Only 9 countries on track to eliminate hepatitis C
New data on hepatitis C released by the Polaris Observatory*, and presented today at the World Hepatitis Summit (WHS) in Sao Paulo, Brazil shows that nine countries — Australia, Brazil, Egypt, Georgia, Germany, Iceland, Japan, the Netherlands and Qatar — are on course to eliminate hepatitis C by 2030.
Worldwide, viral hepatitis kills more than one million people each year, and more than 300 million people are chronically infected with hepatitis B or C. Yet, with the development of highly-effective direct acting antivirals (DAAs) for hepatitis C and the increasing rates of hepatitis B treatment and vaccination coverage globally, elimination of viral hepatitis has become a real possibility.
“This new data shows that elimination of hepatitis C is possible. It also shows more must be done to support governments in tackling viral hepatitis,” said Charles Gore, President of the World Hepatitis Alliance. “The World Hepatitis Summit offers governments the opportunity to learn from other countries and public health experts, in an effort to speed up progress to elimination.”
Since the adoption of World Health Organization’s (WHO) elimination targets in 2016, which include a 90% reduction of new hepatitis B and C infections and a 65% reduction in hepatitis B and C related mortality by 2030, some countries are making great strides yet multiple factors preventing progress remain for the majority. These include a lack of political will and global funding mechanism, poor data and surveillance, access to diagnostics and medicines and poor diagnosis rates (approx. 10% worldwide for hepatitis B and 20% for hepatitis C), that together mean that many countries are struggling to reach the targets.
Some key countries which are being highlighted at the Summit for their innovative work to eliminate viral hepatitis are Brazil, Egypt, Australia and Georgia. In 2017, Egypt pledged to test 30 million for hepatitis C by the end of 2018 by implementing mass screening initiatives (including assistance from the military), as well as mass producing generic copies of DAA drugs for under US $200 per 12-week course.
Meanwhile, WHS host nation Brazil has committed to gradually lift treatment restrictions in 2018, meaning that the country will be able to treat all people infected with hepatitis C, ensuring it is on target to eliminate hepatitis C. Previously, treatment was restricted to only the sickest patients with advanced liver disease.
“Brazil has championed the cause of hepatitis on the world stage for many years and has pushed for an intensified global hepatitis response,” says Adele Schwartz Benzaken, director of the Brazilian Ministry of Health’s Department of Surveillance, Prevention and Control of STIs, HIV/AIDS and Viral Hepatitis. “In addition to the work we have already done on hepatitis B, opening up vaccination to the whole population, we are now gradually removing the restrictions on access to hepatitis C treatment – so that, from 2018 on, the entire infected population can be treated, not just the sickest.”
The Australian government responded to the call for universal access to the hepatitis C DAAs with an AUS $1billion dollar investment over 5 years. This risk-sharing agreement with pharmaceutical companies provides government-funded treatment to all adults without restriction and has paved the way for the elimination of hepatitis C by 2030. More than 30,000 patients with hepatitis C were treated and cured in 2016.
“What we are seeing is that some countries, especially those with a high burden, are making the elimination of viral hepatitis a priority and are looking at innovative ways to do it,” said Homie Razavi, Director of CDA. “However, it will be near-impossible for most other countries to meet the WHO targets without a huge scale-up in political will and access to diagnostics and treatment.”
Although only a handful of countries are on track to reach the WHO’s elimination targets, there are a number of other countries which are making progress. Mongolia, Gambia, and Bangladesh have shown real political will and, along with Brazil, Georgia and Egypt, are spearheading the NOhep Visionary Programme* in their region, due to their commitment to ending their epidemics.
“Because viral hepatitis has been neglected for so long, much needs to be done rapidly to make up for lost time,” concluded Gore. “In that context, the Summit, a biennial event, focuses on the public health approach to viral hepatitis and acts as the central forum for countries to share their experience and best practice in order to drive rapid advances in national responses.”
Hepatitis C vaccine could dramatically reduce transmission in people who inject drugs
MAYWOOD, IL – Among the most serious consequences of the opioid epidemic is the spread of hepatitis C among injecting drug users.
A major new study shows that if a hepatitis C vaccine were successfully developed, it would dramatically reduce transmission of hepatitis C among drug users – even though it’s unlikely such a vaccine would provide complete immunity.
