Genes Tied to Gap in Treatment of Hepatitis C

"The standard treatment for infection with the hepatitis C virus is a grueling 48-week course of the antiviral drugs interferon and ribavirin that gives some patients flulike symptoms and severe depression. The treatment varies in its effectiveness, being much more successful in Americans of European descent than in African-Americans.

A Duke University team has now uncovered the principal reason for the disparity between the races. It lies not in differing compliance to the treatment or access to health care, as some have assumed, but in genetics.

Using a genetic test called a genome-wide association study, the Duke team, led by David B. Goldstein and John McHutchison, found that the coding at a single site on the DNA, out of the three billion sites in the human genome, made all the difference in people’s response to the treatment."



read the whole thing

It turns out that the common treatment works very well in most east asians, a little less well but still effective in most europeans and not so well in most people of african descent. They figure a similar disease ran through certain parts of the world in the past.

Anyway, it looks like those people that say race is entirely a social construct are wrong.

She had an extended course of interferon - an extra 6 months - felt truly awful through the entire thing. It cost many thousands of dollars, was not effective in lowering her viral count, and her Docs told us she had possibly 5 years to live. That was in 1999.

Her liver profile numbers are in the normal zone now, and she has been taken off the transplant list, but it had nothing to do with interferon, which is nothing but very overpriced shit, IMO.

mark

We got a review of her prescribed medication, eliminated all we could, changed some, added some. She also haws Crohn's disease, stenosis and scoliosis and arthritis in both knees and shoulders as well as her neck.
She has had both knees and one shoulder replaced, has very heavy pain medication, but mainly her liver just recovered by itself after some of the drugs were changed for ones not metabolized by the liver. She has not been this healthy in maybe 15 years. She had encephalopathy, was in coma 5 times - I was again told all 5 times she would never regain consiousness - now goes to a gym 3 times a week.
I think having a GOOD DOCTOR is a key to this, but there ase wo man bad ones you really have to search and decide for yourself.

Hope you are not aflicted with this.

mark

They had no symptoms, but did have a distant history of risk behavior, re intravenous drug use. They were diagnosed by having a reg physical, w/blood work coming back high in red blood cells. Doctor wanted to know why, followed up w/liver panel and voila! Lots of Hep C virus present.

They were sold on the Interferon/Ribavirin combo treatment, were shown and had to sign waiver on a 3-page list of potential side effects including the black box warning that it has led to suicide in some cases as a result of severe depression. They were also told he ugly truth that the combo treatment was only about 30% effective, but that it was the only game in town. They read accounts on the internet and had friends relate stories of cases that did have horrible side effects. All the holistic methods with chinese herbals like milk thistle, St. John's Wort, etc. were pooh-poohed by the doctors as ineffective. The only side effect this family member experienced was a rash at the injection sites on belly and severe anemia from the Ribavirin.

They were found to be increasing their Hep C load over the first 30 weeks, so the treatment was abandoned. They underwent ultrasound, MRI, liver biopsy and multitudinous blood tests, etc., in addition to an echo stress test and retinal fluoroscan demanded by the insurance company prior to treatment because they were considered a higher risk for the treatment due to age, 59.

They do not seem any different, still no adverse liver symptoms or pain of any kind. Lucky they are in only Stage 2 of liver damage, which means they have no cirrhotic tissue formed, and only some minor septis at this point. No tumors, no cancer. The doctors have estimated they have lived with the Hep C for at least 35 years. My family member now fears other things much more, does not fret that Hep C will kill them. They are lucky as they are very healthy otherwise and sleep, eat and exercise well and regularly. They also feel a lot better about their overall health due to all the tests that were required in leading up to the treatment. If they did have any cancers growing, they would have been detected by all the testing, which included their first colonoscopy, not for the Hep C but for the overall assurance of nothing being wrong. They commented the worst part of the treatment was the requirement they drink a gallon of filtered water every day. They spent a lot of time peeing they did not do otherwise.

Needless to say, none of this could have happened without some kind of guarantee of insurance coverage, which they have through their spouse's plan from work. They pay co-payments, and the drugs were not that expensive through the coverage, I think less than $60/month. They did take some cynical pleasure from using a needle on themselves again, this time legally. They also raised the question to their doctors about whether those cases that exhibit little or no side effects are more likely to have the combo treatment be ineffective in killing off the virus. The doctors said they did not have data on such a question, but I think they could if they tried. They keep records don't they? Wouldn't it be possible to crunch that data and come up with at least some rough figures on those many thousands of cases that didn't work and gauge what percentage of them experienced low levels of the dreaded side effects?

We need to insure that all Americans have medical coverage, free for those that can't afford it, and subsidized for those that can pay some form of contribution, but expensive for those that can and do and have paid for this very expensive coverage with no difficulty. I think a sliding scale but availability to all with no question is the answer. In other words government guaranteed healthcare for all, not just some or a few lucky government employees, etc.


Just my dos centavos,
robdogbucky