Interferon Aids Hepatitis C Victims
Nearly all people infected with the serious liver-damaging hepatitis C virus can vanquish it if they are treated soon after becoming infected, scientists reported Monday. The key: aggressively treating patients with a virus-fighting drug--interferon--in the first few months of infection.
Under current therapies, only about 50% of so-called chronic cases of hepatitis C can be cured. The disease, which affects an estimated 2.7 million people in the United States, can cause chronic liver disease, leading in some cases to death from liver failure. It also increases the risk of liver cancer.
The new findings are from a study conducted in Germany and released weeks before its scheduled publication in the New England Journal of Medicine because of its clinical importance. The study highlights the need for periodic screening in high-risk groups such as health care workers and intravenous drug users, hepatitis C experts say. Regular screenings can detect infections early, before symptoms appear, allowing infected people to be treated at a time when they have the best chance of a cure.
Experts noted that the study has shortcomings, such as the lack of a control group. Despite that, researchers in the field hailed the study as a major advance.
“The long-term personal and public health value of identifying and treating patients with this infection during the acute phase are phenomenal,” said Dr. Karen L. Lindsay, associate professor of clinical medicine at the Keck School of Medicine at USC. “It’s an extremely important area of research.”
Hepatitis C is one of several hepatitis viruses. Unlike hepatitis A or B, there is no vaccine for hepatitis C, and the infection usually takes hold without obvious symptoms.
According to the federal Centers for Disease Control and Prevention, about 36,000 people become newly infected each year. The virus is transmitted by exposure to contaminated blood or other body fluids. It may be transmitted sexually, but is primarily passed along through illegal intravenous drug use. Health care workers can also be infected if they accidentally stick themselves with needles.
Finding the 44 patients for the study was no easy task: To do so, study leader Dr. Michael Manns of the Medical School of Hanover and co-workers asked thousands of doctors across Germany to notify them of any patients with acute infections and then agree to treat those patients with the drug regimen.
All 44 patients were treated with injections of a drug called interferon alfa-2b. Just how the interferon acts to fight hepatitis C isn’t totally clear, but the drug is known to interfere with the ability of viruses to reproduce; it also boosts the immune system. Two of the study’s 10 authors had ties to the drug company Essex-Pharma, which manufactures interferon and helped fund the study.
During the course of the study, one patient dropped out because of side effects from the interferon. Among the remaining 43, levels of virus became undetectable in the blood of 42 and remained so during the entire 24 weeks, as well as a further 24 weeks of follow-up.
The ability of the researchers to track as many patients as they did impressed Lindsay.
“Because of the extraordinarily well-organized health care system in Germany, the entire German medical community could participate,” she said. Performing a similar study in this country would be much harder because of the health system’s fragmentation.
But one important reservation about the study involves the lack of a control group--similar patients who were not treated with interferon. A certain percentage of people infected with hepatitis C rid their bodies of the virus on their own. Without a control group, Lindsay said, there is no way to compare the study’s findings with what would have happened had nature been left to take its course.
Still, she said, it’s unlikely that 98% of infected patients would be able to eradicate the virus.
Lindsay also noted that study participants may not represent most of those infected, because they had symptoms; most do not.
