Most newly diagnosed HCV patients not treated: study
Less than half of patients (47%) newly diagnosed with hepatitis C virus (HCV) who are eligible for antiviral treatment received such treatment in the 12 months after diagnosis, a study from NSW has found.
A review of 200 HCV notifications from 2017 found that of the 79 diagnosed by GPs and eligible for antiviral treatment, only 6% were treated, while 63% were referred to a specialist and a further third were lost to follow up.
For specialist-diagnosed patients with HCV, 61% started DAA treated and about a quarter lost to follow up.
The study authors said it was understandable that GPs might not initiate treatment if they were unfamiliar with HCV management, and only saw an average of one case every six months. The high loss to follow up showed the need for better targeted pro-active follow up systems if Australia is to meet its target for HCV elimination, they said in Public Health Research and Practice.
COVID-19 vax booster to be recommended for immunocompromised patients
A third COVID-19 vaccine booster dose will soon be recommended for some Australians with immunocompromising conditions, according to the Australian Technical Advisory Group on Immunisation (ATAGI).
In advice released on 23 September, ATAGI said it anticipated that “a relatively small cohort of individuals, such as those with severely immunocompromising conditions, are likely to require a third dose as part of their primary course of vaccination to ensure optimal vaccine effectiveness.”
ATAGI added that boosters for other populations may be required in the future, and it was preparing recommendations to be released in the next few weeks.
Factors to be considered in recommendations for boosters include the duration of protection provided by additional doses, timing of booster doses to cover anticipated future peaks and the balance of efficacy and safety of third doses of mRNA vaccines, it said. ATAGI is also reviewing the types of vaccine to be used as boosters and the potential for newer types such as the protein subunit vaccines variant vaccines as they become available.
In the meantime it said first and second dose coverage remained a priority for achieving protection in the current Delta outbreak.
Cap-assisted endoscopy best for removal of impacted oesophageal FB
A novel cap-assisted endoscopy technique is more effective and less costly than the conventional ‘push’ approach for managing oesophageal food bolus impaction and should be first-line treatment, Australian gastroenterologists say.
A randomised controlled trial in 342 patients with oesophageal FBI led by Dr Marie Ooi at the Royal Adelaide Hospital found that the cap-assisted technique had a higher success rate (170/171 vs 160/171), lower rate of procedure-related mucosal tear and bleeding (0/171 vs 13/171) and was associated with a shorter retrieval time (4.5 vs 21.7 minutes), compared with the conventional approach.
There were no major adverse events and the cost of consumables was lower in the cap-assisted group compared with the conventional group (A$6,239.90 vs A$19,644.90) according to results published in the American Journal of Gastroenterology.