HEPATITIS: Successful Treatments Use AIDS Research Model
Using the model AIDS researchers established to develop HIV treatments, researchers have recently reported great progress in identifying drugs to treat hepatitis B and hepatitis C, offering hope to the nearly 4 million Americans infected with either one or both of those viruses, the Washington Post reports. And, experts say that these treatments have come none too soon, as the death rate from hepatitis is poised to overtake the number dying of AIDS in just a few years. In some instances, drugs now used to treat hepatitis infections were originally developed as HIV treatments. One of the first of these drugs was Glaxo Wellcome's lamivudine, which received FDA approval as a treatment for hepatitis B in 1998.
New Treatments on Horizon
According to a recent study published in the New England Journal of Medicine, 52% of patients who were treated with lamivudine for one year showed "notable liver improvements." Other tests found that giving the drug for a longer period of time -- up to three years -- increased the number of patients who benefited from the treatment. In addition, lamivudine has very few side effects. Dr. Eugene Schiff, a leading hepatitis researcher at the University of Miami who conducted studies on the drug, indicated that nearly every patient taking the drug showed some benefit and a smaller percentage achieved "long-lasting suppression of the virus." For patients who did not respond to lamivudine, subsequent treatment with interferon, an older drug, appeared helpful. Although experts still debate over which drug to use first, Schiff believes that between the two drugs, 50% to 60% of patients will achieve lasting suppression of the virus. However, improved treatments are necessary as interferon has some side effects including fatigue, fever and flu-like symptoms. Other treatments are on the horizon as many drug manufacturers are testing hepatitis B drugs. One possibility is Gilead Sciences' adefovir dipivoxil, another drug originally developed as an HIV treatment. At the high dosage required to fight HIV, adefovir caused serious kidney damage, prompting the FDA to reject it. However, scientists have discovered that given at lower doses, the drug is effective in treating hepatitis and kidney damage is unlikely. Currently, Gilead is conducting large, global testing aimed at winning adefovir FDA approval as a hepatitis treatment. Physicians are anticipating using it in combination with lamivudine, similar to the cocktails currently used to treat HIV (Gillis, Washington Post, 2/6).
See Ya, Hepatitis C?
Researchers also are looking into new treatments for hepatitis C, a disease so prevalent that former Surgeon General C. Everett Koop called it "one of the most serious public health crises faced in this century." Usually treated with interferon, only 10% of patients experienced lasting viral suppression. Combined with Schering-Plough's ribavirin, interferon produced lasting anti-viral activity in nearly 40% of patients. However, the side effects associated with the combination, including anemia, have researchers searching for a better alternative. Many are focusing on adjusting doses of interferon to relieve some symptoms. Both Hoffmann-La Roche and Schering-Plough are working on a variation of interferon that will last longer in the body. An initial study of the drug used in combination with ribavirin showed that 70% of patients had undetectable amounts of virus in their blood after two years of treatment. Supporting those findings, a study published in the November issue of the American Gastroentological Association found that the "long-running" treatment produced lasting liver improvements. Currently the NIH is conducting a study to confirm those results, and researchers suggest that there is reason to be hopeful. Dr. John Vierling, director of hepatology at Cedars-Sinai Medical Center in Los Angeles, said, "I think the prospect does exist in this disease to eradicate the virus and to be contemplating the ability to cure people" (Gillis, Washington Post, 2/6).