April 30, 2013
The Icahn School of Medicine at Mount Sinai and the International Association of Providers of AIDS Care jointly sponsored the 3rd International Conference on Viral Hepatitis (ICVH 2013) from March 25 to March 26 on the stately grounds of the New York Academy of Medicine. Hepatitis experts Douglas Dieterich, M.D., (from the Mount Sinai School of Medicine in New York) and Mark Nelson, M.D., (from Chelsea and Westminster Hospital in London) chaired the two-day conference.
Several hundred attendees from multiple countries heard plenary presentations from world-class experts and panel discussions on the pharmaceutical discovery pipeline, liver transplantation, managing side effects and perspectives on stigma.
Forty-five original investigations were discussed at the conference, following three major themes (each of which I summarize in more detail within additional articles on TheBodyPRO.com): new HCV agents, HCV testing and management strategies and HCV/HIV coinfection. In keeping with the international theme, an impressive number of abstracts were presented from outside of the U.S., including Africa, Asia, Eastern Europe and the European Union.
While international conferences are excellent in stimulating discussion among researchers and stakeholders, the impact of most meetings is limited to attendees who are fortunate (in both their amount of time and money) to make the trip to New York City. For the first time, the entire ICVH 2013 conference was webcast at no cost (and PDFs of the PowerPoint presentations are available online). Speaking to the global reach of viral hepatitis, the webcast reached hundreds of additional viewers in 17 countries as diverse as China, Ghana, India, Mexico, Myanmar, Pakistan, Peru, Russia and Ukraine.
John Ward, M.D., (from the U.S. Centers for Disease Control and Prevention's Division of Viral Hepatitis) started the conference with a review of the global epidemiology of viral hepatitis. He noted the requirements of both primary and secondary prevention strategies, as well as the need to strengthen collaborations between public health, clinical care providers, payers and industry to improve HCV testing, care and treatment.
Graham Cooke, M.D., Ph.D., (from Imperial College in London) provided a compelling review of the obstacles to scaling up viral hepatitis treatment in low- and middle-income countries. He noted that access to direct-acting antivirals is a major barrier for HCV treatment -- but not HBV treatment -- in many parts of the world. He reminded the group that there are many lessons to be learned from the development of HIV care, including political commitment, patient and community engagement, simplification of treatment and task shifting.
Another key plenary lecture given by Courtney Fletcher, Pharm.D., (from the University of Nebraska) covered the critically important yet complex issue of drug-drug interactions involving the new direct-acting HCV antivirals. She especially highlighted the many potential pitfalls of interactions between HCV and HIV medications. Fletcher's talk drew on many lessons from HIV pharmacology, concisely summarizing the pharmacologic issues that matter when treating viral hepatitis: pharmacokinetics, pharmacodynamics, drug resistance, adherence, convenience and tolerability.
ICVH 2013 provided a place to showcase many recent advances in the treatment of hepatitis, yet also called attention to unmet needs and challenges. As Jeffrey Weiss, Ph.D., (from the Mount Sinai School of Medicine) pointed out: "While the hepatitis communities are rightly focused on the impressive progress that the pharmaceutical industry has made in recent years, there's a great deal of work to be done, from training of primary care providers to provide treatment, educating the community about treatment options and access to care, and developing effective interventions to educate and prepare patients to begin HCV treatment. There's a lot of misinformation out in the general population about hepatitis C infection and it remains highly stigmatized. This is a major barrier to patients accessing care."
This is part of a series of articles summarizing ICVH 2013. Read the other articles in the series:
Benjamin Young, M.D., Ph.D., is the vice president and chief medical officer of the International Association of Providers of AIDS Care, one of the joint sponsors of ICVH 2013. Dr. Young is also an adjunct professor at the Josef Korbel School of International Studies at the University of Denver. Click here to read a more detailed bio of Dr. Young, which includes financial disclosure information.