2006-12-29 22:14:43

Husband and wife are in bed together.

She feels his hand rubbing her shoulder.

She: "Oh, that feels good."

His hand moves to her breast.

She: "Gee, honey, ....."

His hand moves to her leg.

She: "Oh, honey, don't stop."

But he stops.

She: "Why did you stop?"

He: "I found the remote control
---------...and the beat goes on......." Sonny Bono.....I will say of the L-rd,
He is my refuge andmy fortress: my G-d; in Him will I trust.Psalm

Re: [HepCingles] Biospy Results

2006-12-29 16:17:53

Jan so sorry you are sick.... I am going in for colonoscopy and EGD
again... I do them both every year. I have a pre cancerous colon and bad
tummy...... my ulcers are gone..... the EGD isn't so bad... well my doc
puts me in the hospital and I am completely out.... but had one in
Colorado and it was awful....... re the antibiotics, you may want to buy
gyna lotrimin over the counter and take while taking them in order to
avoid a yeast infection......... wow that's a lot of antibiotics... which
ones? wow they make me real sick and I am allergic to everything other
than keflex, cipro and levaquin sp???? but I try not to take them.... I
had to do a totally yeast free diet from taking too many antibiotics over
the years.... You will feel better...... thinking of you..... sorry you
are ill...... I just got back from ER due to reaction from the dye they
used in an MRI.... I fell and have a smashed knee and a torn rotator
cuff.... so I can feel for ya... hang in there, this, too shall pass...
love, sally

Pizza as Health Food?

2006-12-29 15:57:49

Pizza as Health Food?
Chemists at the University of Maryland say they have found a way to
improve pizza as a source of antioxidants. Researchers experimented with
baking temperature, baking time, and fermentation time. They found that
using whole-grain dough, giving it lots of time to rise, and baking it a
higher temperature enhanced the antioxidant content of pizza.
As Reported by CNN
Medscape. 2007; ©2007 Medscape
---------...and the beat goes on......." Sonny Bono.....I will say of the L-rd,
He is my refuge andmy fortress: my G-d; in Him will I trust.Psalm

Wow... this sure hits home.... enjoy

2006-12-29 07:09:05

There's some mighty fine advice in these words, even if you're not
superstitious. This has been sent To you for good luck from the Anthony
Robbins organization. It has been sent around the world ten times so Far.
ONE. Give people more than they expect and do it cheerfully.
TWO. Marry a man/woman you love to talk to. As you get older, their
conversational skills will be as important as any other.
THREE. Don't believe all you hear, spend all you have or sleep all you
want.
FOUR. When you say, "I love you," mean it.
FIVE. When you say, "I'm sorry," look the person in the eye.
SIX. Be engaged at least six months before you get married.
SEVEN. Believe in love at first sight.
EIGHT. Never laugh at anyone's dream. People who don't have dreams don't
have much.
NINE. Love deeply and passionately. You might get hurt but it's the only
way to live life completely.
TEN. In disagreements, fight fairly. No name calling.
ELEVEN. Don't judge people by their relatives.
TWELVE. Talk slowly but think quickly.
THIRTEEN. When someone asks you a question you don't want to answer, smile
and ask, "Why do you want to know?"
FOURTEEN. Remember that great love and great achievements involve great
risk..
FIFTEEN. Say "bless you" when you hear someone sneeze.
SIXTEEN. When you lose, don't lose the lesson
SEVENTEEN. Remember the three R's: Respect for self; Respect for others;
and responsibility for all your actions.
EIGHTEEN. Don't let a little dispute injure a great friendship.
NINETEEN. When you realize you've made a mistake, take immediate steps to
correct it.
TWENTY. Smile when picking up the phone. The caller will hear it in your
voice.
TWENTY-ONE. Spend some time alone.
A true friend is someone who reaches for your hand and touches your heart.
---------...and the beat goes on......." Sonny Bono.....I will say of the L-rd,
He is my refuge andmy fortress: my G-d; in Him will I trust.Psalm

Rick

2006-12-29 04:59:25

Great post Rick! Thank you :-)

CDC Refuses Request From Grassley for Ombudsmen Briefing

2006-12-28 17:53:38

CDC Refuses Request From Grassley for Ombudsmen Briefing
CDC has refused a request from Senate Finance Committee ranking member
Chuck Grassley (R-Iowa) for a briefing by agency ombudsmen about efforts to
improve employee morale, the Atlanta Journal-Constitution reports. In a March 5
letter to Grassley, CDC Director Julie Gerberding wrote that the two contract
employees CDC has hired to serve as interim ombudsmen -- Joseph McDade and
Gerald Naehr -- believe that briefing the senator would violate standards of
practice for ombudsmen and leave them unable to perform their jobs effectively.
She wrote, "While I am respectful of your desire to get further information, I
am also sensitive to these principles -- especially because the CDC's Ombudsman
Office is in a critical stage of development." In response, Grassley on Thursday
sent a letter to Gerberding that warned her about federal laws against
interference with a congressional investigation. Grassley also questioned the
reason for the refusal of his request and the credibility of the ombudsmen with
CDC employees. He wrote, "I fully intend to exercise my oversight
responsibilities to ensure the success and integrity of the Ombudsman effort."
In a statement on Friday, Grassley said, "It's very important that the new
ombudsmen establish themselves as a force that's independent from the CDC
director and a trustworthy place where CDC employees can turn. Hunkering down,
except for meetings with the director, sends the wrong signal." CDC spokesman
Tom Skinner on Friday said, "We have and will continue to cooperate with Senator
Grassley's office, and if there's any impression on the senator's part that Dr.
Gerberding is stonewalling, nothing could be further from the truth." McDade and
Naehr did not respond to requests for comment (Young, Atlanta
Journal-Constitution, 3/24).
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=43877

Meta-analysis confirms hepatitis C vertical transmission more likely with coinfected mothers

2006-12-28 07:38:09

Meta-analysis confirms hepatitis C vertical transmission more likely with
coinfected mothers
Derek Thaczuk, Thursday, March 29, 2007
A new meta-analysis has confirmed that the mother-to-child transmission risk for
hepatitis C virus (HCV) nearly doubles for mothers who are HCV/HIV coinfected.
In coinfected mothers with detectable HCV viremia, the risk is nearly tripled.
The results, published in the April 15th issue of Clinical Infectious Diseases,
confirm those of a 2003 meta-analysis by another researcher.
Rates of vertical (mother-to-child) transmission of HCV range from 4 to 10%;
mothers coinfected with HIV are more likely to transmit HCV to their child. An
earlier meta-analysis (Pappalardo, 2003) determined the odds ratios for
HIV-coinfected compared to HIV-negative mothers as 2.82 (95% CI, 1.78 to 4.45,
p=.00001) for HCV antibody-positive women, and 1.97 (95% CI, 1.04 to 3.74,
p=.04) for women with HCV viremia (detectable HCV in the blood).
Researchers from Johns Hopkins University School of Medicine have now performed
a similar meta-analysis including two large studies not published at the time of
the Pappalardo review. One of these - the European Pediatric Hepatitis C Virus
Network (EPHN) study - is the largest such cohort to date, including 1479
babies.
The team's conclusions were drawn from a restricted analysis that they believed
provided the most reliable estimate (details below). According to this analysis,
vertical transmission was 1.9 times more likely for HIV/HCV coinfected mothers
than for HCV-infected mothers without HIV (95% confidence interval, 1.36-2.67).
For coinfected mothers with detectable HCV viremia, the risk was 2.82-fold
greater (95% CI, 1.17 to 6.81) than for HIV-negative mothers without HCV
viremia.
Much of the Johns Hopkins report details the methodology of how studies were
selected for the meta-analysis. The original literature review found 243
"potentially relevant" published articles (conference abstracts were not
considered). From these, the team selected only results published in English
which (among other criteria) presented original data, compared coinfected with
HCV-monoinfected women, and included at least 20 coinfected women. This left
only ten (mostly European) studies, published between 1993 and 2005 (Lam, 1993;
Zanetti, 1995; Paccagnini, 1995; Zuccotti, 1995; Tovo, 1997; Zanetti, 1998;
Granovsky, 1998; Resti, 2002; Rerrero, 2003; EPHN, 2005). All but one of these
were prospective cohorts, yielding a total of 4424 mother/child pairs, 19.4% of
which included coinfected mothers.
However, the investigators felt that the "most reliable estimate" came from an
even more restricted pool - the five studies with sample sizes of at least 50.
The odds ratio for coinfected mothers, calculated from the ten originally
selected studies, was 2.75 (95% CI, 1.51 to 4.99). However, analysis indicated
that the estimates in this group were "heterogeneous and ideally should not be
pooled". The lack of comparability was ascribed to "a lack of standardised HCV
diagnostic criteria and the inability to control for known confounders" - such
as selection bias, loss to follow-up, and means of delivery (Caesarean vs. live
birth). The researchers therefore analysed various subgroups of the ten studies,
leading to the 1.9-fold odds ratio drawn from the five studies (Paccagnini,
Tovo, Granovsky, Resti, and EPHN) which "showed low heterogeneity, and were of
better overall quality."
Despite the similarity to the 2003 findings, the report concludes that more
research is still required, particularly calling for "large studies that control
for potential known confounders, use clear selection criteria . and employ
standardized HCV testing[.]"
References
Polis CB et al. Impact of maternal HIV coinfection on the vertical transmission
of hepatitis C virus: a meta-analysis. Clin Inf Dis 44:1123-1131, 2007.
Pappalardo BL. Influence of maternal human immunodeficiency virus (HIV)
co-infection on vertical transmission of hepatitis C virus (HCV): a
meta-analysis. Int J Epidemiol 32:727-734, 2003.
http://www.aidsmap.com/en/news/D2AD58ED-AABF-4D78-B771-0CB7EADA23CB.asp

