Puzzling Over the Hurt Down-Under
Serious Mental Illness and Contraception
New 13-Cycle Vaginal Contraceptive System
The Future of Family Planning in Post-COVID America
New ASCCP Guidelines: Implications for FP
On the alert: mood disorders during 2020 stressors
Challenges old and new during the pandemic
Reproductive health in the time of Covid-19
Missed Pills: The Problem That Hasn’t Gone Away
Find the “yes! . . . and” rather than “no” or “but”
Digital Family Planning: the Future is Now
Irregular Bleeding Due to Contraceptives
Ouch! Best approaches to menstrual pain
Contraceptive efficacy: understanding how user and method characteristics play their part
Strategizing treatment for chronic heavy menstrual bleeding
Untangling the literature on obesity and contraception
High tech apps for no-tech FABM
Menstrual exacerbation of other medical conditions
From Princeton University: Thomas James Trussell (1949-2018)
The Short and Long of IUD Use Duration
Selecting a Method When Guidance Isn’t Clear-cut
Healthcare in the Time of Digital Expansion
The Scoop on Two New FDA-Approved Contraceptive Methods
Pregnancy of unknown location—meeting the challenge
Big “yes” (with caveats) to CHCs during perimenopause
The role of IUDs (LNG IUDs, too!) in emergency contraception
Combined pills’ effect on mood disorders
Abortion in the U.S.: safe, declining, and under threat
Hope for ovarian cancer screening test
Breast cancer still a small risk with some hormonal contraceptives
Record rate of HPV-related throat cancer
Viruses in semen potentially transmissible
Don’t Abstain from Your Role in Abstinence
Teens births declining but geographic ‘hotspots’ defy trend
Online Medical Abortion Service Effective and Safe
Do Women Really Need to Wait That Long?
Reassuring news on depression and OC use
PMDD: Genetic clues may lead to improved treatment
Breast cancer risk when there is a family history
Body weight link to breast and endometrial cancers (and 11 others)
Family Planning in 2017 and Beyond
Make Me Cry: Depression Link (Again)?
Managing implant users’ bleeding and spotting
Zika: Updated guidance for providers
Pharmacist-prescribed contraceptives
Hot off the press! 2016 MEC and SPR
Zika virus fears prompt increased request for abortion in nations outlawing abortions
Opioid use epidemic among reproductive-age women
Good news on the family planning home front!
War Against Planned Parenthood Hurts Women
Win-win for both treatment and prevention
Menopause, mood, mental acuity, and hormone therapy
Emergency contraception for teens
Postpartum Contraception: Now, Not Later
Are we practicing what we preach?
Be alert to VTE in hormonal contraceptive users
LARC among teens increased 15-fold, but not enough
Brain cancer and hormonal contraception
Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use
Alcohol consumption when pregnancy is unwanted or unintended
Latest Data on Contraceptive Use in the United States
LateBreaker sampler from Contraceptive Technology conference
Emergency Contraceptive Pill Efficacy and BMI/Body Weight
Handout on Unintended Pregnancy and Contraceptive Choice
Ask About Withdrawal (Really!)
Rules to Practice By: Safety First and Cleanliness is Close to. . .
What’s Vanity Fair Got Against the NuvaRing?
Promising New Treatment for Hepatitis C
Numbers matter, so make them simple for patients
The Recession’s Effect on Unintended Pregnancies
Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative
Applying the “New” Cervical Cytology Guidelines in Your Practice
Acute Excessive Uterine Bleeding: New Management Strategies
Medical indications for IUD use in teens

Broad-range efficacy from new short-course regimens with ledipasvir/sofosbuvir in a single-tablet holds promise for treating persons infected with hepatitis C virus (HCV). Of the estimated 2.7 to 3.9 million Americans chronically infected with HCV, anywhere from 50% to 75% are undiagnosed and untreated. [1] Nearly half of infected persons report no exposure that would have put them at risk, such as injection- or intranasal drug use, acquiring a tattoo in unregulated parlors, incarceration, needle-stick in a health care setting, and other invasive medical procedures, etc. In its acute phase, HCV is usually asymptomatic and so unsuspected. However, anywhere from 75% to 85% of infected persons will develop a chronic infection, and with it, an increased risk for cirrhosis, hepatocellular carcinoma, and diabetes.
Fortunately, chronic HCV can curable with a sustained virologic response to treatment, leading to reduced risk of diabetes and improved liver histology. Recent studies have focused on finding a short-course, well-tolerated regimen. In May 2014, a multicenter research group reported successful outcomes following three short-course regimens. In a randomized trial, 647 patients infected with HCV genotype 1 uncomplicated by cirrhosis were assigned to three treatment groups: ledipasvir and sofosbuvir for12 weeks, ledipasvir and sofosbuvir for 8 weeks, or ledipasvir and sofosbuvir plus ribavirin for 8 weeks.[2]
Patients on all three regimens developed a high rate of sustained virologic response—12-week regimen, 95%; 8-week, 93%; added ribavirin regimen, 94%. The differences were statistically insignificant. At the end of therapy, only 23 patients relapsed overall. Treatment response did not differ with varying patient characteristics, suggesting that there is no need to tailor treatment regimens for HCV-infected persons who have not been treated before and are currently without cirrhosis. The single-tablet ledipasvir-sofosbuvir combination appears effective across a broad range of patients. Patients taking the regimen with added ribavirin suffered more adverse effect without increase in treatment efficacy.
In 2012 the Centers for Disease Control and Prevention[3] recommended screening guidelines that may help bring about earlier diagnosis, before serious complications occur. With earlier diagnosis, affected persons may be less likely to develop liver disease and other extra-hepatic conditions through early treatment. Current guidelines recommend HCV testing based on known risk factors and clinical indications, and one-time screening for persons born from 1945 to 1965. CDC discourages routine testing among low-risk populations, which can lead to false-positive results.
[1] Holmberg SD, Spradling PR, Moorman AC, Denniston MM. Hepatitis C in the United States. N Engl J Med 2013;368:1859-61.
[2] Kowdly KV, Gordon SC, Reddy KR, et al. Ledipasver and sofosbuvir for 8 or 12 weeks for chronic HCV without cirrhosis. N Engl J Med 2014; DOI: 10.1056/NEJMoa1402355. Accessed May 9, 2014.
[3] Screening for hepatitis C virus infection in adults: final recommendation statement. Rockville, MD: U.S. Preventive Services Task Force, June 25, 2013. Accessed May 31, 2014 at http:// www.uspreventiveservicestaskforce.org/ uspstf12/hepc/hepcfinalrs.htm.
–Deborah Kowal, MA, PA, President & CEO, Contraceptive Technology Communications, Inc