Excavating the Bible- New Archaeological Evidence for the Historical Reliability of Scripture- Yitzhak Meitlis Torrent Downloads. Religion Matters from the Bible to the. What few Bible readers realize is that the claim to be. Century Jewish villas the team has been excavating. The Hebrew Bible contains the continuous history of civilization from Creation to. The team of Italian archaeologists excavating Ebla have reported that these. Search results for bible torrents (1-50 of 500) . Bible Believers Defense Of The Perfect King James Bible torrent. Latest breaking news, including politics, crime and celebrity. Find stories, updates and expert opinion. Bietak who has been excavating ancient Avaris says that there is no evidence for a violent destruction. The Bible is History by Ian Wilson. Excavating the Bible: New Archaeological Evidence for the Historical Reliability of Scripture-Yitzhak Meitlis. 12:32:51 +0200 http:// -New-Archaeological-Evidence-for-the-Historical-Reliability-of-the-Bible--Yitzhak-Meitlis-epub.
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It was checked for updates 263,517 times by. 9/23/2017 0 Comments Guilty Plea Admissible Civil TrialPlea bargaining legal definition of plea bargaining. The process whereby a criminal defendant and prosecutor reach a mutually satisfactory disposition of a criminal case, subject to court approval. Plea bargaining can conclude a criminal case without a trial. When it is successful, plea bargaining results in a plea agreement between the prosecutor and defendant. In this agreement, the defendant agrees to plead guilty without a trial, and, in return, the prosecutor agrees to dismiss certain charges or make favorable sentence recommendations to the court. Plea bargaining is expressly authorized in statutes and in court rules. In federal court, for example, plea bargaining is authorized by subsection (e) of rule 1. Federal Rules of Criminal Procedure. Under rule 1. 1(e), a prosecutor and defendant may enter into an agreement whereby the defendant pleads guilty and the prosecutor offers either to move for dismissal of a charge or charges, recommend to the court a particular sentence or agree not to oppose the defendant's request for a particular sentence, or agree that a specific sentence is the appropriate disposition of the case. A prosecutor can agree to take any or all of these actions in a plea agreement. Under rule 1. 1(e), plea bargaining must take place before trial unless the parties show good cause for the delay. Your decision on what plea to enter is the most important decision you will have to make. Whether you feel that you are guilty or not, we suggest that you read the. Trial meaning, definition, what is trial: the hearing of statements and showing of objects, etc.
Generally a judge will authorize a plea bargain if the defendant makes a knowing and voluntary waiver of his or her right to a trial, the defendant understands the charges, the defendant understands the maximum sentence he or she could receive after Pleading guilty, and the defendant makes a voluntary confession, in court, to the alleged crime. Even if a defendant agrees to plead guilty, a judge may decline to accept the guilty plea and plea agreement if the charge or charges have no factual basis. The judge does not participate in plea bargain discussions. Prosecutors have discretion whether to offer a plea bargain. However, a prosecutor may not base the determination of whether to negotiate on the basis of an unjustifiable standard such as race, religion, or some other Arbitrary classification. Plea bargaining can be advantageous for both prosecutors and defendants. Prosecutors may seek a plea bargain in certain cases to save valuable court time for high- priority cases. Prosecutors often are amenable to plea bargaining with a defendant who admits guilt and accepts responsibility for a crime: plea bargaining in this context is considered the defendant's reward for confessing. Prosecutors also accept plea bargains because they are evaluated in large part according to their conviction rates and all plea bargains result in a conviction because the defendant must plead guilty as part of the plea agreement. Plea bargaining is widely used in the criminal justice system, yet seldom praised. Plea agreements are troublesome because they are something less than a victory for all involved. Prosecutors are loath to offer admitted criminals lighter sentences than those authorized by law. Likewise, most criminal defendants are less than enthusiastic over the prospect of openly admitting criminal behavior without the benefit of a trial. Despite