LiverHope
VOLUME 5, ISSUE 6 JUNE 2003
LiverHope
VOLUME 5, ISSUE 6 JUNE 2003
Are you newly diagnosed or do you want more information about Hepatitis
C?
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July
20, 2003 -
In This Issue
Calendar.............................................................................................. 1
Senator Kay
Bailey Hutchison and Senator Edward Kennedy Act to Protect Millions of
Americans With Hepatitis C 1
Don't Forget
This Infectious Killer................................................. 2
Drugs may
Block Hepatitis Virus.................................................... 2
Help Wanted...................................................................................... 3
Evaluation of
the 24-hour Decline in HCV Genotype 1 Viral Load to Predict Response to Pegasys
Plus Ribavirin Combination Therapy 3
Nail Salons
Ripe For Infection Outbreak....................................... 4
Beads Battle
Liver Cancer................................................................ 4
May You............................................................................................. 5
Sad News............................................................................................ 5
Senator Kay
Bailey Hutchison and Senator Edward Kennedy Act to Protect Millions of
Americans With Hepatitis C
WASHINGTON
--(BUSINESS WIRE)--May 23, 2003--Senators Kay Bailey Hutchison and Edward
Kennedy today filed The Hepatitis C Epidemic Control and Prevention Act
(S-1143), announced the National Hepatitis C Advocacy Council (NHCAC). This is
the first federal response to the hepatitis C epidemic, the most common
blood-borne viral infection in the United States. An estimated four million
Americans are currently infected with the hepatitis C virus (HCV). HCV yearly
costs are already at an alarming $15 billion dollars. That figure is expected
to skyrocket to $26 billion by 2021.
Hepatitis C threatens the health of millions of Americans. NHCAC has worked to
educate federal and state governments about the seriousness and magnitude of
the hepatitis C epidemic. Approximately 85 percent of those who contract HCV
remain infected for life, and an estimated 15,000 die each year. The annual
death toll is expected to triple by 2010. There is currently no vaccine to
prevent HCV infection.
The Hepatitis C Epidemic Control and Prevention Act is groundbreaking
legislation. It will establish a comprehensive program for HCV public awareness
campaigns, screening and counseling, early detection, professional education,
and research. The program will be administered by the Department of Health and
Human Services. State and local hepatitis C agencies will be supported to
implement program activities.
The National Hepatitis C Advocacy Council is comprised of 22 hepatitis C groups
from across the United States. NHCAC President Lorren Sandt commented:
"This is a major step in achieving a key goal of NHCAC: increasing
financial and infrastructure support for the delivery of hepatitis C
prevention, education, and patient care services at a level commensurate with
the impact of this disease. Chronic hepatitis C is completely preventable with
sound public health policy in place."
NHCAC Government Affairs Chairperson Sharon Phillips added: "For the first
time, we have a bill that will work for the millions of infected Americans. We
congratulate Senators Hutchison and Kennedy for taking action now with S-1143
and providing the resources necessary to address this previously unfunded
epidemic."
Cosponsors of this bipartisan bill include Senators Daschle (D-SD), Biden
(D-DE), Smith, (R-OR), Johnson, (D-SD), Bingaman (D-NM), Breaux (D-LA),
Campbell (R-CO), Clinton (D-NY), Cornyn (R-TX), Dodd (D-CT), Jeffords (I-VT),
and Schumer (D-NY). A companion bill will be introduced in the House in the
next few weeks.
Contacts:
National Hepatitis C Advocacy Council
Lorren Sandt, 877/737-4372
Andi Thomas, 954/931-8463
Sharon Phillips, 903/235-0408
(Editor’s Note: LiverHope is a member of the National
Hepatitis C Advocacy Council (NHCAC) and is one of the 22 Hepatitis C groups
mentioned in the above article. We were in Washington for the Council meetings
and lobbying in the Senate and the House for support of this bill the week of
May 17th-May 24th.)
Don't Forget This Infectious Killer
The New York Times - March 1, 2003, Saturday
DALLAS -- AIDS deserves our attention. But so, too, does
another infectious disease, one that in the developing world is even more
widespread than AIDS -- hepatitis.
Worldwide, 400 million people have hepatitis B, 10 times the
number of AIDS cases, and 170 million have hepatitis C. Both cause chronic
liver infection that can be fatal, especially in developing countries where
treatment is rare and a liver transplant is beyond almost everyone's means.
Hepatitis B and C are implicated in 80 percent of cases of liver cancer, the
fourth most common cause of cancer deaths worldwide. Cancer resulting from
these viruses appears to be increasing in most developing countries as well as
in the United States.
