Exploring Patient-Reported Costs Related to Hepatitis C on the Medical Crowdfunding Page GoFundMe (R)
Authors: Joseph Mattingly, T., II; Li, Karen; Ng, Arnold; Ton-Nu, Tieu-Long; Owens, Jennifer
Background Successful medical crowdfunding campaigns may alleviate or even eliminate the financial burden of expensive, cumulative medical bills. GoFundMe(R)crowdfunding pages for hepatitis C virus (HCV) patients were reviewed and analyzed to better understand the characteristics that contribute to a successful fundraising campaign in a disease often associated with patients with a lower social standing or stigma. Methods A pilot cross-sectional study of all publicly available GoFundMe(R)crowdfunding pages was conducted for posts related to HCV on GoFundMe(R)in June 2019. Similar to data extraction steps in a systematic literature review, page data were reviewed to identify whether the source of the patient's HCV infection was disclosed, if disclosed then how did the patient report contracting the disease, and all costs reported in the description as part of the rationale for requesting funds. Descriptive statistics of category and numeric variables were reported for the full sample, and exploratory analyses were conducted to determine any potential associations with categorical variables and the amount of donations received, categorized as small (< US$1000), moderate (US$1000-4999), and large (>= US$5000). Results A total of 685 unique GoFundMe(R)pages were included in the analysis. Only 30% (206/685) of the pages disclosed the source of HCV infection. Of those that disclosed a virus source, 86% (177/206) described a source that appeared more socially desirable to our research team (blood transfusion, organ transplant, occupational exposure, etc.). In terms of actual donations received by a page, 46% (312/685) were less than US$1000, 38% (262/685) were between US$1000 and US$4999, and 16% (111/685) were US$5000 or more. Disclosing the virus source was associated with a higher donation category (p = 0.0099). Conclusion These exploratory findings yield important insights, both for patients or caregivers seeking support on GoFundMe(R)crowdfunding websites and for researchers interested in exploring the types of costs self-reported by patients in their public requests for financial assistance.
Prophylactic and therapeutic HBV vaccination by an HBs-expressing cytomegalovirus vector lacking an interferon antagonist in mice
EUROPEAN JOURNAL OF IMMUNOLOGY
Authors: Huang, Hongming; Ruckborn, Meike; Le-Trilling, Vu Thuy Khanh; Zhu, Dan; Yang, Shangqing; Zhou, Wenqing; Yang, Xuecheng; Feng, Xuemei; Lu, Yinping; Lu, Mengji; Dittmer, Ulf; Yang, Dongliang; Trilling, Mirko; Liu, Jia
Cytomegalovirus (CMV)-based vaccines show promising effects against chronic infections in nonhuman primates. Therefore, we examined the potential of hepatitis B virus (HBV) vaccines based on mouse CMV (MCMV) vectors expressing the small HBsAg. Immunological consequences of vaccine virus attenuation were addressed by either replacing the dispensable gene m157 ("MCMV-HBs) or the gene M27 ("Delta M27-HBs"), the latter encodes a potent IFN antagonist targeting the transcription factor STAT2. M27 was chosen, since human CMV encodes an analogous gene product, which also induced proteasomal STAT2 degradation by exploiting Cullin RING ubiquitin ligases. Vaccinated mice were challenged with HBV through hydrodynamic injection. MCMV-HBs and Delta M27-HBs vaccination achieved accelerated HBV clearance in serum and liver as well as robust HBV-specific CD8(+) T-cell responses. When we explored the therapeutic potential of MCMV-based vaccines, especially the combination of Delta M27-HBs prime and DNA boost vaccination resulted in increased intrahepatic HBs-specific CD8(+) T-cell responses and HBV clearance in persistently infected mice. Our results demonstrated that vaccines based on a replication competent MCMV attenuated through the deletion of an IFN antagonist targeting STAT2 elicit robust anti-HBV immune responses and mediate HBV clearance in mice in prophylactic and therapeutic immunization regimes.