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S.A. doctors find faster, better way to beat hepatitis C
January 8, 2013

From left: Dr. Fred Poordad and Dr. Eric Lawitz

By Jennifer R. Lloyd

Two local physicians who studied therapies for liver-damaging hepatitis C have found that a new drug combination wipes out the virus quicker and without the harmful side effects of the current treatment.

Their study found that the new drug cocktail boosted the rate of curing certain types of patients from 70 percent to 95 percent in a quarter of the time, said Dr. Fred Poordad, the study's lead author.

Poordad and Dr. Eric Lawitz, liver specialists and professors at the University of Texas Health Science Center, authored the study with several other physicians. It was published Thursday in the New England Journal of Medicine.

Abbott Laboratories created the two investigational drugs, preliminarily called ABT-450 and ABT-333, and funded the study of 50 South Texas patients, Poordad said.

Hepatitis C is the most common blood-borne infection in the United States, with about 3.2 million people chronically infected, according to the Centers for Disease Control and Prevention. It can cause liver disease, liver cancer and death.

People can get the virus from contact with infected blood, often through contaminated needles. Some got it from blood transfusions before the U.S. began screening for it in 1992, according to the CDC.

There are several types of hepatitis C, and Poordad's study tackled genotype 1, which he said is the most common and most difficult to cure. None of the study subjects had cirrhosis, a common consequence of hepatitis C.

The current 48-week treatment includes an injection of interferon, which stimulates part of the immune system to fight the virus but depresses other parts, producing side effects, Poordad said. Interferon is administered through a weekly injection, accompanied by other drugs taken daily in pill form.

"Interferon has a tremendous number of side effects, particularly flu-like symptoms," including headaches, nausea, depression and thyroid gland damage, Poordad said.

"Many people actually never got treated because they'd heard so many horror stories about the interferon side effects."

So researchers have been hunting for less-toxic drugs. ABT-450 and ABT-333 are antiviral agents that stop the virus from replicating, he said.

In the South Texas study, those who had not been previously treated for the virus fared better.

For 12 weeks, researchers gave patients pills containing the two investigational drugs, plus the currently used antiviral drug ribavirin and the drug ritonavir.

Between 93 and 95 percent of patients who had not already been treated were considered cured of hepatitis C when evaluated after treatment. Of those who had been unsuccessfully treated before, 47 percent were considered cured.

The side effects were largely mild but included fatigue, nausea, headache, dizziness, insomnia, itching, rash and vomiting, according to the study.

Judith Hyland, 54, of San Antonio said she was one of the study's lucky patients who had been treated before but who found success with the new drugs anyway.

She said she discovered she had hepatitis C decades ago when a blood bank screened blood she had donated. Hyland believes she contracted the disease from her ex-husband, an intravenous drug user who passed away last year from hepatitis C complications.

"I couldn't work. Many times, I couldn't eat," she said, calling her prior interferon treatment "debilitating."

During the study, she had a three-day period where she felt ill, fainted and lacked energy, but said she felt fine afterward.

Then, in May, she learned the good news - the drugs had scrubbed the virus from her bloodstream and liver.

"I got my letter of clearance in May and was like, 'Oh, my God,'" she said. "I wanted to bronze it and put it up on the wall."

Baby boomers such as Hyland have particularly high rates of the virus, which often has no symptoms. This year, the CDC recommended those born between 1945 and 1965 get tested.

"This cohort is the group we're really worried about because they're advancing to cirrhosis of the liver and getting liver cancer and needing transplants," Poordad said. "We want to be able to find viable cures for these individuals so they don't develop all of these complications."

The new drugs are still a couple years away from coming to the market, he said. The next step is to examine the drug's effects on a broader population of patients.


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