Cingles Info

Simple Scoring System Can Help Identify Patients with Cirrhosis at Low or High
Risk for Hepatocellular Carcinoma
Increased knowledge of the risk factors associated with the appearance of
hepatocellular carcinoma (HCC) could improve the efficacy of surveillance
programs. In the March issue of Hepatology, R F Velázquez and colleagues
describe the development of a simple scoring system that can help detect early
signs of HCC.
A total of 463 patients aged 40 to 65 years with liver cirrhosis in Child-Pugh
class A or B were included in a program of early diagnosis. The predictive value
of different risk factors was evaluated using the Kaplan-Meier method and Cox
regression model.
Thirty-eight patients developed HCC. In the multivariate analysis, 4 variables
showed an independent predictive value for the development of HCC: age 55 years
or older, antibody to hepatitis C virus (anti-HCV) positivity, prothrombin
activity 75% or less, and platelet count less than 75 × 103/mm3.
According to the contribution of each of these factors to the final model, a
score ranging between 0 and 4.71 points was constructed to allow the division of
patients into 2 different risk groups.
The low-risk group included those with a score of 2.33 points or less (n = 270;
4 with HCC; cumulative incidence of HCC at 4 years, 2.3%), and the high-risk
group included those with a score greater than 2.33 (n = 193; 34 with HCC;
cumulative incidence of HCC at 4 years, 30.1%).
In conclusion, a simple score made up of 4 clinical and biological variables
allowed the investigators to distinguish 2 groups of cirrhotic patients at high
and low risk for the development of HCC. They believe this score can be useful
in establishing a subset of cirrhotic patients in whom a surveillance program
for early detection of HCC could be unjustified.
04/14/03
Reference
R F Velázquez and others. Prospective analysis of risk factors for
hepatocellular carcinoma in patients with liver cirrhosis. Hepatology 37:3;
520-527. March 2003.
http://www.hivandhepatitis.com/hep_c/news/041403a.html
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Highlights of Recent Research Articles on Hepatitis C and Hepatitis B
Following are highlights of recent research articles on hepatitis B and
hepatitis C published in the April issue of Hepatology.
Durability of Serologic Response after Lamivudine Treatment of Chronic Hepatitis
B
In persons who have HBeAg seroconversion on lamivudine, 77% (30/39) retained
HBeAg-negative status a mean of 36.6 months after cessation of therapy. Also 23%
had a sustained loss of HBsAg. Some relapsers could be retreated to achieve
HBeAg seroconversion again. Lamivudine clearly deserves its many converts.
JL Dienstock and others. Durability of serologic response after lamivudine
treatment of chronic hepatitis B. Hepatology 37:4; 748-755. April 2003.

Has anyone heard from Mykal? Have not seen him post and we are getting a little
nervous here!! MYKAL Where are you??? Hugs....Dana

Hi Teresa! I just try to pass along all the info I run across in
hopes that it helps someone :-) We sometimes have an impact on
peoples lives that we aren't even aware of...... I like to
*fantasize* that I am helping others because so many helped me when I
was first diagnosed :-) Hope all is going well at your end......
Take care of yourself!
Peace and Love,
Pam

Have Hepatitis C? Want to talk? Please meet us at the HepCat Hideout Chat at
http://forums.delphiforums.com/HepCingles
on Saturday nights at 5pm PST which is 8pm EST.
**THIS IS A NEW EARLIER TIME**
(Thank you ewob!) You do NOT have to be single to attend!! EVERYONE with Hep C
or interested in Hep C is encouraged to attend. If someone is not there PLEASE
hang out for a few and they will show up shortly :-) Hope everyone has a
wonderful weekend and I am sorry I didn't get this out in a more timely
manner........the 8PM is a new time and people should be *in and out* until 2AM
EST (Thank you Gracie :-) Is it be there or be square?...... or be there or
be talked about?? Take care all!!
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Dear PeachStatePam,
Thank you for all your valuable information. We really appreciate it. Theresa

Date: April 11, 2003
For Release: Immediately
Contact: HHS Press Office
(202) 690-6343
STATEMENT BY TOMMY G. THOMPSON
Secretary of Health and Human Services
Regarding New Federal Privacy Regulations
From the time of Hippocrates, privacy in medical care has been of prime
importance to patients and to the medical profession. Today, as electronic
data transmission is becoming ingrained in our health care system, we have new
challenges to insure that medical privacy is secured. While many states
have enacted laws giving differing degrees of protection, there has never before
been a federal standard defining and ensuring medical privacy. Now
new federal standards are coming into force to protect the personal health
information of every American patient.
As of Monday, April 14, millions of health plans, hospitals, doctors and other
health care providers around the country must comply with new federal
privacy regulations. To develop these regulations, the Department of Health and
Human Services went through an extensive process of consultation and
consensus that included reviewing and considering more than 100,000 public
comments.
These new federal health privacy regulations set a national floor of privacy
protections that will reassure patients that their medical records are kept
confidential. The rules will help to ensure appropriate privacy safeguards are
in place as we harness information technologies to improve the quality of care
provided to patients. Consumers will benefit from these new limits on the way
their personal medical records may be used or disclosed by those entrusted with
this sensitive information.
The new protections give patients greater access to their own medical records
and more control over how their personal information is used by their health
plans and health care providers. Consumers will get a notice explaining how
their health plans, doctors, pharmacies and other health care providers use,
disclose and protect their personal information. In
addition, consumers will have the ability to see and copy their health records
and to request corrections of any errors included in their records. Consumers
may file complaints about privacy issues with their health plans or providers or
with our Office for Civil Rights. The new rules also reflect a common-sense
balance between protecting patients' privacy and ensuring the best quality care
for patients. They do
not interfere with the ability of doctors to treat their patients, and they
allow important public health activities, such as tracking infectious disease
outbreaks and reporting adverse drug events, to continue.
Over the past two years, we've worked aggressively to provide doctors, hospitals
and other covered entities with the information that they need to
comply with the rule. We've held a series of regional conferences on the privacy
regulations and participated in hundreds of other conferences and
meetings with those affected by the regulations. We've provided extensive
guidance and other technical assistance materials that clarify key
provisions of the rule, so those affected take the right steps but don't go
overboard at the expense of the quality of their patients' care. Many of these
materials, including an extensive collection of frequently asked questions, are
on our Web site at http://www.hhs.gov/ocr/hipaa/assist.html.
We will continue our efforts to encourage covered entities to comply with the
regulations' requirements. After all, this is the best way to ensure that
patients get the rights and protections that they expect. Of course, we have all
the enforcement options available to us under the rule, including civil monetary
penalties, and we will use them as and when
necessary to obtain our goal of protecting the confidentiality of personal
medical information.