The study, which employed mathematical modeling, is published in Science Translational Medicine.
Four of the study’s authors are members of the Program for Experimental and Theoretical Modeling in the division of hepatology of Loyola Medicine and Loyola University Chicago Stritch School of Medicine. One of the Loyola researchers, Harel Dahari, PhD, is a co-senior author of the study, along with Marian Major, PhD, of the U.S. Food and Drug Administration. Dr. Dahari is an assistant professor at Loyola University Chicago Stritch School of Medicine.
Vaccines are currently available for hepatitis A and hepatitis B, but a vaccine for hepatitis C is still under investigation. A clinical trial is testing an experimental hepatitis C vaccine on injecting drug users. Unlike many other vaccines, the hepatitis C vaccine is not expected to provide complete immunity, known as sterilizing immunity. A vaccinated person exposed to HCV could still be infected with the virus, although the amount of virus in the bloodstream would be significantly reduced.
The new study calculated how effective a vaccine that provided incomplete immunity would be in preventing transmission among injecting drug users. Researchers developed a mathematical model to determine transmission probabilities in drug users who share needles and syringes. They simulated the sharing of two types of common syringes used by drug users. Using previously published data from people infected or reinfected with hepatitis C virus, researchers then estimated the transmission risks between injecting drug users.
The study estimated that if an injecting drug user shared a syringe/needle with a second drug user who was infected with hepatitis C, there would be a greater than 90 percent chance the first drug user would also become infected with hepatitis C after six months. However, if a vaccine were used, the transmission risk would decrease to between 1 and 25 percent, depending on the type of needle used and other factors.
“Our findings suggest that a hepatitis C vaccine would be an essential part of a comprehensive prevention strategy to meet the World Health Organization’s goal of eradicating hepatitis C by 2030,” said study co-author Scott Cotler, MD, head of Loyola’s division of hepatology and a professor in the department of medicine of Loyola University Chicago Stritch School of Medicine. Other Loyola co-authors are mathematical modelers Alexander (Sasha) Gutfraind, PhD, and Louis Shekhtman, MSc.
Hepatitis C is caused by the hepatitis C virus (HCV). Long-term infection with HCV, known as chronic hepatitis C, usually is silent for many years. But the disease eventually can cause cirrhosis (advanced scarring) of the liver, liver cancer and liver failure. In the United States, as many as 3 million people are chronically infected with HCV, with more than 30,000 new infections per year.
Hepatitis C spreads through contaminated blood, and an estimated 60 percent of HCV infections in the U.S. are attributed to sharing needles, syringes or other drug paraphernalia.
Antiviral drugs are used to treat hepatitis C, with cure rates higher than 90 percent. In addition to stopping the disease from progressing, antivirals also can prevent transmission. However, antivirals are expensive, and many injecting drug users lack access to healthcare in the U.S. And even if they are cured, injecting drug users can become infected again if they continue to share needles.
“While extremely effective, antivirals alone are unlikely to eliminate hepatitis C globally,” Dr. Dahari said. “We need to combine antivirals with a hepatitis C vaccine and harm-reduction measures such as needle-syringe exchange programs, opioid substitution therapy and behavioral counseling.”
Some people think a vaccine needs to be perfect, Dr. Dahari added. “But we found that a vaccine still can be extremely beneficial even if it does not provide complete sterilizing immunity.”
The study was conducted with Qingwen Cui, MSc, and Alla Kachko, PhD, of the U.S. Food and Drug Administration, Behzad Hajarizadeh, PhD, of University of New South Wales, Sydney, Australia, Rachel Sacks-Davis, PhD, of the Burnet Institute and University of Melbourne, Kimberly Page, PhD, of the University of New Mexico Health Sciences Center and Basmattee Boodram, PhD, of the University of Illinois at Chicago.
The study is titled, “Modeling of patient virus titers suggests that availability of a hepatitis C vaccine could reduce HCV transmission among injecting drug users.” The study was funded by the Food and Drug Administration, National Institutes of Health, and Burnet Institute.
Alzheimer's and Brain
June is Alzheimer’s and Brain Awareness Month. Alzheimer’s affects more than 3 million Americans in the US. It is a type of dementia that affects memory and overall behavior. The greatest factor is increasing age and it worsens over time. Currently there is no cure to Alzheimer’s but there are treatments available and there is ongoing research to find a cure.
