Hep C in the News
~ All descriptions and quotes come from the respected websites ~
December 16, 2005
"Patients with hepatitis C who are treated with combination ribavirin and pegylated interferon (PEG-IFN) according to current recommendations under community-practice conditions have good outcomes, with rates of sustained virologic response (SVR) of approximately 66%, according to results of a large German study. The study's co-author Elmar Zehnter, MD, Gastroenterologist and Hepatologist, and Researcher in the BNG Hepatitis Group, Dortmund, Germany, presented the findings here on December 13[th at the Frontiers in Drug Development for Viral Hepatitis HEP DART 2005 meeting.
"If patients are treated to recommendations, they have a good chance of cure, but what we know is that every week counts and patients must sometimes be encouraged to remain on therapy despite side effects," Dr. Zehnter said. "These 'real-life' results are very similar to those we've seen in the clinical trials, a fact that is very encouraging and shows that HCV treatment in Germany is at a high level."
Dr. Zehnter and colleagues presented data on the 2203 patients they have evaluated to date, who were treated in a total of 213 clinical office practices throughout Germany between September 2003 and October 2005. The patients had an average age was 40.3 years. They received 800-1200 mg/daily of ribavirin and 1.5 mcg/kg weekly of PEG-IFN for periods of 24 or 48 weeks, depending on their genotype.
Of the patients studied, 83.5% were Caucasian and 56.4% had genotype A. Fully 90% were treatment naïve at study inclusion, and 57 patients were HIV-coinfected, Dr. Zehnter noted. Nearly 20% were on narcotic-substitution during treatment.
Results show that 75% of the 1058 treatment-naïve patients had normalized alanine aminotransferase (ALT) levels at study end, compared to 57% of the 111 treatment-relapsed participants. The overall rate of SVR was 66%; it was 17% and 14%, respectively, in relapsed patients and non-responders. SVR for the 61 patients who underwent dose reduction was 55.7%.
The researchers hope to enroll a total of 2541 patients into this ongoing study, Dr. Zehnter noted, and will be replicated in the Canadian setting."
December 12 2005
"There are some tests for early detection of both the diseases. Early stages of hepatitis B and C are usually diagnosed by general practitioners and family doctors who subsequently refer the patients to specialists. Liver transplant is the only cure in cases where the liver is totally destroyed through the diseases. “The success rate of transplant surgeries, wherein the liver is obtained from cadavers, is 80%,” the doctors said."
December 13 2005
"Campaigners were dealt a blow yesterday in their fight for a public inquiry into why hundreds of people contracted hepatitis C through contaminated blood transfusions in the 1980s. A judge refused to break Scottish legal ground by protecting relatives of three victims against expenses of about £10,000 each should their court action against the Executive fail. Lord Glennie ruled at the Court of Session that no financial case had been made for sparing the relatives from the risk of having to pay, even if their litigation was in the public interest. Jean Black lost her husband, the Rev David Black, in 2003. A haemophiliac, he received blood products and transfusions in the 1980s. He was later diagnosed as suffering from hepatitis C and had a liver transplant in 1996. He died of liver cancer caused by hepatitis C. Mary McArthur's husband, Alexander, 69, died in 2000 from liver disease, a known complication of hepatitis C infection. He received blood transfusions when he had a kidney transplant in 1984. Roseleen Kennedy, said her mother, Eileen O'Hara, who died aged 72 in 2003, underwent heart surgery in 1985, received contaminated blood in transfusions and developed hepatitis C."
BOSTON, December 2005
"Hepatitis C is a liver disease caused by a virus in the blood. It affects about 3.4 million people in the United States."
December 2005
Newswise — Scientists at the University of Texas Medical Branch at Galveston (UTMB) have identified a key biochemical connection between the hepatitis C virus and liver cancer.
The molecular mechanism is similar to the one that links the human papilloma virus (HPV), the cause of genital warts, and cervical cancer, according to Dr. Stanley M. Lemon, the senior author of a paper on the discovery that will be published this week in the online early edition of the Proceedings of the National Academy of Sciences.
