Iran Hepatitis Scientific Club (IHSC) Newsletter, June 2013; 1(1)

7/28/2019 Iran Hepatitis Scientific Club (IHSC) Newsletter, June 2013; 1(1)

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Iran Hepatitis Scientific Club (IHSC)NewsletterVolume 1, Issue 1, June 2013

The new chapter in chronic HCV

therapy has already begun. 1

About IHSC. 2

What we have done so far andhave planned to do.. 3

The DAA educational

package. 4

The Comprehensive Hepatitis

Registry (CHR). 5

The THC5 HCV symposium

report.. 6

World Hepatitis Alliance day. 7

Some key publications.. 8 Hepatitis congress updates.. 9

In this issue

The quarterly newsletter of thehepatitis scientific club serving the

hepatitis health-care community.


2/11

The new chapter in chronicHCV therapy has alreadybegun. Lets set our sight on acollaborative communitywithin IHSC.

IHSC (Iran Hepatitis Scientific Club) is an initiative by a

number of renowned Iranian experts in the field of

hepatitis care. Experts recommendation and support has

led to consolidation of the core executive committee

comprising multi-disciplinary hepatitis care providers in

Iran. The scientific activities of IHSC which are outlined

in this newsletter have been endorsed by Iran hepatitis

network and received attestation and support from

several hepatitis care and research centers across the

country.

The founding panel of IHSC hope this newly formed

scientific club provides a boosting impact on the currently

in place hepatitis-related scientific activities.

This is expected to update physicians about the growing

advances in the dynamic and challenging field of

hepatitis care and the related applied science.

Like any other clubs, IHSC welcomes membership and

contributions from interested colleagues. Everything in

IHSC is at the prime of its journey and expected to

steadily grow through your support and collaboration.

This will not be possible without your forward thinking

towards the planned scientific activities within this

scientific club.

1

On the cover

The core proteinmaterial containing

hepatitis C viralRNA released into

the cytoplasm of ahepatocyte


3/11

To reach the above IHSC has planned for thefollowing scientific activities in coming

months:

1. Organizing and conducting scientific

leaders (SLs) meetings to arrive at practical

consensus in the field of viral hepatitis (the

second SL meeting is to be held in quarter 3,

2013).

2. Holding symposia, seminars, group

discussions and scientific round table

communications in interval basis.

3. Contributing to nationally renowned

hepatitis treatment and research centers

active in viral hepatitis field.

4. Facilitating members access by re-

directing them to live on-line scientific

educational activities managed by the world

authorities in viral hepatitis.

5. Data-gathering and preparing publishable

scientific reports (as clinical case series) on

the initial efficacy and safety outcomes of the

patients who have been on the most

advanced therapy for hepatitis C.

6. Assisting data registry in hepatitis by

means of the IHSCs already developed and

in place registry (the comprehensive hepatitis

registry: CHR).

7. Publishing comprehensive educational

materials such as e-books, lecture notes,slide casts, podcasts, etc.

8. Providing public and patient awareness

programs in line with the world hepatitis

alliance activities ( Hepatitis Awareness

Month, July each year)

About IHSCAs the title indicates, IHSC ( Iran Hepatitis

Scientific Club) is a scientific club focusing on

the viral hepatitis field. This independent

scientific community has received attestation

from local field experts who contribute to

diagnosis, management and surveillance ofviral hepatitis. IHSC will continue to appeal

endorsement and contribution from many of

the hepatitis field authorities across Iran.

IHSC pursues some central goals not

restricted to:

1. Fostering scientific cross-links betweenexperts of allied disciplines to utilize the most

innovative and evidence-based management

strategies in viral hepatitis.2. Serving an arena in which experts canprovide professional education in the field of

viral hepatitis to those with less expertise.

3. Providing career development in viralhepatitis research and clinical experience to

scholars/clinicians through facilitation of their

participation in well-known viral hepatitis

events and organizing post-event update

meetings.4.Acquiring endorsement and strong scientificcollaboration from credible scientific societies

and viral hepatitis treatment and research

centers nationwide.

