Fears of hep B sweat risk
Sweat
may transmit hepatitis B (HBV) during contact sports, latest research suggests.
HBV is a blood-borne virus that attacks the liver. It can cause life-long
infection, liver cirrhosis (scarring), liver cancer, liver failure and death.
Researchers looked at blood and sweat samples from 70 Olympic wrestlers for
evidence of HBV infection.
Over a third of the men said they had had bleeding or weeping wounds during
training and competition and almost half said that they had episodic bleeding
outside the ring. None had active hep B infection but the virus was found
in the blood of nine (13 per cent), suggesting hidden or ‘occult’
infection.
Eight had particles of the virus in their sweat at levels that closely matched
those in the blood. The study author suggested sweat, like open wounds and
mucous membranes, could be another way of transmitting hep B.
Some sporting bodies insist on HIV testing for all contact sport competitors,
but no such recommendations have been made for hepatitis B, which is far more
infectious and kills around a million people each year worldwide.
Br J Sports Med 2007
New hep B drug may cause HIV
drug resistance
Fears have been raised that a drug used to treat active chronic hep B infection
may trigger HIV drug resistance.
Canadian health ministers issued the warning after receiving a single US report
on an HIV positive man on the hep B drug entecavir (Baraclude) who developed
resistance to a commonly used HIV drug.
The HIV drug’s name is not mentioned in the report but the man was not
taking any antiretroviral drugs to suppress his HIV.
The case is the latest of three US reports submitted by entecavir’s
manufacturer Bristol-Myers Squibb about people with HIV not on HAART who experienced
a fall in their HIV virus levels while on entecavir.
Studies to date show entecavir is not active against HIV.
Other drugs used in hepatitis B treatment like the HIV nukes lamivudine (3TC,
Epivir) and emtricitabine (FTC, Emtriva) can reduce hepatitis B levels in
co-infected people.
Use of these drugs as monotherapy (one drug treatment) for hep B in people
co-infected with HIV is not recommended due to the risk of HIV resistance.
www.hc-sc.gc.ca
New safety warning issued against
co-infection drug combination
People taking the HIV drug abacavir, a component of Kivexa and Trizivir, along
side hepatitis drug interferon-alfa must be closely monitored for liver problems,
US government experts warn.
The US Food and Drug Administration recently approved revised safety labelling
warning of the risk of liver damage associated with using the drugs together.
Liver damage occurs where the liver fails to repair itself from injury, resulting
in permanent reduction in liver function.
Drug packaging inserts changed following reports of hepatic decompensation
(some fatal) in people co-infected with HIV and hepatitis C taking Trizivir
and interferon-alfa.
People taking interferon-alfa, with or without ribavirin, and Trizivir (abacavir/lamivudine/zidovudine)
should be closely monitored for side effects, especially hepatic decompensation,
neutropenia, and anaemia.
Doctors are also urged to take patients off abacavir-containing combos if
medically appropriate and consider reducing or discontinuing interferon-alfa
and ribavirin if blood tests worsen.
www.medscape.com
Hep C deaths continue to climb in US
Deaths in the US due to hepatitis C infection will continue to rise and not
peak till 2030, scientists have predicted.
This compares poorly with HIV-related death rates that peaked in 1999 and
are now falling thanks to the success of HAART.
Researchers used a range of data to calculate the burden the two infections
are having on the US health system.
They found new cases of hep C peaked in the US in 1984 at 350,000, and then
fell to about 77,000 in 1998.
New cases of HIV in the US were at their highest in 1989 at 142,000, and then
declined to 79,000 in 1998.
Deaths from liver failure or liver cancer in the US rose from about 3,700
in 1998 and is expected to peak at about 13,000 deaths in 2030.
“With the availability of effective HAART, mortality from HIV appears
to have declined substantially, whereas HCV-related deaths as a result of
pre-1999 infections will likely continue to increase over the next 25 years,”
the researchers said.
Deaths due to hep C will fall only if there is increased treatment access
or more effective therapy.
Both viruses would remain a significant financial burden on the health system
for some time, they said.
Journal of Viral Hepatitis 14(2): 107-115. February 2007.
