Hepatitis C and its significance
Hepatitis C affects approximately 4 million or 2% of Americans, and more
than 100 million persons worldwide. Chronic hepatitis C can progress to
cirrhosis and liver cancer. Endstage liver disease and liver cancer due
to hepatitis C account for 30%-50% of adult liver transplantations in
western countries. Most people with chronic hepatitis C do not have
symptoms and are not diagnosed until they have advanced liver disease.
There is as yet no vaccine for hepatitis C.
Current treatment for hepatitis C
Currently, the only treatment is combination therapy with pegylated
interferon and ribavirin. This treatment can lead to virus clearance in
roughly 50% of patients. However, the treatment is expensive and
associated with many side effects. Only a small percent of hepatitis C
patients are treated because of lack of access to medical care or
presence of other medical conditions that preclude them from treatment.
Of those who are started on treatment, 15%-30% are unable to complete
the course of treatment due to inability to tolerate the side effects.
Thus, there is a need to develop more effective and better tolerated
treatments. There is also an urgent need to develop treatments that
would be effective for those who have failed to respond to currently
available treatments.
University of Michigan Hepatitis Program
The Viral Hepatitis program is the center piece of the University of
Michigan Hepatology Program. This program is led by Drs. Anna Lok, Hari
Conjeevaram and Robert Fontana, national and international leaders in
the field. The program integrates state-of-the-art care with cutting
edge research.
The clinical program evaluates approximately 2000 new patients with
viral hepatitis and provides antiviral treatment to more than 250
patients each year. This program is supported by 2 physician assistants:
Kelly Oberhelman and Tracy Licari, who ensure that all the patients
receiving antiviral treatment are closely monitored and optimally
managed.
In addition to providing standard of care, patients referred to our
Viral Hepatitis program are also evaluated for entry into clinical
trials. These clinical trials provide access to investigational
treatment that frequently prove to be superior to existing treatment. In
addition, the clinical trials often provide free medications to patients
who otherwise cannot afford the treatment. During the last 10 years, we
have participated in more than 20 industry-sponsored clinical trials and
have provided care to more than 500 patients.
In the past two years, we participated in two trials on the safety and
efficacy of viramidine in combination with pegylated interferon, and a
16 vs. 24 week course of pegylated interferon and ribavirin for patients
with genotype 2/3 infection. We are currently involved in studies on
novel treatments to block hepatitis C virus replication and fibrosis
(scarring) of the liver.
Our Program is also a participating site in two key NIH trials on
hepatitis C: HALT-C and VIRAHEP-C. The HALT-C trial aims to determine if
long-term maintenance therapy with low dose pegylated interferon can
decrease the rate of progression to cirrhosis, liver failure and liver
cancer. The VIRAHEP-C trial aims to unravel the mechanisms (genetics,
immune response and viral factors) that account for the poorer response
of African Americans to interferon-based therapies. Data from these
trials will revolutionize our management of the "difficult-to-treat"
hepatitis C patients.
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Our Program is also active in hepatitis B research. The University of
Michigan Viral Hepatitis Program is one of the top programs in the
country, with more than $1million/year grant funding from the NIH and
more than 20 peer-reviewed scientific publications each year.
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Anna S. Lok, MD
Dr. Lok is Professor of Internal Medicine and Director of Clinical
Hepatology. She is a world renowned investigator in viral hepatitis. She
has lectured all over the world and has published more than 200
scientific papers. She is currently an Associate Editor of HEPATOLOGY,
the official journal of the American Association for the Study of Liver
Diseases. She is also a member of the National Board of Directors of the
American Liver Foundation. Dr. Lok is listed in "Who's Who" and "Best
Doctors" of America. She has trained more than 20 young doctors in the
care of patients with liver diseases and in research on viral hepatitis.
She also participates in community education and recently won an "Award
for Outstanding Contribution to Health" from the Community Health
Charities.
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Hari Conjeevaram, MD
Dr. Conjeevaram is an Assistant Professor of Internal Medicine. He has
made significant contributions to viral hepatitis and fatty liver
disease research. He is the principal investigator at Michigan in the
VIRAHEP C study. Dr. Conjeevaram has received numerous teaching awards.
He also devotes time and energy to community health providing service to
free clinics for the indigent patients, and relief efforts to Katrina
and Tsunami victims.
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Robert Fontana, MD
Dr. Fontana is an Associate Professor of Internal Medicine and Medical
Director of the Liver Transplant Program. He has made important
contributions to research into viral hepatitis, drug induced liver
disease, and acute liver failure. He has lectured in many parts of the
world and has published around 100 scientific papers.
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Michael L. Volk, MD, MSc
Dr. Volk is a Lecturer in the Division of Gastroenterology and Hepatology,
as well as an investigator in the Center for Behavioral and Decision Sciences.
He is a former Robert Wood Johnson Scholar who performs health services research
to improve the quality of care for patients with Hepatitis C. He also
publishes on medical decision making and the ethics of liver transplantation.
He sees patients at the University of Michigan Healthcare System, the Veteran's
Affairs Ann Arbor Healthcare System, and volunteers at the Hope Medical Clinic
in Ypsilanti.
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Allocation of donations for Hepatitis C research
We are currently funding a research project headed by Michael Volk,
MD, MSc, which is intended to measure the public health impact of
current Hepatitis C treatments. Future donations will go towards, among
other things, the development of a patient education tool and decision
aid for the treatment of Hepatitis C. This is intended to improve the
quality of care for patients with Hepatitis C.
Other research topics may include optimizing treatment response in clinical
practice (for example, research into methods to reduce side effects and
to improve dose adherence), or evaluation of new treatment strategies
(for example, research on impact of weight reduction or treatment of
associated metabolic conditions such as insulin resistance on rate of
viral decline during antiviral therapy).
More information on Hepatitis C
For more information, please view our Basics on
Hepatitis C or Basics plus our Research Project
PowerPoint presentation.
You are welcome to use this PowerPoint for educational purposes. Please keep me informed at : Debbie@vedit.com
Below are some links to websites containing information on Hepatitis C:
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Help us Win the Fight!
Help support the fight against Hepatitis C by purchasing our cookbook, Cooking Around the World.
All proceeds go to benefit Hepatitis C research.
Also Available at:
Nicola's Books
Supporters
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