from Jules: In an attempt to create controversy the NY Times writer Andrew Pollack in an article published in the NY Times on July 21 where he talks about the new HCV drugs in development prints some very inflammatory & incorrect information. While at the same time appearing to say it is good that new more effective HCV drugs are in development that will save people's lives, he quotes a Dr Koretz who is based in LA and apparently not a hepatitis doctor as saying 'there is no good evidence that HCV treatment makes a difference since many patients cured might never develop serious liver disease'. This expresses an incorrect & irresponsible misunderstanding of hepatitis C care & treatment, it ignores much of the published and well known facts and does a disservice to patients & the entire health system. Over 4 million people in the USA are estimated to have hepatitis C virus (HCV). Many have been infected for 30 years or longer. A recently published paper by a well respected hepatitis researcher and doctor Gary Davis based at Baylor University in Texas reported in a model how the many people infected with HCV over 20 years ago are now aging and in these people the disease has progressed to serious disease where there is much greater increased risk for liver cancer and dying from the disease. This is true. The disservice by the Times article is that it discourages individuals from getting tested to see if they have HCV, because if you don't know you have HCV you certainly will not see a clinician to receive further care. It is known that 75% of HCV-infected individuals in the USA do not know they have HCV. Many individuals have died of liver disease and liver cancer because they were not tested. Once diagnosed with HCV an individual can then receive advise from a good doctor regarding whether they should be treated or if they can defer treatment, they can be monitored over years to see if the disease is progressing or not, they can improve their lifestyle to take better care of their health & liver, and they can make informed decisions about treatment. We need a large national HCV screening/testing program throughout the USA, particularly in major urban cities, as HCV very disproportionately affects African-Americans & Latinos, the health disparities are enormous. At the cost of The abandoning ethical reporting the Times reporter chose to create harmful controversy, as reporters sometimes do. The costs of many people getting sick from HCV to the governments in the USA will be enormous as large numbers of patients age with HCV and develop serious liver disease, costs for hospitalizations will zoom. If tested and in care not all patients require treatment but they can at least make informed decisions. Jules Levin, NATAP
Aging of Hepatitis C Virus (HCV)-Infected Persons in the United ...
Stacked prevalence curves showing number of cases by year with cirrhosis according to gender and age at time of initial hepatitis C virus infection. ...
www.natap.org/2010/HCV/031110_02.htm
Hope Against Hepatitis C, New Drugs - 'this will be revolutionary' - (07/19/10)
New cases of liver cancer are already rising year by year. And hepatitis C is the leading cause of liver transplants, like the one recently received by the rock musician Gregg Allman.
Hopes for new treatments were buoyed in May by the first results from a late-stage clinical trial of one of the new drugs, telaprevir from Vertex. When added to the existing treatment - a combination of alpha interferon and ribavirin - telaprevir effectively cured 75 percent of patients, compared with 44 percent of those treated with the existing drugs alone. And for many patients, the course of treatment could be halved to 24 weeks.
Dr. Poordad, who is a consultant to some of the pharmaceutical companies, said that one-fifth of his patients were being "warehoused," meaning they were forgoing treatment now to wait for the new drugs.
"I think the companies have done a superb job of marketing this disease," said Dr. Ronald L. Koretz, emeritus professor of clinical medicine at the University of California, Los Angeles. Dr. Koretz said there was no good evidence that treatment made a difference since many patients cured by the drugs might never have developed serious problems anyway.
NVHR Responds to New York Times Article on Hepatitis C Testing
WASHINGTON, July 22 /PRNewswire-USNewswire/ -- In response to today's New York Times article, "Hope against Hepatitis C," Andrew Muir, M.D., M.H.S., Director, Gastroenterology/Hepatology Research, Duke Clinical Research Institute and Steering Committee Member of the National Viral Hepatitis Roundtable (NVHR) released the following statement:
"Today's New York Times article details potential promising new drug therapies that could significantly improve the way we treat individuals infected with hepatitis C. Regrettably, the article suggests that expanded screening for hepatitis C may not be warranted. This approach is wrong and contrary to the direction in which we should and must move our health care system, particularly through improved access to care under health care reform. More than 5 million Americans are estimated to be infected with viral hepatitis B or C - and most are unaware they are infected as there are often few symptoms. Our health care system misses most infected individuals, who only learn that they have hepatitis C once they have progressed to liver cancer, cirrhosis, or liver failure. At that juncture, treatment options are limited and success rates are lower.
"Precisely because we do not know which individuals with hepatitis C will advance to these terrible diseases, it is critical that our public health infrastructure be modernized to achieve early detection of new infections and also to screen for individuals within specific risk groups, such as baby boomers and disproportionately affected populations. Once individuals are aware of their status, they will be empowered with this information, not only to make treatment choices, but also lifestyle choices to decrease their likelihood of disease progression and not to spread this infectious disease to others. In our current health care system, there are far too few options for diagnosis, care, and treatment. Unless or until the health care system provides access to all persons in need of hepatitis C treatment, it is important for the pharmaceutical industry to provide comprehensive compassionate care programs for those who are un/under insured.
"We can't prevent or treat what we don't know, which is why screening is critical. Access to screening would capture more infected individuals who can respond favorably to early intervention, reduce transmission, avoid needless medical expenses, and ultimately save thousands of lives annually."
NVHR is a coalition of more than 150 public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from chronic viral hepatitis that afflicts more than 5 million Americans. http://www.nvhr.org/
SOURCE National Viral Hepatitis Roundtable
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