Connect with us

Latest News

Hepatitis C cure eludes patients as states struggle with costs

Published

on

Often, patients don’t take hepatitis drugs as they should. Drug users may sell the valuable pills, or patients may forget a few doses, allowing the virus to mutate. Tia did not fall into either category.

Bordon now thinks it was likely one of the many “natural” supplements that Tia had been taking interfered with the drug’s action, making it less effective and allowing virus to survive in her body.

“Supplements can screw up hepatitis C treatments,” said Dr. Douglas Dieterich, director of the Institute of Liver Medicine at the Icahn School of Medicine at Mount Sinai in New York.

Related

“They can cause drug toxicity. They can interfere with liver enzymes which can reduce the levels of the drugs. The most common one is St. John’s wort.” St. John’s wort is a plant that many people use to treat depression symptoms, but it’s metabolized in the liver in a way that can interfere with many pharmaceutical drugs.

Tia had no idea that herbal or “natural” supplements could do this.

“It was part of her normal life to take all these supplements,” Bordon said.

Barriers to treatment

Now, Tia would have to try a different hepatitis C drug. There are several on the market, but that was where she ran into policy wars. Many insurers are reluctant to pay for a second round of treatment.

“They don’t want to pay for it unless you fight,” Tia said.

Salo said there are some reasons for this reluctance, not the least the cost. If every Medicaid patient in a state showed up at once asking for treatment, “it would bust the budget,” he said.

Medicaid is a state-federal health insurance plan for people with low incomes and no other source of health insurance. Some states, such as New York and California, put a lot into their plans while others have smaller budgets.

“A lot of states put restrictions in place and said let’s try to prioritize the sickest first,” Salo said. “States were trying to buy themselves time to give time for the price to come down.”

Related

The prices of the hepatitis C drugs are coming down as more companies develop their own versions and competition kicks in. AbbVie’s Mavyret is priced at $26,400 for a treatment round, a price that has pressured other companies to lower their prices.

“Now that there are multiple drugs on the market, prices have obviously been driven down,” Dieterich said. “The insurance companies have contracted with pharma and they have their preferred products,” he added.

But still, he said, insurance companies and state Medicaid programs often put up barriers if they can.

“There are always plans that are trying to get out of it…by having alcohol tests or marijuana tests. Even if you are smoking marijuana, they’ll exclude them,” Dieterich said.

Last October, the AIDS Institute, which also represents patients with hepatitis, said 31 states and Washington, D.C. decline to treat patients until they have moderate or worse liver damage.

Or they balk at treating patients, like Tia, whose first course of treatment fails.

Related

People can be cured of hepatitis C but they are not immune from getting it again. Some states fear that people who had been infected through risky behavior, such as injecting drugs, might get re-infected, and they’d end up treating the same patients over and over.

That is a shortsighted policy, argued Alyson Harty, clinical nurse manager for Mt. Sinai’s liver institute.

“Even if a patient doesn’t need a transplant, the cost of cirrhosis care for a patient that’s in and out of the hospital over even a year is way more than the cost of treatment,” she said.

And the cure rate is high. “In my office, more than 93 percent of patients treated for hepatitis are cured,” Bordon said.

‘We are going to beat this’

In Tia’s case, Bordon ran the requested tests. He filed an appeal with the insurance company providing Tia’s Medicaid coverage.

“This is crazy,” Tia said as she waited to hear if she would be covered. “I called back again and again. How can an insurance company say they’ll only cover one treatment in a patient’s lifetime?”

Because she had developed some cirrhosis, a board finally determined she was eligible to receive a second round of treatment. She was sick enough to qualify for Vosevi, a combination of three hepatitis C drugs that’s approved for cases like hers.

She started taking it in April and is feeling optimistic. “I am hoping my liver will regenerate,” she said.

Bordon said indications are that Tia’s will, and the medication is knocking down the virus, he said. She’ll be taking the pills for three months.

Two weeks in, Tia had good news. “The virus is almost undetectable,” she said.

“I feel good,” she added. “I have a plan. We are going to beat this.”

Source link

Latest News

Daniel Pearl murder: British-born man acquitted over journalist’s killing to be released from Pakistan prison | World News

Published

on

The Supreme Court in Pakistan has ordered the release of British-born Ahmed Omar Saeed Sheikh who was convicted, and later acquitted, over the beheading of a US journalist in 2002.