Children With HCV Rarely Symptomatic Initially

2006-12-28 06:54:57

Children With HCV Rarely Symptomatic Initially
By David Douglas
NEW YORK (Reuters Health) Mar 21 - Children with hepatitis C virus (HCV)
infection, mostly acquired through blood transfusions, are generally
asymptomatic, according to a study of such patients treated at a Washington,
DC hospital.
In the February issue of the Journal of Pediatrics, Dr. Parvathi Mohan of
Childrens National Medical Center and colleagues note that there is a lack
of uniformity in the descriptions of the natural history, clinical
presentation, and histologic features of HCV infection in children.
This prompted them to evaluate a cohort of 60 HCV-infected children followed
at the medical center over a 5-year period. Sources of infection were
transfusions (68%), perinatal transmission (13%), both (7%), and unknown
(12%). The mean age at infection was 7.1 months, and the duration of
infection was 13.4 years.
Mean alanine aminotransferase level was normal in 25% of the children, up to
3-times normal in 62%, and greater than 3-times normal in 13%. In addition,
liver biopsy specimens showed minimal to mild inflammation in 71%, absent or
minimal fibrosis in 88%, and bridging fibrosis in 12%.
Most patients were asymptomatic, but three patients had advanced liver
disease at presentation. Two died after transplantation.
Summing up, Dr. Mohan told Reuters Health that further research is required,
but "most children who acquire HCV infection early in life manifest only
mild liver disease over the first two decades of their infection."
"However," she concluded, "it is apparent that severe liver disease may
develop in some -- and all children with HCV should be followed closely."
J Pediatr 2007;150:168-174.

White House Spokesman Has Surgery for Liver Metastasis

2006-12-27 22:33:35

White House Spokesman Has Surgery for Liver Metastasis
By Mark Bloom, Editor-in-Chief, MedPage Today
March 27, 2007
WASHINGTON, March 27 -- Presidential spokesman Tony Snow has had surgery for
metastatic liver cancer, the White House announced today.
Snow, 51, who had surgery and chemotherapy in 2005 for Stage III colon cancer,
announced last week that surgeons would remove a small growth discovered in his
right pelvic area. At the time he cautioned against "jumping to conclusions."
The White House said the growth resected yesterday was a liver metastasis. The
extent of the liver involvement was not made clear, nor was it clear whether the
disease had recurred in the colon as well. Snow's deputy quoted him as saying
that the small growth that was removed was in the general area of the original
malignant lesion and that the cancer had spread to the liver.
The White House said physicians were considering a range of treatment options.
http://www.medpagetoday.com/HematologyOncology/ColonCancer/dh/5338

Time off for bad behavior

2006-12-27 12:28:11

Time off for bad behavior
EVERY day about 19 people who are waiting for organ donations die before they
can receive them. Clearly, the need is far greater than the supply. But reducing
prison inmates' sentences in exchange for tissues or organs, as the South
Carolina legislature is considering, is not the answer.
Legislators in the Palmetto State know that more transplantable organs are
greatly needed. But if an idea to shave six months off prisoners' sentences in
return for organ donations goes anywhere, it will open the doors to a slippery
slope to the unsavory. What about a poor woman selling a kidney so that her
family can keep their house?
South Carolina lawmakers are pondering legislation to let prisoners donate
organs or bone marrow for reduced sentences. Although they are still
investigating the issue, so far a state Senate panel has backed the creation of
an organ-and-tissue donation program for inmates.
This is not a good idea, even though the state's Senate corrections committee
backs the proposal. For one thing, it unfairly discriminates against those
inmates physically unable to donate; most drug users, for example, are
ineligible to donate organs.
And while the state corrections department says some lifers and other inmates in
for the long term would gladly donate organs if they knew they might save a
child's life, is this in fact a truly voluntary donation? Frankly, no matter
what type of spin they try to put on the measure to try to get it accepted, it
sounds unseemly.
A much better strategy would be to conduct more public awareness campaigns and
promote the need for donor tissue and organs. The laws do need to be changed in
order to make it easier for a person to specify that she or he wants his or her
organs donated at their death, and to have that information entered in a
national registry. As it is now, a person can sign organ donor cards, but upon
his or her death, the ultimate decision lies with the families.
People should be motivated by their own unselfish desires to donate organs.
Anything less is inappropriate and can end only in a moral cesspool.
What the South Carolina legislators may not know is that this idea isn't
original. In the 1950s, a young physician showed up at an Ohio prison to ask
inmates on Death Row if they would be willing to donate their organs while still
living instead of being electrocuted.
When the warden found out, he threw the doctor out. His name, by the way, was
Jack Kevorkian, and he has been clamoring for the harvesting of organs ever
since. Somehow, we don't think that's where society wants to go.
http://toledoblade.com/apps/pbcs.dll/article?AID=/20070328/OPINION02/703280306

James Redford Institute to be featured at Red Stick Festival 2007 "Animation Collaboration" to highlight importance of organ donation

2006-12-27 10:07:38

James Redford Institute to be featured at Red Stick Festival 2007 "Animation
Collaboration" to highlight importance of organ donation
BATON ROUGE - James Redford, writer, director, producer and son of Robert
Redford, will attend the Red Stick International Animation Festival this year to
emphasize the importance of organ and tissue donation through his organization,
the James Redford Institute for Transplant Awareness, or JRI.
Red Stick International Animation Festival is an annual event in downtown
Baton Rouge that brings together artists, animators, filmmakers, computer
scientists and also people who just like cartoons to showcase the latest
developments in Louisiana's digital arts and technology sectors, which are
leading to economic development for the state and the city. The festival will
take place April 18-22 in the Baton Rouge Arts District at a variety of historic
venues in the capital city.
JRI is a supporter of the 2007 Red Stick Animation Festival with the
Animation Collaboration for a Cause segment. This portion of the festival is
where artists work closely with school-age children from Louisiana to help them
use animation to express their feelings and share their stories about various
social issues.
The 2007 Animation Collaboration will focus on organ transplant awareness
and will include two days of workshops, on Thursday, April 5, and Friday, April
6, for the children.
During the 2007 Red Stick International Animation Festival, Redford will
sit on a panel on Friday, April 20, to discuss his organization and the
importance of donor awareness. Redford is a recipient of two liver transplants
and created his foundation to raise awareness about the need for more people to
choose donation.
The Inaugural Animation Collaboration at Red Stick 2006 was with FilmAid
International, AnimAction and Listen Up! Youth Media. That collaboration, which
took place as a three-day workshop at the Shaw Center, was designed to empower
students affected by Hurricanes Katrina and Rita to tell their stories of hope
and inspiration. The films created by the 2006 collaboration are still being
screened at festivals worldwide.
Red Stick Director Stacey Simmons said the event was so inspiring last
year, she has now slated the Animation Collaboration as a permanent addition to
the annual Red Stick International Animation Festival.
"We hope that we can use this part of the festival each year to not only
raise awareness of different causes, but to show participants how animation is
an innovative means of communicating about today's important social issues,"
Simmons said.
Animation Collaboration takes place at Red Stick through a partnership
with AnimAction, a company that focuses on youth expression through animation.
AnimAction projects emphasize working collaboratively and expressing creativity.
AnimAction has worked with youth media and the "DIY Youth Culture"
globally for more than 17 years and has trained thousands of young people and
teachers throughout the United States, Canada, Europe, Africa and Asia.
Youth-produced animated shorts from AnimAction workshops have been shown
worldwide on network television, in movie theaters, schools, hospitals and on
Web sites, and have been award finalists in international animation festivals,
competing side-by-side with industry leaders.
"Our audiences get larger every year, and we look for collaborative
opportunities, such as this feature at Red Stick, to reach out to more youth who
can benefit from using animation as creative expression," said Clifford Cohen,
AnimAction director. "We hope to continue having a presence at Red Stick to
raise awareness about a new cause each year."
AnimAction is a supporter of the 2007 Red Stick Animation Festival with
the Animation Collaboration for a Cause segment.
For more information, please visit www.redstickfestival.org or call CCT
Manager of Public Relations Kristen Meyer Sunde at (225) 578-3469.
http://www.thetowntalk.com/apps/pbcs.dll/article?AID=/20070324/NEWS01/70314002

NSW Dept. of Health update on "Sushi from Xanadu"

