Medical Advances: Wiping Out Hepatitis C

DETROIT, MI (American Health Newswire) -- About four-million Americans are infected with the hepatitis C virus, and most of them don't know it. Often, patients live for years or decades with few or no symptoms while the virus destroys the liver. A new treatment has just been approved by the FDA that's helping more and more patients rid the body of the virus for good. Rhonda Gilbert loves to cook for hours, but until just a few months ago, she couldn't stand for more than a few minutes. "I would walk down the block, and I would get so exhausted, I would have to sit down," Rhonda Gilbert, who has hepatitis C, told American Health.

For more than a decade, Gilbert lived with persistent fatigue. It's one of the most common 

symptoms for people infected with the hepatitis C virus. Hepatitis C enters the bloodstream and attacks the liver. It can be introduced into the body during intravenous drug use, or before 1990, during a blood transfusion. Rhonda Gilbert needed a transfusion in 1972 after a tonsillectomy. Her doctors believe the virus has been attacking her body since then.  

Doctors say until now, the standard treatment for hepatitis C has been a weekly injection of Interferon and a pill taken twice daily called Ribavirin. This treatment works in about half the patients. Doctor Stuart Gordon is an expert in liver disease. 

He's been tracking the results when a third drug is added to the mix. Boceprevir is a protease inhibitor, meaning it works by blocking the virus's ability to replicate.

"We've looked in liver tissue and blood cells and followed up with these patients years later. The virus is still gone. That's as close to a cure as you're going to get," Stuart Gordon, M.D., a director of hepatology at Henry Ford Health System, said.

Rhonda Gilbert was treated with the three-drug cocktail in 2009. The virus is now gone, and Gilbert's energy is back for the first time in almost 20 years. Doctor Gordon says the drug cocktail using protease inhibitor Boceprevir worked for almost 70 percent of the patients in the trial.

Treating Melanoma with DNA

PHILADELPHIA, PA (American Health Newswire) - 68 thousand Americans are diagnosed every year with melanoma, a deadly form of skin cancer. When caught early, a patient has an excellent chance of surviving the disease, but once the disease spreads, doctors have had very few treatment options. Now, researchers have found new treatments that may stop the cancer in its tracks.

63-year-old Michael Sosnowicz never imagined that something he did when he was his children's age could kill him decades later. Michael spent years in the sun at his family's marina.

"The way I looked at things, you can't hurt superman," Michael Sosnowicz, a melanoma patient, told American Health.

Thirty years ago, doctors removed a cancerous tumor Michael's leg and told him he was cured.

"Last April or May, I was driving home, and I put my hand on my thigh right next to the excision spot," Michael said. "I felt what I thought was a lipoma, a fatty tumor."

Doctor Lynn Schuchter is a melanoma expert at the University of Pennsylvania. She says the biggest breakthrough in decades may lie within a patient's DNA. Forty percent of the patients with melanoma have a broken gene-called the BRAF gene.

"What's really exciting is that there are new drugs, new inhibitors that target these genes," Lynn Schuchter, M.D., a chief of hematology and oncology at Abramson Cancer Center at the University of Pennsylvania, said. "They can put the brakes on these rapidly-dividing cells."

In some patients, whose tumors have a broken BRAF gene, the inhibitors even shrink tumors-by 50 percent or more.

"Three days after taking the drug, I wake up on my left-hand side, and I don't have this discomfort in my stomach," Michael said. "I move over to my right, and I don't have it."

Doctor Schuchter says while patients have had tremendous results, eventually, the melanoma cells may become resistant. The next stepis combining the BRAF inhibitor with other therapies, and ultimately find a cure. Hope keeps Michael Sosnowicz strong, hope and his family.

"I want them to be fighters just like me," Michael said.

Now called Vemurafenib, the BRAF inhibitor is still being tested in clinical trials. The FDA is expected to consider it for approval by the end of this year.

Diastolic Dysfunction Increases Risk of Death

(American Health Newswire) - Individuals with diastolic dysfunction (impaired relaxation of the heart's ventricle after contraction) appear to have increased risk of death, regardless of whether their systolic function (contraction of the ventricle) is normal or they have other cardiovascular impairments, according to this study.

During each heartbeat, the heart contracts (pumping blood out, a phase called systole) and then relaxes (allowing the heart chambers to refill with blood, a phase called diastole). Diastolic dysfunction (DD), which occurs when the relaxation phase of this cardiac cycle is impaired, has been associated with an increased risk of death from cardiovascular and other causes, sometimes when systolic function is normal. The authors sought to determine whether the mortality risk associated with DD was independent of other cardiovascular conditions or systolic function, and whether the risk existed for mild cases.

Carmel M. Halley, M.D., and colleagues from the Cleveland Clinic studied the clinical records and echocardiographic findings of 36,261 patients who, between 1996 and 2005, had an outpatient echocardiogram that revealed normal systolic function. Researchers then determined whether patients' diastolic function was normal or abnormal, and graded cases of DD as mild, moderate, or severe.

Rates of established cardiovascular disease were low in the study population, including congestive heart failure (3.5 percent), coronary artery disease (0.6 percent) and peripheral vascular disease (1.1 percent). Most of the patients (65.2 percent) had some degree of DD; 60.0 percent of cases were mild, 4.8 percent were moderate, and 0.4 percent were severe. During an average followup time of 6.2 years, 5,789 deaths occurred, and the unadjusted mortality rate was higher in patients with worsening degrees of DD (4,469 deaths [21 percent] in the mild DD group, 429 deaths [24 percent] in the moderate DD group and 49 deaths [39 percent] in the severe DD group). However, in statistical analysis using propensity matching techniques, only moderate and severe DD were associated with an increased mortality risk.

"Because the overall prevalence of DD was high, most patients who presented for outpatient echocardiographic testing in our institution had, by definition, preclinical DD," the authors were quoted as saying. In this regard, the study "provides the physician with a prognostic context when DD is reported," particularly because in most cases, noncardiologists are ordering the echocardiographic procedures.

The researchers call for further investigation about how moderate and severe DD raise the risk of mortality. "However," they add, "our results suggest that an increased awareness of the clinical significance of advanced DD may lead to earlier identification of those patients who are at risk, especially at a preclinical stage."

SOURCE: Archives of Internal Medicine, published online June 27, 2011