Carrier of SARS Made 7 Flights Before Treatment
By KEITH BRADSHER
HONG KONG, April 10 - Health officials announced here tonight that a man
infected with a new respiratory disease had flown from Hong Kong to Munich,
Barcelona, Frankfurt, London, Munich again, Frankfurt again and then back to
Hong Kong before entering a hospital.
The Hong Kong Department of Health appealed for passengers and air crews from
all seven flights to consult medical professionals. A health department
spokeswoman said it was not yet known whether the man, who is 48, had infected
anyone else on the flights with the disease - severe acute respiratory syndrome,
or SARS.
All the flights were on Lufthansa. The airline said in a statement tonight that
it had disinfected all the planes and was contacting the air crews and
passengers. It said the chances of anyone's having become infected during the
flights were "very remote."
Airlines have been saying that the filters aboard modern planes do a good job of
removing viruses from the air. But according to the health department here, at
least 13 people have fallen ill with SARS so far after they shared a flight from
Hong Kong to Beijing last month with an elderly man who had been infected with
the disease while visiting his brother in a hospital here.
Tonight's appeal for the Lufthansa crews and passengers to come forward follows
nearly a dozen such calls by health officials and by airlines operating flights
in and out of Hong Kong. Travelers have continued to board planes while feeling
ill despite strenuous warnings from the World Health Organization and national
health agencies that they not do so.
In the case that was announced tonight, the man flew on Lufthansa Flight 731 on
March 30 from Hong Kong to Munich, and traveled the next day on Flight 4316 to
Barcelona, according to an itinerary that was released here by the health
department. He developed symptoms while in Barcelona.
The man then traveled on Flight 4303 to Frankfurt on April 2 and on to London
the same day on Flight 4520. He went to Munich the next day on Flight 4671, then
headed for Frankfurt on April 4 on Flight 265. He connected with Flight 738 the
same day back to Hong Kong, arriving on April 5.
The man checked into a hospital here on April 8 and was confirmed today to have
SARS.
Doctors do not yet know how infectious, if at all, people are in the early
stages of SARS. Increasingly, doctors suspect that some people may be able to
transmit the disease before the symptoms become evident. But Hong Kong's health
secretary, Dr. Yeoh Eng-kiong, warned tonight that doctors here had become
infected from people who had not yet shown the full symptoms identified by the
World Health Organization.
Dr. Yeoh suggested that even someone with just diarrhea could be infectious.
The sick man's nationality was a mystery tonight. The health department's
statement did not specify it, while the airline's statement described the man as
"Chinese." A Lufthansa official said the company had been told by the health
department only that the man was Chinese. The department spokeswoman, in turn,
said that the man seemed to be of Chinese descent but that the agency had been
unable to determine his nationality.
"He travels a lot," the spokeswoman said. "We don't know his passport."
Hong Kong, which is a special administrative region of China, still issues
separate passports from mainland China, a legacy of its days as a British crown
colony. Officials here sometimes refer to people as Chinese if they are from
Taiwan, which Beijing regards as a renegade province, or if they are people of
any nationality who happen to be of Chinese descent.
The infected man's travels could not come at a worse time for Hong Kong, as
countries have begun limiting the entry of people traveling from here or
imposing quarantines on them.
Malaysia stopped issuing visas today to practically all holders of passports
from Hong Kong and mainland China. Cathay Pacific Airways, Hong Kong's main
airline, said tonight that it had suspended all flights to Kuala Lumpur, the
Malaysian capital, because there were few passengers.
Regina Ip, Hong Kong's security secretary, met with Malaysia's consul general
here to protest the decision. "There is no reason why the mobility of Hong Kong
residents who do not have any close contact with infected persons should be
restricted," she said afterward.
Singapore also imposed a 10-day quarantine on all foreign workers earning less
than $24,000 a year who have recently been in a SARS-affected country or
territory. Employers must pay costs of the quarantine. Singapore has been trying
for years to lure high-income employees in financial services and other
lucrative industries, while making it harder for lower-income workers to go
there and do jobs that less-educated Singaporeans might otherwise do.
Hong Kong's economy depends heavily on its role as Asia's transportation hub,
the place from which businesses can control and coordinate factories and other
businesses spread across the continent. Hong Kong has the world's busiest
container port for sea freight, the world's busiest airport for international
cargo shipments and what was, until recently, Asia's busiest airport in terms of
international air passenger departures.
But the availability of flights here is withering as many governments have
warned citizens not to visit and many businesses have ordered their employees
not to travel here.
Cathay Pacific has canceled a quarter of its daily flights here. Dragonair, an
affiliated carrier that dominates the skies between Hong Kong and cities in
mainland China, has stopped operating almost half its flights. Continental
Airlines canceled its daily nonstop flight from Hong Kong to New York this week
for lack of passengers.
The airport authority here said that a third of all flights originally scheduled
to operate today had been canceled for various reasons.
Health officials have said that the virus causing SARS can probably survive no
more than several hours outside the body, so that air and sea cargo shipments
from Hong Kong, as well as mail, do not pose a risk to recipients.
http://www.nytimes.com/2003/04/11/science/sciencespecial/11SARS.html?th
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Saturday, May 31, 2003
5K Run & 5K Walk (approx. 2 miles)
Griffith Park (near the Merry-Go-Round across from the Ranger Station)
Larry Hagman - Honorary Chair
Steve Morris - Master of Ceremonies
6:30 am - Check in-turn in pledges & on-site registration
7:00 - Opening Ceremonies
7:30 - Warm Up
8:00 - Official Start
9:30 - 1.5K Turtle Walk
8:00-Noon - Health Fair, Entertainment by "Get Back" Celebration
Tribute to the Beatles, Family Activities, Celebrity Autographs,
Food, Awards, & Prize Drawings
For More Information:
Contact Isabel Velasquez @ 1-310-670-4624
http://www.liver411.com