“What we’ve found is that one of the hepatitis C virus proteins targets a cell protein that is crucial for suppressing the development of tumors, interfering with its ability to control cell proliferation,” Lemon said. “By knocking out this ‘tumor suppressor’ and promoting the proliferation of liver cells, this viral protein is setting up the liver for cancer.”
According to the federal Centers for Disease Control and Prevention, about 85 percent of liver cancer cases in the United States occur in people infected by the hepatitis C virus. Approximately 200 million people worldwide suffer from chronic hepatitis C, which can persist in the body for decades after an initial infection, often causing so much liver damage that a transplant may be a patient’s only chance for survival. The most effective treatment available, interferon therapy, works only about half the time and often causes debilitating side effects. Those who fail treatment are at risk for fatal cirrhosis or developing liver cancer.
Researchers have known for a long time that hepatitis C virus infection can lead to liver cancer. But how the virus goes about this has been unclear.
The UTMB group discovered that the tumor-suppressing retinoblastoma protein is present at markedly reduced levels in cells containing a hepatitis C virus “replicon,” a large piece of hepatitis C genetic material that is able to reproduce itself in cultured cells and also able to produce proteins made by hepatitis C viruses. “The replicon experiments enabled us to identify a protein known as NS5B that attaches to the retinoblastoma protein, a critical tumor suppressor, and accelerates its breakdown,” Lemon said. He continued: “The way NS5B docks with the retinoblastoma protein is biochemically almost identical to the way a protein made by human papilloma virus does so to produce similar cancer-promoting results. That’s
interesting, because the two viruses are so different —HPV is a DNA virus, while hepatitis C is composed of RNA.”
Understanding just how hepatitis C infection leads to the development of cancer is of critical importance, Lemon said. With no one “silver bullet” cure for hepatitis C on the horizon, he explained, researchers must use new knowledge to maximize the effectiveness of various virus-fighting therapies now under development, managing the care of chronically infected patients in ways that will best help them avoid liver cancer."
December 2005
"Vertex Pharmaceuticals Inc. has launched a midstage human clinical trial for VX-950, its drug to treat hepatitis C.
The Cambridge, Mass., company (Nasdaq: VRTX) announced on Monday that the midstage, or Phase II, trial would last 28 days and explore the drug's safety and effectiveness when combined with two other hepatitis C treatments. Vertex expects to launch multiple midstage trials for the compound in 2006. Vertex has made strides in reorganizing its financing as well as clinical progress. Late last month the company announced it would exchange 6.7 million shares of its common stock for $95 million of its convertible notes."
December 2005
Paul G. Donohue Question & Answers
Q: My daughter has hepatitis C. Is there any cure? What can we expect for her future?
A: In the United States, 4 million people have been infected with hepatitis C. About 30,000 new cases occur annually. Close to 80 percent of those infected will have a chronic infection, meaning the virus lives in their livers forever. Of that 80 percent, up to 20 percent will develop liver cirrhosis in 20 to 30 years; 15 percent face the possibility of liver failure in 10 years; and a smaller number will get liver cancer. A considerable number don’t ever become seriously ill.
Treatment is given if a person shows ongoing liver destruction with persistently elevated blood levels of liver enzymes. Treatment is also given if the person has evidence of the hepatitis C virus in the blood or if a liver biopsy shows scarring and inflammation.
Two drugs are given: peginterferon, which is infused into a vein; and ribavirin, an oral medicine. If no virus can be found in the blood six months after completion of treatment, the person is said to have a sustained virologic response — a cautious statement implying but not confirming a cure.
The number who achieve this state depends on the strain of hepatitis C virus involved. With strain 1, 60 percent achieve viral clearance. With strains 2 and 3, close to 85 percent do. Second treatments can be administered. Curing is possible.
Q: I take verapamil for high blood pressure and timolol eyedrops for glaucoma. A brochure I read said they should not be taken together. Both doctors who prescribed the medicines say it’s all right to continue using them.
