by paige varner pvarner@post-dispatch.com 314-340-8018
Posted: Thursday, July 29, 2010 12:00 am
For the 40 percent to 50 percent of patients who aren't cured of hepatitis C after their initial treatment, Dr. Bruce R. Bacon of St. Louis University and his team of researchers have increased the chances of a cure upon re-treatment.
About 11 percent of the 515 people retreated in Bacon's trials were cured using the Food and Drug Administration-approved medication combination, Infergen with an antiviral pill.
Of those with milder strains of hepatitis C, about 35 percent in the trials were cured.
In the first round of treatment, patients are given weekly shots of an alpha interferon — in larger amounts than that which the body normally makes to fight pathogens — along with the antiviral pill ribavirin.
This combination cures 50 percent to 60 percent of cases, but others can start another round, this time injecting the interferon medicine Infergen daily, along with taking the ribavirin, for up to 48 weeks.
Bacon, who holds the endowed chair in gastroenterology at SLU School of Medicine, and his team published their findings last summer after researching from 2004 to 2006.
For those with the virus who feel the 11 percent cure rate in the second round isn't high enough, Bacon said they will still have hepatitis C if they don't at least try re-treatment.
Another concern about the medicine combination is the side effects, which are similar to the flulike symptoms the virus already causes, such as fatigue, anemia, troubled breathing, irritability.
"But more than the side effects, you don't want to have hepatitis C," Bacon said.
Interferon and ribavirin are the only treatments for hepatitis C, which inflames the liver and after many years can lead to cirrhosis, or liver scarring, in 20 percent to 30 percent of patients.
Those with the virus can prevent cirrhosis development by not drinking excessive amounts of alcohol.
Some won't know they have the virus. Bacon said the flulike symptoms can set in gradually, making them feel sick for decades before they are diagnosed.
Contracting hepatitis C requires a blood-to-blood transmission, and Bacon said most cases have a history of one of three things:
• A blood transfusion before 1992.
• Sharing needles or illicit drugs — "even teenagers at a party who did something stupid," Bacon said
• Working in the health care field. Paramedics, physicians and nurses come into contact with blood daily. Just one needle stick could cause hepatitis C.
Acute cases of the virus can clear on their own. Infergen with ribavirin is FDA-approved in chronic cases, or for people who have had the virus for at least six months.
Infergen cannot be taken by anyone under 18 years old or with compensated liver disease due to cirrhosis complications.
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