Mr Sheikh has been on death row since his initial conviction for Daniel Pearl’s murder 19 years ago, but his lawyer argued that his client “should not have spent one day in jail”.

Lawyer Mehmood A Sheikh added that the court also ordered the release of three other Pakistanis who had been sentenced to life behind bars for their part in Mr Pearl’s kidnapping and murder.

An appeal hearing in the Daniel Pearl murder case was held at the Supreme Court, in Islamabad, Pakistan, Thursday, Jan. 28, 2021. The court on Thursday has ordered the release of Ahmad Saeed Omar Sheikh who was convicted and later acquitted in the gruesome beheading of American journalist Pearl in 2002. The court also dismissed an appeal of Sheikh's acquittal by Pearl's family. (AP Photo/Waseem Khan)
Image:
The Supreme Court voted two to one in favour of Mr Sheikh. Pic: Associated Press

Mr Sheikh was formally acquitted of his involvement in April 2020.

The court also dismissed an appeal by the family of Mr Pearl and the Pakistani government over the acquittal of Mr Sheikh.

In statement released by their lawyer, Mr Pearl’s family said: “Today’s decision is a complete travesty of justice and the release of these killers puts in danger journalists everywhere and the people of Pakistan.”

The country’s three-judge Supreme Court ruled two to one in favour of upholding Mr Sheikh’s acquittal and ordered his release, Pearl family lawyer Faisal Siddiqi said.

The US government has previously said it would demand that Mr Sheikh be extradited to the US to be tried there.

“We urge the US government to take all necessary actions under the law to correct this injustice. We also hope that the Pakistani authorities will take all necessary steps to rectify this travesty of justice,” the Pearl family said.

Mr Siddiqi said that the only legal avenue left to pursue would be to ask for a review of the court’s decision, but added that would be carried out by the same court that upheld the appeal, meaning “in practical terms” there is no further legal route in Pakistan.

FILE - In this April 15, 2007, file photo, Dr. Judea Pearl, father of American journalist Daniel Pearl, who was killed by terrorists in 2002, speaks in Miami Beach, Fla. Pakistan's Supreme Court on Thursday, Jan. 28, 2021, ordered the release of Ahmad Saeed Omar Sheikh who was convicted and later acquitted in the gruesome beheading of American journalist Pearl in 2002. The court also dismissed an appeal of Sheikh's acquittal by Pearl's family. (AP Photo/Wilfredo Lee, File)
Image:
Daniel Pearl (R) was beheaded after being lured to a meeting in Pakistan. Pic: Associated Press

Mr Sheikh was convicted of helping to lure Mr Pearl to a meeting in the Pakistani city of Karachi before the journalist was kidnapped.

Mr Pearl had been looking in to the link between Pakistani militants and Richard C Reid – the “shoe bomber”, who tried to blow up a flight between Paris and Miami with explosives in his shoes.

He went missing on 23 January, with his body being found in a shallow grave shortly after a video of his beheading was sent to the US consulate in Karachi.

Source link

Continue Reading

Latest News

Kate Moss and daughter Lila star in Paris catwalk show together | Ents & Arts News

Published

on

She is one of the most famous supermodels in the world, and in recent years her daughter has been following in her catwalk footsteps.

So it was inevitable that British star Kate Moss and teenager Lila would one day walk the same runway.

Model Kate Moss, left, and her daughter Lila Grace Moss wear creations for Fendi's Spring-Summer 2021 Haute Couture fashion collection. Pic: AP
Image:
It is reported to be the first time the mother and daughter pair have walked the same fashion show catwalk. Pic: AP


British model Kate Moss leaves the Topshop Unique Spring/Summer 2014 collection with her daughter Lila Grace during London Fashion Week
Image:
Kate and Lila Moss pictured in 2014

Modelling for the Fendi spring/summer show in Paris on Wednesday, the mother-daughter pair were the stars of the show.

In 2016, they appeared on the cover of Vogue together, but this is believed to be the first time they have appeared on the same catwalk.

Lila, 18, whose father is Kate’s ex-partner Jefferson Hack, was pictured wearing a beaded caped dress, while Kate, 47, wore a silver satin dress.