Signs of Alzheimer’s Dementia
Memory loss that disrupts daily life.
Memory loss that disrupts daily life.
Confusion with time/place
Problems with speaking or writing
Misplacing things and losing the ability to retrace steps
Withdrawal from social activities
Changes in mood and personality
Trouble understanding visual images
Source: Alz Org
Join us on June 20th to fight Alzheimer’s via an online or at-home awareness of fundraising activity
More info: The Longest Day
Radiation treatment may alleviate symptoms of severe Alzheimer’s disease
- A pilot study showed that treatment with a low dose of radiation in people with severe Alzheimer’s disease could improve quality of life.
- The low dose of radiation causes a small amount of damage to molecules, which stimulates a cellular protective response that involves antioxidant production and damage repair.
- Further studies are needed to determine the optimal range of radiation efficacy.
Alzheimer’s disease (AD) is a progressive neurodegenerative disease that involves damage in the brain’s nerve cells, leading to memory loss and disruption of cognitive functioning. In the United States, AD is one of the leading causes of death in older populations, making up 60–80% of dementia cases.
There is no cure to prevent or treat AD, although there are therapies to relieve and slow the progression of some of its symptoms.
Key symptoms of AD include memory loss, confusion, and the loss of other cognitive abilities such as reasoning and decision-making. Health experts characterize late-stage, severe AD as an inability to communicate as well as impaired movement.
A recent pilot study — conducted by scientists at the Baycrest and Sunnybrook Health Centres in Toronto, and Cuttler & Associates in Vaughan, Canada — showed that administering low doses of radiation, such as from a CT scan, may improve quality of life in severe AD patients.
The study appears in the Journal of Alzheimer’s Disease.
Dr. Sean Symons, a scientist at the Sunnybrook Research Institute and author of the study, provided additional comments for this article.
The team wanted to determine if they could observe similar results from a 2015 case study. According to this research, a patient with severe AD who received low doses of radiation displayed significant improvement in cognitive abilities, speech, and movement to the point where they were able to transfer out from a hospice into a care home.
Oxidative stress, which can cause DNA and cellular damage, can contribute to the development of Alzheimer’s disease and other neurodegenerative diseases.
The authors of the study hypothesized that low-dose ionizing radiation (LDIR) stimulates the mechanisms that offer protection from the damaging effects of oxidative stress, alleviating some of the symptoms of AD.
Four participants between the ages of 81 to 90 years, with severe AD, received a total of three low-dose radiation treatments through normal CT brain scans, 2 weeks apart. The first treatment consisted of two scans with a total of 80 milligrays (mGy) of radiation, while the latter two treatments were 40 mGy each.
The study analyzed both quantitative measures — measuring cognitive, behavioral, and functional abilities — and qualitative measures, meaning observations and reports of interactions with family members and caretakers, to determine improvements in quality of life.
The quantitative measures displayed minor differences, while the authors noted these measures were not sufficient to observe significant changes in severe AD patients.
However, the researchers saw the most significant changes through the qualitative measures. For three of the four participants, their family or caretakers reported increased alertness, awareness of surroundings, and recognition within a day after their first treatment.
One of the participants “was able to get into his wheelchair easily and put his feet on the footrests when asked to do so. At a concert, he sang to the rhythm and applauded appropriately.”
Another participant’s family member noted, “He was excited to see me — he spoke to me right away and gave me multiple kisses — real kisses like years ago. He was clapping his hands to the music. My mom agreed [it’d] been years since he has done this.”
One of the participants showed no changes or improvements in qualitative or quantitative measures. However, in all participants, there was no evidence to suggest worsened conditions or symptoms after radiation.
Rejuvenating' the Alzheimer's brain
Alzheimer’s disease is the main cause of dementia and current therapeutic strategies cannot prevent, slow down or cure the pathology. The disease is characterized by memory loss, caused by the degeneration and death of neuronal cells in several regions of the brain, including the hippocampus, which is where memories are initially formed. Researchers from the Netherlands Institute for Neuroscience (NIN) have identified a small molecule that can be used to rejuvenate the brain and counteract the memory loss.
