| Medicare Reverses Denial of Costly Treatment for Hepatitis C Patient
UNITED STATES :: Viral Hepatitis
The Reporter (Lansdale, PA) (05.16.2014) :: By Richard Knox, Kaiser Health News
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The Reporter announced that Medicare has reversed its decision and will cover the cost of the expensive new drugs to treat an Arizona man with hepatitis C virus (HCV) infection. Medicare officials have stated that the new policy will be used for HCV patients whose doctors prescribe combined use of the two drugs if the patients meet the criteria presented in January by the Infectious Diseases Society of America and the American Association for the Study of Liver Diseases. The guidelines recommend combined use of the two drugs for patients with advanced liver disease who were not cured by earlier drug treatments.
Medicare officials contend its beneficiaries should receive required treatment if they demonstrate “medical necessity” and have “medically accepted indications” for the treatment. Medicare is consulting with medical specialty groups to make improvements to the guidelines concerning when patients should receive treatment and with what treatments. At present, Medicare’s Part D plans to make a case-by-case decision on whether to approve payment for the expensive treatment. The agency expects to be able to determine the potential costs of covering the drugs after it receives bids that include the cost of the new treatments from Part D drug plans.
Sovaldi, one of the new drugs, costs $84,000 for a typical 12-week treatment, but some patients may need treatment for 24 weeks. The other drug, Olysio, costs approximately $66,000, but is approved for a smaller group of patients. These drugs are used in combination with others, which increases costs even more.
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International News
 | HIV Rising Among Men Having Sex with Men in Vietnam
VIETNAM :: HIV/AIDS
Thomson Reuters Foundation (05.16.2014) :: By Sean Kimmons
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Thomson Reuters Foundation reported that HIV prevalence in Vietnam is increasing among men who have sex with men (MSM). Social stigma has forced the Vietnam MSM community to operate mainly underground, which makes it difficult for advocacy services to reach. Government efforts to curb HIV in this small Asian country have focused more on female sex workers and injecting drug users, contributing to the rising HIV incidence among MSM.
According to the 2012 Integrated Biological and Behavioural Surveillance (IBBS) survey, between 2006 and 2009, MSM HIV cases nearly doubled in Hanoi and more than doubled in Ho Chi Minh City, the country’s two largest cities. “Out of all of Vietnam’s sub-epidemics, the epidemic among MSM appears to be rising the fastest,” said Christopher Fontaine, an adviser for the Joint UN Programme on HIV/AIDS (UNAIDS) in Vietnam.
HIV-positive MSM face the double stigma of being gay and having HIV, which drive many MSM to not disclose their HIV status, often fearing being disowned by their traditional Vietnamese parents. “New infections are increasing for MSM but there are a limited number of them seeking services,” said Son Minh, executive board member of the Vietnamese Network of MSM and Transgender People. “It’s our biggest concern since we cannot educate them on safe sex.”
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Medical News
 | No Concerning Safety Patterns for HPV4 During Pregnancy
UNITED STATES :: STDs
Healio (05.07.2014)
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Healio reported on a study of adverse effects in women who were exposed to the quadrivalent HPV vaccine during pregnancy. The Advisory Committee on Immunization Practices does not advise use of the vaccine for pregnant women. Pedro Moro, MD, MPH, of CDC’s Immunization Safety Office and colleagues assessed HPV4 safety in pregnant women and their infants using data from the Vaccine Adverse Event Reporting System, an FDA- and CDC-sponsored national vaccine safety surveillance program.
The researchers reviewed reports of adverse events in pregnant women who received HPV4 vaccine during pregnancy between 2005 and 2012. Serious reports were those that resulted in death, hospitalization, and lengthy hospitalization or permanent disability. The researchers found 1,261 reports of adverse events, and 8 percent were considered serious. Approximately 72 percent of reports were from the manufacturer’s pregnancy registry.
Most of the pregnant women (91 percent) had received HPV4 in their first trimester. There were no maternal deaths. Of the women, 195 experienced spontaneous abortion––the most common adverse event––followed by elective termination of the pregnancy (9 percent), and premature delivery (7.9 percent). Of 385 infant births, 53 infants had major birth defects and five died. The researchers concluded that, in general, the vaccine revealed no safety patterns of concern.
This study, Abstract #S26, was presented at the Annual Conference on Vaccine Research; April 28-30, 2014; Bethesda, MD.
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Local and Community News
 | Griffin Hospital: Insulin Pen Misuse Could Have Infected Patients with Diseases
CONNECTICUT :: HIV/AIDS,Viral Hepatitis
Middletown Press (05.16.2014) :: By Mercy A. Quaye
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The Middletown Press reported that several thousands diabetes patients who were admitted to Griffin Hospital in Derby, Conn., may have been exposed to hepatitis B and C, as well as HIV. Hospital officials said that they discovered a misuse of insulin pens between September 1, 2008, and May 7, 2014. “We believe that insulin pens meant to be used on a single patient may have been used on more than one patient,” said Patrick Charmel, president and chief executive officer of Griffin Hospital. Although no disease transmission has been found yet, Griffin called the breach a “serious safety issue.”
The hospital notified 3,149 patients by letter last week recommending they get tested for the three infectious diseases within the next 30 days. Charmel said the hospital believes the likelihood of infection is very small, but that they will pay for the testing, as well as any treatment required. They also wanted to make the issue public help other health facilities from making the same mistake. The Connecticut Department of Public Health has opened an investigation into the misuse of the insulin pens at Griffin Hospital, according to spokesperson William Gerrish.
The pens are meant for use by only one patient because even though the needles are single-use, there could be a backflow of blood or skin cells into the pen’s insulin cartridge. CDC was prompted to send out information on proper use of the pens to health facilities due to increased usage of the pens. Griffin Hospital discontinued using the pens on May 7.
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News Briefs
 | Chlamydia Cases Spike in Muskingum County
OHIO :: STDs
WHIZnews.com (Ohio) (05.15.2014) :: By Courtney Wheaton
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WhizNews.com reported that chlamydia is the number one reported disease in Muskingum County, Ohio, and is especially problematic among men and women between the ages of 14 and 21. The county’s health department reports an average of 55 to 65 cases per month. According to epidemiologist Kristen Baker, about 75 percent of cases are asymptomatic, which facilitates spreading the disease to others. The disease can cause complications such as pelvic inflammatory disease and problems with pregnancies, and can be transmitted to infants as well. Chlamydia increases susceptibility to other STDs—including HIV—but is treatable.
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| | Fulton Co. Probing Spike in Tuberculosis Cases
GEORGIA :: TB
MyFoxAtlanta.com (05.16.2014) :: By Associated Press
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MyFoxAtlanta.com reported that health officials in Fulton County, Ga. said they are investigating a rise in TB cases associated with local homeless shelters. Health officials are investigating 16 TB cases that have been linked to Central Night Shelter, Atlanta Union Mission, and the Task Force for the Homeless. According to Patrice Harris of the Fulton County Department of Health and Wellness, risk for infection from the disease is linked with exposure for at least six hours in an enclosed space with an infected individual. Harris said the TB-infected residents have been removed from the shelters and are receiving treatment.
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The CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention provides the above information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, viral hepatitis, other sexually transmitted diseases, and tuberculosis does not constitute CDC endorsement. The above summaries were prepared without conducting any additional research or investigation into the facts and statements made in the articles being summarized, and therefore readers are expressly cautioned against relying on the validity or invalidity of any statements made in these summaries. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/Hepatitis/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted above for full texts of the articles.
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