2006-12-27 09:08:50

NSW Dept. of Health update on "Sushi from Xanadu"
March 29, 2007
UPDATED: Hepatitis A
NSW Health has today renewed its warning to customers of "Sushi From Xanadu" at
Birkenhead Point following new information that extends the dates that patrons
may have been at increased risk of contracting hepatitis A from a food handler
at the food outlet.
NSW Health has now extended the date range to include March 13 and March 19 - in
addition to previously advertised dates of March 11, 12, 17 and 18 of this year.
"Patrons who ate any food product from this outlet on March 11, 12, 13, 17, 18
and 19 March should remain vigilant for the signs of hepatitis A and see their
doctor if symptoms appear," Dr McAnulty said.
"This message is critical, especially for anyone who may have eaten at the food
outlet on March 12 and March 13 as the immunoglobulin will be most effective for
these people only if given in the next 24 hours.
These people are advised to call the NSW Health Information Line on 1800 064 400
as soon as possible.
Dr McAnulty said people who ate food from the outlet on these dates could attend
a free Clinic set up at the Balmain Hospital Conference Centre this afternoon or
tomorrow to receive advice and an immunoglobulin injection.
Dr McAnulty said people who have been immunised against Hepatitis A or those who
have had the disease would already be immune and will not need an injection. The
immunoglobulin injection should be given as soon as possible after exposure.
Hepatitis A is a virus that causes inflammation of the liver. The main symptoms
develop two to six weeks after infection and include:
* fever
* feeling unwell
* poor appetite
* abdominal discomfort.
A few days later, people develop jaundice (which is yellowing of the skin and
eyes) and dark urine. However, not all people who are infected develop symptoms.
Hepatitis A does not cause long-term liver disease.
Click on the following to read the full article:
Source: NSW health media releases 2007
Date: March 26, 2007
http://www.ausfoodnews.com.au/db/node/31444

Pappasitos Offers Cash After Hepatitis Exposure

2006-12-26 19:09:44

Pappasitos Offers Cash After Hepatitis Exposure
POSTED: 5:23 pm CDT March 28, 2007
HOUSTON -- Customers from a north Houston Pappasitos Cantina restaurant are
getting offers of cash and gift cards after they were exposed to hepatitis A
last month. But accepting the offers has strings attached, KPRC Local 2 reported
Wednesday.
Hundreds of people who worked or dined at Pappasitos Cantina on the North
Freeway near Airtex Drive were vaccinated after a waiter was diagnosed with the
disease.
Thousands of diners and employees at the restaurant on the following dates were
possibly exposed:
a.. Jan. 23 through 27
b.. Jan. 30 and 31
c.. Feb. 1
d.. Feb. 3
e.. Feb. 7 through 9
Health officials made the shots available to diners or employees who were at the
restaurant Feb. 7 through 9.
"We waited for three and a half hours in line to get the shot," said a customer
who did not want to be identified.
The customer then received an offer of $300 in cash and two $50 dining cards to
compensate him for the inconvenience.
"They were quite anxious to get this signed and back in their hands, so that
certainly concerned us," the customer said.
Personal injury attorney Steve Waldman said he should be concerned.
"Remember, this isn't a gift. This is a tradeoff. They are buying your right to
sue away from you," Waldman said.
In order to get the money, Pappas wants customers to sign a document that would
"fully release and discharge Pappas Restaurants from all claims suits .
connected with any alleged exposure to hepatitis A at Pappasitos Cantina."
The release said the terms of the agreement are to be held in strict confidence.
"They do this because they don't want the bad publicity," Waldman said.
He said that before anyone signs the Pappasitos document, they should see a
doctor and feel confident that they are not at risk for contracting hepatitis A.
No one from Pappasitos Cantina would return KPRC Local 2's phone calls for
comment.
Hepatitis A passes from person to person. Most people recover without any major
long-term health problems.
Health workers suggested that those possibly infected should use bacterial gels
or hand sanitizer to prevent the possibility of spreading the disease to their
family members.
A person with the virus is infectious from about two weeks before to one week
after the person experiences jaundice, a yellowing of the skin and whites of the
eyes. Infants and children do not always show symptoms.
Symptoms of hepatitis A include:
a.. Extreme tiredness
b.. Fever
c.. Nausea and/or vomiting
d.. Stomach pain or diarrhea
e.. Light-colored stool or dark, rust-colored urine
f.. Jaundice
Officials said the best way to protect against hepatitis A is to thoroughly wash
hands with soap and water.
Previous Stories:
a.. February 21, 2007: Day 2: More Houstonians Vaccinated Against Hepatitis A
b.. February 20, 2007: Hundreds Get Hepatitis A Prevention Shot
c.. February 19, 2007: Free Shots Available For Those Exposed To Hepatitis A
d.. February 18, 2007: Restaurant Employee Tests Positive for Hepatitis A
http://www.click2houston.com/news/11423636/detail.html

World's Cruelty and Pain, Seen in an Unblinking Lens

2006-12-26 17:59:08

World's Cruelty and Pain, Seen in an Unblinking Lens
By MICHAEL KIMMELMAN
Published: March 28, 2007
If this were a perfect world, everybody would see the photographer James
Nachtwey's astonishing shows at the United Nations and at 401 Projects in the
West Village.
Sadly, as Mr. Nachtwey knows, this isn't a perfect world, a point he brings home
in the work shown here. "Inferno," the title of a 1999 book of the photographs
he shot in Kosovo, Rwanda and other hellholes, aptly describes the horror in
these two exhibitions.
For years, in Time magazine and elsewhere, he has demonstrated the good uses to
which art can be put. Since 2000, he has crisscrossed Southeast Asia and Africa,
documenting the resurgence of tuberculosis related to the global AIDS epidemic.
(The show at the Visitors Center at the United Nations was timed to coincide
with World TB Day last Saturday.) He has also photographed the war wounded in
Iraq, where he himself was injured by a grenade a few years ago, and traveled
with Medevac units to field hospitals and emergency rooms.
The series of Iraq pictures, some of which were first published in National
Geographic, are called "The Sacrifice." The title refers to the medics and
physicians who treat everyone, including wounded insurgents. The insurgents are
given goggles so they can't see and later seek out to kill the Iraqi translators
helping the medics, for which reason Mr. Nachtwey doesn't photograph
translators. He does photograph an Iraqi child mangled in a suicide attack: the
boy is screaming beneath his oxygen mask.
The title also refers to American soldiers whose work daily forces them to play
Russian roulette with roadside bombs, soldiers regularly sacrificed in the war.
Mr. Nachtwey devised a collage of photos (grainy, black-and-white, shot under
the fluorescent glare of military trauma centers) suggesting the choreographed
chaos in which American doctors tend to failing patients. The last of the
pictures, a mordant coda, shows a dead soldier on a gurney under a blanket, a
chaplain's arm reaching into the frame and holding up a dog tag.
It matters not a little that Mr. Nachtwey is such an artful composer of images,
that his work, although almost too painful to look at, is so graphic and
eloquent. He snaps a picture just at the moment that the arms of rushing,
dodging medics trading scalpels and scissors form a perfect zigzag of thrusting
lines ending with a nurse pressing a fist into a patient's head wound - the
punctum of the image, to borrow Roland Barthes's term. The nurse's gesture has a
strangeness that carries something of the quality of grace.
He finds the same encapsulating detail, concentrated by simple geometry, in a
photograph of two doctors. (You just see their arms.) They're gingerly examining
the spine of a rail-thin woman with AIDS; she is sitting on the floor and facing
away from Mr. Nachtwey so that only her bare left foot, leathered, turned toward
the camera, reveals her advanced age. One of the doctors presses his index
finger into her back - another memorable motion, subtly conveying care and
dignified by the stately, condensed order of the picture.
Beauty is a vexed matter in scenes of suffering, cruelty and death. The
difference between exploitation and public service comes down to whether the
subject of the image aids the ego of the photographer more than the other way
around. The two are not mutually exclusive.
Along with bravery and perseverance, Mr. Nachtwey's pictorial virtue makes him a
model war photographer. He doesn't mix up his priorities. His goal is to bear
witness, because somebody must, and his pictures, devised to infuriate and move
people to action, are finally about us, and our concern or lack of it, at least
as much they are about him and his obvious talents.
He finds heroes in the most woebegone spots. These are the soldiers and the
doctors and the aid workers, but also the wives, mothers, children and priests
who try to ease the pain of the afflicted.
In Thailand, north of Bangkok, he came across an American priest named Michael
Bassano who spends endless days with the most desperate of AIDS patients,
massaging their feet, changing their diapers, helping them die. Their flesh
clings like cellophane to their bones, and their eyes roll up in their heads. In
one photograph Father Bassano's arm just barely extends into the lower right
corner of the frame, clasping the tiny wrist of a young woman named Lek. She
stares doe-eyed back at him, as if from the grave.
And I hardly know what to say about three remarkable photographs of an orphaned
12-year-old Cambodian peasant named Va Ling. Barefoot, he leads a small
procession down a dirt road, clutching to his chest the wedding photo of his
dead 33-year-old mother, Am Nita.
Elsewhere, she is a flesh-draped skeleton on a bier, utterly unrecognizable; his
head shaved, Va Ling closes her eyes for her, a gesture in which you see him
grow up all at once. In the third picture, he stands before her funeral pyre,
engulfed in smoke, wearing a loose white sash, a swatch of rough black cloth
pinned at his shoulder. He is lost in thought.
Beside that photograph at the United Nations is a vitrine displaying the
medicine that, at modest cost (about $20 per patient per month), could eradicate
tuberculosis if the drugs were properly distributed and taken; but they aren't,
because of corruption, politics and ignorance. With the pictures, the message is
devastating.
Mr. Nachtwey's work about the war wounded in Iraq is no less haunted. Finding
the most human detail amid chaos, he photographs an unconscious soldier on the
operating table at the instant his wedding band is removed from his hand. He
photographs Brian Price, an Army sergeant wounded by an improvised explosive
device in Ramadi, wincing on a gurney, the camera focused on the name of the
soldier's four-month-old daughter, Ashlynn Jaide, tattooed in script over his
heart.
In a separate image a nurse lifts and turns the limp Sergeant Price over. His
back has several small holes. The scene is like a Pietà. You read in the nurse's
fallen face the sudden realization that the soldier's spine has been severed.
And at a military hospital in Germany, Mr. Nachtwey found Pvt. Andrew Bouwma in
a coma, watched over by his stunned parents. His mother, Kandi, smiling in her
University of Wisconsin sweatshirt, gently caresses his hair. His father, Jim,
sunglasses perched on his head, rubs one eye and leans with his other hand on
the railing of the bed for support. A chaplain's hand, extending into the
picture, touches Andrew's shoulder. They're praying. It's frozen drama, like a
Jeff Wall staging, but true. Breathing through a respirator, eyes shut, Private
Bouwma looks heartbreakingly young.
Is this how these men would wish to be remembered? Are the pictures an invasion
of privacy?
That was the Bush administration's excuse for prohibiting photographs of
returning coffins. But then there's the argument made at the opening of the show
at 401 by a ex-marine who lost his right arm in Iraq. (He was among a number of
veterans who stopped by the gallery, a nonprofit space devoted to this sort of
exceptional photographic projects, to pay tribute to Mr. Nachtwey.) The marine
said he thought these pictures should be on billboards in Times Square so that
everybody would know what's really happening over there, and nobody could miss
seeing them.
Wouldn't that be something? Public art of real consequence and quality for a
change, bringing home a war that the whole country is conducting but that only
the small percentage of families in the volunteer military experience firsthand.
There would be no chance to turn the page or flip the channel or skip the
exhibition.
If the AIDS pictures were blown up onto billboards too, there would be no
sanctuary from images like the one of the black stick-figure man in a
white-walled hospital in Zimbabwe, struggling alone down a narrow, bending
corridor to a shower for lack of a doctor's or nurse's help.
Nor would there be any way to avoid the photograph of Derek McGinnis, an amputee
from Iraq, on Pismo Beach in California, under a leaden sky, leaning over, his
head obscured behind his surfboard, so that man, prosthesis, surfboard and fin
make a perfect right angle. It's an amazing image. He's a modern-day Discobolus.
That's a redemptive sight, celebrating a brave soldier who survived the inferno
and made the best out of what he had left. We would prefer not to see him,
perhaps, but Mr. Nachtwey calls us out in our discomfort and neglect.
The least we should do is not look away.
"The Sacrifice" runs through April 24 at 401 Projects, 401 West Street, at
Charles Street, West Village, (212) 633-6202. "World Free of TB" runs through
April 27 in the visitors' lobby of the United Nations, First Avenue at 46th
Street, Manhattan, (212) 963-0089. (Closed on April 6.)
http://www.nytimes.com/2007/03/28/arts/design/28nach.html?_r=1&th&emc=th&oref=sl\
ogin

