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Effective Treatment for Hepatitis C
April 18, 2003
| latrans
Posted on 04/18/2003 8:22:23 AM PDT by latrans
Just this hour the Hepatologist picked up the phone and called my wife with the stunning news that she is completely virus free. Six months ago she finished the second year of Interferon chemotherapy. The first attempt failed, so the treatment was repeated with Pegylated Interferon. The good doctor was so excited that he did not wait till her appointment next week, he called my wife with the good news as soon as he read the test results. We are so grateful.
TOPICS: Unclassified
KEYWORDS: cure
1
posted on
04/18/2003 8:22:23 AM PDT
by
latrans
To: latrans
Wonderful news. I thank the Lord.
2
posted on
04/18/2003 8:23:23 AM PDT
by
fightinJAG
(A liberal mind already is terribly wasted.)
To: latrans
IS this the same treatments they call "Pegasus"? I have a friend who has tried everything for the past ten years. His wife called me last month and told me that this Pegasus worked! Thank God.
3
posted on
04/18/2003 8:25:18 AM PDT
by
Hildy
To: latrans
Congratulations to you and your wife! Praise, God!
4
posted on
04/18/2003 8:25:51 AM PDT
by
Pan_Yans Wife
(Lurking since 2000.)
To: latrans
Congratulations! And thanks for sharing this wonderful news. My sister is being treated for hepatitis. Best wishes to you and your wife.
5
posted on
04/18/2003 8:27:54 AM PDT
by
NewYorker
To: latrans
That's great. I've had several patients that have responded well with the new Ribavirin/Interferon combo.
To: latrans
What wonderful news on this Easter weekend.
Blessings!
To: latrans
That is wonderful, congratulations!
God works through our scientists :)
8
posted on
04/18/2003 8:50:55 AM PDT
by
TheSpottedOwl
(America...love it or leave it. Canada is due north-Mexico is directly south...start walking.)
To: latrans
That is wonderful news!!!
I'm so thankful for you and for your wife. Praise God!! I'm hearing good news for a lot of my fellow HepC sufferers. The combination of the Peglated Interferons (only "once a week injections" instead of daily injections, because it is longer acting) and Ribaviron seem to be clearing a lot of people of this dreaded disease. I believe I heard up to 50 percent of HepC sufferers are clearing the virus on this therapy.
However, for the sake of education and I don't mean to discourage anyone,.. I have to say that there are many of us who are genotypes 1 a, who have failed Interferon therapy, who the Peglated Inteferons are not suggested for.
I've been a failure twice now. (Failure is a medical term.. I'm not saying I'm a failure :o)
The most recent study states 1 a's are not recommended for re-treatment with any Interferons at this time.
Something will come for us who cannot do another round with Interferon. They are working on a couple things. I/we have to remain hopeful. I'am hopeful!!
For now, I'd just like to celebrate this wonderful news with latrans and his wife!!!!
We are both really truly happy for you!! WOOOOO HOOOOOO!!
God Bless you always.. Vets
To: arkfreepdom
Hi, just wanted to make sure you had seen this study. From my last conversations with Dr's Gish and Wakkil (sp) and with conversations from other patients who see Dr. Pemstone (all reknown Dr.s in HepC treatment as you probably already know :o) they would tend to agree with the conclusion of this study. As I've failed twice on tx, it would be a quality of life issue to do further tx at this time, considering any chances I have as a
1a genotype of responding. Also, I was in the one percentile of those who got worst while on tx. My Alt's, Ast's and GGT's, all went close to 1000 on tx. They remain very high.. but I'm hopeful of a new treatment soon.
HOWEVER, a YOUNG fairly newly diagnosed 1a would probably be treated. It is just not being recommended for people who are older (sheesh,.. I didn't think 52 was OLD) and have had the disease for a long time.
:o)
This is just an FYI post to ya.. as I know many times very busy Dr's can't get to all the articles posted out there.
FRegards, Vets
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
J Hepatol 2003 Apr;38(4):499-505
Sustained response to combination therapy in patients with chronic hepatitis C who failed to respond to interferon.