the reservations of the parties, plea agreements resolve roughly nine out of every ten criminal cases. The sheer numbers have caused many legal observers to question the propriety of rampant plea bargaining. Some critics of plea bargaining argue that the process is unfair to criminal defendants. These critics claim that prosecutors possess too much discretion in choosing the charges that a criminal defendant may face. When a defendant is arrested, prosecutors have the authority to level any charge if they possess enough facts to support a reasonable belief that the defendant committed the offense. This standard is called Probable Cause, and it is a lower standard than ability to prove a charge Beyond a Reasonable Doubt, the standard that the prosecution must meet at trial. Thus, for leverage, a prosecutor may tack on similar, more serious charges without believing that the charges can be proved beyond a reasonable doubt at trial. Because prosecutors are evaluated in large part on their conviction rates, they are forced to try to win at all costs. According to some critics, prosecutors use overcharging to coerce guilty pleas from defendants and deprive them of the procedural safeguards and the full investigation of the trial process. For example, assume that a defendant is arrested for trespassing. Assume further that the Trespass was an honest mistake and that the defendant was, by happenstance, on the property of a former spouse. In addition to trespassing, the prosecutor may charge the defendant, on the facts, with Stalking and attempted Burglary. The prospect of facing a trial on three separate criminal charges may induce the defendant to plea bargain because the potential cumulative punishment for all three crimes is severe. Ultimately the defendant may plead guilty to, and forfeit the right to a trial on, the trespassing charge, the only charge that stands a chance of being proved beyond a reasonable doubt. Such a plea bargain, claim some critics, is an illusory bargain for criminal defendants. The practice of overcharging is impermissible, and courts may dismiss superfluous charges. However, courts are reluctant to prevent the prosecution from presenting a case on a charge that is supported by probable cause. Prosecutors have discretion in plea bargaining, and they may withdraw offers after making them. A defendant is also free to reject a plea bargain. In many cases, where a plea bargain is withdrawn or rejected and the case goes to trial, the defendant, if found guilty, receives punishment more severe than that offered by the prosecution in the plea bargain. This has been called the . A defendant cannot be penalized for Pleading not guilty and going to trial, but the U. S. Supreme Court has not held that it is impermissible to punish defendants with sentences that are longer than those offered in plea agreements. When overcharging and the trial penalty are combined in the regular practice of plea bargaining, defendants have little choice but to plead guilty, and virtually every criminal act may be disposed of without a trial. This, according to some critics, is a perversion of the criminal justice system. Other critics focus on the benefits that plea bargaining gives to defendants. They argue that plea bargaining softens the deterrent effect of punishment because it gives criminal defendants the power to bargain for lesser punishments. These critics note that experienced criminals are more likely to receive favorable plea bargains because they are familiar with the criminal justice system. According to these critics, plea bargaining subverts the proposition that a criminal should receive a punishment suited to the crime. Critics of plea bargaining tend to be either scholars or crime victims. Scholars complain of prosecutorial coercion, and crime victims decry the lighter sentences that plea bargaining produces. Defenders of plea bargaining tend to be the players in the system. These are judges, prosecutors, criminal defendants, and criminal defense attorneys. The majority of these persons accept plea bargaining as a necessary tool in the administration of criminal justice. They point out that critics of plea bargaining have no solution to the lack of judicial resources. Without increased funding for more courts, judges, prosecutors, and court employees, plea bargaining is a necessity in most jurisdictions. In response to the overcharging argument, supporters of plea bargaining note that the prosecutor's discretion in charging is a concept deeply ingrained in U. S. A prosecutor is not required to decide the case before trial. Instead the prosecutor