http://clinicaltrials.gov/ct/gui/screen/BrowseAny;jsessionid=123277B29A42533BE93\
941A2E9294B9B?recruiting=true&path=%2Fbrowse%2Fby-condition%2Faz%2FH%2FD006526%2\
BHepatitis%2BC
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The World Today - Hepatitis C vaccine, phase-one trials to begin in the US
The World Today - Monday, 7 April , 2003 12:30:19
Reporter: Tanya Nolan
ELEANOR HALL: As medical experts worldwide grapple with the growing incidence of
Severe Acute Respiratory Syndrome, the globe's leading virologists are meeting
in Sydney this week to discuss progress on another, much more common major
health problem - hepatitis.
And one of those experts is predicting a vaccine will be developed for SARS in a
matter of years. Doctor Michael Houghton and his team have just developed a
vaccine for Hepatitis C, the leading cause of chronic liver disease, and have
received approval to begin phase-one trials in the United States.
More than half a billion people worldwide are infected with one or more of the
five hepatitis viruses, with nearly 200 million suffering from Hep C.
Tanya Nolan has been speaking to Doctor Houghton, who says the Hepatitis C
vaccine could be available within seven years.
MICHAEL HOUGHTON: The global burden is huge. The WHO have investigated that 170
million people are infected worldwide. What that means is over the next 10, 20
years the amount of liver disease is going to be very, very large, requiring
extensive and very expensive treatment. And along with that is a necessity for
preventing new infections.
TANYA NOLAN: How has your vaccine managed to overcome the ability of the virus
to subvert the body's natural immune response by constantly mutating during the
infectious period?
MICHAEL HOUGHTON: Yes, the vaccine that we've tested in animal models, and we're
shortly going to be testing in humans, in a phase-one clinical trial in the
United States, is able to prime, and I should say produce, anti-bodies to the
virus, as well as prime t-helper cells that recognise the virus, and in
combination the vaccine is able to prevent infection against a variety of
different strains of the virus.
TANYA NOLAN: You've proved in animal trials that it could protect against
heterologous viruses, not just homogenous viruses. Does that mean it could
potentially provide protection against other forms or other strains of the
virus?
MICHAEL HOUGHTON: Yes, absolutely, and Hepatitis C virus, like HIV, is very
heterogenous, so any vaccine that you make cannot just protect against the virus
from which you've made the vaccine, you have to show it can protect against
other strains.
And because these are such heterogeneous viruses, it's a key point in vaccine
development, and that's what we've been able to show in the last couple of
years, that we can protect animals not just against homologous virus, but
against different strains of that particular virus type.
TANYA NOLAN: So how likely is it that we could see new drugs to fight the virus,
and a vaccine within the next decade?
MICHAEL HOUGHTON: Yes, well, we're just entering phase-one clinical trials in
the United States. There are three phases to a complete clinical program. We
anticipate finishing our complete program in about 5, 6 years from now. So I
think by 2010, hopefully, we're optimistic that we can have a vaccine on the
market to Hep C.
In terms of new drugs, there's a tremendous amount of effort going on globally
at research institutes and in big Biopharma, to develop inhibitors of key
enzymes involved in the viral life cycle. Rather like was done for HIV in the
last 10 years, we now expect the same process to be applied to Hep C, and for
new drugs to be available by the end of this decade.
TANYA NOLAN: As a virologist, how do you see the current medical ability to
control the outbreak of a pandemic of the corona virus, Severe Acute Respiratory
Syndrome?
MICHAEL HOUGHTON: Well, I think we need to do two things. First of all, the
measure that's already being taken by many countries to quarantine infected
individuals and suspected infected individuals, that's very important in order
to prevent a mass epidemic; number two, with the technologies we have available
now in vaccine research and development, I think we can move fast in order to
develop a vaccine to this agent.
I am personally fairly optimistic that we can develop a vaccine quite quickly.
But having said that, just to develop a vaccine that's safe, and has been
tested, and approved by the authorities, takes time, takes several years
basically, and so, in the interim, we have to be very carefully and keep up our
surveillance, and take adequate quarantining procedures, I think.
ELEANOR HALL: One of the world's leading virologists, Dr Michael Houghton,
speaking there to Tanya Nolan.
This is a transcript from The World Today for Monday, April 7, 2003. The
program is broadcast around Australia at 12:10pm on ABC Local Radio.
This is the print version of story
http://www.abc.net.au/worldtoday/content/2003/s826662.htm
© 2003 Australian Broadcasting Corporation
Copyright information:
http://abc.net.au/common/copyrigh.htm
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Theory Links Hepatitis C to Polio Syringes in Italy
Thu Apr 10, 2:41 PM ET
By Rossella Lorenzi
FLORENCE, Italy (Reuters Health) - Poorly cleaned glass syringes used to
administer the polio ) vaccine in the 1950s and 60s could have spread the
hepatitis C virus from person to person in southern Italy, researches from
Italy's National Cancer Institute suggested this week.
The accidental spread of the virus might explain why southern Italy has a
particularly high rate of the chronic liver disease, suggest Dr. Maurizio
Montella and colleagues.
In the mid 1950s and 1960s, an injected vaccine known as the Salk vaccine was
used to protect against the crippling disease polio. In southern Italy,
reusable glass syringes were used to deliver the vaccine until the new oral
version, known as the Sabin vaccine, was introduced in 1965. The authors'
theory is that the syringes, if not properly sterilized, may have spread the
hepatitis C virus.
Montella told Reuters Health Wednesday there was already some indirect evidence
linking the glass syringes used for the older vaccine to high hepatitis C rates.
"The phenomenon is circumscribed to certain areas -- where glass syringes were
widely used, there is an increase of hepatitis C cases," he said.
To look closer at the link, he and others drew on a previous investigation that
included a sample of 1,908 people aged 30 to 60 years.
The subjects were originally enrolled as healthy "controls" in another study.
They were known not to have used intravenous drugs or to have had blood
transfusions, both of which can spread the disease.
Tests showed that seven percent of men and five percent of women aged 40 to 49
years had antibodies to hepatitis C, suggesting infection with the virus.
People born between the 1940s and early 1960s were nearly three times as likely
as younger subjects to have the virus, they reported in this month's Journal of
Medical Virology.
Overall, about six percent of older adults had been infected with the virus
compared with about two percent of those aged 30 to 39.
The prevalence of hepatitis C is about 1.8 percent in the U.S. and ranges from
0.5 percent to nine percent in Western Europe.
"This is indisputable data, and it is linked to the years when the Salk polio
vaccination was administered," Montella said. "The high rate of HCV is most
likely attributable to a misuse and reuse of needles and glass syringes being
inadequately sterilized."
Because chronic hepatitis C infections may not cause any symptoms, "it will be
useful to inform the population of southern Italy about the implication to
their future health," the authors write in the article.
About four million people in the United States and 150 million worldwide have
hepatitis C, an infection of the liver that is spread by contact with blood and
other body fluids.
About 20 percent of people infected with the virus will develop severe and
potentially fatal liver damage, or cirrhosis, which in turn increases a
person's risk of liver cancer.
SOURCE: Journal of Medical Virology 2003;70:49-50.
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1.) Fibromyalgia Pain Diary Work Sheet
http://www.geocities.com/Wellesley/3466/worksheet.html
2. Fibromyalgia & Chronic Myofascial Pain Syndrome Worksheet
http://www2.rpa.net/~lrandall/fmslog.html
3.) Chronic Neuroimmune Diseases CFS, FM, MCS and more.
http://www.anapsid.org/cnd/diagnosis/berne.html
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Pam,
Thank you! This was a great artical and I love Freddy Fender!
Hugs..Dana

