Re: Hepatitus(hepatitis) C

Posted By HFHSM.D.-DM on March 17, 1998 at 18:46:01:

In Reply to: Hepatitus (hepatitis) C posted by Rhodri Wynne Evans on March 05, 1998 at 07:26:32:









My wife has tested positively for Hepatitus (hepatitis) C. I am rather shocked. We await the results of further tests. We think she has had this for about
15 Years with no symptoms ; it was picked up during a routine blood test.

It is my understanding that there is an outside chance that her body could have fought and resisted the virus - is this the case?

Does interferon ever clear the virus on a long term basis? Under what circumstances would one prescribe Interferon?

Do many paitents manage the disease with little loss of quality of life or does it always make the carrier very sick?

Reuters have reported that a Hungarian and US Doctor have discovered a cure for the disease. I am sceptical about such reports. Roughly how long does it generally take to implement a new treatment?







Dear Rhodri Wynne Evans:

I understand your shock and dismay about you wife recently being tested for Hepatitis C.  The subject of hepatitis C is somewhat complex but I will try to answer your questions as thoroughly as I can without knowing the specfics of your wifes situation.  First and foremost, the diagnosis of hepatitis C is never a reason for panic.  This is an infection that typically takes decades to evolve and in a large percentage of patients never evolves to significant liver disease.  You are doing the right thing for now which is to simply get as much information as you can.

First of all, it is possible for an individual to fight and clear the infection for good.  In fact, 10 to 15% of patients who are infected clear the infection themselves.  Most of these patients remain positive for the antibody to hepatitis C which is the usual diagnostic test used even though they are no longer infected.  It is critical in this setting to do a special blood test to actually look for the virus itself.  This test is called a PCR test for hepatitis C.  It is also called the  HCV RNA.  If this test is done correctly and is positive,  an individual has an on-going infection.  

The decision to treat an individual with interferon is not straightforward and really requires consultation with a gastroenterologist/hepatologist with experience in hepatitis C.  Interferon can permanently clear the virus or cure an individual in approximately 10 to 20% of cases.  Any individual with a hepatitis C infection should be considered for interferon therapy.  If there is no contraindication, a decision to use or not use interferon is made by the individual in consultation with their physician.  

I appreciated your questions about symptoms.  Most patients with hepatitis C are not even aware that they are infected and feel fine.  Most patients who are infected do not have any more symptoms than most people their age who are not infected.  However, many patients do complain of symptoms and these include fatigue and even abdominal discomfort.  In additional, there can be a significant emotional distress that comes with this diagnosis even if there are no physical effects.  Hepatitis C rarely makes a patient very sick unless it as an advanced stage where it has destroyed a marked amount of the liver.  Very few patients are at this stage and most patients will never reach this stage.  Patients who are at this stage are usually readily identified and I am going to assume your wife is not in this position.

I would like to comment very directly to you and Frances Morrison about experimental therapy.  There is enormous interest in developing better treatment for hepatitis C and a number of new drugs are at different stages of drug development. It typically takes several years for a drug to be adequately tested in hepatitis C to confirm its effect but it can take much longer.  Right now, the only approved therapy for hepatitis C is interferon.  There is no uniform cure for the disease and I can state that without reservation.   Several drugs are being used in combination with interferon and they may represent the cocktail to which you refer.  Some of these combinations may provide  a somewhat higher cure rate than interferon alone, but none offers a dramatically better cure rate and the combinations are associated with increased side effects.   It is critical that an individual know all the potential benefits and risks before embarking on any experimental therapy.

The most critical thing for you to do is to obtain consulation with a gastroenterologist/hepatologist who is knowledgeable in this area and whom you can trust.  He/she can make sure all the proper tests are done and can discuss all potential therapies and review experimental therapies or information that you have.

I can tell you at Henry Ford, we have an active group of Hepatologtists including myself who specialize in just liver disease.  We have a very strong interest in hepatitis C with a large clinical experience.  We do a significant amount of research in hepatitis C and run numerous clinical trials for hepatitis C with different experimental drugs.  I would encourage you to contact us at [phone].

This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  

I hope this information is helpful to you.