WSU research leads to more effective Hepatitis C treatment for blacks

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CAMPUS: WSU research leads to more effective Hepatitis C treatment for blacks

Dec/7/2004

By ChmielewskiStaff WriterSince the first treatment for chronic Hepatitis C became available in 1991, the Wayne State University School of Medicine has had a large role in investigating improved methods for treatment. Hepatitis C is most commonly spread through infected blood or body fluids. According to AOL.com’s WebMD, “Sharing needles and other equipment used to inject drugs is the most common way HCV is spread.” This does not mean only drug users come in contact with Hepatitis C, however. It may also be spread through sexual contact, though the risk is very low and a person may even have become infected from an organ transplant. Currently, organs are tested for the virus, but this was not always the case. About 15-20 percent of people infected with the Hepatitis C virus are able to clear it from their system without any medical treatment. But the majority of those infected develop a chronic condition that in some can lead to cirrhosis of the liver or cancer, said Dr. Mutchnick, WSU professor of Internal Medicine.Hepatitis C is often treated with interferons described by WebMD as “a complex family of proteins produced by the body that boosts its ability to fight disease” that “can also stop viruses from multiplying and damaging the body.” Ribavirin is given with the interferon to achieve better results.Treatment of Hepatitis C has greatly improved since initial methods, which produced an 8-10 percent response rate. It was found that when interferon and ribavirin were combined in treatment, the response rate increased to 30 percent and when long acting interferon was used, 40-50 percent of patients responded. However, one long-standing problem of treatment has been that blacks are only about half as likely to respond to treatment as whites. Not only are blacks harder to treat for the Hepatitis C virus, but the virus itself is generally more prevalent in them than other groups. One-and-a-half percent of whites in the United States tested positive for the Hepatitis C antibody, while 2.8 percent of Hispanics and 3.2 percent of blacks were positive. Mutchnick also said that in the inner cities, there is greater risk for becoming infected with the virus than in urban areas, which provide a higher risk than rural areas. Though the exact cause of blacks resistance to Hepatitis C treatment is unknown, Mutchnick said, “It seems to be genetic.”Mutchnick also added that it seems to have something to do with the individual’s ability to mount an immune response to the virus. Dr. Mutchnick and WSU Assistant Professor of Internal Medicine Dr. Firdous Siddiqui recently led the WSU branch of the WIN-R (Weight-Based Dosing of PegIntron and Rebetol) Study. The study began in 2000 and involved hundreds of cities across the United States. Mutchnick brought the study to WSU and added that “Dr. Siddiqui did most of the work,” as far as hands-on research. The WIN-R study took approximately four years to complete. However, as a result of WSU’s findings, a more effective way of treating blacks with chronic Hepatitis C was discovered.When blacks were given a weight-based dose of ribavirin in combination with peginterferon as part of the WIN-R study, twice as many were able to clear the virus than had successfully responded to flat dose treatments. When asked how it was decided upon to test a weight-based dosage of ribavirin combined with peginterferon, Dr. Mutchnick explained how the combination of ribavirin and peginterferon works. The pegylated form of interferon stays in the blood longer, he explained, and ribavirin is needed in order for the patient to experience the full effect of the interferon. With old treatments, injections caused greater fluctuation within the bloodstream and would not remain within the blood to combat the virus for as long as the new treatments allow. The peginterferon injection and ribavirin, taken orally as pills, currently lasts for five to seven days. The newest findings on the effects of weight-based treatments of peginterferon on black patients were presented as part of the 55th Annual Meeting of the American Association for the Study of Liver Diseases. They provide new hope for patients who may benefit from the new treatment where they resisted the old. However, WSU will continue to test newer forms of treatment as they become available, Mutchnick said, so that as many chronic Hepatitis C patients as possible may have access to effective treatment.http://www.southend.wayne.edu/modules/news/article.php?storyid=666