Over­com­ing virus early beats hep­ati­tis

The Weekend Australian - Travel - - Health - Adam Cress­well Health ed­i­tor

DRIV­ING down the num­ber of cir­cu­lat­ing copies of the hep­ati­tis C virus to un­de­tectable lev­els in the ear­li­est stages of in­fec­tion makes it highly likely that the pa­tient will even­tu­ally be cured — even among pa­tients who are also in­fected with HIV.

The find­ings, the in­terim re­sults from an Aus­tralian study pre­sented to a re­cent in­ter­na­tional con­fer­ence in Italy, sug­gest that rapid vi­ro­log­i­cal re­sponse — or RVR, the term used to in­di­cate suc­cess­ful sup­pres­sion of vi­ral load within four weeks of start­ing treat­ment — is just as good a pre­dic­tor of even­tual cure among pa­tients suf­fer­ing acute hep­ati­tis C in­fec­tion as it is al­ready known to be among chron­i­cally in­fected in­di­vid­u­als.

In ad­di­tion, the trial — which is still con­tin­u­ing — sug­gests new treat­ment op­tions for dif­fi­cult-to-treat groups such as peo­ple with HIV and in­ject­ing drug users. Un­like most hep­ati­tis C treat­ment stud­ies, this re­search in­cluded sig­nif­i­cant num­bers of HIV pa­tients and in­ject­ing drug users, and the find­ings showed RVR was just as good at pre­dict­ing even­tual cure in th­ese as in other pa­tients.

The Aus­tralian Trial in Acute Hep­ati­tis C, known by its acro­nym ATAHC, was funded by the US Na­tional In­sti­tutes of Health. The in­terim find­ings were pre­sented as a poster at the re­cent an­nual sci­en­tific meet­ing of the Euro­pean As­so­ci­a­tion for the Study of the Liver in Mi­lan, where it was voted into the top 10 per cent of the more than 800 poster pre­sen­ta­tions at the meet­ing.

An es­ti­mated 264,000 Aus­tralians have been ex­posed to hep­ati­tis C, a blood-borne virus that at­tacks the liver and left un­treated can lead to liver in­flam­ma­tion, cir­rho­sis and even­tu­ally can­cer.

Al­though 25 per cent of peo­ple clear the virus nat­u­rally, the prog­no­sis for the re­main­ing 75 per cent is more dif­fi­cult as most will usu­ally ex­pe­ri­ence symp­toms such as de­bil­i­tat­ing fa­tigue, pain and nausea.

While cure is pos­si­ble with drug ther­apy, the drugs are quite toxic and hard to tol­er­ate. Treat­ment also lasts a year and only works in fewer than 50 per cent of cases. Co-in­fec­tion with HIV makes it even harder to erad­i­cate hep­ati­tis C.

Syd­ney-based hep­ati­tis ex­pert Greg Dore, a co-au­thor of the study and who at­tended the Mi­lan con­fer­ence, said the mes­sage from the ATAHC find­ings was that if doc­tors could drive vi­ral lev­els down to un­de­tectable lev­els early ‘‘ you can get in­cred­i­bly good re­sponse rates’’.

While 107 pa­tients in the study elected to have treat­ment for acute hep­ati­tis C, 84 pa­tients con­tin­ued to the point where they

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