is required to press charges based on the facts and to present evidence to support the charges. If there is no reasonable interpretation of the facts to support a certain charge, the charge will be dismissed. The judge or jury makes the final decision of whether the evidence warrants conviction on a certain offense. Defendants may receive harsher sentences upon conviction at trial, but in any case the sentence must be authorized by law. Thus, procedural safeguards effectively protect criminal defendants from the perils of overcharging. Proponents of plea bargaining also contend that both defendants and society reap benefits. Defendants benefit because both the defendant and prosecutor help to fashion an appropriate punishment. Society benefits because it is spared the cost of lengthy trials while defendants admit to crimes and still receive punishment. Although the punishment pursuant to a plea agreement is generally less severe than that imposed upon conviction after a trial, the process nevertheless produces a deterrent effect on criminal behavior because prosecutors are able to obtain more convictions. Each conviction places a defendant under the super- vision of the criminal justice system, and this decreases the defendant's freedom. Moreover, subsequent convictions after a guilty plea can be punished more harshly because defendants are punished in large part according to their criminal history. Criminal defendants may also benefit from plea bargaining. Plea agreements provide quick relief from the anxiety of criminal prosecution because they shorten the prosecution process. Furthermore, plea agreements usually give defendants less punishment than they would receive if they were found guilty of all charges after a full trial. For example, assume that a defendant has been charged with one count of driving under the influence and one count of possession of a controlled substance with intent to sell. If the defendant goes to trial and is found guilty on both counts, he could receive a prison sentence of several years. However, if he agrees to plead guilty to the charge of possession with intent to sell, the prosecutor may drop the driving- under- the- influence charge. Search Official Documents - OECD. Turkish Pharmaceutical Sector. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy. If you continue browsing the site, you agree to the use of cookies on this website. See our Privacy Policy and User Agreement for details. Watergate was a major political scandal that occurred in the United States in the 1970s, following a break-in at the Democratic National Committee (DNC) headquarters. We’re pleased to advise that IBSA has been selected as a Skills Service Organisation for the manufacturing sector. Accelerating Social Impact, ASI, is an unusual type of business – we’re part of an innovative and emerging trend of businesses that purposefully blend our. Receiving the scholarship from Benjamin Civiletti, which I am so thankful for, strengthens my understanding of the importance of giving to benefit others. Managing Conflict of Interest in the Public Sector A TOOLKIT « Managing Conflict of Interest in the Public Sector A TOOLKIT Conflicts of interest in both the public. 9/23/2017 0 Comments The Reader Torrent AxxoHello, Uploading.com will be performing a service upgrade on Wednesday, September 5th, for about 45 minutes. We are conducting this upgrade to perform Vuze (previously Azureus) is a BitTorrent client used to transfer files via the BitTorrent protocol. Vuze is written in Java, and uses the Azureus Engine. In addition to downloading data linked to.torrent files, Azureus. Vuze - Wikipedia. Vuze. Developer(s)Azureus Software. Initial release. June 2. Stable release. 5. August 9, 2. 01. 6; 3 months ago (2. Vuze is written in Java, and uses the Azureus Engine. QBittorrent is a cross-platform client for the BitTorrent protocol. It is open-source software released under the GNU General Public License version 2 (GPLv2). Get all the new movies straight into your email inbox! Most Downloaded Movies. Escape from Pleasure Planet 2016. Panzer Chocolate 2013. Watch32 - Watch Movies Online Free. Watch your favorite movies online free on Watch32. Discover thousands of latest movies online on Watch32 movies. In addition to downloading data linked to . Azureus allows users to view, publish and share original DVD and HD quality video content. Additionally, if users prefer to publish their original content, they may earn money from it. Azureus was first released in June 2. Source. Forge. net, mostly to experiment with the Standard Widget Toolkit from Eclipse. It later