Fargion S, Bruno S, Borzio M, Battezzati PM, Bissoli F, Ceriani R, Orlandi A, Maraschi A, Chiesa A, Morini L, Fracanzani AL, Crosignani A, Fiorelli G, Podda M.
Dipartimento di Medicina Interna, Ospedale Maggiore IRCCS, Universita di Milano, Pad Granelli, Via F Sforza 35, 20122, Milan, Italy
BACKGROUND/AIMS: The best treatment for chronic hepatitis C patients who do not respond to interferon is still unknown. Reported rates of response to treatment vary as the result of heterogeneous definitions of non-responders and small study size.METHODS: One hundred nineteen hepatitis C virus (HCV) RNA-positive non-responders to high-dose interferon monotherapy received alpha-interferon, 5 MU tiw plus oral ribavirin, 1000-1200 mg/day for 48 weeks (Group A, n=74) or alpha-interferon, 5 MU daily for 4 weeks, followed by 5 MU tiw plus oral ribavirin, 1000-1200 mg/day for 44 weeks (Group B, n=45) according to the Institution where they were followed. Persistently normal alanine aminotransferase and negative HCV RNA up to 72 weeks from treatment onset defined a sustained response.RESULTS: Eighteen patients discontinued treatment (13 developed anemia, two mucositis, one granulocytopenia; two were dropouts), none for serious adverse events. There were 24 (20%) sustained responders, with similar final response rates in Groups A and B. Sustained response was more frequent in patients aged </=40 years (36% vs. 13%; P=0.006) and in those with non-1 genotype (44% vs. 14%; P=0.002). Among genotype 1 patients, the younger ones showed higher response rates (32% vs. 7%; P=0.005). Compared with patients harboring non-1 genotypes, the odds ratio of being a non-responder was 1.68 (confidence interval (CI): 0.53-5.37; P=0.381) in younger genotype 1 patients and 9.53 (CI: 2.84-32; P<0.001) in older genotype 1 patients.
CONCLUSIONS: Chronic hepatitis C patients who are non-responders to interferon monotherapy and infected by non-1 genotypes should undergo re-treatment with combination therapy. Treatment should be extended to younger genotype 1 patients who are more susceptible to liver disease worsening because of longer life expectancy and have a higher probability of being long lasting responders than their older counterparts.
PMID: 12663243 [PubMed - in process]
To: Vets_Husband_and_Wife
Thank you friends, for the kind words. My wife was cured
of 3-A (Egyptian)with Pegylated Interferon and Ribivarin.
11
posted on
04/18/2003 9:53:22 AM PDT
by
latrans
To: arkfreepdom
I have a relative who doesn't want to take the treatment because of the side effects. I have another relative who took it and said if she had known how awful they were she would have thought twice. Do you know if everybody gets them. Hair loss, etc.
12
posted on
04/18/2003 9:55:25 AM PDT
by
Samizdat
To: latrans; Budge; T'wit
PINGING all BLOODHOUNDS!!! Please ping this good news to your list. :o)
What a blessing.. and what a wonderful time of year to get news like this :o)
God Bless you both latrans!!! Vets
To: Samizdat
I have not found hair loss to be a frequent problem, but depression can be a quite severe side effect. The meds do make one feel like they have the the flu.
To: Samizdat
I hope you don't mind me butting in on your question. But I think I can answer that one. No,.. not everyone gets side effects. I've even heard some people feel better on treatment as a result of their liver functions and enzymes going down (less inflammation?).
Though it has been my experience that most people DO have side effects, especially in the beginning,..luckily quite a few cease to have "severe" side effects as they take the treatment. Especially on the new Infergen/Pegasys type Interferon. But not "all" people are so lucky. I was one who didn't do all that well on tx.
But even if it was going to be rough.. if I thought I had a chance to eradicate the virus.. I'd do it again in a New York minute!!! A year of even horrible side effects would be worth it IMHO.
Advanced liver disease is way worst than treatment.
It is a hard decision. A very personal decision. I guess in the end,.. you just support the decision that the patient makes.
But it would be helpful to know what their genotype is. If they are a 1 b, 2a or b, or a 3a or b,..there chances of success are really pretty good.
Something to think about.
Hope my answer helped in some small manner.
