New Study: Early Hepatitis C Progression Detection
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Chronically infecting an estimated four to five million Americans, the Hepatitis C virus is capable of wrecking havoc on the liver’s health. Treatment for this communicable disease has drastically improved with the addition of recently approved drugs. However, many are waiting to sign up for Hepatitis C drug treatment until the recovery odds rise even higher and the side effects of the medications are less severe.
Chronic liver disease is the tenth leading cause of death among adults in the U.S. and about 40 percent of deaths from chronic liver disease can be attributed to Hepatitis C. Nonetheless, Hepatitis C is seldom lethal, as many more people die with this virus than from it. The illness only becomes dangerous when chronic Hepatitis C infection progresses to advanced liver disease. This progression to advanced disease is marked by increasing scarring of the liver (fibrosis) that eventually causes cirrhosis, the irreversible hardening and shrinking of the liver.
Just a year ago the drug duo used to treat Hepatitis C had a 50 percent success rate. The drug cocktail currently used to treat Hepatitis C has a greatly improved success rate – helping approximately 75 percent of those infected rid their bodies of the virus. Unfortunately, the combination of medications used to fight Hepatitis C can have devastating side effects – sometimes severe enough to mandate abandoning treatment.
For those who have previously failed Hepatitis C treatment or who have been sidelined from severe drug-induced complications, waiting for better, safer drugs seems to be the answer. The strategy to await an improved treatment is also a desirable option for certain individuals who follow a mild and stable disease course. However, those who are likely to progress rapidly to cirrhosis or liver-related death are strongly encouraged to begin Hepatitis C treatment sooner rather than later. A new study claims that certain tests can identify the people who should be first in line to get treated, because they are highly likely to incur severe liver damage from Hepatitis C in a short period of time.
As published in a July 2012 edition of the journal Proceedings of the National Academy of Sciences, researchers detected that elevated blood levels of a specific enzyme and a specific protein early on in the course of Hepatitis C infection were much more likely to develop into advanced fibrosis or cirrhosis. This National Institutes of Health study sought to decode the mechanisms underlying the different rates of Hepatitis C progression. They found the following:
- The long-term course of chronic Hepatitis C is determined early in infection.
- Rapidly progressive disease correlated with persistent and significant elevations of alanine aminotransferase (ALT), an enzyme released when the liver is damaged or diseased.
- Rapidly progressive disease correlated with persistent and significant elevations of the protein MCP-1 (CCL-2), a chemokine that is critical to the induction of progressive fibrogenesis and, ultimately, cirrhosis.
Armed with this new information, clinicians should be able to make a fairly accurate assessment of which Hepatitis C patients are likely to develop advanced disease rapidly. A growing number of people with chronic Hepatitis C are putting off treatment waiting for the next class of drugs to be approved, hoping for a more effective, safer drug cocktail. However, patients with consistently high ALT and CCL-2 levels are likely to be pressed to start treatment right away – with the goal of wiping the virus out before it has the chance to cause cirrhosis of the liver.
References:
Bittar, E. Edward, The Liver in Biology and Disease, Elsevier, 2004; 194-195.
http://hivandhepatitis.com/hepatitis-c, Early Biomarker Changes Predict Which Hepatitis C Patients Develop Severe Liver Disease, Retrieved August 16, 2012, hivandhepatitis.com, 2012.
http://www.pnas.org/content/early/2012/07/23/1210592109.abstract, Profibrogenic chemokines and viral evolution predict rapid progression of hepatitis C to cirrhosis, Patrizia Farci, et al, Retrieved August 16, 2012, Proceedings of the National Academy of Sciences of the United States of America, July 2012.
http://www.webmd.com/digestive-disorders/alanine-aminotransferase-alt, Alanine Aminotransferase, Retrieved August 19, 2012, WebMD, LLC, 2012.
