Study Points To a Better Hepatitis C Treatment

According the early release of a study to be published on November 14, 2001 in the New England Journal of Medicine, almost all cases of chronic liver disease caused by the hepatitis C virus could be prevented if people were given the antiviral drug interferon soon after becoming infected. The study, led by Michael P. Manns of the University of Hannover, represents an important advance over current, less effective treatments for chronic hepatitis C.

"These findings are persuasive," said Raymond T. Chung, medical director of the liver transplant service at Boston's Massachusetts General Hospital. "I think one of the more important implications . . . is that we have to be more vigilant for the discovery" of new cases of hepatitis C infection.

About 4 million Americans and about 170 million people worldwide are estimated to be infected with hepatitis C. The German study found that 42 of 453 newly infected patients who received six months' treatment with interferon alfa-2b became virus-free and remained so after therapy ended. About 6,500 people in the United States become infected with virus each year, according to the CDC. About one-quarter of those who chronically remain infected develop cirrhosis. The virus kills between 8,000 and 10,000 Americans annually.

Identifying people with hepatitis C is difficult and expensive, requiring multiple laboratory tests to distinguish liver function impaired by hepatitis C from other forms of liver inflammation. Most people infected with the virus acquired it from transfusions before a blood test for the virus was licensed in 1990. It can be spread through intravenous drug use and by contaminated medical and dental instruments. Tattooing has been implicated in some cases. It can also be transmitted sexually or from a pregnant woman to her infant.

In the reported study, funded in part by the drug's manufacturer, researchers treated 44 hepatitis C patients with interferon alfa-2b daily for four weeks, then three times a week for another 20 weeks. Forty-three received the full treatment; one stopped after 12 weeks because of side effects. Tests conducted 24 weeks after treatment found that hepatitis C was undetectable in 42 of 43 patients.

Interferon can cause side effects such as muscle and joint aches, headache and fever. Some patients experience depression or a reduction in white blood cells or platelets. Six months of treatment with interferon alfa-2b costs about $6,000, according to investigator Manns.

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