TREATMENT FOR HEPATITIS C FAILS IN AFRICAN-AMERICANS-WHY?
Under a $1.2 million grant from the National Institutes of Health, physicians at the University of Illinois at Chicago are investigating why the current treatment for hepatitis C is ineffective in African-Americans who suffer from this "silent killer."
"Medical science has made important progress in the last decade in treating hepatitis C," said Dr. Thelma Wiley, who is the study's principal investigator. "We have discovered, for example, that a combination therapy of interferon and ribavirin, an antiviral medication, works best against resistant strains of the virus. But African-Americans often don't respond to our advanced therapies. We need to find out why so that we can offer these patients some hope."
Hepatitis C is caused by a viral strain first identified in 1989. It affects nearly 4 million people in the United States and is the leading cause of liver disease today. If left untreated, it can result in cirrhosis, liver cancer or even liver failure. Approximately 70 percent of those infected with the hepatitis C virus develop chronic hepatitis, and up to 20 percent progress to cirrhosis of the liver. At present, liver failure due to hepatitis C is the single most common indication for liver transplantation in the country.
"Hepatitis C is called the 'silent killer' because most people who get the disease have no recognizable signs or symptoms in its early stages," said Wiley. "Some people may experience a loss of appetite, nausea and vomiting, fever, weakness, and tiredness, perhaps even mild abdominal pain, but these are often confused with symptoms of the flu."
The virus is transmitted by contact with infected blood, largely through intravenous drug use (by the sharing of needles), blood transfusions and body piercing, according to Wiley. About 1.5 percent of the general population is infected with hepatitis C, while the incidence among the African-American population is 4 to 5 percent.
"Not only is the incidence of hepatitis C higher in the African-American community," said Wiley, "but response to treatment is poorer."
The current treatment requires a combination therapy of interferon, one of many naturally occurring proteins that the body makes to protect against viral infections, and ribavirin, which impedes the replication of viruses. In the general population, the response rate for this therapy is about 40 percent, but among African-Americans, it is significantly less, said Wiley.
According to Wiley, researchers studying this phenomenon have ruled out various factors to account for the difference in response rate, including the possibility that African-Americans are infected with a different strain of hepatitis C. Seeking an explanation, Wiley is investigating differences in the immune system of African-Americans compared with other racial groups, the amount of virus present in individuals with hepatitis C (viral load), and genetic mutations within the virus.
The UIC College of Medicine is the nation's largest medical school. One out of six Illinois doctors is a graduate of the college, as are 70 percent of the minority physicians practicing in Chicago. The college produces more medical school faculty than all but five schools in the country.
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