What do you think?
A: The manufacturer says that caution should be used when timolol eyedrops are combined with a calcium channel blocker such as verapamil. The combination might cause a drop in blood pressure, disturb the electrical signal generated by the heart’s pacemaker or lead to heart failure. All this sounds bad, but reactions from the combination happen infrequently. However, if a person has impaired heart function, he should not use the combination.
If you’re still worried, an immense number of blood-pressure medicines can be substituted for verapamil.
Trusopt, Azopt, Xalatan and Lumigan are glaucoma medicines that can be used in place of timolol.
Q: My doctor has me on hydrocortisone because of adrenal-gland insufficiency. How serious is adrenal-gland insufficiency? I gave up my apartment and moved in with my sister and brother-in-law.
A: The adrenal glands, located above the kidneys, produce a number of life-sustaining hormones. They make hormones of the cortisone family that help the body cope with stress and suppress inflammation, and a hormone that figures into blood-pressure control and retaining enough body fluid, sodium and potassium.
Adrenal insufficiency happens for many reasons. An immune attack on the glands is the chief reason. Previously, tuberculosis infections of the glands caused failure; infections still occur today, but not as many as in the past.
Once the condition is discovered, treatment is easy — supply the missing hormones in pill form. That takes away its seriousness.
Dr. Donohue answers letters only in his North America Syndicate column but provides an order form of available health newsletters. Write him at P.O. Box 536475, Orlando, Fla. 32853-6475.
December 2005
Dr. Paul Donohue Questions & Answers
Dear Dr. Donohue: I am writing in regard to my daughter, 45, who has hepatitis C. Is there any cure for it? What can we expect for her future? She is supposed to start medicine -- shots combined with pills. Please give me some information on this illness. -- S.E.
Dear S.E.: In the United States, 4 million people have been infected with the hepatitis C virus, and about 30,000 new cases occur annually. Close to 80 percent of those infected will have a chronic infection. That means the virus continues to live in their livers forever. Of that 80 percent, up to 20 percent will develop liver cirrhosis in 20 to 30 years; 15 percent face the possibility of liver failure in 10 years; and a smaller number will come down with liver cancer. A considerable number don't ever become seriously ill.
Treatment is given if a person shows ongoing liver destruction with persistently elevated blood levels of liver enzymes. Treatment is also given if the person has evidence of hepatitis C virus in the blood or if the person's liver biopsy discloses scarring and inflammation.
Two drugs are given. One is peginterferon, which is infused into a vein. The other is ribavirin, an oral medicine. If no virus can be found in the blood six months after completion of treatment, the person is said to have a sustained virologic response -- a cautious statement that implies cure but doesn't come right out and say so. The number of people who achieve this state depends on the strain of hepatitis C virus that is responsible for the infection. With strain 1, 60 percent achieve viral clearance. With strains 2 and 3, close to 85 percent do. Second treatments can be administered. Cure is possible.
Dear Dr. Donohue: I am between a rock and a hard place. I take verapamil for high blood pressure. I also take timolol eyedrops for glaucoma. According to the brochure, they should not be taken together. Both doctors say it's all right to continue using them. What are your feelings? -- P.L.
Dear P.L.: The manufacturer says that "caution" should be used when timolol eyedrops are combined with a calcium channel blocker like verapamil. The combination might cause a drop in blood pressure, might disturb the electrical signal generated by the heart's pacemaker or could lead to heart failure. All this sounds like you are on the edge of a cliff, ready to step off. But bad reactions from the combination happen infrequently. However, if a person has impaired heart function, that person should not use the combination.
If you want to completely wiggle out of the space between the rock and the hard place, you can do so without a whole lot of fuss. There are an immense number of blood pressure medicines that can be substituted for verapamil.
Trusopt, Azopt, Xalatan, and Lumigan are glaucoma medicines that can be used in place of timolol. They are completely different drugs and can be used with verapamil.