IHSC Newsletter 2013;1(1) 2


4/11

3

What we have done so far:The concept of IHSC has just recently been consolidated, however a team with the same philosophy

comprising field experts, researchers and interested contributors have implemented some robust medical

activities over the past few years . These activities were:

a. contributing to the scientific leaders meeting on the use of protease inhibitors (PIs) in chronichepatitis C management, report published in 2011.

b. patient and public awareness activities on the world hepatitis day ( 2011, 2012).

c. holding hepatitis symposia; published hepatitis symposium report from the 4th International TehranHepatitis Congress, 2012 (THC4) and having the report from the cross-border HCV symposium during

THC5 under review, 2013.

What IHSC has planned to do:IHCS planned activities in 2013 include:

a. holding a 2-day hepatitis school and clinic tour addressingjunior hepatologists, in collaboration with Iran hepatitis network

(IHN),

b. composition of an e-book and educational package ondirect-acting antivirals (DAAs), edited by distinguished national

hepatitis field experts (see page 5).c. Providing public and patients educational material forhepatitis.

d. Updating members with field news, recently publishedevidence, congress and symposia coverage, etc.


5/11

Dear Colleagues

The landscape for hepatitis C has recently faced a dramatic change, The most striking changes have been demonstrated in the

treatment perspective. To keep pace with these changes and come up with local consensus on applying new therapeutic regimens

in treating HCV, we had a consensus forum leading to a report publication on 28th of July ,2011( 28th of July is the world hepatitis

day). It has elapsed a year since then and now, the anticipated changes and the new insights are expected to change the decisionmaking paradigm in our local practice when approaching chronic hepatitis C for medical evaluation and care.

With the approved protease inhibitors, boceprevir and telaprevir, we may consider offering patients the highest potential for

sustained virological response (SVR) that we have yet seen. This is exciting because we have data to demonstrate that SVR is

associated with improved clinical outcomes, including reduced mortality and rates of decompensated liver disease, liver transplant,

and hepatocellular carcinoma. However, to arrive at the optimal response with these new therapies, patients adherence is of critical

importance. Plus, physicians should acquire a thorough knowledge of response-guided therapy algorithms, futility rules, and side

effect management.

The Iranian viral hepatitis field experts have decided to contribute to the present educational program entitled: DAA

Treatment; A guide for managing HCV, today. Apart from the e-learning text chapters which are authored by the lead faculty and

the programs group of experts and editors, within the slide cast section, Dr. Mohraz would initially elaborate on that why HCV

prevalence is rising, who is at risk, and why we should respond with screening and treatment. Next, Dr. Alavian and Dr. Nassiri

Toosi will review the clinical trial efficacy and safety data, guide you through treatment algorithms, and recommend side effect

management strategies on DAAs in current practice. We also would discuss 3 cases in our case based roundtable. Finally, Dr.Zamani and Dr. Alavian will summarize by where we stand today?, what should be considered? and further. I will lead the faculty in

a panel discussion of typical cases we see in clinical practice to model how treatment is to be considered and delivered to individual

patients with individual needs.

As disclosure, we need to mention that this program has been medically organized, coordinated and produced through the

support received from the medical division at Behestan Darou PJS, Tehran, Iran. We are glad youve chosen to participate in this

informative scientific activity.

Sincerely,

N. Ebrahimi Daryani, MD

Program Director

The DAAseducationalpack project

Message from theprogram director



6/11

The clinical data which emerges from Hepatitis practice deserve documentation. This can beachieved via a comprehensive and well-structured registry system.

IHSC has it own hepatitis registry (CHR) software which can be installed in offices, clinics and

research centers actively involved in hepatitis care.

There are some unique features about CHR:

1. It includes all needed items and nothing not.

2. Concise, user friendly and multi-faceted at the same time.

3. The digital patient file enables close and precise follow up through out the treatment

journey4. Defined treatment response criteria and announced highlights at distinct milestones ( e.g.

RVR, EVR, etc.).

