U.S. Panel Recommends Expanding Therapy for Victims of Deadly Blood-Borne Virus

Drug users, children and AIDS patients should not be excluded from treatment for hepatitis C, a federal advisory panel said Wednesday. The blood-borne virus has infected an estimated 4 million Americans and is a leading cause of liver cancer. A 12-member committee of experts selected by the National Institutes of Health said that treatment for hepatitis C has improved in recent years, and that groups previously excluded from therapies should now receive treatment. The committee, which met Monday through Wednesday in New Orleans, released its report in Washington.

About 4 million Americans are infected with hepatitis C, making it the most common blood-borne infection in the nation. It is spread mostly through the shared needles of drug users but can also spread through high-risk sex, organ transplants, or from an infected mother to her baby. Blood transfusions were a common source of infection until the late 1990s, when screening almost eliminated that risk. However, many patients infected before the tests began may be diagnosed in coming years as they develop symptoms.

Dr. James Boyle, a liver expert from the Yale University School of Medicine and chair of the panel, said clinical studies that led to the development of hepatitis C drugs excluded children, drug users, the elderly, people with HIV, alcoholics and those with depression. As a result, he said, there was no clinical evidence that such patients responded to hepatitis C therapies and doctors tended not to treat them. "We now know that these patients can respond to the standard treatment so we are recommending they receive it," Boyle said.

To treat the virus, a drug combination including interferon with ribavirin has been shown to be the most effective, the panel said. A large drug trial is underway to determine if long-term maintenance therapy with interferon alone can prevent cirrhosis or liver cancer among chronically infected patients.

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