New Treatment Offers Hope for Hardest-to-Treat Hepatitis C Patients
Oct. 13, 2000 -- There are very few therapeutic options available to patients with chronic hepatitis C virus infection, but over the last two-and-a-half years LeighAnn Vogel has tried just about all of them.
She first went on the antiviral agent interferon for four months. When tests showed the drug was not working, her doctors added ribavirin, the only other drug approved for treatment of the disease, to the mix. After a year of unsuccessful combination treatment, the 44-year-old Fillmore, Calif., woman went back on interferon alone, but this time she was given large doses of the drug every day.
During the various treatments Vogel lost 45 lb, her hair started to fall out, and she was so tired she couldn't even climb the stairs in her home without stopping to rest. With the daily interferon treatments, she says, the therapy turned out to be worse than the disease. Her blood cell counts dropped dramatically and she could barely function before her doctor took her off the drug.
"Because the therapies weren't working, there were many times when I questioned whether it was worth it. But I'm only 44. I'm not ready to die yet, and I am terrified of the idea of a liver transplant," she tells WebMD. "If I didn't try therapy, I'd be doing nothing, and in my mind that is the same as letting the virus win."
Unfortunately, Vogel's experience is common among hepatitis C virus patients who receive drug treatment. In previously untreated patients, only 20% of patients treated with interferon for a year achieve sustained viral remissions, in which the virus is completely cleared from the blood. About 40% treated with interferon plus ribavirin, which is now the standard therapy for hepatitis C virus, achieve sustained remissions.
But an Italian study that included the hardest to treat hepatitis C patients suggests that a combination approach to therapy, in which a third antiviral agent known as amantadine is added to the interferon/ribavirin regimen, may offer hope to patients like Vogel. Amantadine is also commonly used to fight the flu and to treat Parkinson's disease, and now it appears it might help fight hepatitis C. The three-drug regimen was found to prompt sustained responses in almost half of the study patients who did not respond to initial therapy with interferon alone.
"I think this study shows that treatment with several antiviral agents given simultaneously is a good approach," study author Stephano Brillanti, MD, of Italy's University of Bologna, tells WebMD. "The lessons we learned from treating HIV will serve us well in the treatment of hepatitis C. We are learning that the best options in difficult to treat patients is a cocktail approach, like that used to treat AIDS."