January 24, 2011

Boomers may be vulnerable to hepatitis

~ Another article inaccurately stating sex as a
transmission risk of Hepatitis C ~
(see below highlighted in RED)

You may contact the author of the article:
Richard Craver
(336) 727-7376
Published: January 24, 2011

Hepatitis C, like heart disease, is considered as a "silent killer" by health-care officials.

With hepatitis C, the potential victim may have been carrying the virus for decades without knowing it until damage to the liver appears.

About 3.2 million Americans have chronic liver problems related to the virus, and an additional 3 million are not aware they are infected.

Considered particularly vulnerable to the disease are baby boomers — those born between 1946 and 1964 — because of lifestyle decisions made in their younger years.

That's why local physicians focused on infectious diseases are encouraged that two powerful drugs targeting hepatitis C — Vertex Pharmaceuticals' telaprevir and Merck & Co.'s boceprevir — could be available by summer if they gain Food and Drug Administration approval.

Some specialists are drawing comparisons to the early 1990s, when potent combination therapies emerged to treat AIDS.

"These drugs represent a major step forward for treating both new hepatitis C patients and those who have failed therapy," said Dr. Stan Link, an infectious-disease specialist at Forsyth Medical Center.

The new drugs are aimed at blocking an enzyme named protease that's key for the virus to reproduce. But they must be taken together with standard medications that are thought to boost the immune system.

According to the U.S. Centers for Disease Control and Prevention, nearly 70 percent of people with the hepatitis C virus will develop chronic liver disease.

Complications from hepatitis C cause between 4,600 and 12,000 deaths each year in the U.S. Deaths related to the disease are expected to increase to nearly 40,000 a year by 2040.

Transmission risks include injecting illegal drugs — the most common form — getting a tattoo with an unclean needle, having sex with an infected person and receiving donated blood, blood products and organs before 1992.

Hepatitis C "cuts across every segment of society," said Dr. Arun Sanyal of Virginia Commonwealth University in Richmond, the past president of the American Association for the Study of Liver Diseases. "I can tell you our hepatitis C treatment clinic is a great social equalizer."

The current two-drug treatment, which takes 48 weeks, cures about 40 percent of patients with the most common variety of the virus. A cure is defined as no sign of the virus six months after their last dose.

"Those 48 weeks of treatment can be very rough, contributing to depression, hair and weight loss, and severe fatigue," Link said.

Adding one of the new drugs to the regimen is projected to raise the cure rate to 75 percent, while cutting the treatment schedule in half, or to 24 weeks. Telaprevir's main risk is a rash that is sometimes severe, and boceprevir's is anemia.

Link said that while the treatment won't be inexpensive — potentially costing $25,000 to $30,000 a person — he expects most insurance companies will cover it as a less costly alternative to a liver transplant.

The CDC has begun a study at four hospitals to determine whether a one-time hepatitis C test for baby boomers makes sense.

Link and Dr. Marina Nunez, an assistant professor of infectious disease at Wake Forest University Baptist Medical Center, said the potential new drugs could encourage doctors and baby boomers to get tested for hepatitis C.

"We're constantly getting more referrals for hepatitis C treatment, perhaps as more doctors are more conscientious of asking their baby-boomer patients about whether they had any of the risk factors for the virus," Nunez said.

Link said he is recommending that recently diagnosed patients postpone starting therapy until the new drugs are available.

"The potential is there that the odds of their cure rate will be higher," Link said. "Being able to cut the treatment cycle in half will hopefully make it more tolerable for more people."


Also See: New Hope For Hepatitis C, An Often Hidden Disease

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