Couple focus on happier days

2006-12-26 17:14:44

Couple focus on happier days
By JOCELYN ALLISON - jallison@...
McHENRY - Barbara Kinsala is waiting to get her life back.
She's waiting for the day when she can visit her 14 grandchildren with ease,
when she and her husband, Don, can retire to Pigeon Forge, Tenn., and live out
their days amid the Smoky Mountains enjoying a marriage that still is young.
Barbara Kinsala, who has hepatitis C, is waiting for the day when she won't feel
sick anymore, when a successful liver transplant will reverse the effects of a
disease that for years lay dormant inside her.
"The days are kind of different for me," said Kinsala, who speaks slowly and
with visible effort. "I'd like to get better and enjoy my grandkids. I wish I
could have a long time ago."
Kinsala, 53, of McHenry is among a growing number of people across the country
in the past five to 10 years who have started to experience the symptoms of
hepatitis C, a viral hepatitis that is transmitted through blood and can lead to
liver disease.
In McHenry County, the health department recorded 124 cases of hepatitis C in
2006, making it among the most frequently reported illnesses to the department's
communicable disease program, said Debra Quackenbush, community information
coordinator with the health department.
First diagnosed 10 years ago, Kinsala's condition has worsened over the years to
the point where she rarely leaves the house, and then only to visit the doctor
or go to the lab for bimonthly blood tests, Don Kinsala said.
For the Kinsalas, who once took every opportunity to travel since they were
married in October 1995, every day is the same.
"Saturday, weekday, it's pretty much the same," said Don Kinsala, 72, who cares
for his wife full time.
Doctors believe that Barbara Kinsala's hepatitis C might have resulted from a
blood transfusion she received in the late 1970s, before blood tests included a
screening for the disease.
Although many people with hepatitis C never experience the symptoms, about 30
percent go on to develop cirrhosis, a chronic liver disease that can lead to
liver failure, said Dr. Steven Flamm, hepatologist at Northwestern Memorial
Hospital.
Barbara Kinsala has been on the national organ transplant list since February
1999, but until her condition worsens, she won't receive the liver she needs,
Flamm said. And because her blood type, Type O, is the most common, her wait
time is longer, he said.
Estimates show that about 2 percent of the U.S. population, or about 4 million
people, have hepatitis C, and more than half of them don't know that they have
it, Flamm said.
Many who are beginning to show symptoms now contracted it during the late 1960s
to early 1980s during a period of high drug use, before HIV/AIDS awareness
prompted people to use clean needles, he said.
And because the disease can remain undetected for 20 to 30 years, many just now
are starting to experience the symptoms, said Flamm, who estimated that he saw
close to 300 new hepatitis C patients a year.
"If even a fraction of the patients with hepatitis C who developed cirrhosis
ended up on the [transplant] list, if the patients started to present, it would
just cripple the system and a lot of people are fearful of that," Flamm said.
If caught early enough, there are medications to treat, and even cure hepatitis
C, he said.
But for Barbara Kinsala, whose advanced condition prevents her from benefiting
from such medications, the only option now is to wait.
And while she does, she finds strength in her faith and comfort in the memories
she made during the first five years of her marriage, before the disease started
to take hold, she and her husband said.
"Times when she's really feeling down or we're sitting alone at night, we'll go
back to those years and the fun we had together," Don Kinsala said.
"Had, back then, we'd said, 'No, wait until next year [to take that trip],' we
wouldn't even have that," he said. "Live your life to the fullest, because you
just don't know."
Did you know?
April is National Donate Life Month. In 2006, nearly 300 people died while
waiting for organ transplants at Illinois transplant centers. Nationally, more
than 5,000 people died while waiting for transplants.
Source: Gift of Hope Organ & Tissue Donor Network, www.giftofhope.org
Area cases
Number of new hepatitis C cases reported in McHenry County over the last five
years:
2002: 77 cases
2003: 70 cases
2004: 106 cases
2005: 88 cases
2006: 124 cases
Source: McHenry County Department of Health
http://www.nwherald.com/articles/2007/03/28/news/local/doc460a354d6017c913352838\
.txt

Stress Reducing Mah Jongg at Web MD

2006-12-26 07:59:22

Stress Reducing Mah Jongg
Feeling a little tense? A game of mah jongg can relieve that stress.
http://www.webmd.com/content/article/131/118175.htm?ecd=wnl_skin_032807

Biospy Results

2006-12-26 03:22:11

Im very very sick well the biopsies show I have inflammation in my duodomen and
a potent bacteria going through my stomach its so potent it could cause bleeding
ulcers and even cancer of the stomach he put me on 3 antibiotics and prevacid
for the the inflammation he said the antibiotics are potent for this kind of
bacteria and they will make me feel icky while fighting this..Then,I go back in
a month to see how I am doing and to schedule another EGD to make sure the
bacteria is gone and no problems there and this one he will do a liver biospy
also..He said,was going to the first time but since he had done so much than he
didnt want to put my body through anymore strain..Not sure how I got the
bacteria in my tummy but its there now I know why I have so much pain besides
the pain from the hepatitis too..
Sooo for now just going to take it easy relax and work on getting well from
this bacteria and take care of my hep and liver and enjoy some sort of life
through all this..
Thankyou for being so caring and good friends,mauhhhhh Jan

