The Earlier, the Better for Treating Hepatitis C

Oct. 1, 2001 -- Infection with the hepatitis C virus is the No. 1 cause of chronic liver disease in the U.S., but it usually takes decades for life-threatening complications to develop. Now, new research suggests that treating people within months of initial infection may be the key to preventing the damaging liver effects of hepatitis C.

Researchers from Germany's Medical University of Hannover found that people treated within the first three to six months of infection successfully cleared the virus and did not develop chronic infection, the most harmful and deadly form of the infection. Their study will appear in the Nov. 15 issue of The New England Journal of Medicine but was released early due to its potential impact on treatment.

Eugene R. Schiff, MD, president of the American Association for the Study of Liver Diseases, says the study represents the best clinical evidence yet indicating the importance of early treatment.

"The earlier you treat hepatitis C, the better your chances of preventing chronic disease and clearing the virus," Schiff tells WebMD. He is with the University of Miami Center for Liver Disease.

Approximately 4 million people in the U.S. and 170 million people worldwide are believed to have long-standing infection with hepatitis C. Long-term infection can lead to cirrhosis, liver cancer, and liver failure. Symptoms do not generally develop until a decade or more after infection, so many people don't realize they are infected.

Hepatitis C is spread by contact with the blood of an infected person. Those at high risk for infection include surgeons and other medical workers who perform invasive procedures, intravenous drug users, people who received blood transfusions or organ transplants prior to 1992, children born to mothers who have hepatitis C infection, and people with evidence of chronic liver disease.

Less common means of transmission include infection through tattoo needles, scissors, and nail files or toothbrushes contaminated with infected blood. Sexual transmission is also possible, but it's uncommon. Many people are unable to determine when they were infected.

In this study, researcher Michael P. Manns and colleagues identified and treated 44 people with newly acquired hepatitis C, known as the acute phase of infection. The patients received daily treatments of the hepatitis C drug interferon alfa-2b for one month, followed by a five-month course of the drug given three times a week. At six months follow-up almost all of the patients (98%) had cleared the virus.

"Normally, an average of 70% of those who get infected progress to chronic infection, and once they become chronic only about 1% of people clear the virus per year [without treatment]," Manns tells WebMD. "Our findings show that with treatment, the acute phase of hepatitis C infection has become a curable disease."