To: Samizdat; latrans; arkfreepdom; T'wit; Budge
VERY IMPORTANT READ!!! Here is an article just released today by the NIH (National Institue of Health)!!
I think Protease inhibitors are our next best hope. Those of us who have not responded to Interferons, OR are treating hard to treat patients, will take GREAT comfort in reading this one!!
FRegards, Vets
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Source: NIH/National Institute Of Allergy And Infectious Diseases
Date Posted: 2003-04-18
Web Address:
http://www.sciencedaily.com/releases/2003/04/030418081413.htm KEY TO HEPATITIS VIRUS PERSISTENCE FOUND
Scientists at two Texas universities have discovered how hepatitis C virus thwarts immune system efforts to eliminate it. The finding, published online today in ScienceExpress, could lead to more effective treatments for liver disease caused by hepatitis C virus, says author Michael Gale, Jr., Ph.D., of University of Texas Southwestern Medical Center at Dallas. Dr. Gale and coauthor Stanley Lemon, M.D., of University of Texas Medical Branch at Galveston, are grantees of the National Institute of Allergy and Infectious Diseases (NIAID).
"Persistent hepatitis C virus (HCV) infection is a major cause of liver disease worldwide and is the leading reason for liver transplants in this country," notes NIAID Director Anthony S. Fauci, M.D. "The most prevalent form of HCV in the United States is, unfortunately, the least responsive to available treatments. Moreover, African Americans are even less responsive to therapy than Caucasians," he adds.
The immune system has many ways to detect and fight off invading microbes, and microbes have just as many ways to elude and disarm immune system components. Through a series of experiments on cells grown in the laboratory, Drs. Gale and Lemon defined the strategy HCV uses to evade the host's immune response. As HCV begins to replicate in its human host, it manufactures enzymes, called proteases, which it requires to transform viral proteins into their functional forms. The Texas investigators determined that one viral protease, NS3/4A, specifically inhibits a key immune system molecule, interferon regulatory factor-3 (IRF-3). IRF-3 orchestrates a range of antiviral responses. Without this master switch, antiviral responses never begin, and HCV can gain a foothold and persist in its host.
Next, the scientists searched for ways to reverse the IRF-3 blockade. They applied a protease inhibitor to human cells containing modified HCV. This prevented the virus from making functional NS3/4A and restored the cells' IRF-3 pathway. Follow-up studies have shown that once restored, the immune response reduced viral levels to nearly undetectable levels within days, according to Dr. Gale.
The identification of this viral protease-regulated control of IRF-3 opens new avenues in both clinical and basic research on hepatitis C, notes Dr. Gale. Until now, scientists had not considered the possibility that inhibiting this protease did anything more than halt viral replication. "Now that we know NS3/4A inhibition essentially restores the host's immune response to the virus, we can assess hepatitis drug candidates for this ability as well," Dr. Gale says.
NS3/4A will be a valuable tool in further dissecting the roles of viral proteases and their host cell targets, says Dr. Gale. For example, the scientists plan to use NS3/4A to hunt for the still unknown host cell enzyme responsible for activating IRF-3. Conceivably, Dr. Gale explains, future therapeutic approaches to viral disease could involve boosting the activity of any key host enzymes that are found.
"Understanding the tricks that the hepatitis C virus employs to impair the immune system represents an important advance with potential implications for successful cure of those suffering from liver disease," says Leslye Johnson, Ph.D., chief of NIAID's enteric and hepatic diseases branch.
###
NIAID is a component of the National Institutes of Health (NIH), which is an agency of the Department of Health and Human Services.
To: Samizdat
I have met numerous people that have suffered from strong side effects. I have been taking this treatment for 3 1/2 months and had mild side effects until the last two weeks. Having said that I have put myself on a healthy diet 3 meals a day suggested by the nurse, drinking lots of water, eating lots of fruit and taking antidepressant medication before starting and taking sleeping medication to get lots of sleep. I was off work last week because we had a couple of strong snow storms and did a lot of physical work. I learned the hard way - do not get to physical.
Results of following directions, getting support from home and work. I believe that the side effects are not as bad as they can be and it is manageable.
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