http://www.nytimes.com/2003/04/09/science/sciencespecial/09INFE.html?th
Asian Officials Say SARS May Be Here to Stay
By KEITH BRADSHER with LAWRENCE K. ALTMAN
ONG KONG, April 8 - Health officials in Hong Kong and Singapore warned their
citizens today that the agent that causes a mysterious respiratory disease has
spread so far in their communities and abroad that it will be hard to bring
under control any time soon, if ever.
"Singaporeans must be psychologically prepared for the problem to stay with us
for some time," said Lee Hsien Loong, Singapore's deputy prime minister.
Hong Kong and Singapore officials began emphasizing new measures to slow the
spread of the disease, but refrained from suggestions that they might be able to
get rid of the disease completely.
The World Health Organization, however, remained cautiously optimistic that the
disease, severe acute respiratory syndrome, or SARS, could be kept in check.
Dr. Leung Pak-yin, Hong Kong's deputy director of health, said that residents
should be concerned that the illness could be spread through contaminated
objects, particularly if their apartment buildings developed large numbers of
cases.
"We believe that every citizen could become a carrier of the virus," especially
if people do not follow practices like hand washing and the wearing of face
masks, he said.
The cause of SARS is unknown, but officials are almost certain that it is a
virus, and they strongly suspect that the culprit is a previously unknown member
of the coronavirus family.
Epidemiologists have traced most SARS cases to close person-to-person contact.
That finding initially led officials to believe that they could break the SARS
chain by isolating patients and their contacts and by requiring health workers
to use standard infection control measures in caring for patients. Such
measures, including frequent hand washing and wearing masks, gloves, gowns and
goggles, have worked in most places.
But in recent days epidemiologists have been unable to trace a number of SARS
outbreaks in hotels, hospitals and apartment complexes in Hong Kong, Singapore
and China to such person-to-person spread. Because of that, many health
officials have become increasingly suspicious that the disease can be spread
through contaminated objects like door knobs, water and sewage, as well as by
person-to-person contact. Hong Kong officials also have theorized that insects
like cockroaches could spread the disease, perhaps by tracking contaminated
sewage from apartment to apartment.
Hong Kong University researchers have found evidence suggesting that many people
may come in contact with the virus and only become mildly ill and not meet the
case definition. Also, officials are now suspicious that some people may be able
to spread the disease even if they are only mildly ill with SARS.
If it can be spread by insects or objects or healthy human carriers, containing
its spread would be much more difficult. The fear is that in a short time SARS
could become another on the long list of diseases that are a fixture in many
areas.
Still, two top W.H.O. officials expressed cautious optimism that SARS could be
stopped before that happens.
Dr. David L. Heymann, executive director in charge of communicable diseases for
W.H.O., said that his United Nations agency "was hopeful that SARS can be
contained, we haven't given up hope."
A W.H.O. team has just concluded a visit to Guangdong Province in China, which
is adjacent to Hong Kong and is where the epidemic apparently began last
November. W.H.O. expects to learn a considerable amount from the team's
research.
The team found that the Chinese kept "really meticulous records," Dr. Heymann
said, adding, "So there's a lot to learn because as the cases went on, the death
rate apparently was lower, meaning either the doctors learned to handle the
disease better or something else happened."
He also said that W.H.O. has two additional teams of scientists on standby to go
to China to help with the epidemiology and infection control.
Dr. Klaus Stöhr, the scientific director of the W.H.O. team investigating SARS,
said, "There is still a good chance we can contain it, provided that there is
nothing ongoing in China that is similar to what is going on in Hong Kong."
Experts think that SARS is largely spread through droplets exhaled by dry
coughs. There are two distinct ways in which coughing can spread viral diseases:
droplet or airborne transmission. In droplet transmission, the infective
material is coughed or sneezed out of a patient's airway surrounded by a bit of
moisture. The particles are too large to travel more than about three feet, and
so relatively close, face-to-face contact is required for transmission to take
place through the air. But the viruses may also persist on inanimate objects,
and people can become infected from touching contaminated surfaces. Masks,
gloves and frequent hand washing can sharply reduce droplet transmission.
By contrast, airborne viruses travel much farther than three feet and can hang
in the air and infect other people for a long time after a coughing or sneezing
patient has left the room. Airborne transmission is far more efficient than
droplet transmission, and it is the way that diseases like influenza and measles
spread. Experts doubt that SARS is airborne, because if it were, there would be
even faster spread and many more cases.
To help determine whether seemingly healthy people can spread the SARS agent,
Hong Kong is conducting a number of studies involving the hundreds of people in
isolation here because they had contact with a SARS patient.
In 10 percent of one study involving 200 people, scientists have found evidence
of the new coronavirus in their feces. But the virus is in an immature form and
is unable to cause infection unless other parts of the virus are present, Dr.
Stöhr said.
"So we do not know what the finding means," Dr. Stöhr said.
He said that similar studies are being conducted in Ontario, where more than 180
SARS cases, including 10 deaths, have occurred.
Mr. Lee and Tung Chee-hwa, Hong Kong's chief executive, each warned of serious
harm to their cities' economies because of the outbreak, which has particularly
hurt the airline, hotel, retailing and restaurant industries. "This SARS has now
a profound long-term impact on our economy and it is a very serious matter," Mr.
Tung said at a news conference this evening.
Hong Kong reported 45 new cases today, including 18 health care workers, as well
as the deaths of two elderly men who were infected with SARS but had other
health problems as well. Figures for new cases over the last several days have
included 30 cases at the Ngau Tau Kok apartment complex, which had not
previously been affected, Dr. Leung said.
The disease has already infected close to 300 people in the nearby Amoy Gardens
apartment complex, and it appears that people from the Ngau Tau Kok complex had
been visiting Amoy Gardens, Dr. Leung added.
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http://www.scn.org/health/hepatitis/handbook.htm
Prepared by
The Hepatitis Education Project
October 1996

HHS WEEKLY REPORT
April 6-12th, 2003
THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS AT:
http://www.hhs.gov/news/newsletter/weekly
IN THIS ISSUE:
President Bush Proclaims April "National Donate Life Month
Last week President Bush issued a Presidential proclamation dedicating April
2003 "National Donate Life Month." Right now, close to 81,000 people are
awaiting organ or tissue donations. Yet last year only 24,851 were performed.
Despite our technological advances, 17 people who are waiting for a donated
kidney, liver, heart, lung, or other organ die each day due to the lack of
donors---and over half of the transplant recipients are minorities.
Although most Americans indicate they support organ donation, only about 50
percent of families asked to donate a loved one's organs agree to do so.
President Bush and HHS Secretary Tommy G. Thompson are working together to
increase awareness about the importance of choosing to donate your organs or
tissue, then communicating your decision to your loved ones so they are
aware of your wishes in the event of an emergency.
To learn more about the donation initiative, and to read the Presidential
Proclamation, please visit organdonor.gov http://www.organdonor.gov/
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Future complications of chronic hepatitis C in the United States
Despite the declining incidence of acute HCV infection, chronic hepatitis C is
common, find researchers in the April issue of Liver Transplantation.
Chronic hepatitis C virus (HCV) infection is common and often results in slowly
progressive liver disease.
Acute hepatitis C is now uncommon, however most patients with acute infection
have developed chronic hepatitis. Therefore, the pool of infected patients is
large.
In this study, researchers from the United States modified a previously
described natural history model for HCV infection. They used this to project the
number of cases of HCV infection, cirrhosis, and liver failure over the next 40
years.
The proportion of the HCV-infected individuals with cirrhosis will increase from
16% to 32% by 2020.
Liver Transplantation
The model estimated that the prevalence of HCV infection in the United States
was 3.07 x 106 in 1993. This compared with an adjusted National Health and
Nutrition Evaluation Survey (NHANES) III estimate of between 2.8
to 3.5 x 106.
The researchers predict a gradual decline in the prevalence of infection by year
2040, due to aging and natural deaths among the infected pool.
However, the proportion with cirrhosis will increase from 16% to 32% by 2020 in
an untreated population, as the duration of infection increases in the surviving
cohort.
In addition, the complications of cirrhosis also will increase dramatically over
the next 20 years. The team predicts that hepatic decompensation will increase
by 106%, hepatocellular carcinoma by 81%, and liver-related deaths by 180%.
Furthermore, although current treatment regimens eradicate HCV in over 50%
of cases, many more patients would need to be treated to significantly impact
disease progression.
Identification and treatment of every case of HCV infection would reduce the
number of cases of decompensated cirrhosis by almost half after 20 years.
Dr Gary Davis's team concluded, "Despite the declining incidence of acute HCV
infection, chronic hepatitis C is common".
"The prevalence of cirrhosis and the incidence of its complications will
increase over the next 10 to 20 years."
This is, "Because the duration of infection increases among those with chronic
hepatitis C."
"These data emphasize the need for greater access to transplantation by
expansion of the donor pool, increasing use of split livers and living donors,
and novel options such as xenotransplantation".
Liver Transpl 2003; 9: 331-8
09 April 2003
http://www.gastrohep.com/news/news.asp?id=1962
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Schering-Plough advances development of hepatitis capsules
21st April 2006
By Tom Neilson
Schering-Plough has completed patient enrollment in the first part of its
ongoing phase II clinical study to determine the appropriate dose range of SCH
503034, its investigational oral hepatitis C protease inhibitor capsules.
SCH 503034 is being evaluated in a large phase II study in combination with
peg-intron (peginterferon alfa-2b) for the treatment of patients chronically
infected with hepatitis C virus (HCV) genotype 1 who were nonresponders to
peginterferon and ribavirin combination therapy.
The current standard of care in treating chronic hepatitis C is the combination
of peginterferon and ribavirin. HCV genotype 1 is the most common form of the
virus worldwide and is considered the most difficult to treat successfully.
Currently, no alternative therapy has been shown effective for the large number
of patients who failed previous therapies, representing an area of great unmet
medical need.
The company also reported that with the completion of enrollment of the original
protocol doses of 100, 200, 400mg three times a day, it continues to explore a
full range of dosing options for the drug. As such, the ongoing phase II study
has been expanded to include an additional treatment arm with 800mg of the drug
administered three times a day in combination with peg-intron for 24 weeks. This
arm will enroll up to an additional 65 patients.
In all, the ongoing phase II study will enroll a total of approximately 350
patients at centers in the US and Europe, making it the largest clinical study
to date with an HCV protease inhibitor.
"SCH 503034 is one of the most advanced investigational agents in this new class
of drugs that target key HCV proteins necessary for viral replication," said Dr
Robert Spiegel, chief medical officer and senior vice president, Schering-Plough
Research Institute. "This promising oral antiviral agent has the potential to
greatly improve treatment for all hepatitis C patients, and may lead to future
regimens that are more effective, better tolerated and shorter in duration."
~Bayla~
SVRnWaiting
"C" It! Treat It! Beat It!!
"Currently about one in 15 people
are living with Hepatitis."

