icon_folder.gif   Conference Reports for NATAP  
  AASLD ( American Association for the Study of Liver Diseases)
November 9-13, 2001, Dallas
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Interferon Improves Risk for Death and Cancer
New Ribavirin in Early Development
Normal ALT in African-Americans
Fats, Overweight, Diabetes in HCV
How Often Should You Do a Biopsy in HCV/HIV Coinfection
  A Japanese research group reported that interferon therapy improves the risk for developing HCC and death. This is not a new finding. Several studies have reported this. But this study was a large one. The study measured ALT response. Authors reported therapy was 4-12 months & presumably interferon alone. Responders and transient responders improved risk but non-responders did not compared to untreated patients. One of the key questions is if you take IFN+RBV therapy and are a partial responder, relapser or nonresponder how long will improved histology last after stopping therapy? I don't think we know but anecdotal opinion is that histology can improve while on IFN even if you're a nonresponder. After stopping therapy progression starts up again but it may take a year to get back to where you were before therapy. Opinion is that by staying on interferon histology improvement is continued. Two large studies in HCV monodisease are ongoing to prove this.
Levovirin is a second generation ribavirin being made by ICN Pharmacueticals. In a poster today they reported that in monkeys they found Levovirin gets into the red blood cell less than ribavirin. This would suggest perhaps less side effects. RBV can lead to reduced hemoglobin and fatigue. A study in HCV-infected patients is planned and required to see if this new version of RBV has antiviral activity as RBV does in combination with IFN.
A study reported today by Thelma Wiley from the University of Illinois, Chicago reported finding that in African-Americans compared to non-AAs cirrhosis was as likely to occur whether ALT is normal or abnormal (25%). Among the general population, normal ALT implies less progression in general. Although ALT is not a predictor of non-progression. You could have nomal ALT and have moderate or more advance liver disease. Wiley said African-Americans with normal ALT are as likely to develop significant histologic disease as whites with abnormal ALT.
Several posters associate overweight, elevated fats (cholesterol, triglycerides), and sugar with HCV and progression. This is not new information but is worth reporting because these are things that patients can have some control over with dietm, exercise, and medical intervention for lipids.
One poster suggested in HCV monodisease a follow-up biopsy should be done 3-5 years after the first to evaluate progression. Since HIV accelerates HCV perhaps a followup biopsy should be considered 1-2 years after the first, if HCV therapy was not started.
A San Diego group reported that HCV/HIV patients treated with HAART & for HCV have better survival if they are compliant with taking meds, participating in support groups, and in stopping alcohol. In other words, good support systems are important.