Re: [HepCingles] Fast Pitch: Vertex Pharmaceuticals

2006-12-25 19:04:09

Thanks, Pam, for info. This is the best news for Hep C - my fingers are
crossed. The day it gets approved for all genotypes - I march into my doctor's
office.
PeachStatePam <figment@...
Fast Pitch: Vertex Pharmaceuticals
By Motley Fool Contributors
March 27, 2007
The analysis below first appeared in Motley Fool CAPS back in December. Click
here for more CAPS coverage from this contributor on more than 43 stocks in the
biotech sector.
Vertex Pharmaceuticals (Nasdaq: VRTX) is a biotechnology company that creates
small-molecule drugs for the treatment of serious diseases. The firm has two HIV
drugs on the market now, Lexiva and Agenerase, which are marketed by partner
GlaxoSmithKline (NYSE: GSK). Top priorities in the company's development
pipeline include drugs for hepatitis C, rheumatoid arthritis, and cystic
fibrosis.
2007 is expected to be a very eventful year for the company, as it will furnish
some important clinical trial results for its investigational drugs. Recently
disclosed results on its groundbreaking hepatitis C drug telaprevir have been
quite encouraging. Early telaprevir results indicate it could deliver a major
advance. This has garnered the interest of Johnson & Johnson (NYSE: JNJ), which
has become Vertex's partner on the product. Now all eyes will be glued to the
sustained virological response (SVR) data on telaprevir, which is expected to be
available this year.
Considering the fact that well more than 170 million people are infected by the
hepatitis C virus, and the rapid growth of this disease in the global market,
those augur well for telaprevir, which is expected to emerge as a potential
blockbuster drug for the company.
In our view, the positive outlook for Lexiva for HIV and achievements from
telaprevir will drive the company forward in 2007.
Fast pitches are designed to provide high-level analysis on a wide array of
companies from various sectors. This analysis has been provided by Netscribes.
Click here for more Netscribes research across a variety of sectors on CAPS.
Vertex Pharmaceuticals is a Rule Breakers recommendation and Microsoft is a
Motley Fool Inside Value pick. Johnson & Johnson and GlaxoSmithKline are Income
Investor selections. To provide feedback on this article, please click on the
"feedback" button below.
http://www.fool.com/investing/high-growth/2007/03/27/fast-pitch-vertex-pharmaceu\
ticals.aspx

HEP C-MO Support Group Schedule for the month of April

2006-12-25 15:07:24

HEP C-MO Support Group Schedule for the month of April
Mondays: 6-8pm (St. Luke's Hospital and North Kansas City Hospital)
Wednesdays: 5-7pm (HEP C-MO office - Bible Study) - New session starts April 4th
(registration necessary)
Contact: Barbara at: 816.767.8472 for directions
Johanna Blanding-Koskinen
Executive Director
Hepatitis C Multicultural Outreach
Website: http://www.hepcmo.org

Bill pending to let fertility clinics use 'washed' specimens

2006-12-25 01:12:11

Ban of use of sperm from HIV-positive men under review
Bill pending to let fertility clinics use 'washed' specimens
Greg Lucas, Chronicle Sacramento Bureau
Tuesday, March 27, 2007
(03-27) 04:00 PDT Sacramento -- Dan Hartmann, a 32-year-old Oakland graphic
artist, met his wife Susan six years ago, and like many couples they decided
they wanted to start a family.
There's a complication: A blood transfusion 20 years ago left Hartmann
HIV-positive.
Medical technology has existed for more than a decade to "wash" the HIV from
Hartmann's sperm, which then could be used to add a new member to the Hartmann
household while mother and child remain HIV-free.
Except Hartmann can't get the treatment in California because the state bans the
use of sperm from an HIV-positive donor.
"We want to have a kid, but the law here doesn't allow fertility clinics to help
a man who is HIV-positive," Hartmann said.
Legislation will be debated Wednesday in the Senate Health Committee to permit
the use of washed sperm from an HIV-positive donor to impregnate a consenting
woman.
If signed into law, California would join 48 other states that allow the
practice. Delaware is the other state that doesn't.
Because of the increase in life expectancy of people with HIV, more people who
have the virus are considering starting a family. Supporters of the bill --
SB443 by Sen. Carole Migden, D-San Francisco -- say the measure helps ensure the
rest of the family stays HIV-free.
"This isn't a gay issue. It's in society's interest to give these couples a safe
method of reproduction," said Migden. "A clean procedure is available. Making it
available in California is a positive step the government can take to produce
healthy children."
HIV is present in seminal fluid and white blood cells but not in sperm. Through
washing and the use of centrifugal force, sperm can be separated from the other
components of semen and then injected into the woman's body or used for in vitro
fertilization.
In studies issued over the past decade, some 4,500 fertilizations using treated
HIV-positive sperm have been conducted worldwide without any infection of either
mother or child, according to Dr. Deborah Cohan, an obstetrician and
gynecologist at the University of California at San Francisco specializing in
HIV.
A survey conducted by Cohan of 67 California fertility centers logged 135
HIV-infected couples seeking help during the last year.
"That's the tip of the iceberg," Cohan said. "We don't even know how many people
in California have HIV. We just started the process of collecting data last
summer."
More than 80 percent of the clinics said they would provide services to HIV
couples if the law were changed, Cohan said.
Without a change in law allowing HIV-positive men in California to use the sperm
treatment, the only way they can impregnate their wife or partner is through
unprotected sex, which can lead to transmission.
Cohan said one study found a 12 percent risk of male-to-female HIV transmission
over a year of unprotected sex. Limiting unprotected sex to the period in which
the woman is ovulating lowers the transmission rate to 4.3 percent but doesn't
eliminate the possibility of infection.
"Timed, unprotected sex puts my wife at greater risk," said Hartmann.
Well-heeled couples can visit fertility centers outside California that offer
the sperm treatment. That can be costly and time-consuming because more than one
visit and, often, more than one attempt at fertilization are needed.
While the sperm washing is relatively cheap -- roughly $200 -- fertility
treatments can be expensive. Uterine insemination, the so-called turkey-baster
method, costs approximately $1,000, while in vitro fertilization, in which the
egg is fertilized outside the body, can cost between $10,000 and $15,000,
according to Migden's office.
"No fertility treatment is guaranteed to work especially the first time around,"
said Hartmann. "It's very expensive and a lot of time insurance doesn't cover
it."
The treatment is available in most other states because their laws don't include
a blanket prohibition on sperm donation from men with HIV. Under Migden's bill,
the sperm washing would be done using procedures approved by the American
Society of Reproductive Medicine.
California's ban stems from a 1989 California law aimed mainly at preventing
what happened to Hartmann through blood transfusion from happening to others.
"No one would have thought in 1989 that people would be living so long with HIV
or that we would have these techniques to wash HIV-positive semen so women could
get pregnant and have healthy babies," Cohan said.
In 1997, exemptions were made to the sperm-donor category to allow sperm from
men with syphilis, hepatitis B and hepatitis C. The lawmaker who carried that
bill has since died, but Cohan said others involved in the bill's passage said
HIV was not added to the list of exemptions for fear its inclusion would
increase opposition to the legislation at the time.
"I'm hoping we've done sufficient education that people will realize this is
good science and good public health, and it has nothing to with how someone got
HIV," Cohan said. "It has everything to do with the rights of individuals with
HIV and the partners of individuals with HIV."
There is no listed opposition to Migden's bill, and the measure has the
tentative support of at least one Republican on the health committee
"There needs to be some stronger oversight built into the bill, but allowing an
HIV-infected person to lead a normal life with their spouse and/or partner to
procreate -- I'm absolutely for that," said Sen. Sam Aanestad, R- Grass Valley
(Nevada County), vice chair of the panel. "Government should be in the business
of encouraging those kinds of family decisions and make sure it's safe for
everybody."
E-mail Greg Lucas at glucas@....
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/03/27/BAGASOSGFL1.DTL&feed\
=rss.bayarea

Fast Pitch: Vertex Pharmaceuticals

2006-12-24 23:05:24

Fast Pitch: Vertex Pharmaceuticals
By Motley Fool Contributors
March 27, 2007
The analysis below first appeared in Motley Fool CAPS back in December. Click
here for more CAPS coverage from this contributor on more than 43 stocks in the
biotech sector.
Vertex Pharmaceuticals (Nasdaq: VRTX) is a biotechnology company that creates
small-molecule drugs for the treatment of serious diseases. The firm has two HIV
drugs on the market now, Lexiva and Agenerase, which are marketed by partner
GlaxoSmithKline (NYSE: GSK). Top priorities in the company's development
pipeline include drugs for hepatitis C, rheumatoid arthritis, and cystic
fibrosis.
2007 is expected to be a very eventful year for the company, as it will furnish
some important clinical trial results for its investigational drugs. Recently
disclosed results on its groundbreaking hepatitis C drug telaprevir have been
quite encouraging. Early telaprevir results indicate it could deliver a major
advance. This has garnered the interest of Johnson & Johnson (NYSE: JNJ), which
has become Vertex's partner on the product. Now all eyes will be glued to the
sustained virological response (SVR) data on telaprevir, which is expected to be
available this year.
Considering the fact that well more than 170 million people are infected by the
hepatitis C virus, and the rapid growth of this disease in the global market,
those augur well for telaprevir, which is expected to emerge as a potential
blockbuster drug for the company.
In our view, the positive outlook for Lexiva for HIV and achievements from
telaprevir will drive the company forward in 2007.
Fast pitches are designed to provide high-level analysis on a wide array of
companies from various sectors. This analysis has been provided by Netscribes.
Click here for more Netscribes research across a variety of sectors on CAPS.
Vertex Pharmaceuticals is a Rule Breakers recommendation and Microsoft is a
Motley Fool Inside Value pick. Johnson & Johnson and GlaxoSmithKline are Income
Investor selections. To provide feedback on this article, please click on the
"feedback" button below.
http://www.fool.com/investing/high-growth/2007/03/27/fast-pitch-vertex-pharmaceu\
ticals.aspx

