Brian R. Edlin, MD presents this segment. At the time of this presentation, Dr. Edlin served as Visiting Professor of Medicine in the Division of Infectious Diseases at SUNY Downstate Medical Center in Brooklyn, Adjunct Associate Professor of medicine and Public Health at the Weill Medical College of Cornell University, and the Epidemiologist for the Center for the Study of Hepatitis C in New York.

An extremely enlightening presentation, here are three particular highlights of interest:

Dr. Edlin lists examples of the under-served or disenfranchised population with the Hepatitis C focus to be: Socially/economically marginalized populations, the homeless, incarcerated, drug users, and the 37 million people in the US living under the poverty line (Defining “Poverty” as people that cannot afford the basic needs of food, shelter, and clothing). Dr. Edlin includes these populations within the “Cycle of Invisibility” and provides solid reasoning why current models of screening and treating these individuals must begin to include Hepatitis.

Vastly under or misreported instances of Hepatitis currently are used statistically to gauge the importance of Hepatitis C affect on the mass population. This point is accentuated with first hand studies in San Francisco where 400-500 cases of Hepatitis C were found in one year, versus zero to two per year being reported to the Health Department Surveillance Department.

With regard to the conference itself: “This is extremely important. If we can speak with an enlightened voice, we can accomplish a great deal, and we really have no alternative, because we simply cannot afford to fail.” Brian R. Edlin MD

John B. Wong, MD, Professor of Medicine and Physician at Tufts Medical Center in Boston, Massachusetts (Along with many other titles of affiliations and accomplishments) provides answers to the questions:

What is the economic burden of Chronic hepatitis B and C?

What is the cost of antiviral treatments and their projected impact on that economic burden?

What health benefits will result from these treatments, and do they justify the cost?

Jeffrey S. Murray, MD, MPH, Deputy Director for the Division of Antiviral Products, US Food and Drug Administration, Center for Drug Evaluation and Research, speaks regarding some principal issues that should be considered when conducting HCV studies while acknowledging the drug pipeline for HBV therapies has diminished substantially.

Highlights include concerns and safety issues along with the importance of encouraging combination drug-therapy treatments, the immediate goals of the FDA in creating guidance documents for rational drug development regimens, minimizing drug resistance, toxicity problems, identifying relevant populations, and more.

Edward C. Doo, MD of the (US) National Institure of Health speaks regarding the question. Dr. Doo's speech relies heavily upon the visual aids for those physically present at the Summit.

*Side note: The NIH assigns Government allocations toward Hepatitis C largely to research co-infection afflictions of HIV infected people. The US Government does not presently allocate any funds toward research of Hepatitis C. Any studies specific to research of Hepatitis C are done through the generosity of the NIH as explained in a letter emailed to Debbullan Inc., by Dr. Darling, a recipient.

This letter is found through this url: http://www.debbullan.org/Kington_response_5-29-09.pdf

// Call to Action: HR3974 is currently awaiting the support of co-sponsors within the House of Representatives.Debbullan fully supports the bill, as currently written, as the first responsible and proactive legislation focused on positive awareness and treatment of Hepatitis and funded by the US Government. To learn more as well as to make a personal difference visit: http://www.debbullan.org/lead.htm

This segment contains a speech by David L Thomas, MD, MPH Professor of Medicine, Director of Infectious Diseases for John Hopkins University School of Medicine.

Dr. Thomas has has provided valuable information regarding the future direction HCV / HBV resources must be pointed toward in order to achieve effective education and care for people with Hepatitis B and C.

Below are just a few highlights of Dr. Thomas' speech:

David B. Ross, MD, PhD speaks regarding a variety of coexisting medical affect the natural history of chronic hepatitis B & C. These include alcohol misuse, coinfection with human immunodeficiency virus (HIV), coinfection with other hepatotropic viruses, substance use disorders, psychiatric disease and metabolic syndrome. Dr. Ross explains how these comorbidities may affect the progression of liver disease, the patient's candidacy for treatment, as well as adherence and/or response to antiviral therapy. More, how demographic factors, particularly race and ethnicity, can also affect the patient's response to antiviral therapy. How the public health and disease management response to chronic liver disease involves risk stratification. This strategy aims to identify sub-populations at higher risk for worse clinical outcomes then, to design and execute the appropriate interventions.

Ira M. Jacobson, MD speaks regarding Hepatitis C:

Whom to Treat, When to Treat, and New Treatments

Headphones will help you focus on Dr. Jacobson's speech. This Summit was largely held for professionals to speak to other professionals therefore there is strong assumption by speakers that the listener will have good knowledge of the subject matter. Debbullan's readers are largely the HCV informational novice.

There is good information within this presentation, if you find it difficult to listen at the beginning, skip approximately 10-11 minutes in for audio easier to hear. Discussion highlights point toward focus on:

• Response guided therapy as an increasingly sharpening focus as a means of tailoring treatment duration in order to optimize the chance of achieving "SVR" (sustained viral response or lowering the virus to undetectable levels in the blood).

• Current genotype success rates achieving SVR

• SVR comparisons between European decent and African, Latino, co-infected, transplant recipients as well as patients that have begun to develop other diseases caused by HCV infection.

• The enormous need for improved therapies due to the challenges of using the Interferon drug (many patients intolerance to it).

• The hope of drugs currently in stage three trials.

If you would like a scanned synopsis of this presentation as supplied by Dr. Jacobson please email Debbullan@debbullan.org. Title your email: "Summit Synopsis/Jacobson"

  To read more about:

When Treatment Can Be Most Effective. Helping to Develop an Informed Decision

OR

Using the word "CURED" and Hep C in the same sentence

visit here: http://debbullanincblogs.blogspot.com/

The first speaker at the summit was John G. Bartlett, MD. Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Doctor Bartlett speaks with regard to "How Does a Public Health Response Have Public Health Impact? What Have We Learned From HIV"

We owe great appreciation to Jürgen Kempel of Germany. Mr. Kempel, founder of "Artists 4 Charity", has been volunteering his time to edit/enhance Debbullan's live audio recordings of the speakers of Sept 11's '09 National Summit on Viral Hepatitis for your best possible educational and listening pleasure.

Further, the music that is incorporated into each segment was written and performed by Mr. Kempel. Titled A NEW DAWNING, the song was named specifically after the spirit of the Summit. The complete version of the song is offered for your listening pleasure here.

For more information about "Artists 4 Charity" visit:

http://www.myspace.com/artists4charity
http://www.artists4charity.org