While aggressive testing and prevention programs have slowed
H.I.V. transmission rates in some countries, the spread of hepatitis in the
developing world continues unabated. In Uganda, for instance, H.I.V. infection
rates have diminished greatly because of public health programs that encourage
safe-sex practices. The prevalence of H.I.V. there has declined from 30 percent
of Ugandans in 1992 to 5 percent in 2002.
Over the same period, however, the rate of hepatitis B
remained steady, and is now found in 12 percent to 15 percent of the
population, three times the number infected with H.I.V. The true extent of
hepatitis C in Uganda and the rest of Africa is still unknown because testing,
though common for more than 10 years in the United States, has not yet become readily
available in developing countries.
The lack of testing and treatment means that the disease
will continue to spread as the infected unwittingly pass it on to their sexual
partners, newborns and to hospital patients via blood transfusions. In the case
of hepatitis B, the virus can be spread through living with a infected person.
Fortunately, it is possible to treat, and sometimes cure,
people with hepatitis B and C. For that to happen in the developing world,
however, testing must be made inexpensive, readily available and reliable.
Seeing to it that tests are available at blood banks will lead to a reduction
in hepatitis C transmission, as has been the case with H.I.V. and hepatitis B.
Focusing on infected sex workers and pregnant women would be a cost-effective
way to cut down on the transmission rates.
Some drugs being used in Africa against H.I.V. can also be
used against hepatitis B. Treating H.I.V. without at the same time diagnosing
and treating hepatitis B or C co-infection is foolish.
The push for hepatitis B vaccination is beginning in Uganda and elsewhere; the bad news is that there is not yet a vaccine for hepatitis C. Until such vaccines are widely available, hepatitis, as well as AIDS, deserves the world's attention.
Drugs may Block Hepatitis Virus
April
21, 2003
DALLAS (Ivanhoe Newswire) -- A new generation of drugs may
restore the immune response blocked by the hepatitis C virus, which would
reduce the virus to nearly undetectable levels in a matter of days.
The new protease inhibitors are already undergoing clinical
trials as therapies to treat chronic hepatitis C infections. Protease is an
enzyme required to process viral proteins into their functional forms.
Researchers from UT Southwestern Medical Center at Dallas and UT Medical Branch
at Galveston explain, "If you block the protease, it neutralizes the virus
and restores the host response to infections, allowing the cell to clear the
virus naturally."
According to the Centers for Disease Control and Prevention,
85 percent of people exposed to hepatitis C develop chronic infections that are
unresponsive to therapy. Seventy percent of those with chronic infections
develop chronic liver disease and nearly 3 percent with long-term infections
die of related illnesses.
Investigators found the virus persists partly because it
blocks the natural immune response of infected cells. They say new drugs could
prevent the virus from blocking this immune response and restore the antiviral
response in human cells. Other researchers note protease inhibitors active
against the AIDS virus have revolutionized treatment of that disease.
Hepatitis C virus affects 4 million people in the United
States, which makes it the most common blood-borne infection in the nation. It
is the leading cause of cirrhosis and liver cancer, and accounts for more than
8,000 deaths each year in the United States.
SOURCE: Published online in Science Express, April 17, 2003
Where: Gay Pride Festival
Loring
Park
Mpls,
MN
When: Saturday, June 28, 2002 - 10 AM to 8:00 PM
Sunday,
June 29, 2002 - 12 Noon to 6:00
PM
We’re
still looking for volunteers to staff our LiverHope booth. We’ll be offering free Hep C testing again,
so we also need people who are certified to draw blood. Please call Helen (952-933-0932) or Pat
(763-566-3839) if you can spare a couple of hours to help us out.
The response to antiviral therapy in chronic
hepatitis C can be measured at various time points. The 24h response to a
single IFN dose (24hVR) identifies unresponsiveness to standard IFN/ribavirin
therapy (a decrease in viral load of <0.8 log predicted nonresponse with 100
percent specificity (Jessner et al, Lancet 2001).
Early virologic response (EVR) after 12 weeks
has a high predictive value to achieve a sustained response to 48 weeks of
Pegasys (40kD-PEG-IFN alfa2a / ribavirin therapy. The Aim of this study was to
investigate the value of 24hVR prospectively.
In an ongoing prospective trial which compares
amantadine and placebo in addition to treatment with 180 microgram PEGASYS week
+ 1-1.2g ribavirin /day in chronic hepatitis C (genotype 1), patients are
stratified according to the 24hVR at randomization (stratum A: >1.5 log
decrease in viral load within 24 hrs; stratum B: 0.8-1.49; stratum C: <
0.8).