Hepatitis infection rates decline to record lows

2006-12-24 14:35:51

Hepatitis infection rates decline to record lows
By Nicholas Bakalar Published: March 27, 2007
Thanks in large part to effective vaccines, rates of hepatitis A and hepatitis B
infection have declined to their lowest levels in 40 years, according to data
recently published by the U.S. Centers for Disease Control and Prevention.
Incidence of hepatitis C, for which there is no vaccine, has also declined
substantially.
Vaccination for hepatitis A has been recommended by the CDC since 1996 for
international travelers and men who have sex with men, and since 1999 for
children living in communities with the highest rates of the disease. The 2005
rate, the latest for which complete data is available, was 1.5 per 100,000, down
from 12 per 100,000 in 1995.
The agency now recommends universal hepatitis B vaccination of infants, children
and adolescents; screening of pregnant women; and vaccination for adults at
increased risk for infection. In 2005, the hepatitis B rate was 1.8 cases per
100,000, the lowest recorded since surveillance began in 1966 and an 80 percent
decline since 1991. Hepatitis B can be contracted only through exposure to
infected blood or body fluids.
The report appears in The Morbidity and Mortality Weekly Report for March 16.
Incidence of hepatitis C has declined 11 percent since 1992, probably because of
risk-reduction practices among injection drug users, but about 3.2 million
Americans are chronically infected. Hepatitis C is spread through contaminated
blood and, inefficiently, through sexual contact.
http://www.iht.com/articles/2007/03/27/arts/snvital.php

Nearly 2,000 haemophilia patients were exposed to HIV

2006-12-24 14:09:48

Nearly 2,000 haemophilia patients were exposed to HIV
Publisher: Ian Morgan
An independent inquiry concerning the deaths of nearly 2,000 haemophilia
patients who were exposed to HIV and or hepatitis C through contaminated NHS
blood and blood products got under way today.
Former Solicitor General Lord Archer of Sandwell, who is heading the public
inquiry, said its purpose was to investigate the circumstances surrounding the
supply of contaminated NHS blood and blood products to patients, the
consequences for the haemophilia community and others afflicted.
He added that the inquiry would also suggest further steps to address both the
problems and needs of patients and those of the bereaved families.
The hearings concern the deaths of 1,757 haemophilia patients who were exposed
to HIV and/or hepatitis C by contaminated NHS blood and blood products. Many
more are said to be terminally ill.
"The purpose of the inquiry is to unravel the facts, so far as we are able, and
to point to the lessons that may be learnt," he said in his opening statement.
"As in the case of any public inquiry, the consequences of its report cannot be
foreseen.
"Its impact will, however, depend crucially on the public perception of its
value and we shall endeavour to make it a report worthy of high regard.
"Hopefully our findings may help to restore public confidence in the future
treatment of patients.
"We trust it will also help those afflicted and bereaved to come to terms with
the tragedy - knowing much more of how it came about."
The tragic events, which took place between the early 1970s and the mid 1980s,
have been described by fertility expert Lord Winston as "the worst treatment
disaster in the history of the National Health Service".
The campaign on their behalf has been led by Labour peer Lord Morris of
Manchester who was Britain's first minister for disabled people and who is
president of the all-party Parliamentary Group on Haemophilia.
He said of the 4,670 haemophiliac patients exposed to hepatitis C, 1,243 were
also exposed to HIV and despite improvements in treatment for both viruses, only
2,552 patients with hepatitis C and just 361 with HIV are still alive.
Lord Morris said that successive governments had resolutely resisted a public
inquiry since 1988, preferring in-house inquiries at the Department of Health.
Lord Archer of Sandwell said today that the inquiry was not statutory. He said
it was of "primary importance" to establish and maintain its independence.
Already a number of former ministers in the Department of Health and others able
to give information have made contact, he said.
"There is no hidden agenda, he said. "Neither I nor either of my colleagues will
receive any remuneration."
He added that expenses would be funded privately and it was for the donors to
decide whether they wished their support to remain confidential.
The inquiry will begin hearing oral evidence on April 18.
:: The inquiry website address is: www.archercbbp.com
http://www.24dash.com/health/18503.htm

Disclosure Laws Do Not Fully Reveal Drug Company Payments to Physicians

2006-12-24 03:57:59

Tue, 27 Mar 2007 10:15:39 -0700

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Disclosure Laws Do Not Fully Reveal Drug Company Payments to Physicians
Reuters Health Information 2007. © 2007 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or
similar means, is expressly prohibited without the prior written consent of
Reuters. Reuters shall not be liable for any errors or delays in the content, or
for any actions taken in reliance thereon. Reuters and the Reuters sphere logo
are registered trademarks and trademarks of the Reuters group of companies
around the world.
NEW YORK (Reuters Health) Mar 20 - Laws that mandate disclosure of payments to
physicians by pharmaceutical companies provide limited public information,
according to a new report.
At present, five states and the District of Columbia have legislation requiring
payment disclosure. Among these states, Minnesota and Vermont require that the
information be made available to the public.
In the current study, reported in the March 21st issue of the Journal of the
American Medical Association, Dr. Joseph S. Ross, from Mount Sinai School of
Medicine in New York, and colleagues examined the accessibility and quality of
information provided by the disclosure laws in Minnesota and Vermont.
The analysis included data from January 2002 to December 2004 in Minnesota and
from July 2003 to June 2004 in Vermont.
The researchers found that obtaining the payment information was not easy. In
Vermont, extensive negotiation with the Office of the Attorney General was
needed, while in Minnesota, manual photocopying of individual disclosure forms
at the State Board of Pharmacy was required.
Missing disclosure information was common in both states.
In Vermont, 61% of payments were not released to the public because the drug
companies classified them as revealing trade secrets and 75% of disclosed
payments lacked information to identify the recipient.
In Minnesota, just 25% of drug companies reported payment information in all
three years of the study.
Quite large payments to physicians were commonplace, the report indicates. In
Vermont, 2416 of the 12,227 payments studied were each at least $100, amounting
to a total of $1.01 million; the range was $100 - $20,000 and the median payment
was $177. In Minnesota, such payments were even more common: 6238 of 6946
payments were at least $100 (ranging up to $922,239, with a median payment of
$1000), and these amounted to $22.39 million.
In a related editorial, Dr. Troyen A. Brennan, from Aetna Inc. in Hartford,
Connecticut, and Michelle A. Mello, from Harvard School of Public Health in
Boston, comment that pharmaceutical companies' "primary commitment is to create
shareholder value, not maintain an altruistic commitment to patients. But at
some point the leadership of the pharmaceutical industry and their board of
directors must begin to recognize that growing public and professional mistrust
could substantially detract from that value."
JAMA 2007;297:1216-1223,1255-1257.

Standard screening tests may not detect hidden hepatitis B virus in HIV/HBV-coinfected patients

