Emerging Epidemic
Researchers' limited ability to decipher the virus has hampered the hunt for a new and better treatment. While the current therapy boosts the body's natural defenses, it doesn't attack the virus directly. The approaches being investigated will target certain known regions of the virus, like using a guided missile instead of an atomic bomb, says Joshua Boger, CEO of Vertex, one of the pharmaceutical research firms racing to develop new cures. Targeted drugs should both improve effectiveness and reduce side effects. "We're going to look back in five years," says Boger, "and just say, 'Wow.'"
Vertex and pharmaceutical giant Schering-Plough are focusing on protease inhibitors, drugs best known for their success in treating HIV. Scientists and doctors agree that protease inhibitors and the similar polymerase inhibitors are the most promising. They slow the spread of the virus in the liver by binding to and disabling areas the virus needs to replicate. In small groups of patients, using drugs with and without interferon and ribavirin, both Schering and Vertex have seen the level of virus in the blood fall to undetectable levels in just a couple of weeks. Standard treatment in patients with the same strain of virus generally takes several months.
The FDA has given both companies' efforts fast-track status, most likely accelerating the approval process. Even assuming approval, however, it will be several years or more before doctors can use the drugs, which haven't yet been proved safe in large-scale studies. But many are optimistic it is only a matter of time. New drugs are "going to happen," says Schiff. "The question is, is it going to be five years or closer to 10 years?" He and others expect that hepatitis C will eventually be treated with a cocktail, mixing protease and polymerase inhibitors, ribavirin or newer, more tolerable substitutes, and, perhaps, interferon.
Mainstream. The pressing current need is to encourage testing. Many people don't know they need testing or, worse, choose to stay ignorant because of a stigma surrounding the disease. Those infected "are often treated like lepers, and it's totally unjustified," says Schiff. Back in the 1970s, he says, "people were experimenting with drugs. These people are now in their 50s. They're mainstream America. They're not drug addicts."
They do need to be somewhat cautious, however. Hepatitis C cannot be transmitted casually--for example, by hugging, shaking hands, or sharing glasses or utensils. But people with the disease should not share their toothbrushes or razors, which might carry minute amounts of blood. And while the rate of sexual transmission is very low, especially for people in monogamous relationships, it does rarely happen. "We tell people who have a partner with hepatitis C to use condoms," says the CDC's Williams.
One of those trying to correct stereotypes of hepatitis C patients is Dee Lemmon, 46, who briefly dabbled with IV drugs when she was younger. Treated and free of the virus since 2000, she is now president of an advocacy and support group for hepatitis C patients in northern Georgia. "We're taxpayers, we have jobs, we are contributing members of society," she says. "We screwed up when we were kids. People do that."
AS THE TOLL CLIMBS
Deaths from complications of hepatitis C are projected to peak in 2015.
Annual deaths in thousands
PEAK: 19,529
9,433
18,942
Source: John Wong, Tufts University School of Medicine
advertisement