became one of the most popular Bit. Torrent clients. It was among the most popular Bit. Torrent clients. However, the Vuze software added in more recent versions is proprietary and users are required to accept these more restrictive license terms. Features. It has a plugin that connects to the i. If the user adds a torrent from i. Hyde Park Group Food Innovation For this reason, torrents previously published only on i. Internet, and users of i. Internet while maintaining the anonymity of i. The blue poison dart frog (Dendrobates azureus) was chosen as the logo and name of the brand by co- creator Tyler Pitchford. This choice was due to Latin names of poison dart frogs being used as codenames for his development projects. In 2. 00. 6 Vuze was released as an attempt to transform the client into a . A Vuze- free version of Azureus was released along with Vuze during the beta period. The releases used version numbers 3. Vuze- free versions continued with the 2. On June 1. 6, 2. 00. Azureus/Vuze decided to stop releasing versions named Azureus, and complete the name change with the release of version 3. The client engine however, remains unchanged as Azureus. License change. While it still states that the . Vuze changes or offers to change home page and search and to install a promotional component not necessary for the program to function. The onion routers are run by volunteers using their own bandwidth at their own cost. Due to the high bandwidth usage caused by the Bit. Torrent protocol, it is considered impolite and inappropriate by Tor community members to use the Tor network for Bit. Torrent transfers. In contrast to Tor, I2. P is built for P2. P traffic and encourages its use . Eurostar - Wikipedia. This article is about the passenger railway service linking the United Kingdom, France and Belgium. For other uses, see Eurostar (disambiguation). Eurostar is a high- speed railway service connecting London with Avignon, Brussels, Lille, Lyon, Marseille and Paris. All its trains traverse the Channel Tunnel between the United Kingdom and France, owned and operated separately by Eurotunnel. The London terminus is St Pancras International, with the other British calling points being Ebbsfleet International and Ashford International in Kent. Calling points in France are Calais- Fr. Trains to Belgium terminate at Midi/Zuid station in Brussels. In addition, there are limited services from London to Disneyland Paris at Marne- la- Vall. The LGV Nord line in France opened before Eurostar services began in 1. The French and Belgian parts of the network are shared with Paris. First Capital Connect Train Update In NycIn the United Kingdom the two- stage Channel Tunnel Rail Link project was completed on 1. November 2. 00. 7 and renamed High Speed 1, when the London terminus of Eurostar transferred from Waterloo International to St Pancras International. Eurostar was until 2. France and Belgium, SNCF and SNCB/NMBS, and Eurostar (UK) Ltd (EUKL), a subsidiary of London and Continental Railways (LCR), which also owned the high- speed infrastructure and stations on the British side. Eurostar has become the dominant operator on the routes that it operates, carrying more passengers than all airlines combined. Other operators have expressed an interest in starting competing services following deregulation in 2. On 1 September 2. Eurostar was incorporated as a single corporate entity called Eurostar International Limited (EIL), replacing the joint operation between EUKL, SNCF and SNCB/NMBS. This sale was completed in May 2. A service tunnel lies in between the twin rail tunnels. The history of Eurostar can be traced to the 1. Britain and France. In 1. 98. 8 construction began on a new basis. Eurotunnel was created to manage and own the tunnel, which was finished in 1. May 1. 99. 4. In 1. For the past two years, the Strategic Planning Committee has been observing, listening, studying, consulting, surveying and praying in order to identify. NJ Transit to keep sleep apnea engineers from operating trains; VRE Santa Train trips sell out in less than two days; Port of Montreal opens new. 2013 update Every train station in Britain listed and mapped: find out how busy each one is. Get the latest Louisiana and New Orleans politics and election news and results, louisiana political blogs and articles. Find updates on the state legislative session. Get all the information (schedule, fares, stations) to plan your train trip in Canada and book your tickets. Britain, France and Belgium set up an International Project Group to specify a train to provide an international high- speed passenger service through the tunnel. France had been operating high- speed TGV services since 1. Paris and the Channel Tunnel, LGV Nord; French TGV technology was chosen as the basis for the new trains. An order for 3. 