5. Perfect ability to record untoward /adverse effects for surveillance interest.

6. Ease of statistical analyses for report generation

7. Possibility to record same patients various treatment courses ( main, retreatment, etc.)

separately.

8. Not restricted to a specific regimen, unbiased and truly designed from scientific viewpoint.

9. Possibility to be used not only in research setting but also in daily practice

10. Using this system one can allocate and track appointments to the patients11. Restricted access for designated users secures the data safety

12. Possibility to merge data with other databases for the purpose of multi-centered research

projects.Interested to have the CHR installed at your office/center? Please call 02188774200 ext 1634

The comprehensive Hepatitis Registry(CHR) at your fingertips5


7/11

The cross-border symposium on hepatitis C,

entitled why treating now? was held on 15th

May 2013 during the 5th International Tehran

Hepatitis Congress (THC5). With regard to

hepatitis C treatment advances and the need

for a clear understanding on the recently

available regimens implications, benefits,

untoward effects or practical challenges, this

symposium tried to highlight: 1- why timely

treatment with the currently available PI-

included triple therapy is needed for a distinctcategory of patients and waiting for future

therapies is normally not recommended, 2-

what practical considerations must be noted

when applying these regimens and 3- where

we stand with regard to our local experience

with PI-included triple therapy for GT1 HCV-

infected patients and where we plan to reach?

In our local setting, the use of boceprevir-

included triple combination for the management

of hard-to-treat CHC cases has been

commenced over the past 6 months. Some

Iranian hepatitis experts have shortlisted almost

40 cases to receive this regimen, however 23

patients have already been started on therapy

and the remaining patients are currently on the

waiting list.

A preliminary report on baseline characteristics,

disease-related particulars and the initial

treatment data of the above already on-

treatment 22 cases was summarized during

this symposium. The scientific report of this

activity is already prepared for submission,

evaluation and possible publication in an

international peer-reviewed journal.

The THC5 HCV symposiumreportIHSC Newsletter 2013;1(1) 6


8/11

Some key publications inhepatitis field1. Boceprevir for untreated chronic HCV genotype 1

infection. Poordad F, McCone J Jr, Bacon BR, et

al. N Engl J Med. 2011 Mar 31;364(13):1195-206.

2. Boceprevir for previously treated chronic HCV

genotype 1 infection. Bacon BR, Gordon SC,

Lawitz E, et al. N Engl J Med. 2011 Mar

31;364(13):1207-173. Telaprevir for retreatment of HCV infection.

Zeuzem S, Andreone P, Pol S, et al. N Engl J Med.

2011 Jun 23;364(25):2417-28.

4. Telaprevir is effective given every 8 or 12 hours

with ribavirin and peginterferon alfa-2a or -2b to

patients with chronic hepatitis. C. Marcellin P,

Forns X, Goeser T, et al. Gastroenterology. 2011

Feb;140(2):459-468.

5. (NEW) Sofosbuvir for Previously Untreated Chronic

Hepatitis C Infection. Lawitz E, Mangia A, et al. N

Engl J Med. 2013 Apr 23. [Epub ahead of print].

6. (NEW) Sofosbuvir for Hepatitis C Genotype 2 or 3

in Patients without Treatment Options. Jacobson

IM, Gordon SC, et al. N Engl J Med. 2013 Apr 23.

[Epub ahead of print].

7. Nucleotide polymerase inhibitor sofosbuvir plus

ribavirin for hepatitis C. Gane EJ et al. N Engl J

Med. 2013 Jan 3; 368:34.

8. Exploratory study of oral combination antiviral

therapy for hepatitis. Poordad F. N Engl J Med.

2013 Jan 3; 368:45.

9. Relationship between adherence to hepatitis C

virus therapy and virologic outcomes: a cohort

study. Lo Re V 3rd, Teal V, Localio AR, et al. Ann

Intern Med. 2011 Sep 20;155(6):353-60.

