Private MD News

Hepatitis treatments improving, but infectiousness may linger

Category: Liver Diseases

Despite approximately 1 in 12 people worldwide living with chronic hepatitis B or C, higher than HIV or any cancer, hepatitis receives far less attention than either of those two diseases. According to the CDC, there are an estimated 4.5 million persons in the U.S. living with chronic hepatitis B or C and it is believed to be responsible for 5,000 deaths.

Recent advances in treatment options do provide hope, however.

A recent study from investigators at the Duke Clinical Research Institute showed that the addition of the anti-viral drug telaprevir to a standard treatment for hepatitis C can not only shorten the duration of therapy, it also increases the number of patients who can be cured.

"We observed that 67 percent of patients who received standard therapy for 48 weeks in conjunction with 12 weeks of telaprevir were cured of their hepatitis C," said Dr John McHutchison, lead investigator on this study.

McHutchinson pointed out that almost as many patients, 61 percent, were cured with only 24 weeks of standard therapy and 12 weeks of telaprevir. Since the side effects of treatment can be intense, anything that shortens treatment could be of great help.

In some cases, that might not even be necessary. Researchers in Italy found that among patients who had hepatitis C and then ended up contracting acute hepatitis B, nearly a quarter emerged without any hepatitis C virus present in their bodies.

Given that the acute hepatitis B is serious, the researchers are exploring whether a hepatitis B vaccination might produce a similar effect more safely.

However, despite this promising result, other research shows that those with resolved heptatis C might still be contagious. Researchers led by Tomasz I. Michalak of Memorial University of Newfoundland, Canada examined if those who had received successful treatment could still infect others.

Using a system to detect trace amounts of hepatitis C virus in patients who showed no clinical evidence of the disease, they tested whether blood plasma from these patients could infect healthy donor tissue. Of the 12 cultures tested, 11 showed the presence of viral RNA, and three developed active hepatitis C virus replication.

"Our present findings reveal that HCV circulating in some individuals with resolved hepatitis C is capable of inducing productive infection in vitro at doses of 20 to 50 copies," the authors conclude. "This can be interpreted as a strong indication of potential virus infectivity in vivo."

The new research is welcome in May, which is National Hepatitis Awareness Month, where health agencies try to raise awareness of the disease.

There are effective vaccines for the A and B versions of the disease, but no vaccine exists as of yet for hepatitis C.

Hepatitis A is spread by consuming food or drink contaminated with the hepatitis A virus, or by contact with an infected person. Hepatitis B is spread through unprotected sex or blood-to-blood contact with a carrier. It can also be spread to the child of an infected mother. Hepatitis C disease is spread by coming into contact with infected blood, commonly by sharing dirty needles.

According to the CDC, some people infected with viral hepatitis may never show any symptoms of having the disease. This means that they can spread the disease to others without ever being aware they are carriers.

A blood test is a simple and effective way to confirm whether or not someone is infected, which can not only prevent further unknowing transmission of the disease, but also limit the progression of the disease and allow for early treatment.

The CDC recommends prevention, vaccination and testing as the best ways to protect against the disease.