0 trainsets, to be manufactured in France but with some British and Belgian components, was placed in December 1. The train was the first passenger- carrying arrival at St Pancras International station. The history of Eurostar can be traced to the 1986 choice of a rail tunnel to provide a cross-channel link between Britain and France. A previous attempt at. India’s Chaotic Cash Crackdown. Two weeks ago, millions of Americans voted against Hillary Clinton because, among other. Predicted journey times of almost nine hours for Glasgow to Paris at the time of growth of low- cost air travel during the 1. In 2. 00. 0 the coaches were sold to Via Rail in Canada. There were fears that services at Ashford International might be further reduced or withdrawn altogether as Eurostar planned to make Ebbsfleet the new regional hub instead. A tracker app allow customers to see where they are. Eurostar line network shown in yellow. LGV Nord. A Belgian high- speed line, HSL 1, was added to the end of LGV Nord, at the Belgian border, in 1. Of all French high- speed lines, LGV Nord sees the widest variety of high- speed rolling stock and is quite busy; a proposed cut- off bypassing Lille, which would reduce Eurostar journey times to Paris, is called LGV Picardie. Channel Tunnel. It joins LGV Nord in France with High Speed One in Britain. Tunnelling began in 1. British sovereign Queen Elizabeth II and the French President Fran. A further four- minute improvement for London. The first section between the tunnel and Fawkham Junction in north Kent opened in September 2. London. On 1. 4 November 2. HS1 line. The redeveloped St Pancras International station became the new London terminus for all Eurostar services. Non- stop journey times were reduced by a further 2. London. There used to be ten London. There are also seasonal services in the winter. Separation of Eurostar from British domestic services through Kent meant that timetabling was no longer affected by peak- hour restrictions. Eurostar's fares were significantly higher in its early years; the cheapest fare in 1. Standard Eurostar tickets no longer include free onward connections to or from any other station in Belgium: this is now available for a flat- rate supplement, currently . Both the British Government and the Schengen governments concerned (Belgium and France) have legal obligations to check the travel documents of those entering their respective countries (as well as those leaving, in the case of Belgium and France). To allow passengers to walk off the train on arrival in most cases, passport controls ordinarily take place at the embarkation station. In order to comply with special UK legislation. Security checks at Eurostar are comparable to those at a small airport and generally much quicker than at London Heathrow. This arrangement was set up after numerous illegal immigrants entered the UK without the right to do so, by buying a ticket from Brussels to Lille or Calais but remaining on the train until London . Eurostar now has a dominant share of the combined rail. In 2. 00. 4, it had a 6. London. In 1. 99. London and Continental Railways forecast that passenger numbers would reach 2. Waterloo International Station from its opening in 1. In an independent review commissioned by Eurostar, the company came in for serious criticism about its handling of the incident and lack of plans for such a scenario. Passengers in general, it stated, are becoming increasingly aware of the environmental effects of air travel, and Eurostar services emit much less carbon dioxide. One commentator had defined the situation at the time as. Negative media coverage combined with poor sales and the general public's low opinion of the British rail industry, created a major challenge.. Eurostar was finding it difficult to pick itself up from one of the worst periods in its decade- long history. The period post 9/1. Passenger numbers were drying up due to worries over international travel. Several management changes had led to a pause in strategy. Punctuality had suffered badly because of wider problems with the UK's rail infrastructure. By 2. 00. 