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Hepatitis C: targeted treatment options for patients with newly-acquired infections

(Vienna, 28th December 2011) Around 30 per cent of all acute hepatitis C infections are self-curing, while 70 per cent become chronic. A prediction of the condition’s progress, however, has so far only been possible to a limited degree. Patients have therefore frequently had to undergo tedious and expensive treatment, which comes with numerous side effects. A team of researchers at the MedUni Vienna has now described two factors that make predicting the course of the condition, and therefore targeted therapy, possible.

The team led by hepatologist Harald Hofer from the University Department of Internal Medicine III has demonstrated that the combination of two factors can be useful in predicting spontaneous cures. Says Hofer: “Polymorphism in the IL28B gene, a genetic characteristic, and the interferon gamma inducible protein 10 (IP-10) influence the later development of an acute hepatitis C viral infection. If a patient has a good constellation of both factors, which can be detected in blood tests, a spontaneous cure is very likely.”

This has been confirmed by the results of the Austria-wide, multi-centre study of patients with acute hepatitis C led by the MedUni Vienna, which has now been published in the renowned American professional journal Gastroenterology.

Treatment with numerous side effects
As a result, treatment could be targeted more efficiently and some of the patients affected were able to be spared treatment. Currently, the patients are treated for 24 weeks with interferon alpha, which has an anti-viral effect and stimulates the immune system.

The treatment consists of one injection a week. The aim is, six months after treatment has been completed, for the virus to be undetectable. The treatment is associated with high costs and numerous side effects. The patients frequently exhibit flu-like symptoms such as fever, joint pain, headache, increased tiredness and hair loss; the thyroid gland can also malfunction. The treatment is frequently also accompanied by depression and anxiety states.

“Prompt treatment of acute hepatitis C is hugely important because it can stop it from developing into a chronic condition," says Hofer. Several hundred patients with chronic hepatitis C are treated each year within the Clinical Department of Gastroenterology and Hepatology at the University Department of Internal Medicine III.

Hepatitis C is an inflammation of the liver caused by infection by the hepatitis C virus. It is primarily transmitted via direct contact with contaminated blood or blood products. The most at-risk groups are drug addicts who share needles with others. It is virtually impossible to contract in everyday settings.

Service: Gastroenterology
“Serum Level of IP-10 Increases Predictive Value of IL28B Polymorphisms for Spontaneous Clearance of Acute HCV Infection.” S. Beinhardt, J. H. Aberle, M. Strasser, E. Dulic–Lakovic, A. Maieron, A. Kreil, K. Rutter, A. F. Staettermayer, C. Datz, T. M. Scherzer, R. Strassl, M. Bischof, R. Stauber, G. Bodlaj, H. Laferl, H. Holzmann, P. Steindl–Munda, P. Ferenci, H. Hofer. doi:10.1053/j.gastro.2011.09.039