Rock Solid: The Story Behind Benihana
Restaurateur Rocky Aoki doesn't let hepatitis C get in his way.
By: Tamra Orr
Rocky Aoki just returned from a trip to Istanbul where he opened yet another of
his Benihana restaurants. While there, he purchased a 5 x 10 silk Turkish rug
for a mere $27,000. "They knew I was coming," he says with a rueful chuckle.
Maybe they did-but it's unlikely anyone could pull any kind of rug over this
businessman's head. With his years in the restaurant business, the lessons he
has learned and the success he has had, he is certainly nobody's fool. And he
hasn't let his hepatitis slow him down for a moment, either. "I keep a 'the show
must go on' attitude," he says.
In addition to hot air balloon and cross-country car races, Aoki has also been a
longtime fan of offshore powerboat racing. He had three fairly serious accidents
between the years 1979 and 1982 and attributes his diagnosis of hepatitis C to
one of them. "I broke many, many bones," he says, "and I feel that one of those
accidents is where I got hepatitis C. I had many blood transfusions.
"I was diagnosed with hepatitis 20 years ago, just after one of my accidents"
says Aoki. "I had interferon injections for more than five years and I felt
terrible then. I was dizzy with headaches and fever. I even lost all of my hair,
but now it has grown back. The interferon helped me," he adds, "and I survived.
Now I am going to Dr. Christopher Calapai, D.O., at Comprehensive Medical
Services in East Meadow, New York, for vitamin C drips one or two times a week.
I checked my blood just last week and I am doing well."
Challenging the disease
While hepatitis has obviously been a factor in Aoki's life, it hasn't slowed him
down at all. His future plans include opening his first restaurants in Shanghai
and Beijing, China, and, within 10 years, to have at least 35 of them in those
areas. He travels back and forth to Japan every two or three months. "I call
myself a challenger," he says. "I will challenge myself until I die. I work hard
and I work smart. You win only if you are not afraid to lose."
Much of Aoki's time, money and dedication are spent with charity work. He is a
regular contributor and spokesperson for such groups as the American Liver
Foundation, the National Foundation for Cancer Research and the Leukemia
Society. On the 25th anniversary of his restaurant chain, he raised $25,000 for
Juvenile Diabetes. He has worked to raise public awareness and funds for
hepatitis C, and the Rocky Aoki Foundation, a community service organization,
helps to solve community problems at the local level. One of his most recent
charitable efforts took place in September. In order to honor the nation's men
and women in uniform, he offered 50 percent discounts each Wednesday to anyone
showing a badge. Son Kevin stated, "We want to pay tribute to those who fight
for freedom and justice, especially during this important time in history. This
is just one small way that we can thank the American men and women in uniform
who are willing to sacrifice their lives for our country."
Connecting two cultures
The company continues to be represented in hot air balloon races across the
country and acts as associate sponsors of American Spirit Racing and driver
Michael Lewis, as well as other major sporting events. In his drive to
interconnect the United States' culture with Japan's, Aoki brought the first
heavyweight-boxing match to Japan in 1971, including international boxing stars
Muhammad Ali and Mac Foster, and then brought the Japanese tennis team here to
be part of the U.S. Championship. He has sponsored several cultural events,
including the "Asian Festivals" in Manhattan's Central Park and numerous
contributions to Japanese artists currently in this country. Despite his
inability to cook, Aoki has made a number of cooking videos for home use, using
his knowledge and an assistant's cooking talents. His Benihana National
Corporation also develops a line of frozen foods for home use.
Aoki first came to this country with the 1960 Japanese Olympic wrestling team.
He had already won national wrestling championships in Japan. Now, he was here
to compete for the New York Athletic Club and in doing so, he added three U.S.
titles to his growing collection. In 1995, he was inducted into the Wrestling
Hall of Fame.
Aoki was only 20 years old, and he already had quite a bit of business knowledge
just waiting to take root in this new country. His father, Yunosuke Aoki, was a
popular entertainer in Japan, as well as a restaurant owner. "My dad was a
vaudevillian," says Aoki. "He was a song and dance man and a comedian. He taught
me everything he didn't know." Yunosuke and his wife, Katsu, had opened their
first coffeehouse-style restaurant just after the end of World War II and named
it "Benihana" for the red safflowers that grew along the streets. "My father's
restaurant was known for using real sugar," says Aoki. "In those times, he would
often have to bicycle more than 20 miles to get it." All four of Yunosuke and
Katsu's sons grew up immersed in the business with their parents. Rocky, or
Hiroaki as he was called then, was the oldest of the brothers, and he saw how
his father made his restaurants special by using the unique combination of great
food, a touch of drama and a splash of entertainment. It was a lesson that would
one day bring him great success.
From ice cream in Harlem to Chicago
Without any real money, contacts or family here in the United States, Aoki knew
he had to start small. First, he changed his name from his native Hiroaki to the
simpler and easier to remember Rocky. "I leased a big truck from Mr. Frosty," he
recalls, "and started selling ice cream right in the heart of Harlem." To make
his treats memorable, Aoki would stick Japanese cocktail umbrellas in each one.
The truck cost him $25 a day to rent and yet, through incredible hard work and
dedication, he managed to save up $10,000 in a matter of months. The price he
paid was sometimes a bit much. "It was the era of the 60s," he says. "During
that time, I was stabbed two times in the leg, mugged several times, beaten up
and robbed. It was a real challenge to my spirit," he says, but then, he adds
with a grin, "I'm only 5'4" but I am one pretty good street fighter."
Aoki's father had passed away by the time his son was on the verge of following
in his footsteps. "My mother back in Japan was worried about me," he says, "and
so she came to New York to live with me in a studio apartment. She worked as a
waitress to help me with money." At the same time, Aoki was also going to New
York City Technical College for
classes on hotel and restaurant management. By 1964, his money and education
combined to help him open up his first restaurant on New York's West Side.
Although Japanese restaurants can be found today in even small cities, back in
the mid-60s, Japanese cuisine was a mystery to most Americans. The menu at
Aoki's first restaurant was intriguing and unusual to say the least. To make
things even more unusual for customers, and following the lessons he had learned
from his father, Rocky introduced an all-new concept to the dining
experience-eatertainment. Along with exotic food, customers were also highly
entertained by dramatic chefs, wielding sharp, shiny knives as easily as if they
were a child's rubber balls. With overhead lights glinting off cutlery that flew
up in the air and then back down to the grill in the middle of each table to
slice, dice and flip, people began to eat at Benihana as much for the fun as the
food. "In my restaurants, the chef is right in front of the customer," explains
Aoki. "He is there for appetizers through the main entrée. I think that in
America, showmanship is very important." Don't be fooled into thinking that it
was Aoki who taught the chefs their culinary skills. "I do not even know how to
cook," he admits. "I just know how to create the right kind of system."
In addition to this avant-garde style of tableside cooking, tables at Benihana
seated several parties together at communal tables instead of separately, as in
most restaurants. Most tables sat approximately eight people. A positive review
from a restaurant critic from the now defunct New York Tribune soon had Benihana
packed to capacity. "I began doing many television and magazine interviews," he
says. At this point, Aoki opened a second restaurant about three blocks to the
east and inside of six months, it, too, was packed to capacity. As its
popularity began to grow, Mr. Hilton-as in the hotel chain-approached Aoki. "He
said 'I like this place. Let's put one in Chicago,'" Aoki explains. "It hit very
big, but I was not surprised after New York. As the song lyrics say, 'If you can
make it there, you can make it anywhere.'"
Taking risks
One by one, Aoki went to large cities and opened more Benihana restaurants.
Today, there are more than 100 around the world and Benihana is considered the
No. 1 most well known international restaurant, serving more than 7 million
people each year. A recent addition to some of the restaurants is a sushi bar.
Of course, during the chain's growth, Aoki kept more than busy doing
promotion-and taking some considerable risks. One of the hot air balloon races
he participated in produced a record-breaking trip from Japan to California. It
took four days, and in the Pacific Eagle balloon, Aoki and his crew were plagued
with everything from ice and storms to near- fatal crashes. The trip was
highlighted in a 1982 issue of the National Geographic and in a book entitled
"Flight of the Pacific Eagle." His company continues to fly in a number of hot
air balloon competitions, and the company uses a hot air balloon as one of its
icons.
Personal life risks
Along with physical risks, Aoki was also taking a few risks with his love life.
He has been married three times and has seven children altogether. "I never
learn my lesson when it comes to women," he laughs. "I just get divorced and
they take all of my money-I am still paying all of them today. They had a very
famous and very good lawyer." His oldest child is daughter Grace, who lives in
New Jersey, and his youngest is Devon, a professional runway model for Chanel
and Lancome, as well as an actress starring in the film "Fast and Furious 2."
Aoki's son, Kevin, is also following in his dad's footsteps. He has worked as
vice-president for Benihana in Miami for many years and has his own restaurant
there named Doraku. Aoki's younger brother is taking his father's example to
heart, also, and has opened up four Japanese restaurants himself. "Competition
is very healthy," says Aoki. "It is a rat race with businessmen in New York;
everyone wants to be the champion. My brother and I are not brothers now, we are
competitors."
Learn more about Rocky Aoki's life story and subsequent success in these books:
Making It in America: The Life and Times of Rocky Aoki, Benihana's Pioneer, by
Jack McCallum, Dodd Mead, 1985.
Mr. Benihana: The Rocky Aoki Story by Takahashi Miyuki (comic book format),
Stone Bridge Press, 1997.
Aoki has authored eleven books himself, including 2003's Sake, a book about the
history, background and use of this Japanese wine.
http://hepatitismag.com/features/default.asp?HepStoryID=50
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Geese I didnt even know Freddy was one of us

