Tristate researchers are looking for new ways to knock out the hepatitis C virus.

        Several clinical trials on drug therapies for the virus and its complications are under way in this area.

        The trials come as public health authorities are pushing public awareness efforts to educate Americans on the viral infection, which is the leading cause of liver transplants.

Dr. Kenneth Sherman is conducting trials for the treatment of hepatitis C (Gary Landers photo) | ZOOM |

        An estimated 3.9 million Americans have been infected with hepatitis C. Of those, 2.7 million cases are chronic, meaning treatment has failed to suppress the virus.

        Dr. Kenneth Sherman, director of hepatology and liver transplantation medicine at the University of Cincinnati, says three trials are now enrolling patients at UC:

        • A study of a combination of pegylated interferon and ribavirin, two antiviral agents, on hemophilia patients with hepatitis C or a dual diagnosis of HIV and hepatitis C. Dr. Sherman says researchers hope the combination will both cure the hepatitis C infection and effectively suppress HIV, but the real focus is trying to identify what factors make the combination effective or ineffective, including the patient's immune status, the type of virus or the patient's response to interferon.

        “It's a very detailed scientific study of a relatively small group of people,” Dr. Sherman says. UC is the lead research center for the study, which wraps up in 2005. Six other sites are also participating.

        • A study of a combination of pegylated interferon and Zadaxin, an immune modulator, for patients who didn't respond to older forms of interferon either by itself or in combination with ribavirin. “Much of the focus has turned to: What do we do with these non-responsive patients that have been treated since the first therapy was made available in 1991 and who failed to clear virus? There are many, many thousands of such patients,” he says. Current treatments fail to suppress hepatitis C infection in about half of all patients, he says.

WHAT HEPATITIS IS

Hepatitis C is a viral infection that can lead to permanent scarring and/or cancer of the liver. Symptoms include:     • Jaundice     • Fatigue     • Dark urine     • Abdominal pain     • Loss of appetite     • Nausea     Eighty percent of infected patients show no symptoms.

HOW IT SPREADS

The infection is spread when blood or body fluids from an infected person enters the body of a person who isn't infected. Risk factors include: intravenous drug use or needle sticks and unprotected sex. Pregnant women can also pass the infection to their babies.

        • A study of gamma interferon to reverse serious liver scarring, or fibrosis, that can lead to cirrhosis.

        For enrollment information, call 584-0832.

        Dr. Mark Jonas, a gastroenterologist with Greater Cincinnati Gastroenterology Associates in Clifton, is also participating in the gamma interferon study. Liver scarring is especially troublesome because it can lead to cancer, he says.

        Diagnoses of hepatitis C and its complications are on the increase, Dr. Jonas says.

        “Part of that is probably multifactorial. People are more aware of the risk factors for hepatitis C and they're asking to be tested for it,” he says. “And there's somewhat of a Sept. 11 effect. People went to donate blood and they got a letter from the blood bank saying, "we can't accept your blood; you have hepatitis C.' ”

        There's also a demographic factor: Baby boomers who may have been infected after experimenting with intravenous drugs in their youth are noticing symptoms and complications of hepatitis C now.

        Globally, researchers are focusing on developing a hepatitis C vaccine. But the virus is a slippery critter; it mutates rapidly and is “very hardy,” Dr. Jonas says. There are also at least six subtypes of the virus, which makes developing a vaccine that much more difficult.

        An April study from the Johns Hopkins Medical Institutions has led to optimism that humans could be immunized against hepatitis C. Also, early research with primates looks promising.

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