Model Naomi Campbell wears a creation for Fendi's Spring-Summer 2021 Haute Couture fashion collection. Pic: AP
Image:
Fellow British supermodel Naomi Campbell also walked the Fendi catwalk. Pic: AP
Demi Moore. Pic: Fendi/Shutterstock
Image:
As did Hollywood star Demi Moore. Pic: Fendi/Shutterstock

Several other high profile stars and supermodels – including Naomi Campbell – also featured in the show, which featured clothing by designer Kim Jones.

Actress Demi Moore was dressed in a dramatic black top, trousers and long headpiece as she took to the Fendi runway.

Model Cara Delevingne wears a creation for Fendi's Spring-Summer 2021 Haute Couture fashion collection. Pic: AP
Image:
Cara Delevingne and Bella Hadid (below) were also among the show’s stars. Pics: AP
Model Bella Hadid wears a creation for Fendi's Spring-Summer 2021 Haute Couture fashion collection. Pic: AP

Cara Delevingne walked the catwalk wearing a camouflage suit, while Bella Hadid wore a black gown underneath a cape.

Moss’s fellow 1990s supermodel Campbell, 50, wore a long metallic dress and headpiece for her appearance.

Source link

Continue Reading

Latest News

COVID-19: South African coronavirus variant ‘between 20 and 200%’ more infectious than original | World News

Published

on

The KwaZulu-Natal Research Innovation and Sequencing Platform does not exactly trip off the tongue.

That’s probably why the people who work there, along with sister-organisation the Africa Health Research Institute (AHRI), call it KRISP.

And the researchers at KRISP, led by Professor Tulio de Oliveira, have done some really important work in the last few months.

The identification of the so-called South African variant of COVID-19, a hardy and more infectious strain of coronavirus, was done in a congested KRISP laboratory tucked away on the ground floor.

Image:
At the peak of the second wave in January, more than 20,000 people were being infected every day

It was a difficult moment for members of the team to describe – a brilliant piece of detective work that revealed a dangerous new episode in the pandemic.

Professor de Oliveira told me how it happened. “We got very busy in the middle and end of November,” he explained.

Clinical staff at one of main hospitals in Nelson Mandela Bay were seeing a very unusual increase of new cases.

“They were convinced that there was probably something different about the virus so we answered their call very quickly,” Prof de Oliveira added.

By extracting the genetic material from the variant, which they call 501YV2, and tracking the way it was spreading around the country, the team at KRISP was able to determine that it was anywhere between 20 to 200% more infectious that the original.

In an equally disturbing finding, their partners at AHRI discovered that antibodies developed by people in response to the original strain of COVID-19 are “much less able” to neutralise the South African variant.

It raises the prospect that people who have already had coronavirus could get it again.

Prof de Oliveira told me that his team had seen “multiple samples” of this viral re-infection.

The genomic surveillance performed at KRISP has been utilised in neighbouring states, with the South African variant identified in countries including Botswana, Zimbabwe, Zambia, Namibia and Malawi.

“In Zambia, the last 23 genomes that have been done, 22 of those were the 501YV2 variant,” the professor said.

“We have just finished analysing samples from Mozambique and informed the minister of health about the lineages that are circulating in the country. I believe today he will go to the public to announce (the results).”

Image:
Prof de Oliveira, from KRISP, says his team has seen multiple samples of viral re-infection

Prof de Oliveira would not give me advance notice of their findings but it seems inevitable that 501YV2 has indeed been identified in Mozambique.

This research will concern people – and politicians – right across the continent.

South Africa, which boasts relatively modern infrastructure, has struggled to deal with this now dominant variant of COVID-19.

At the peak of the country’s second wave in early January, more than 20,000 people were being infected every day.

Hospitals and clinics faced chronic shortages of staff, beds and critical supplies like oxygen.

In other parts of Africa, people are largely on their own.

I asked KRISP’s Dr Richard Lessells, an infectious diseases specialist, whether the institute has pushed a proverbial alarm bell by identifying the variant and describing many of its characteristics.

“Yes, we are certainly trying to push the alarm bell and trying to make this point that we need help,” he said.

“We need help in South Africa (and) in the region and we need people to understand that this is a global pandemic and that if we leave Africa and African countries to try and deal with this themselves we are going to have a big problem.”

Source link

Continue Reading

Trending