http://hepatitismag.com/features/default.asp?HepStoryID=50"
Resurrected Days, Resurrected Nights
After overcoming obstacles such as drug addiction and jail time, music legend
Freddy Fender now faces hepatitis C and kidney failure in a fight for his life.
By: Brad Dodson
To his fans, Freddy Fender is a Southern blues legend. Some might even call him
immortal if they did not know the irony attached to the word. Because - as
Freddy's true fans know - failing kidneys and a battle with hepatitis C have
brought this beloved star down to Earth in a fight for his life.
On a recent Saturday afternoon in Louisiana, Freddy's fans packed themselves
into the main foyer of the Isle of Capri Casino - ignoring the lure of the slot
machines just feet away - just to catch a glimpse of him before his evening
concert. A rumor has circulated that this might be the last public performance
in a career that has spanned five decades, and it is hard to tell who would miss
the other more: Freddy or his fans.
"It gives me a feeling of professional accomplishment," Freddy says of the
assembling throng who are waiting to rush the concert hall for the best seats,
"and at the same time, a humble feeling of gratitude."
When the wait is finally over, and Freddy - guitar slung over his shoulder -
strolls on stage and up to the microphone, it seems as if talk of his early
demise is certainly premature, until he reminds the audience himself.
"I'm very happy to be here tonight. . Of course, I'm very happy to be anywhere
tonight!" he proclaims before breaking into his first song of the night - the
appropriately titled Tell It Like It Is. Before the show is over, Freddy will
have everyone out of their seats and dancing in the aisles.
The Rise and Fall
Freddy Fender is no stranger to tough times, or adversity. Born in the
Depression, he grew up as Baldemar Huerta in a barrio in the small Texas town of
San Benito. Freddy's family struggled to make ends meet in a time of scarce
jobs, working as migrant laborers around the Rio Grande Valley in Texas. The
hours were long, and the pay was minimal; however, it would not be long before
Freddy would prove true the saying, "tough times never last, but tough people
do."
"Growing up and working in the fields gave me the caring attitude I now have for
my fans," Freddy says. Looking back at his beginning, he adds, helps Freddy keep
his feet on the ground and his ego in check when he thinks of the people who
support his music.
Freddy had an ear and voice for music from an early age, and it would be this
"gift" that would change the course of his life. At the age of 10, he made his
first appearance on radio, singing Paloma Querida. Not long after, another
performance of that song would earn him first prize in a talent contest in
Harlingen, Texas.
Feeling the sensation of performing for others, Freddy began to take in earnest
the lessons of the blues he heard sung in the fields by the African American
workers. Combin-ing the Mexican music of his family, with the polka he heard
played among the German/Czechoslovakian settlers, and the blues, Freddy
developed a style all his own.
As Baldemar Huerta, he had number one hits in Mexico and South America in 1957,
with Spanish versions of Elvis Presley's Don't Be Cruel and Harry Belafonte's
Jamaica Farewell. Soon afterward, success came calling in the form of a contract
with Imperial Records. With the hope of crossing over to the "gringo"
mainstream, Baldemar Huerta became Freddy Fender and in 1959, Freddy would hit
No. 1 in the states with his own song, Wasted Days and Wasted Nights.
The song would prove prophetic. Before success could be further capitalized -
Freddy and his bass player would be arrested and sent to prison for possession
of two marijuana cigarettes. He would leave prison three years later and
eventually wind up back in the Valley, working as a mechanic and taking classes
at the local college, his music career derailed into playing the clubs on
weekends.
The Rise Again
Like a cat with many lives, and over a decade since he had been a rising star,
Freddy was determined to make it to the top again. In the 1970s Freddy turned to
country music and in 1975 hit the No. 1 spot with another song, Before the Next
Teardrop Falls. On April 8, 1975, he made history when the song became the first
debut single to make it to the top of both the Billboard country and pop charts.
A remake of Wasted Days and Wasted Nights made it to the No. 1 spot on the
country chart and with two follow-up No. 1s, Freddy's album went multi-platinum.
By the end of the year, Billboard would name him Best Male Artist of 1975. The
Gavin Report would award him single and album of the year honors.
With a career in full motion, Freddy would follow singing with a move into
acting, most notably with a breakthrough performance in the Robert Redford film,
The Milagro Beanfield War. In the 1980s and 1990s, he would also earn
recognition and acclaim for his work with the Tejano super group, the Texas
Tornadoes. Everything was great - until it got worse. Somewhere along the way to
the top, Freddy would lose something he wasn't even aware he needed - his
health. But he would also gain some perspective.
The Human Side of Stardom
Since 1976 Freddy has been dealing with life as a diabetic. To combat the
disease, he has been giving himself insulin injections daily for almost 25
years. He treated diabetes as little more than a scratch. After all, millions of
people were living with it around the world. So Freddy continued living the life
he loved: traveling, performing, and having as good a time as possible.
Grammy awards for his work with the Texas Tornadoes and critical acclaim came
and, by the 90s, life was as good as it could get. Then, in November 2000, the
wake-up call arrived. He was told he had hepatitis C. He was also told he needed
a kidney transplant; the diabetes was wearing out his organs. And just like
that, much like the 1960s, Freddy Fender found himself in transition, having to
start over again.
A New Challenge
Freddy found out he had the hepatitis C virus after going to the doctor to find
out why he wasn't feeling as good as he thought he should. A former reveler, he
figured he might need to slow down and get some rest. But just to be sure, he
got a professional opinion.
"I had no idea what it might be," says Freddy, "although I had been thinking for
a while that it might be something, because I was always exhausted." The doctor
confirmed it when Freddy's blood work tested positive for the hepatitis C virus.
At first the news was a shock to Freddy. He likened it to Pandora's box. He knew
he needed to find out what was wrong, but "sometimes you don't want to take the
lid off, because you might not like what you find on the inside." And what he
found at first glance wasn't something he wanted to see. "I guess it was a
blow," he recalls, "but like a boxer, I've learned in this life that more than
anything you have to roll with the punches. I've also come to realize that the
only way to mature is to take your hits and get up again."
Freddy's approach toward the disease has been different than many other's facing
the same diagnosis. He's not in denial, but he doesn't see the need for dwelling
over how he contracted the virus. "I can bet you that most of the people who
were diagnosed were surprised - it's a jolt," says Freddy. "But to me, people
spend too much time asking the wrong question. The question should not be 'Where
did you get this disease?' it should be, 'What are you going to do now that you
have it?'"
A New Road, Similar Sights
This is easy for Freddy, because it's similar to another road he traveled in the
1980s - addiction. While it's not something he remembers fondly, he appreciates
the similarity between accepting that he was addicted to alcohol and drugs and
that of living with hepatitis C.
As a person who was trying to figure out addiction in the past, he remembers
always wanting to know why people became alcoholics and addicts, with the hopes
of stumbling onto some hidden criteria. "Then one day a lady said to me,
'Freddy, don't worry about how the cow got into the ditch, just worry about
getting it out of there!'" The approach has worked. Freddy has since maintained
16 years sobriety with the help of Alcoholics Anonymous. That attitude is now
the stance he takes towards hepatitis: Don't get caught up in the how, instead
focus on dealing with it head on.
For this, spirituality and the help of others play a large role. "When you first
go to AA meetings, you have to learn to believe in God," says Freddy. "This was