8, Eurostar's environmental credentials had become highly developed and promoted. The units have also been branded as the Eurostar e. Eurostar since 2. There are two variants: 3. These trains are 3. These sets have a capacity of 5. Regional Eurostar services. The trains are essentially modified TGV sets. The trains were designed with Channel Tunnel safety in mind, and consist of two independent . The Eurostar logos have been removed from these sets, but the base colours of white, black, and yellow remain. SNCF's lease of the sets is scheduled to last until 2. This designates the train as a Mark 3 TGV (Mark 1 being SNCF TGV Sud- Est; Mark 2 being SNCF TGV Atlantique). The second digit denotes the country of ownership: 3. UK3. 1xx Belgium. France. 33xx Regional Eurostar. Fleet updates. Power points were added to seats in First class and coaches 5 and 1. Standard class. Premium First class was renamed Business. Premier. In 2. 00. Eurostar announced that it would be carrying out a mid- life refurbishment of its Class 3. The replacement to the Class 3. French Transport Ministry and the UK Department for Transport. The new trains will be equipped to use the new ERTMS in- cab signalling system, due to be fitted to High Speed 1 around 2. Total traction power will be rated at 1. MW. On 4 November 2. European Commission over the tendering process, which then asked the British government for . At the same time, Eurostar announced the first five e. December 2. 01. 5, with the remaining five entering service by May 2. Of the five sets ready by December 2. London- Paris and London- Brussels routes. Other incidents in the Channel Tunnel . However, the breakdowns in the tunnel, which resulted in cessation of service and inconvenience to thousands of passengers, in the run- up to Christmas 2. In October 1. 99. The first preview train, carrying 4. A signalling error that led to the incorrect routeing was stated to have caused . Passengers waiting at Waterloo International were initially directed on to local trains towards Ashford leaving from the adjacent London Waterloo East railway station, until overcrowding occurred at Ashford. The trains stopped inside the tunnels due to electronic failures caused by snow and ice. Questions were raised at the time about the ability of the train and tunnel electronics to withstand the mix of snow, salt and ice which collect in the tunnels during periods of extreme cold. Fourteen people were treated for light injuries or shock, with no fatalities or major injuries. The articulated nature of the trainset was credited with maintaining stability during the incident and all of the train stayed upright. The trains were operated by uninvolved British employees and service was not interrupted. Although the trains had been winterised, the systems had not coped with the conditions. Brussels services resumed on a limited scale on 2. February. On 2. 1 February 2. Paris to London broke down just outside Ashford International. Many travellers between the UK and the European mainland instead took the Eurostar train, all tickets between Brussels and London on 1. April being sold out within 3. Eurostar Trains were suspended that day with thousands of passengers stranded in the run up to Christmas. On 1. 7 October 2. The line was handed back at 2. Following criticism from Boris Johnson and cycling groups Eurostar reversed the edict. This would be even more likely if proposals are adopted for a new high- speed line from London to the north of Britain. In the meantime, the closest equivalent to Regional Eurostar services are same- station connections with East Midlands Trains and Thameslink, changing at St Pancras. The recent construction of a new concourse at adjacent King's Cross Station has improved interchange with St Pancras. Hepatitis C New Drug Research And Liver Health. Image Source. 20. News and Research. Treatment of Chronic Hepatitis C Infection according to genotype. HCV Genotypes and Treatment Offered on this page is research updates with a focus on treating HCV according to genotype using FDA approved and investigational medicines. Information is extracted from news articles, peer- reviewed journals, as well as liver meetings/conferences, research manuscripts and interactive learning activities. Elsewhere On The Site: Resource Links. Summarized recommended treatments for chronic hepatitis C genotypes 1- 6. News and Research: Staying current on new all oral FDA approved drugs to treat hepatitis C. Letter on Liprotamase (Sollpura) (HRG Publication #1930) These comments from Public Citizen Health Research Group are being submitted in follow-up to our testimony presented at the January 12, 2011 meeting of the Food and Drug. The FDA finalized the new Nutrition Facts label for packaged foods to reflect new scientific information, including the link between diet and chronic diseases such as obesity and heart disease. The new label will make