New cells in old brains
The presence of adult-born cells in the hippocampus of old people was recently demonstrated in scientific studies. It suggests that, generally speaking, the so-called process of adult neurogenesis is sustained throughout adulthood. Adult neurogenesis is linked to several aspects of cognition and memory in both animal models and humans, and it was reported to sharply decrease in the brains of patients with Alzheimer’s disease. Researchers also found that higher levels of adult neurogenesis in these patients seem to correlate with better cognitive performance before death. “This could suggest that the adult-born neurons in our brain may contribute to a sort of cognitive reserve that could later on provide higher resilience to memory loss”, says Evgenia Salta, group leader at the NIN. Therefore, researchers from the NIN investigated if giving a boost to adult neurogenesis could help prevent or improve dementia in Alzheimer’s disease.
A small molecule with big potential
Salta: “Seven years ago, while studying a small RNA molecule that is expressed in our brain, called microRNA-132, we came across a rather unexpected observation. This molecule, which we had previously found to be decreased in the brain of Alzheimer’s patients, seemed to regulate homeostasis of neural stem cells in the central nervous system”. Back then, Alzheimer’s was thought to be a disease affecting only mature neuronal cells, so at first glance this finding did not seem to explain a possible role of microRNA-132 in the progression of Alzheimer’s.
In this study, the researchers set out to address whether microRNA-132 can regulate adult hippocampal neurogenesis in healthy and Alzheimer’s brains. Using distinct Alzheimer’s mouse models, cultured human neural stem cells and post-mortem human brain tissue, they discovered that this RNA molecule is required for the neurogenic process in the adult hippocampus. “Decreasing the levels of microRNA-132 in the adult mouse brain or in human neural stem cells in a dish impairs the generation of new neurons. However, restoring the levels of microRNA-132 in Alzheimer’s mice rescues neurogenic deficits and counteracts memory impairment related to adult neurogenesis”, Sarah Snoeck, technician in the group of Salta, explains.
These results provide a proof-of-concept regarding the putative therapeutic potential of bringing about adult neurogenesis in Alzheimer’s. Salta: “Our next goal is to systematically assess the efficacy and safety of targeting microRNA-132 as a therapeutic strategy in Alzheimer’s disease”.
BioNTech and Moderna set their sights on treating cancer
BioNTech cofounder Özlem Türeci stressed in a recent interview with AP that the mRNA vaccine technology that is its focus could be a powerful weapon against cancer. “We have several different cancer vaccines based on mRNA,” said Türeci, BioNTech’s chief medical officer.
Such therapy could be available to people within a “couple of years,” Türeci said, stressing that it is difficult to predict regulatory timelines involving emerging therapies.
BioNTech is currently working on several novel immunotherapies for oncology targeting melanoma, prostate cancer and cancers associated with human papillomavirus.
Moderna is also exploring the possibility of using its mRNA vaccines for treating cancer. The company has Phase 2 studies underway investigating melanoma and ovarian cancer.
Moderna is also testing mRNA vaccines’ potential to revascularize heart tissue post-heart attack.
Its pipeline also includes a vaccine for cytomegalovirus (CMV), which is a frequent cause of birth defects. Roughly one out of every 200 babies is born with congenital CMV, according to CDC.
Prototype app for mobile devices could screen children at risk for autism spectrum disorder
NIH-funded research project develops app to track eye movements in response to videos.
The study appears in JAMA Pediatrics and was conducted by Geraldine Dawson, Ph.D., director of the NIH Autism Center of Excellence at Duke University, and colleagues. Funding was provided by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and National Institute of Mental Health.
Studies have found that the human brain is hard-wired for social cues, with a person’s gaze automatically focusing on social signals. In ASD, attention to social stimuli is reduced, and researchers have sought to screen for ASD in young children by tracking their eye movements while they view social stimuli. However, equipment used for visual tracking is expensive and requires specially trained personnel, limiting its use outside of laboratory settings.
The current study enrolled 933 toddlers ages 16 to 38 months during a well-child primary care visit. Of these children, 40 were later diagnosed with ASD. They viewed on a mobile device short videos of people smiling and making eye contact or engaging in conversation. Researchers recorded the children’s gaze patterns with the device’s camera and measured them using computer vision and machine learning analysis. Children with ASD were much less likely than typically developing children to focus on social cues and visually track the conversations in the videos.
Pending confirmation by larger studies, the authors concluded that this eye-tracking app featuring specially designed videos and computer vision analysis could be a viable method for identifying young children with ASD.