difficult for me at the time because subconsciously I probably thought I was
him." Freddy's barber helped put it into perspective, telling him, "the only
thing you need to know about God, Freddy, is that you're not him."
"Which was right," says Freddy. "I've gotten a lot of spirituality since then
through what I do." Much of it comes in the form of unwavering support from his
fans, many of whom offer their support through letters posted on his Web site,
www.FreddyFender.com.
Learning to be a Recipient
For a man who's made a living out of giving hope and joy to others, one of the
hardest lessons Freddy has learned since he began battling hepatitis is how to
take instead of give.
"There are days when I feel that no one knows how heavy the sack is except the
one who is carrying it," says Freddy. "It used to offend me when others would
write, or call, to say they were praying for me, as if I was going to die that
day. Then I realized that I was carrying a burden by myself that I didn't have
to. I realized their words and prayers came from the heart.
"I used to find that acceptance was noble, as in acceptance of the disease - now
I see that acceptance of the love of others is more noble."
The words strike a chord in him. "In the past, there were a lot of times I would
call Freddy Fender fans who were terminal," remembers Freddy. "I would say
things I thought were appropriate to the situation, but I didn't know what it
was to be sick. Now I do.
"This has given me an insight, an ability to empathize, appreciate, and have a
love for others. Unfortunately, in some ways it makes you think about dying
every day. But, then you also begin to recognize what it means to be alive. You
learn to live; you realize how fragile we really are - how weak are the links of
our life."
Grace in Action
Freddy's battle for his health has led him to another important realization:
There is much to be grateful for in the world. Most notably his loving wife of
more than 40 years, Vangie. Talking to him, it doesn't take much for you to get
the picture - she's the proverbial "good woman" behind the man. More than a
wife, she works as a manager, caretaker and protector.
He quickly points out her strengths, saying with affection, "My wife is the most
devoted little soldier I've ever met, and the greatest nurse. I've never
appreciated (her) so much, until I was sick." Testament to his love and
appreciation, he is able to recite the date of their marriage without hesitation
when prodded, "August 9, 1957."
Alongside his wife have been their children, although he recalls with chagrin
the way he handled their worries before when the illness caused him to lose a
large amount of weight in a short time. "I'm very independent," he says, "and I
was unaware of the situation; I didn't recognize the sincerity in the concerns
of my children and relatives. Now I try to be more aware and sensitive."
Since going on dialysis every other day for his kidneys, and having the
complications added by hepatitis C, Freddy has agreed to lower his bookings by
about 50 percent. Now he plays mostly weekends but still performs around the
world. Vangie says, "I don't know where he gets the energy. It's not even why
does he still do it, but how does he do it?" Freddy says the cut in his touring
schedule has as much to do with being older - and wanting some time to be home
in Corpus Christi or fishing on his boat in the Gulf of Mexico - as it does with
his ill health.
Making Changes, Moving Ahead
But it's change that he's made, and it's change like this that is for his best
interest. "Medically speaking, I take no medications right now," says Freddy.
"The stage of my HCV is too far advanced for a traditional dose of medication.
I'm suffering from the early stages of cirrhosis.
"I've had to settle my diet down considerably - not much of the spicy stuff
anymore - and of course go to dialysis while I wait for a kidney transplant. But
mostly I treat it (hepatitis C) by trying to rest, maintaining my status with
the doctor, and being sensible." He says one of his biggest regrets is that his
touring and dialysis schedules do not leave time to attend hepatitis support
group meetings.
"My understanding is that you can live with HCV for the rest of your life, so
I'm learning all of the information on it. Right now, I know the basics." As for
the future.well, Freddy thinks it best summed up in two ways:
One is in the words of a song from the past that states his faith toward things,
"Starting all over again, it's gonna be rough, so rough, but we're gonna make
it. . I know we will."
And the other, perhaps the most comical when taken as a sign that, no matter
what, you're going to get what you need comes from the words of Freddy's 86
year-old uncle, Chuy, who told him, "Don't worry, no one ever dies before their
time."
And as for that show being the last one he's ever going to perform - Freddy says
don't count on it.
Brad Dodson is a freelance writer who lives in Seabrook, Texas, who has loved
Freddy Fender's music for years.
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P, i do take way more meds than i want to...but, im a definately afraid of
getting more depressed...when i was on the 'combo' i got wicked depressed, i was
afraid..so i had my meds bumped up...seems its once of the side effects...plus i
thing having hepc in generally, mind and body are effected.
heres a little article i picked up on food and depression;
Date: Wed May 9 09:49:32 2001
Posted By: Michael Parker, Research Chemist
Area of science: Neuroscience
ID: 979348658.Ns
Message:
Sarah,
This is a good question. Although there are many different causes and
types of depression, there is indeed a connection between food and
depression (or mood in general.) However, depression is more often caused
by a lack of certain foods in a diet, rather than being caused by
something that is present. There is also a connection, as you have noted,
between neurotransmitters and depression.
The cause of depression in the biochemical sense is usually associated
with low levels of neurotransmitters (such as dopamine, norepinephrine,
and serotonin) in the central nervous system. Prescription drugs used to
treat depression are designed to restore normal levels of
neurotransmitters. For example, the class of antidepressants known as
selective serotonin reuptake inhibitors (or SSRIs) such as Prozac help to
increase the levels of serotonin.
It is known that carbohydrates in the diet increase the brain's
production
of serotonin. Also, the body needs the amino acid tryptophan, which is
found in food proteins, to produce serotonin. So depression can sometimes
be the result of a diet that is low in carbohydrates or tryptophan.
Research has shown that there may also be a connection between depression
and lack of other dietary components such as omega-3 fatty acids, vitamins
B3 and B6, and magnesium.
There is some speculation that stimulants can lead indirectly to
depression. For example, too much caffeine in the diet can prevent
someone from sleeping well. Since restful sleep is necessary for good
mental health, caffeine and other stimulants can lead indirectly to
depression and anxiety.
As a final comment, alcohol consumption can cause both depression and
aggression. Although alcohol is generally thought of as something that
can brighten your mood, too much alcohol consumption can lead to
depression or worsen it if it is already present. Alcohol also lowers
peoples inhibitions, and for some this leads to more aggressive behavior.
I hope this helps!
http://www.ask.com/main/metaAnswer.asp?t=ai&s=a&MetaEngine=directhit&en=te&eo=6&\
o=0&frames=True&url=http%3A%2F%2Fwww%2Emadsci%2Eorg%2Fposts%2Farchives%2Fmay2001\
%2F989491596%2ENs%2Er%2Ehtml&ac=7&adcat=hlth&pt=Re%3A+Do+certain+foods+cause+dep\
ression+%28passiveness%29%3F&dm=http%3A%2F%2Fwww%2Emadsci%2Eorg%2Fposts%2Farchiv\
es%2Fmay2001%2F989491596%2ENs%2Er%2Ehtml&io=1&qid=A75D7D454517F24C8227057518DE57\
02&back=ask%3Dwhat%2Bfoods%2Bcan%2Bcause%2Bdepression%253F%26o%3D0%26x%3D17%26y%\
3D2&ask=what+foods+can+cause+depression%3F&dt=030221154120&amt=&pg=1&qsrc=0
**********************************
Message: 7
Date: Tue, 8 Apr 2003 22:15:48 -0400
From: "*~PeachStatePam~*" <figment@...
Subject: Corey
Hey there Corey :-) I take an antidepressant to that isn't
particularly
liver friendly........ but I decided it beats the alternative of being
depressed :-) Sometimes you just have to weigh the pros and
cons
since virtually EVERYTHING passes through our livers and just do what
is
best for you :-) Take care!