All patients had a liver biopsy and none had
received an antiviral therapy before signing an informed consent. Currently all
planned 220 patients were recruited, and 131, 101, and 35 completed 12,24, and
48 weeks of treatment, respectively.
In these patients the 24hVR was compared with
the 12 week EVR, the 24-week and end of treatment response (each defined as
HCV-RNA neg). Analysis was done without knowing to which treatment group a
patient was assigned.
The 24hVR was performed 2 weeks prior
randomization and was calculated from the decrease in viral load 24 hours
following a single dose of 9 MU IFNalfa2a (Roche, Basel, CH).
Viral load was determined by the Cobas Amplicor
Monitor HCV Test, v2.0 (Roche Diagnostic Systems, USA). The table below
summarizes the data.
Conclusion: The 24hVR is a good predictor of the response to
Pegasys/ribavirin therapy. Patients with predicted poor response to standard-IFN/ribavirin
therapy may still achieve a virologic response on Pegasys/ribavirin therapy.
Virologic
on treatment response (N HCV RNA neg/N total)
|
Stratum |
week 12 |
week 24 |
end of Tx* |
|
A |
27/29
(93.1%) |
23/24
(95.8%) |
8/9 |
|
B |
35/49
(71.4%) |
37/44
(84.1%) |
17/17 |
|
C |
17/52
(32.7%) |
24/43
(55.8%) |
7/9 |
p
(A/B; A/C; B/C) 0.04;0.00001;0.0002 0.24;0.0016;0.008
treated per protocol analysis, * only HCV-RNA
neg pats. at week 24.
5/21/03 Reference
P Ferenci and others. Prospective Evaluation of The 24-hour Interferon-Induced
Decline in Hepatitis C Virus Genotype 1 Load to Predict Response to
Peginterferon-Alfa2a/Ribavirin Combination Therapy. Abstract T1211(poster).
Abstracts of Digestive Disease Week 2003. May 17-22, 2003. Orlando, FL.
Nail Salons Ripe For Infection Outbreak
by Cathryn Conroy
Netscape News, Saturday, March 29, 2003
For many women,
one of the great luxuries of life is having their nails professionally
manicured. Caution might be the
watchword. A new study from Baylor
College of Medicine in Houston concludes that regulation of hygiene standards
at nail salons nationwide is poor, reports Reuters. None of the 50 states or the District of Columbia require
sterilization of the equipment even though trimming cuticles usually draws
blood. And when poorly trained
technicians use dirty instruments, disease can easily be spread.
Reuters reports
that the foot baths used to soak customers' feet before a pedicure have a high
potential to spread fungal and bacterial diseases. That happened in 2000 when severe bacterial skin infections were
linked to a single nail salon in California leaving 110 customers with
disfiguring leg wounds. "We were
just waiting for an epidemic to happen because the conditions were ripe for an
outbreak," lead researcher Dr Shelley Sekula-Rodriguez told Reuters.
Seukla-Rodriguez
surveyed the licensing and regulation procedures of state cosmetology and
barbering boards. Twenty-four states
responded.
+ West Virginia and
Alabama have the highest standards for nail salons, requiring use of a
high-level, hospital-grade disinfectant to clean equipment for at least 15
minutes.
+ Connecticut is the
most lax of all the states. It does not
regulate the industry and has no licensing requirements.
+ Kansas is the only
state that requires technicians to wear gloves, which protects both workers and
customers from blood-borne diseases.
+ Most of the states
require nail salons to immerse instruments in a hospital-grade, low-level
disinfectant for approximately 10 minutes, but Sekula-Rodriguez told Reuters
this is not a sufficient disease-prevention measure. For the instruments to be sterilized, they must be immersed in a
high-level disinfectant for at least four to 10 hours.
Why is the nail
salon industry reluctant to adopt the proper cleaning and sterilization
procedures? Sekula-Rodriguez says if
the salons were to follow the recommended cleaning procedures, they would have
to stop using the equipment during business hours while it was being
cleaned. For example, to kill the
tuberculosis bacteria that lurks in the pedicure baths, technicians must use a
bleach solution for 10 minutes followed by a 10-minute wash with disinfectant -
and this has to be done after each customer uses the pedicure bath.
The study
findings were presented at the annual meeting of the American Academy of
Dermatology.
If you
must go to a nail salon, be really cautious about the pedicures, if you must
have it done. For manicures, invest in
a set of manicure implements and bring them with you
Wake Forest University, North Carolina is using microscopic
spheres which release radiation directly into liver
tumors. This selective internal radiation therapy is going on at six
centers in the United States, with Wake Forest doing more than any other center
in the world.