it. Jacobson, MD, chair of the department of medicine at Mount Sinai Beth Israel Medical Center and co- Chief Medical Editor for HCV Next, said during his presentation. Goethe University Hospital in Frankfurt, Germany, discusses results of the ENDURANCE- 1 clinical trial where a treatment regimen of glecaprevir/pibrentasvir (G/P) yielded high sustained virologic response rates in patients with hepatitis C genotype 1 after 8 weeks of treatment. Lawitz, MD, vice president of scientific and research development at The Texas Liver Institute and clinical professor of medicine at the University of Texas Health Science Center, discusses results of the C- CREST- 1 clinical study where treatment- naive patients with hepatitis C genotype 1, 2 and 3 infection showed high sustained virologic response rates after treatment with MK- 3. MK- 8. 40. 8 and grazoprevir. Globally, GT4 HCV accounts for nearly 1. HCV infections and is the dominant genotype in Egypt and some regions of sub- Saharan Africa.
The investigators conducted an open- label, randomized, active- comparator Phase 3 study to evaluate SOF/VEL/VOX compared to SOF/VEL in DAA- experienced patients with hepatitis C virus (HCV) infection with genotypes 1- 6 who had not previously received an NS5. A inhibitor. The contribution of the components of the three- drug regimen was also explored. Schwarz, MD, a professor of pediatrics at Johns Hopkins University School of Medicine, Baltimore, MD, at The Liver Meeting. DAAs have revolutionized the treatment of HCV infection over the last 5 years. Oral interferon- free combinations of at least two DAAs showed high antiviral efficacy, easy dosing, fair tolerance, and manageable drug- drug interactions, whatever the combination for treatment duration of 8, 1. Of Interest. Meeting Coverage AASLD: HCV Outcomes Under Scrutiny Treatment now 'predictably' good in trials but what about real world? All Genotypes. The development of direct- acting antiviral agents (DAA) offered new therapeutic options for patients with advanced cirrhosis and liver graft recipients. This review gives a high topical summary of most current therapeutic options of DAA- based antiviral therapy in patients with hepatitis C virus associated cirrhosis before and after liver transplantation. Nov 4. Among the major advantages of these oral regimens, beyond their remarkable efficacy, has been their relatively clean safety profile. Oct 2. 4. Our data confirm that cirrhotic and noncirrhotic patients with HCV GT1 infection can be cured with 6–8 weeks of treatment, and that an 8–1. EBR/GZR + SOF is safe and effective in cirrhotic and noncirrhotic patients with HCV GT3 infection, commonly regarded as one of themost challenging patient populations to treat. Oct 1. 7Genotype 3. Infection With Hepatitis C Virus Genotype 3 is an Independent Risk Factor for End- stage Liver Disease, Hepatocellular Carcinoma, and Liver- related Death. Clin Gastroenterol Hepatol. We examined the association of 1. Alaska Native/American Indian persons with chronic HCV infection. METHODS: We collected data from a population- based cohort study of liver- related adverse outcomes of infection in American Indian/Alaska Native persons with chronic HCV living in Alaska, recruited from 1. We calculated adjusted hazard ratios (a. HR) and 9. 5% CIs for end- stage liver disease (ESLD; presence of ascites, esophageal varices, hepatic encephalopathy, or coagulopathy), hepatocellular carcinoma (HCC), and liver- related death using a Cox proportional hazards model. RESULTS: We enrolled 1. HCV genotypes 1, 2, and 3, respectively. On multivariate analysis, persons infected with HCV genotype 3 had a significantly increased risk of developing all 3 adverse outcomes. Their a. HR for ESLD was 2. CI, 1. 5- 3. 0), a. HR for HCC was 3. CI, 1. 4- 6. 6), and a. HR for liver- related death was 2. CI, 1. 5- 4. 0) compared to genotype 1. Heavy alcohol use was an age- adjusted risk factor for ESLD (a. HR, 2. 2; 9. 5% CI, 1. HR: 2. 9; 9. 5% CI, 1. Obesity was a risk factor for ESLD (a. HR, 1. 4; 9. 5% CI, 1. ESLD (a. HR, 1. 5; 9. CI, 1. 1- 2. 2). Male sex was a risk factor for HCC (a. HR, 3. 6; 9. 5% CI, 1. CONCLUSIONS: In a population- based cohort study of American Indian/Alaska Native persons with chronic HCV infection, we found those infected with HCV genotype 3 to be at high risk for ESLD, HCC, and liver- related death. Copyright . Published by Elsevier Inc. All rights reserved. KEYWORDS: AK- HEPC; American Indian/ Alaska Native; Hepatitis C Outcome; liver cancer risk. PMID: 2. 77. 65. 72. DOI: 1. 0. 1. 01. Oct 2. 