Thanks for the links Mike!
These links are from Medscape, so for those not registered, now is a good time. Two other great sites to register for are "Projects In Knowledge" http://www.projectsinknowledge.com/
and "Clinical Care Options". http://www.clinicaloptions.com/Hepatitis.aspx
These came in an email and since we can't post links I just copied them. I miss having the ability to post links. I'm not sure how valuable these are but I try to read everything related just in case there is some valuable tidbit of information tucked away and I figure maybe others do too - at least I know that you do. Mike
Wow....what a wealth of info. I will have to read them later. I saved them in a document right now.
Thanks, Mike. I needed some evening reading. Some of the topics look pretty good. I miss being able to link - or I should say folllow links - too.
I actually did get one of the articles read last night. It wasn't too long, and had a great impact on my thinking.
The article was "Hepatitis C and the Effects of an Aging Population. "
I have often wondered exactly what made it harder to treat as you age. This article pointed out a few things. I will do my best to paraphase a couple of points.
-Our immune system facilitates the clearance of acute Hepatitis C and determines the severity of chonic hepatitis C. As we age, there are immune changes -- T-cell populations get smaller and memory cell responses slow down. All this leads to a lessoned immune response against hepatitis C AND (get this) a lessened response to interferon.
- As we age other diseases pop up -- steatosis (fatty liver), obesity, and diabetes -- which all have a negative impact on the hepatitis C progression. The article says the linking feature is likely insulin resistance or the metabolic syndrome (abdominal obesity, insulin resistance, hypertension, etc). This metabolic sydrome increases about 10% each decade. -- increasing from 6.7% in 20-29 year olds to 43.5% in 60-69 year olds.
This makes the odds of clearing the virus (if I am reading this right) 2.6 times greater if you treat before you are 40.
- The rate of fibrosis is not linear (I think we all know that). They still have no way to determine who will decline but many docs recommend therapy only for those with advanced disease. Patients with normal ALT levels need to be monitored. Nealy 1/4 develop abnormal ALT within 5 years. Commonly, patients who have been told they don't need therapy never bother to be checked again. As other health issues occur with aging, there are impacts on treatment outcomes so monioting is necessary .
The article continues to give a rundown of what treatment drugs are on the horizon, but the bottom line, and I quote, is " patients waiting for future therapies may miss a window of opportunity for successful viral eradication with currently available therapy.
THank you, Mike. Comments, anyone?
My take is that you obviously absorbed the material extremely well and capsulized it equally well. I think you should lecture. Thanks for your post. Mike