2006-12-24 02:17:17

Standard screening tests may not detect hidden hepatitis B virus in
HIV/HBV-coinfected patients
Liz Highleyman, Tuesday, March 27, 2007
A significant proportion of HIV-positive individuals may have occult hepatitis B
virus (HBV) infection that is not identified through standard screening tests,
according to two studies published in the March 1st issue of the Journal of
Acquired Immune Deficiency Syndromes.
Occult, or hidden, hepatitis B infection refers to the presence of a low level
of HBV genetic material (DNA) in the blood or the liver, without detectable
hepatitis B surface antigen (HBsAg).
By contrast, patients with typical chronic hepatitis B have detectable HBsAg, as
well as HBV surface and core antibodies (anti-HBs and anti-HBc, respectively).
The presence of surface antibodies without surface antigen usually indicates
that a person was exposed to HBV in the past but cleared the infection.
Because it is not detectable using standard antigen and antibody blood tests,
estimates of the prevalence of occult hepatitis B vary widely.
Study 1
In the first study, Norah Shire, MPH, and colleagues aimed to determine how
often occult hepatitis B occurred amongst HIV-positive individuals seen at the
University of Cincinnati Infectious Diseases Center in Ohio.
selected 909 without known HBV infection or non-viral liver disease for further
analysis. Stored blood samples were pooled and a real-time polymerase chain
reaction (PCR) assay was used to amplify HBV DNA. Samples with detectable HBV
DNA were then tested for HBV serological markers using commercially available
ELISA tests for anti-HBc, anti-HBs, and HBsAg.
The mean age of the patients was 35 years, 77% were men, and 50% were Caucasian.
The mean CD4 cell count was 385 cells/mm3, 62% had detectable HIV viral load,
and only 23% were taking antiretroviral regimens, about 60% of which included
drugs with anti-HBV activity. About 14% had hepatitis C virus (HCV) infection.
Forty-three patients (4.7%) were found to be positive for HBV DNA. Twelve of
these (1.3% of all patients) had occult hepatitis B with no detectable HBsAg. In
this group, four tested positive for both HBV surface and core antibodies, two
had detectable anti-HBc but not anti-HBs, and five were negative for all HBV
blood markers.
Participants with detectable HBsAg had significantly higher HBV DNA titres than
those with occult hepatitis B. HBsAg-positive patients also were more likely to
have elevated liver enzymes (ALT and/or AST) compared with both occult hepatitis
B patients and HIV-monoinfected individuals with undetectable HBV DNA.
Mean CD4 cell counts did not differ significantly among the groups, and the
percentages having undetectable HIV viral load were also similar. None of the
patients with detectable HBsAg had hepatitis C, compared with about 14% of both
occult hepatitis B patients and HBV-negative individuals.
Importantly, none of the participants with occult hepatitis B were taking
antiretroviral drugs with anti-HBV activity, such as 3TC (Epivir), emtricitabine
(Emtriva), or tenofovir (Viread).
Study 2
In the second study, Vincent Lo Re, MD, and colleagues conducted a study to
determine the prevalence of and risk factors for occult hepatitis B amongst
HIV-positive individuals, as well as its clinical significance.
The investigators analysed data from 179 HIV-infected patients with undetectable
HBsAg but detectable HBV core antibodies, randomly chosen from a database of 699
study participants at University of Pennsylvania hospitals.
In this study, the mean age was 47 years, 88% were men, and 75% were
African-American. One-quarter had CD4 cell counts below 200 cells/mm3 and 40%
had HIV viral loads greater than 1,000 copies/mL. Three times as many patients
were on antiretroviral regimens as compared with the previous study (73%), of
which about 60% contained drugs with anti-HBV activity. About half of the
participants (55%) had chronic hepatitis C.
In this group, 17 patients (10%) had detectable HBV DNA using a highly sensitive
transcription-mediated amplification assay, signalling occult hepatitis B.
Individuals with and without occult HBV were similar with regard to demographic
characteristics.
HBV surface antibodies were present in similar proportions of patients with and
without occult HBV infection (41% vs 58%, respectively). In a univariate
analysis, patients with occult hepatitis B had lower CD4 cell counts, but this
was no longer significant after controlling for other factors.
Individuals with HIV viral loads greater than 1,000 copies/mL were almost five
times more likely to have occult hepatitis B (adjusted odds ratio [OR] 4.88),
whilst those with chronic hepatitis C were less likely (adjusted OR 0.26). In
this study, too, use of antiretroviral agents with anti-HBV activity reduced the
risk of occult hepatitis B.
In terms of clinical symptoms, patients with occult hepatitis B were slightly
less likely to have elevated liver enzymes compared with HBV-uninfected
individuals, but this was strongly affected by HCV status. Individuals with
occult HBV infection did not have a greater likelihood of significant fibrosis,
as determined by the non-invasive AST-to-platelet ratio index (APRI).
The investigators concluded that occult HBV occurred in a "sizable proportion"
of HIV-infected patients, adding that it was associated with detectable HIV
viral load and the absence of chronic HCV infection.
Implications for patients
Collectively, these studies do little to resolve the uncertainty about the
prevalence of occult hepatitis B amongst HIV-positive individuals. Past studies
have also produced disparate results, with rates ranging from 0% to 89%,
depending on the patient population and the definition of occult hepatitis B.
The recent studies did concur in finding that occult hepatitis B may present
with various patterns of serological markers, and is not ruled out by the
presence of HBV surface antibodies.
Shire and colleagues said that their results indicate a need for better
screening for HBV in "high-risk" populations.
They also recommended that HIV-positive patients who have been vaccinated
against HBV should receive regular testing to ensure continued adequate antibody
levels.
However, the fact that occult hepatitis B can occur in individuals with no
detectable serum markers for HBV and no clinical signs of hepatitis makes it
difficult to identify hidden infection using widely available tests. Universal
HBV DNA testing is impractical, but it may be useful for individuals with
unexplained liver enzyme elevations, even if they have no serological evidence
of HBV infection.
Given the lack of liver-related symptoms amongst patients in these studies,
further research is needed to clarify the clinical implications of occult
hepatitis B in HIV-positive individuals, such as whether it increases the
long-term risk of liver cirrhosis or hepatocellular carcinoma. Until then, both
studies support the recommendation that HIV/HBV-coinfected patients should
include one or more agents with anti-HBV activity in their antiretroviral
regimens.
References
Shire N et al. The prevalence and significance of occult hepatitis B virus in a
prospective cohort of HIV-infected patients. J Acq Immun Defic Synd 44: 309-314,
2007.
Lo Re V et al. Prevalence, risk factors, and outcomes for occult hepatitis B
virus infection among HIV-infected patients. J Acq Immun Defic Synd 44: 315-320,
2007.
http://www.aidsmap.com/en/news/95E6F8E7-AF9A-48F0-A4CB-DFA55030289B.asp

World Hepatitis Awareness 2008 - Planning Survey

2006-12-23 14:53:20

Delegates from Africa, Asia, Australia, Europe and North and South America will
be meeting next month to plan for a coordinated global effort to raise awareness
and the profile of viral hepatitis epidemics. As the delegate representing North
America, I am seeking input to share with organizers. As the steering committee
begins to plan for World Hepatitis Awareness events in 2008, now is your
opportunity to provide input.
Whether you are a person living with hepatitis, family, friend, medical or
social service provider, researcher, public health professional, elected
official or concerned citizen, your input is important! Your input will not only
help inform organizers of the World Hepatitis Awareness Steering Committee, but
may be shared with National as well as State/Provincial planners as they begin
planning events to observe World Hepatitis Awareness in 2008. If you would like
to be a part of planning efforts at the National or State/Provincial level,
please indicate this on the survey.
If you would like to share your ideas with organizers, please complete the
attached survey and return by Thursday, April 5, 2007. Thank you for your
continued dedication and interest in viral hepatitis. Feel free to contact me
with any questions.
Chris Taylor, Viral Hepatitis Program Manager
National Alliance of State & Territorial AIDS Directors
444 North Capitol Street, NW, Suite 339, Washington, DC 20001
Phone: (202) 434-8041 Fax: (202) 434-8092
ctaylor@... www.NASTAD.org
"Bridging Science, Policy, and Public Health"

Doctors Warn Of Liver Damage In Some Supplements

2006-12-23 11:38:15

Doctors Warn Of Liver Damage In Some Supplements
POSTED: 8:06 pm EST February 28, 2007
UPDATED: 6:45 am EST March 1, 2007
PHILADELPHIA -- Doctors at Thomas Jefferson University Hospital tell NBC 10
Healthwatch that some supplements are putting people into liver failure, and
causing them to need liver transplants.
These physicians are afraid if people keep taking supplements without a doctor's
supervision, then the problem will only going to get worse.
Jean Ditzler is usually a very healthy person, that's why she was surprised when
she started getting sick. " I couldn't sleep at nights. I lost like 30 pounds, I
was scratching all over my whole body from head to toe," said Ditzler.
She was in liver failure, and she had a bad feeling she knew why. She was taking
herbal supplements taken on the advice of a naturopathic doctor.
Doctors confirmed her suspicions. Ditzler stopped taking the supplements and is
getting better but she was shocked to learn how bad it could have been.
Dr. Navaro from the Thomas Jefferson University Hospital said, "People can die
from liver failure associated with these supplements."
"In fact it's well reported that certain substances can lead to liver injury, so
severe that the liver starts to deteriorate in it's function and people could go
on to acquire a liver transplant," she said.
Hung Jawa said she took a supplement called Move Free to help with joint pain.
Her physician, Dr. Hann said, "She had severe jaundice her face was like
greenish yellow because of severe jaundice. Her liver was very much destroyed."
After researching all the ingredients in Move Free, Hann thought she had the
answer; an ingredient called Chinese skullcap.
Once her patient stopped taking it and she started to get better.
But the company that makes Move Free said there are different species of
skullcap and theirs is safe.
In a written statement, the company said, "Schiff nutrition's move free uses
Chinese skullcap. .This ingredient has generally recognized as safe status
according to Food and Drug Administration."
Both Thomas Jefferson University doctors say Chinese skullcap along with other
supplements like Kava Kava, and Germander can cause liver injury.
The Food and Drug Administration does not set standards for supplements,
allowing for varying and unpredictable amounts of ingredients.
http://www.nbc10.com/health/11139060/detail.html

Omega-3 Fatty Acids May Boost Brain

2006-12-23 08:32:33

Omega-3 Fatty Acids May Boost Brain
Preliminary Study Shows More Gray Matter in Brain's Mood-Regulating Areas
By Miranda Hitti
WebMD Medical News
Reviewed by Louise Chang, MD
March 7, 2007 -- Omega-3 fatty acids -- found in foods including walnuts, flax,
and fatty fish such as salmon and sardines -- may boost brain areas that govern
mood.
That's the finding from a preliminary study conducted by the University of
Pittsburgh's Sarah Conklin, PhD.
Conklin studied 55 healthy adults who completed a survey on two separate days --
each saying what the participants had eaten the day before. Participants also
got brain scans using magnetic resonance imaging (MRI).
Conklin focused on gray matter -- which processes information -- located in
three brain areas that regulate mood.
Participants with the highest intake of omega-3 fatty acids had the most gray
matter in those brain areas, the study shows.
But don't jump to conclusions. The study doesn't prove that omega-3 fatty acids
build gray matter. Perhaps participants with the most gray matter in those brain
areas happen to favor foods rich in omega-3 fatty acids.
But if omega-3 fatty acids boost gray matter, that could explain earlier
findings linking omega-3 fatty acids to mood regulation, Conklin notes.
She presented the study's results in Budapest, Hungary, at the American
Psychosomatic Society's 65th annual scientific conference.
SOURCES: 65th Annual Scientific Conference of the American Psychosomatic
Society, Budapest, Hungary, March 7-10, 2007. News release, University of
Pittsburgh Schools of Health Sciences.
http://www.webmd.com/diet/news/20070307/omega-3-fatty-acids-may-boost-brain?ecd=\
wnl_din_032607

