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West Nile Treatment Study Begins

Hepatitis C Drug May Prevent West Nile Death, Brain Damage
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WebMD Health News

Aug. 23, 2002 -- A drug now used to treat hepatitis C may help people with severe West Nile virus infection. A clinical trial to test the drug in people with serious West Nile disease already is underway.

The drug is called alpha interferon, a man-made version of one of the body's natural defenses against viruses and other germs. Cornell University researcher James Rahal, MD, and colleagues hope that by treating patients early in the course of a West Nile infection, they can prevent the brain damage that can occur. Interferon treatment will not reverse any brain damage caused by the infection.

Last year, Rahal's team used alpha interferon to treat 15 patients with St. Louis encephalitis virus, a close cousin of West Nile virus. Compared with untreated patients, those treated with the drug did much better. They suffered much less damage from their brain infections.

"I am hopeful it is effective but I am not deceiving myself," Rahal tells WebMD. "The results of that study were sufficiently encouraging to do a trial with West Nile virus patients -- but we just don't know yet whether it will work."

The type of alpha interferon being studied is Intron A, made by Schering Plough. The company is helping pay for the study. Intron A is in drug stores -- and doctors theoretically could prescribe it for West Nile infection. But Rahal warns that it's far too soon to know whether the drug really works against this virus. And it can have serious side effects. It makes people feel like they have a bad case of the flu and it can reduce infection-fighting blood cells to dangerously low levels. These side effects go away when treatment stops.

"Many people may say, 'Well, give it to me,'" Rahal says. "But interferon is not chicken soup. It has its side effects. They should know that this is a powerful drug."

The new study will enroll 40 patients from all over the country. To enter the trial, patients must begin treatment within four days of entering the hospital. Patients aged 50 and older must have evidence of West Nile infection in their spinal fluid. Patients aged 18-49 must have clinical evidence of West Nile encephalitis.

Study patients get two weeks of treatment. Half of them will get a placebo instead of Intron A. Neither the people in the trial nor their doctors will know whether they are getting the real drug or the placebo. This kind of study design is the only sure way to know whether the drug really works.

Right now there is no specific treatment for West Nile virus infection. Fortunately, most people get such a mild infection that they have no symptoms at all. Other people develop more severe disease. When the virus gets into the brain, it causes encephalitis. Encephalitis can be very severe. Treatment may require intense supportive therapy including hospitalization, intravenous fluids, breathing assistance with a ventilator, prevention of other infections, and round-the-clock nursing care.

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