Between 40,000 and 80,000 Austrians suffer from hepatitis C. With new infections the prompt and appropriate treatment is of great importance as this can prevent it developing into a chronic illness which in turn can progress to inoperable liver cancer. Now a research team led by scientists of the MedUni Vienna has succeeded in developing a points system enabling a better prognosis as to whether the illness will become chronic or whether the acute hepatitis C will spontaneously heal itself.
"This is significant by virtue of the fact that, for patients with a tendency towards developing a chronic illness, early treatment with antiviral medication affords a better chance of healing," explains hepatologist Harald Hofer of the University Department of Internal Medicine III at the MedUni Vienna, Clinical Department of Gastroenterology and Hepatology (Chief: Michael Trauner).
The points system was developed by the MedUni Vienna researchers from a combination of clinical and biochemical parameters. Says Hofer: "Using this, the clinical course of the acute hepatitis C can be much better predicted, which means that the costly antiviral therapy with its many side effects can be much more efficiently deployed." The results of the study have been now published in the leading Journal of Hepatology.
Towards an interferon-free therapy
The advances made in treating hepatitis are generally remarkable. Two new, direct acting antiviral substances (DAA/"Direct Acting Antiviral Therapy") have been submitted for licensing not only in Europe but also in the USA (Simeprevir and Sofosbuvir), and will, according to Hofer, also be available in the foreseeable future. "For some of the patients this means that interferon-free therapy is becoming a reality outside clinical trials as well."
Current standard treatment is a combination therapy with interferon-alpha, which possesses an immune-stimulating, antiviral effect. In cases of hepatitis C interferon is injected once a week over a period of up to twelve months – although with undesirable side effects such as aching limbs, fever, headaches, as well as depressive episodes or malfunctions of the thyroid. The advantage of direct antiviral therapy (DAA) is that it acts directly on the hepatitis C virus and is thus more effective – with fewer side effects.
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More information: "A Diagnostic Score for the Prediction of Spontaneous Resolution of Acute Hepatitis C Virus Infection." Beinhardt S, Anna Payer B, Datz C, Strasser M, Maieron A, Dorn L, Grilnberger-Franz E, Dulic-Lakovic E, Stauber R, Laferl H, H Aberle J, Holzmann H, Krall C, Vogel W, Ferenci P, Hofer H. J Hepatol. 2013 Jul 10. pii: S0168-8278(13)00446-7. doi:10.1016/j.jhep.2013.06.028
"Effect of gender and ITPA polymorphisms on ribavirin-induced anemia in chronic hepatitis C patients." Scherzer TM, Stättermayer AF, Stauber R, Maieron A, Strasser M, Laferl H, Schwarzer R, Datz C, Rutter K, Beinhardt S, Munda P, Hofer H, Ferenci P. . J Hepatol. 2013 Jul 10. doi:pii:S0168-8278(13)00448-0. 10.1016/j.jhep.2013.06.030
"Durability of SVR in chronic hepatitis C patients treated with peginterferon-?2a/ribavirin in combination with a direct-acting anti-viral." Rutter K, Hofer H, Beinhardt S, Dulic M, Gschwantler M, Maieron A, Laferl H, Stättermayer AF, Scherzer TM, Strassl R, Holzmann H, Steindl-Munda P, Ferenci. Aliment Pharmacol Ther. 2013 Jul;38(2):118-23. doi: 10.1111/apt.12350
"Role of FDFT1 polymorphisms for fibrosis progression in patients with chronic hepatitis C." Stättermayer AF, Rutter K, Beinhardt S, Wrba F, Scherzer TM, Strasser M, Hofer H, Steindl-Munda P, Trauner M, Ferenci P. Liver Int. 2013 (in press).