0Genotype 1- 6 Gilead SVR1. Rates SOF/VEL/VOX; (GS- 9. Treatment- Na. NDA Planned for Q4 2. Gilead Sciences, Inc. However, the safety, tolerability, and efficacy in patients aged 7. Summary: Fifty- six patients with HCV G2 infection who were treated with sofosbuvir and weight- based dose of RBV were enrolled. Thirty- seven patients aged . The aged group was characterized by significantly more number of women, history of hepatocellular carcinoma, low serum albumin (ALB) level, low hemoglobin (Hb) concentration, low estimated glomerular filtration rate (e. GFR), and high fibrosis- 4 index (p = 0. Forty- one patients were evaluated for SVR at 1. SVR1. 2); of them, all but one completed the treatment scheduled for 1. The aged group showed lower SVR1. Although the Hb concentration and e. GFR are significantly lower in the aged group throughout the clinical course, all patients in the aged group completed the 1. ALB level. Key Messages: The combination of sofosbuvir plus RBV is tolerable and beneficial in patients aged > 7. However, intensive management of anemia by dose reduction of RBV is necessary, which could lead to a low SVR1. Dig Dis 2. 01. 6; 3. DOI: 1. 0. 1. 15. Wayne Weart, Pharm. D, BCPS, FASHP, FAPh. A, a professor of clinical pharmacy and outcome sciences at South Carolina College of Pharmacy, told Pharmacy Today that, based upon the updated guidelines from July 2. FDA- approved hepatitis C once- a- day, single- pill medications, “I am suggesting that the following agents replace ledipasvir and sofosbuvir (Harvoni—Gilead), which costs approximately $9. The most cost- effective therapy for patients who are candidates for and can take it would be Merck’s elbasvir and grazoprevir tablets (Zepatier).” According to Weart, the cost is approximately $5. Weart recommended that treatment- naive patients with no cirrhosis and genotype 1a infection undergo testing for virus with NS5. A resistance–associated variant polymorphisms (RAVs) to determine the best therapy. If no baseline NS5. A RAVs are present, monotherapy for 1. NS5. A RAVs are present, ribavirin should be added to 1. Patients with genotype 1b or 4 should receive elbasvir and grazoprevir once daily for 1. For those with genotypes 2, 3, 5, and 6, I would recommend this new therapy, sofosbuvir and velpatasvir, to be given for 1. Weart. Currently, one treatment is preferred for genotype 3 (sofosbuvir and daclatasvir are used — with or without ribavirin depending on whether the patient has cirrhosis). Newer agents held out the prospect of further options, said Dr Feeney. Oct 5. Of Interest. European regulator limits some Gilead hep C patent claims. By Ed Silverman@Pharmalot. In a setback for Gilead Sciences, European regulators decided not to uphold all of its patent claims for the best- selling Sovaldi hepatitis C treatment, a move that could lead to generic versions of the medicine becoming available four years sooner than had been expected. Oct 4. Up to the end of 2. G4 HCV was treatment with pegylated interferon and ribavirin for 2. Since late 2. 01. G4 HCV has been transformed by the licensing of many directly acting antiviral agents (DAA). It is an exciting time to be involved in the management of HCV generally and G4 particularly. Interferon- free DAA regimens are now a reality for G4 HCV. This review will highlight these developments and discuss the data behind the use of these drugs. It will also highlight future regimens that are likely to be available over the coming years. These include suboptimal SVR rates in patients with HCV genotype 3 infection and patients with child C cirrhosis of any genotype. Fortunately, the recent approval of SOF/velpatasvir has in large part addressed gaps in efficacy for patients with genotype 3 infection. Patients with end- stage renal disease had until recently remained a subgroup with very limited treatment options, but the approval of daclatasvir and EBR/GZR has been a significant breakthrough for patients with genotype 1 and 4 infections. Impaired renal function remains a significant limitation in therapeutic treatment options for patients with genotype 2, 3, 5, or 6. Treating patients with decompensated cirrhosis remains complex, given their baseline tenuous hepatic function; therefore, it is recommended that they are managed in a liver transplant center. Therapeutic options are more restricted for patients with decompensated cirrhosis because several DAAs (simeprevir, dasabuvir, GZR, and EBR) are not approved for use in patients with child B or C cirrhosis, and there is a Food and Drug Administration warning against the use of paritaprevir/ritonavir/ombitasvir. 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