Hepatitis C Treatment Slows Liver Damage

Even reverses it for some patients, study finds

TUESDAY, April 30, 2002 (HealthDayNews) -- French researchers have good news for hepatitis C patients who worry that their livers will fail.

By combining a special type of interferon with the antiviral drug ribavirin, researchers slowed the rate of liver damage for some patients. Better yet, the drugs reversed existing damage in almost half the people they treated, the scientists report in the current issue of Gastroenterology.

"We now have a very effective treatment," says study author Dr. Thierry Poynard, from Groupe Hospitalier Pitie-Salpetriere at the University of Paris in France. "The treatment has many adverse events, but it can stop the progression of the disease to cirrhosis."

About 170 million people worldwide are infected with the hepatitis C virus, according to the study. The National Institutes of Health (NIH) reports that almost 4 million Americans have the virus, which kills between 8,000 and 10,000 a year.

The disease varies greatly from person to person. Some people never have any symptoms or problems, while others develop severe liver disease that leads to liver failure. About 20 percent of those infected with the disease will eventually develop cirrhosis of the liver, according to the NIH, though it may take as long as 20 years for the damage to show up.

Cirrhosis is a disease caused by fibrosis, or scarring, of the liver. These scarred portions of the liver stop working and, when enough of the liver is scarred, can cause liver failure.

Poynard and his colleagues recruited just over 3,000 people with hepatitis C to test 10 different treatment regimens. Most of the patients were in their 40s, and around two-thirds were men. None had ever received any treatment for hepatitis C.

For the study, they were given one of 10 different treatments that included interferon, pegylated interferon (a slightly altered form of interferon), and ribavirin. The researchers did a liver biopsy on each volunteer at the start of the study and then again after treatment.

Interferon is a naturally occurring protein that fights infection. For example, when infected with the flu, our bodies produce interferon to fight off the virus. Pegylated interferon is a long-acting form of the drug that can be given once a week. Ribavirin is an antiviral medication that when used alone has little effect on hepatitis C.

All of the treatments tested slowed the progression of the liver damage, Poynard says.

"We found that interferon in combination with ribavirin was very effective in reducing the fibrosis progression, particularly the last combination of pegylated interferon and ribavirin," Poynard says. "Up to 73 percent of these patients experienced significant improvement, while only 8 percent experienced worsening scars, compared to 23 percent of patients being treated with interferon alone."

The big surprise, according to Poynard, was that in 49 percent of the patients some of the cirrhosis was reversed.

"This is a higher rate of remission than we've seen before. The damage that's done appears to be reversible if you can get on treatment," says Dr. Steven Field, a clinical assistant professor of medicine at New York University School of Medicine. "It gives an extra added incentive to patients sitting on the fence about treatment."

Field says some people are hesitant to start treatment because of the side effects. Patients often have flu-like symptoms -- fatigue, muscle aches, low-grade fever -- especially the first week after treatment, he explains. Also, some patients experience hair loss, a decreased appetite and lingering fatigue. Some patients don't have any side effects at all, Field adds.

What To Do

For more information on hepatitis C, read this from the Centers for Disease Control and Prevention.

To learn more about treatment options for people with hepatitis C, go to the National Institutes of Diabetes and Digestive and Kidney Diseases.

SOURCES: Thierry Poynard, M.D., Groupe Hospitalier Pitie-Salpetriere, University of Paris; Steven Field, M.D., clinical assistant professor, medicine, New York University School of Medicine, New York City; May 2002 Gastroenterology
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