DURHAM, N.C. (Ivanhoe Newswire) –
Reported March 17,
2003
Chemotherapy can be
an effective treatment for cancer patients, but it can leave people asking how
well will it work and how bad side effects will be. A new way to treat
liver cancer brings positive answers to both those questions.
Marilyn Routh and her
husband Tommy were looking forward to retiring and spending time on their
ranch.
"We were just
all excited, couldn't wait. And, y'know, surprise, surprise, you have the 'big
C.' It was like the whole world changed in one sentence," Marilyn tells
Ivanhoe.
The big C was liver
cancer. Standard chemotherapy helped but left Marilyn sick in bed. Then she
learned of a new treatment called selective internal radiation therapy.
Radiologist Robert Cirillo, Jr., M.D., injects microscopic spheres that release
radiation directly into the tumor.
"Because these
particles are so small, they only get trapped within the tumor, and then you
won't cause the side effects that you normally get from chemotherapy because
it's only going after the tumor itself and not the patient's normal
liver," says Dr. Cirillo, of Wake Forest University Baptist Medical Center
in Winston-Salem, N.C.
Marilyn had flu-like
side effects at first. "After that wore off, I felt Goood. I was ready to
take on the world," she says. It worked on her cancer, too.
Her scans from before
and after treatment tell a lot, but not as much as the joy of being with her
family.
Marilyn also receives standard chemotherapy to fight cancer
in her stomach and esophagus. Wake Forest University is one of six centers
doing this treatment in the United States -- and does more than any other
center in the world.
This article was
reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the
week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.
If you would like more information,
please contact:
Wake Forest University
Baptist Medical Center
Outpatient Radiological Clinic
(877) 276-2888
May
you find serenity and tranquility in a world you may not always understand.
May
the pain you have known and the conflict you have experienced give you the
strength to walk through life facing each new situation with optimism and
courage.
Always
know that there are those whose love and understanding will always be there
even when you feel most alone.
May
you discover enough goodness in others to believe in a world of peace.
May
a kind word, a reassuring touch, a warm smile, be yours every day of your life,
and may you give these gifts as well as receive them.
Remember
the sunshine when the storm seems unending.
Teach
love to those who know hate, and let that love embrace you as you go into the
world.
May
the teaching of those you admire become part of you, so that you may call upon
them.
Remember,
those whose lives you have touched and who have touched yours are always a part
of you, even if the encounters were less than you would have wished.
May
you not become too concerned with material matters, but instead place
immeasurable value on the goodness in your heart.
Find
time in each day to see the beauty and love in the world around you.
Realize
that each person has limitless abilities, but each of us is different in our
own way.
What
you may feel you lack in one regard may be more than compensated for in
another.
What
you feel you lack in the present may become one of your strengths in the
future.
May
you see your future as one filled with promise and possibility.
Learn
to view everything as a worthwhile experience.
May
you find enough inner strength to determine your own worth by yourself, and not
be dependent on another's judgments of your accomplishments.
May
you always feel loved.
C 1987 Sandra
Sturtz Hauss
It is with great sadness that we pass along to you the fact that our friend, Pete Gilbertson (Da Yooper) died on March 17, 2003. Pete was just 52 years old and lived in Marionette, WI, near the Canadian border. Pete came to our hepfest the last two years and really showed us what a great sense of humor he had! He loved to talk in a Norwegian accent and tell Ole and Lena jokes. Pete served in the army in Vietnam and was so proud to be a veteran. He was in the process of being listed for a new liver and had an esophageal bleed. He went to the hospital, had minor surgery to stop it, but it failed and he fell asleep and died. He will be greatly missed by all of his friends and family.
Co-Facilitators
Email: info@liverhope.com
Fax: (763) 566-0589
Website: www.liverhope.com
Helen: (952)
933-0932 – helen@liverhope.com
Pat: (763) 566-3839 – pat@liverhope.com
[1]
S. Victoria Ricketts-Wilson R.Ph., M.P.H., is a Clinical
Specialist, Hepatology at Roche Laboratories Inc. She reviews
investigator-initiated research proposals for scientific content, merit,
methodology and safety and supports regional product information requests. She
has a B.S. degree from the School of Pharmacy, Texas Southern University and an
M.P.H from the School of Public Health and Tropical Medicine, Tulane
University. She received a B.A. degree from the University of San Francisco.
Ms. Ricketts-Wilson lives in Maple Grove, MN.