Håvard Midgard

@DrToddLee @AnilMakam @PaulSaxMD @zchagla @selihep Renal AA amyloiosis probably most frequent cause of renal failure among PWID in Oslo.

@DrToddLee @AnilMakam @PaulSaxMD @zchagla @selihep This was a pragmatic trial mirroring real-world settings but I think we were pretty sober. Most patients with short life expectancy (eg end stage renal disease and not dialysis candidates) were left untreated.

Remarkable RCT from Norway demonstrating that starting HCV treatment in the hospital with newly diagnosed HCV among PWIDs is superior to deferring therapy to outpatient care in achieving HCV cure. Results argue for broader use. @HMidgard @selihep doi.org/10.1093/cid/ci…

@AnilMakam @PaulSaxMD @zchagla @selihep Of note, Norway has achieved substantial DAA price reductions in recent years - approx USD 2600 for 8wks Zepatier for instance. The DAA costs are covered by the regional health authorities.

@PaulSaxMD @zchagla @HMidgard @selihep Not universal If someone has a limited life expectancy (definitely < 1 yr but probably even < 5 yrs) any amount of harm makes it net negative even if costs $0 This is 30-50% of my patients same for other cheap therapies w/ lag time to benefit (statin, metformin, CA screening)

@AnilMakam @PaulSaxMD @zchagla @selihep Study participants reflected an ageing HCV-population in a period where Norway was approaching HCV elimination. A total of 7.5% were not treated due to short life expectancy and most of those who died remained untreated for the same reason.

@PaulSaxMD @zchagla @HMidgard @selihep Honestly study lost >75% of control arm in follow up. KM is devastatingly futile And treatment was dispensing final 4 weeks of tx (which is 33-50% of course). So w/ similar SVR rates possible nonadherance was huge (vs informative censoring) So lots of $ possibly wasted

What a concept! Starting treatment for people with chronic but curable infections in the hospital. Too bad most insurers and @MedicareGov won’t cover such out-patient issues.

Inspiring work by inspiring people @Ane_Kristine @HMidgard @selihep - It's time to stop writing "hcv, defer to outpatient" in your consult notes, #idtwitter

Opportunistic treatment of hepatitis C infection among hospitalized people who inject drugs (OPPORTUNI-C): A stepped wedge cluster randomized trial ✅ Just Accepted 🔓 Open Access 🔗 bit.ly/40YwC17 via @HMidgard @selihep

Don’t put off until tomorrow what you can do today: Hospital admissions as an opportunity to treat hepatitis C ✅ Just Accepted 💬 Editorial Commentary 🔗 bit.ly/47nNWip

Opportunistic treatment of hepatitis C infection among hospitalized people who inject drugs (OPPORTUNI-C): A stepped wedge cluster randomized trial academic.oup.com/cid/article/do…

Last session @INHepSU and grateful that the main result from Opportuni-C was highlighted in @tdbrothers rapporteur! @HMidgard

Take home message from Kristian Malme today @INHepSU: Although HCV treatment uptake increased among people who inject drugs in 🇳🇴, strategies to improve treatment among women and individuals not engaged in OAT should be addressed!

Practice changing findings ALERT: from OPPORTUNI-C in Norway, a pragmatic RCT showing inpatient initiation of HCV rx is doable, safe, and WORKS...even in a pandemic. A tour de force from @HMidgard @Ane_Kristine @selihep at #INHSU2022

At #INHSU2021 session #Innovations in HepC Testing and Treatment @HMidgard presented live #peer #mobile #HCVclinic.

@HMidgard How can we achieve WHO's elimination target for hepatitis C incidence? thelancet.com/journals/langa…

Big shout out to @HMidgard and colleagues from Oslo on their work to reach people with recent injecting drug use at #ILC2019 - Treatment uptske 65% so far half of untested LTFU @Cfritsyd

We @WHO just released a new report on #hepatitis C treatment. It shows the annual number of people initiating HCV curative treatment increased from 1 mln in 2015 to 1.5 mln in 2016. But access is focused primarily in a few high-burden countries. bit.ly/2IflsfU #NOHEP

«The times they are a’changin’» – Positioning @EASLnews in the changing landscape of hepatology bit.ly/2oxZyw0 @tomhemmingk

#EASLmono conf on elimination of #hepatitisC infection was a great success, watch the webcasts & ePosters on #EASL #LiverTree bit.ly/2oiN8ay #HCV #publichealth #testing #treatment #epidemiology @EASLnews @JVLazarus @JMPawlotsky @aelsharkawy75 @AghemoAlessio

He did a great job. Thank you @jasongrebely @martinkaberg for the video greetings. His work will be the foundations for NO #hepc strategy twitter.com/oevrehusdk/sta…