10. Preliminary study of two antiviral agents for

hepatitis C genotype . Lok AS, Gardiner DF,

Lawitz E, et al. N Engl J Med. 2012 Jan

19;366(3):216-24

11. Escitalopram for the prevention of peginterferon-

a2a-associated depression in hepatitis C virus-

infected patients without previous psychiatricdisease: a randomized trial. Schaefer M, Sarkar

R, Knop V, et al. Ann Intern Med. 2012 Jul

17;157(2):94-103.

12. Telaprevir for Previously Untreated Chronic

Hepatitis C Virus Infection. Jacobson IM,

McHutchison JG, Dusheiko G, et al. N Engl J

Med. 2011 Jun 23;364(25):2405-16.

13. Peginterferon alfa-2b or alfa-2a with ribavirin for

treatment of hepatitis C infection. McHutchison

JG, Lawitz EJ, Shiffman ML, et al. N Engl J Med.

2009 Aug 6;361(6):580-93.

14. Effect of hepatitis C virus and its treatment on

survival. Butt AA, Wang X, Moore CG.

Hepatology. 2009 Jul 9;50(2):387-392.

7


9/11


World Hepatitis Day is an annual event that each year

provides international focus for patient groups and peopleliving with hepatitis B and C. It is an opportunity around

which interested groups can raise awareness and influence

real change in disease prevention and access to testing

and treatment. In Iran, we have done some related

activities during WHA day in 2011 and 2012.

The World Hepatitis Alliance first launched World Hepatitis

Day in 2008 in response to the concern that chronic viral

hepatitis did not have the level of awareness, nor the

political priority, seen with other communicable diseases

such as HIV/AIDS, tuberculosis and malaria. Since then

thousands of events have taken place around the world,

generating massive public and media interest. The Alliance

has also received support from governments worldwide,

high-profile Non-Governmental Organizations (NGOs) and

supranational bodies, such as Physicians Without Borders.

In 2013, the WHA is focusing on two main themes:

1. This is hepatitis. Know it. Confront it.: This theme has

seen big success since its launch in 2010, as it focuses on

the real-life impact of viral hepatitis.

2. See No Evil, Hear No Evil, Speak No Evil: The message

from this theme is that hepatitis is being ignored around theworld, and we are calling for that to change. The proverb is

widely recognised, and we have two great events to

generate interest around it.

IHSC is planning to get involved

with World Hepatitis Day 2013

activities

One in 12 people worldwide isliving with either chronichepatitis B or C.Am I Number 12?is the global diseaseawareness campaign of theWorld Hepatitis Alliance.

This year, onWorld Hepatitis Day!


10/11

9

Congress Updates 2013The following conferences are to be held over the coming months.

For more detailed info please visit their dedicated websites.

EASL Special Conference: Liver CancerManagementJune 20-22, 2013Istanbul, Turkey

8th International Workshop on ClinicalPharmacology of Hepatitis TherapyJune 26-27, 2013Cambridge, MA, USA

8th International Workshop on Hepatitis

C: Resistance and New CompoundsJune 27-28, 2013Cambridge, MA, USA

3rd International Symposium onHepatitis Care in Substance UsersSeptember 5-6, 2013Munich, Germany

The International Liver Cancer

Association Seventh Annual Conference ILCA 2013September 13-15, 2013Washington, D.C., USA

The Viral Hepatitis Congress 2013September 26-28, 2013Frankfurt, Germany

2013 International Meeting onMolecular Biology of Hepatitis BVirusesOctober 20-23, 2013Shanghai, China

June

Septem

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Octobe

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11/11

Iran Hepatitis Scientific ClubAn independent scientific club comprising hepatitis field experts,researchers and interested contributors , intended to serve

hepatitis care community

IHSCs Newsletter Editorial DeskNo.22, Sorayya Bldg, Pardis St. Mollasadra Ave. Tehran, Iran +982188774200 Ext. 1634

IHSC receives scientific support from the

Medical Division of Behestan Darou PJS.

www.behestandarou.com


Documents

Iran Hepatitis Scientific Club (IHSC) Newsletter, June 2013; 1(1)