Obesity in people with hepatitis C (HCV) is associated with metabolic complications, type-2 diabetes, fatty liver disease and the progression of fibrosis. In the absence of treatment for HCV, people who are overweight may be recommended to lose weight. There are differences in opinion regarding which form of diet is most likely to result in weight loss. A study conducted in Romania in 120 people with HCV infection who were either overweight or clinically obese found that, after 12 months, there was no difference in weight loss between the two groups of participants, who were either randomised to a low-fat diet or to a low-calorie diet. Both groups lost around 3 to 4kg, and experienced improvements in insulin sensitivity and a reduction in the prevalence of metabolic syndrome. Liver function also improved. There was a sustained increase in physical activity after 12 months, and this increase may have contributed to the positive results. This study would have been stronger if it had also randomised participants to different exercise plans, to see how exercise affected metabolic and liver function and body weight.

Another study, conducted in Taiwan, found that the development of new-onset diabetes in people with chronic hepatitis B infection doubled the risk of liver cirrhosis and decompensated cirrhosis during a nine-year period of follow-up. Diabetes can be prevented by regular monitoring of blood sugar, exercise, weight loss and dietary changes.

An expert panel of Canadian physicians has recommended that the Public Health Agency of Canada should introduce screening for hepatitis C for all adults born between 1945 and 1975 – the ‘baby boomer’ generation. This position is also endorsed by the Canadian Liver Foundation. Last year the US Centers for Disease Control recommended screening for all adults born between 1945 and 1965. A study published in September showed that 1% of all deaths in the United States were due to viral hepatitis, and that these deaths were most frequent in people aged 55 to 65 – the ‘baby boomer’ generation.

Transmission of hepatitis B virus (HBV) from mother to child at the time of birth continues to be an important route of transmission in settings where hepatitis B is common. Immediate vaccination of infants and administration of an antibody preparation, hepatitis B immune globulin (HBIG), dramatically reduces transmission risk, but it can still occur if the mother has a high HBV viral load.

A small study from Turkey has reported on the use of tenofovir during the last three months of pregnancy to reduce maternal HBV viral load. All 14 mothers had chronic hepatitis B infection, were hepatitis B surface antigen (HBsAg)-positive and hepatitis B 'e' antigen (HBeAg)-positive, and had high HBV DNA levels (greater than ten million copies/ml at baseline); most had viral loads exceeding one billion copies/ml. All had previously given birth to at least one child infected with HBV, despite the use of HBIG and infant HBV vaccination. In all cases the infants born during this study remained free of HBV and treatment was safe and well tolerated.

People with hepatitis C genotypes 2 or 3 who had HIV co-infection responded just as well as those without HIV to a course of hepatitis C treatment with pegylated interferon and ribavirin, Italian researchers reported last month.

A large Spanish study showed that a sustained virologic response (SVR) to pegylated interferon and ribavirin in people with co-infection was associated with a significant reduction in the risk of death and decompensated cirrhosis after five years of follow-up, especially in people with less severe pre-treatment liver damage.

Further data on the NS5A inhibitor daclatasvir were presented at the ID Week 2013 conference in San Francisco earlier this month. Daclatasvir is being developed by Bristol-Myers Squibb for use with pegylated interferon and ribavirin, or as part of an interferon-free regimen.

A 12- or 16-week regimen of daclatasvir combined with pegylated interferon and ribavirin was more effective than pegylated interferon and ribavirin alone in people with HCV genotype 2 or 3, with or without cirrhosis.

An interferon-free regimen combining daclatasvir with asunaprevir (an HCV protease inhibitor, formerly BMS-650032) and BMS-791325 (a non-nucleoside polymerase inhibitor) cured 88 to 94% of previously untreated patients with HCV genotype 1. Patients with cirrhosis were not included in this trial. Bristol-Myers Squibb has said that it plans to begin testing daclatasvir, asunaprevir and BMS-791325 in a fixed-dose co-formulation soon.

Janssen announced this month that it has bought GSK2336805 (an NS5A inhibitor) from GlaxoSmithKline, and plans to begin testing it as part of an interferon-free combination with its protease inhibitor simeprevir and TMC647055, a non-nucleoside polymerase inhibitor. Simeprevir was approved in Japan for treatment of HCV genotype 1 in combination with pegylated interferon and ribavirin, and is likely to receive marketing approval in the United States and European Union within the next few months.

The American Liver Meeting is one of the major venues for presentation of research on new and experimental treatments for hepatitis C. This year’s meeting takes from 1-5 November in Washington DC. Infohep.org will be publishing news reports from the conference and a comprehensive summary bulletin after the conference.

We aim to provide a comprehensive online database of organisations offering services to people with hepatitis or working in the field of viral hepatitis. We already list nearly 200 services in the European and Eastern Mediterranean region. You can also search for services by country.

Check the infohep database of services and organisations working in viral hepatitis to find out whether your organisation is already listed.

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