Difference between Woman and Man

2006-12-23 01:30:31

Difference Between Women And Men
1.NAMES
If Laurie, Linda, Elizabeth and Barbara go out for lunch, they will call
each other Laurie, Linda, Elizabeth and Barbara.
If Mark, Chris, Eric and Tom go out, they will affectionately refer to
each
other as Fat Boy, Godzilla, Peanut-Head and Scrappy.
2.EATING OUT
When the bill arrives, Mark, Chris, Eric and Tom will each throw in a
$20 ,
even though it's only for $32.50. None of them will have anything
smaller and none will actually admit they want change back.
When the women get their bill, out come the pocket calculators.
3.MONEY
A man will pay $2 for a $1 item he needs.
A woman will pay $1 for a $2 item that she doesn't need, but it's on
sale.
4.BATHROOMS
A man has five items in his bathroom: a toothbrush, shaving cream,
razor, a
bar of soap, and a towel from the Marriott.
The average number of items in the typical woman's bathroom is 337. A
man would not be able to identify most of these items.
5.ARGUMENTS
A woman has the last word in any argument.
Anything a man says after that... is the beginning of a new argument.
6.CATS
Women love cats.
Men say they love cats, but when women aren't looking, men kick cats.
7.FUTURE
A woman worries about the future until she gets a husband.
A man never worries about the future until he gets a wife.
8.SUCCESS
A successful man is one who makes more money than his wife can spend.
A successful woman is one who can find such a man.
9.MARRIAGE
A woman marries a man expecting he will change, but he doesn't.
A man marries a woman expecting that she won't change, and she does.
10.DRESSING UP
A woman will dress up to go shopping, water the plants, empty the
garbage, answer the phone, read a book, and get the mail.
A man will dress up for weddings and funerals - maybe.
11.NATURAL
Men wake up as good-looking as they went to bed.
Women somehow deteriorate during the night.
12.OFFSPRING
Ah, children. A woman knows all about her children. She knows about
dentist
appointments and romances, best friends, favorite foods, secret fears
and hopes and dreams.
A man may be vaguely aware of some short people living in the house.
13.THOUGHT FOR THE DAY
Any married man should forget his mistakes. There's no use in two people
remembering the same thing.
Some people walk in the rain, others just get wet.
-Roger Miller, musician (1936-1992)

Cocoa Boosts "Good" Cholesterol

2006-12-22 20:14:53

Cocoa Boosts "Good" Cholesterol
Antioxidants in Cocoa May Be the Reason, Researchers Say
By Miranda Hitti
WebMD Medical News
Reviewed by Louise Chang, MD
March 9, 2007 -- Drinking cocoa each day may boost levels of HDL ("good")
cholesterol, Japanese researchers report.
Researchers, who included Kazuo Kondo, MD, PhD, of Tokyo's Ochanomizu
University, studied 25 healthy Japanese men with normal or mildly high
cholesterol levels.
None of the men were taking any prescription drugs, antioxidants, or vitamin
supplements. They weren't overweight, judging by their average BMI (body mass
index), and they didn't drink a lot of alcohol.
First, the researchers checked participants' blood and urine samples and divided
them into two groups.
One group was assigned to drink cocoa containing sugar each day for 12 weeks.
For comparison, the men in the other group were told to drink a sugary beverage
containing no cocoa for 12 weeks.
But it was no ordinary cocoa the first group drank. The researchers bought the
cacao beans themselves and roasted, cracked, and ground them in their lab. They
also analyzed the cocoa powder to make sure it hadn't lost major amounts of
antioxidants during processing.
At the end of the 12-week experiment, participants provided more blood and urine
samples.
HDL Cholesterol, LDL Cholesterol
The men in the cocoa group showed a 24% rise in their HDL, or "good,"
cholesterol levels. HDL levels also rose for the comparison group, but to a
lesser extent (5% increase in HDL).
The researchers also tested the men's LDL ("bad") cholesterol.
Those tests included blasting samples of the men's LDL cholesterol with free
radicals to trigger a process called oxidation. Oxidized LDL cholesterol may be
particularly hazardous because oxidation may help LDL cholesterol build up in
the arteries, the researchers explain.
The lab tests showed that the LDL cholesterol of the men who drank cocoa daily
for 12 weeks was more resistant to oxidation than the LDL cholesterol of men who
didn't drink the cocoa.
However, the study shows similar blood levels of LDL cholesterol for both groups
-- including oxidized LDL -- regardless of cocoa consumption.
Cocoa's Antioxidants
Cocoa contains antioxidants called polyphenols, which may be responsible for the
study's results, note the researchers.
The study doesn't prove cocoa was the sole reason for the men's increase in HDL
cholesterol.
The researchers stop short of recommending daily cocoa drinks for everyone. Tea,
wine, fruit, and vegetables also contain polyphenols and may help heart health,
note Kondo and colleagues.
"Moreover," they write, "it is irrefutable that a balanced daily diet is
important for the promotion of human health." In other words, don't count on
cocoa to make up for an unhealthy diet.
The researchers included six staffers from Meiji Seika Kaisha, a Japanese food
and pharmaceutical company whose products include chocolate.
Don't know your cholesterol levels? A simple blood test can fix that. The
results can help you and your doctor make a plan to improve your cholesterol
profile.
SOURCE: Baba, S. The American Journal of Clinical Nutrition, March 2007; vol 85:
pp 709-717.
http://www.webmd.com/cholesterol-management/news/20070309/cocoa-boosts-good-chol\
esterol?ecd=wnl_din_032607

The scare of my life

2006-12-22 14:30:16

The scare of my life
By Debra Danburg
The Daily News
Published March 25, 2007
It started with some bad clams I ate during a visit to Maryland - or so we
assumed. In fact, my diagnosis was far more serious than the hepatitis A that my
husband, Bob, and I erroneously suspected I'd contracted.
Still, with luck, I may end up owing my survival to early diagnosis and a highly
skilled surgeon. And I owe that to having decided a year ago to get my health
care at a world-class academic medical center where well-trained and highly
experienced physicians and surgeons diagnose and treat some of the most complex
and terrifying medical problems human beings can face: UTMB in my new hometown
of Galveston.
But I'm getting ahead of myself. After returning from Maryland, I threw my back
out exercising too intensely in a Pilates class and was bedridden for several
days.
I called my primary care physician, Dr. Tom Blackwell at UTMB, who prescribed
medication and physical therapy. Later, I observed that my urine had turned a
vivid orange, which I suspected was a side effect of the medicine.
Still later, the physical therapist noted that my skin was turning yellowish.
The next morning, a Saturday, when I came downstairs for breakfast, Bob said my
eyes looked like they'd been colored yellow with a Day-Glo highlighter.
By now, I had all the signs of hepatitis A - symptoms I recalled from decades
ago when my hard-living best friend developed the disease. At this stage of my
life, there was no chance that my own risk factors were related to sex, drugs,
or rock 'n' roll. Infected shellfish was the obvious suspect.
Because that was my one hepatitis risk factor, and because there's no treatment
for hepatitis A, many, perhaps most, doctors probably would have advised me to
just rest up and let the infection run its course.
But I wanted reassurance, and although it was the weekend, I paged Dr.
Blackwell's very competent and compassionate nurse, Tonya Arnold. She got back
to me promptly and scheduled blood tests first thing Monday morning. That
morning, she even met me at the lab. While the hepatitis tests didn't come back
for days, the liver counts were available quickly.
Tonya called alerting me that my liver counts were abnormally high and that at
Dr. Blackwell's instruction she was arranging for an outpatient ultrasound
examination Tuesday afternoon.
As I was leaving the ultrasound lab in the Primary Care Clinic, Tonya called my
cell phone. Dr. Blackwell had already received the ultrasound and was going to
admit me to the hospital that night for an endoscopic ultrasound and a battery
of other tests, including a CT scan.
Chillingly, the tests revealed a lentil-sized tumor on my ampulla of Vater, the
area where the bile and pancreatic duct enter the duodenum. It was blocking the
drainage from the gall bladder, bile ducts and whole biliary system into my
stomach.
Pancreatic cancer is usually fatal and not discovered until it has metastasized.
The good news was that my tumor was small and apparently contained, and that its
location had caused the symptoms that prompted early diagnosis.
The doctors recommended something called a Whipple operation, a complex
procedure popularized by Dr. Alan Whipple in the 1930s that involves removing
the head of the pancreas, part of the bile duct, the gallbladder and the
duodenum. The procedure remained extremely risky into the 1970s, when up to 25
percent of patients at tertiary centers and up to 40 percent at general surgery
centers died from the surgery.
In recent years, however, the operation has become much safer, with a mortality
rate of less than 4 percent, at least when it's done at tertiary care centers
where many of the procedures are performed by a select few surgeons.
In another stroke of good luck for me, UTMB has a Pancreatico-Biliary Surgery
Center. Its leader, Dr. William H. Nealon, and Dr. Courtney M. Townsend Jr.,
UTMB's chair of surgery, had recruited Dr. Taylor S. Riall, a skilled
pancreatico-biliary surgeon from Johns Hopkins University - a center recognized
around the world for its expertise in this field - to join it.
Dr. Riall has extensive experience in treating patients with cancer of the
pancreas and has written many papers helping to define its treatment.
During my initial hospital stay, I met everyone who was expected to be involved
in my surgery and post-ope