Pam what the point was, was that my Doctor wrote that article you sent out
to us! LOL

Hey there Corey :-) I take an antidepressant to that isn't particularly
liver friendly........ but I decided it beats the alternative of being
depressed :-) Sometimes you just have to weigh the pros and cons
since virtually EVERYTHING passes through our livers and just do what is
best for you :-) Take care!
Peace and Love,
·´¨¨)) -:¦:-
¸.·´.·´¨¨))
((¸¸.·´ ..·´ -:¦:-Pam
-:¦:- ((¸¸.·´*
"I have studied many philosophers and many cats. The wisdom of cats is
infinitely superior." - Hippolyte Taine

from what i understand anything that goes into our body via ingestion, our
skin....effects our liver.
i dont use chemically cleaning products due to this, and i try not to cow on
foods that are bad for me...
however, i must, at this time take my anti-depressants....which has been known
to casue liver damage.
i like the article..thanks...i used to get hat magazine...maybe i still do, lol,
it only comes out 4 times a year...i think*.. but its a GREAT mag with LOTS of
info...
corey
***************************
Balancing Act: Drugs that can help and hurt
Message: 2
Date: Mon, 7 Apr 2003 16:52:00 -0400
From: "*~PeachStatePam~*" <figment@...
Subject: Balancing Act: Drugs that can help and hurt
http://www.hepatitismag.com/features/default.asp?HepStoryID=37

Pam they were testing this in Atlanta a couple of years back. I have always said
they should take out the bad blood and put new in as a joke. I too wish I could
try this but if they won't let cirrhotics I will be out. Sometimes I feel like
they don't want us to make us look bad. Back in the beginning of my dance with
hep they wouldn't even give treatment to me because of Cirrohsis. Go figure.
love ya, Tricia

'Two Months After Treatment
A Hepatitis Poem Parody
By Bill Buckels
Based on an Account of a Visit from St. Nicholas
('Twas the Night Before Christmas)
By Clement Clarke Moore (1779-1863)
'Two months after Treatment; I was feeling quite bold,
Not a virus was stirring, not even a cold;
I dimly remembered Hepatitis'' first scare,
Thinking Success just hadn't a prayer.
The druggists were nestled all snug in their beds,
While visions of profits danced in their heads;
My claims had been settled without any cr*p;
I was thinking 'bout taking a long liver's nap.
When out in the back there arose such a clatter,
I sprang from my keyboard to see what was the matter;
Away to the window where my cat turned and tossed,
I opened the blinds and scraped off the frost.
The moon on the breast of the now-yellow snow
Gave the lustre of jaundice to objects below,
When, what to my wondering eyes should appear,
But a wizened old croaker, with a nurse he called "Dear",
He was a quack doctor, I could tell by his beak;
Plus-he made duck-sounds when starting to speak;
More rabid than beagles his treatments they came,
And with them he shouted, each pharmacorp's name;
"Now, Amgen, now, Schering! now, ICN! Roche!
On, Maxim, on, Viragen!, SciClone, Oh Gosh!
They have promised you nothing so you've nothing to lose!"
"Like fecal dry-doogie their efficacies lay,
They come-out in the-wash and crumble away."
Then up to the house-top a coin-flip he-threw,
He said "Heads or Tails?" while it twinkled and flew.
And then, as he caught it, he banged on the door,
His Nurse looked familiar, I had seen her before;
As I got to the knob, and was turning it 'round,
Crashing right past me they came with a bound.
He was dressed all in white, from his head to his foot,
But his clothes were all soiled with hospital food;
A bundle of drugs he had flung on his back,
And he looked like a peddler just opening his pack.
His eyes -- how dilated! His speech it was slurred!
Unclear as the writing on his scribbled words!
As I looked at his nurse I recalled that we'd spoke,
But it must have been years back when I was broke;
I'd gone to his office and they'd taken some blood,
But I'd long since changed doctors, there was no follow-up;
That was back in the the days of my large swollen liver,
That quivered and shook, and that fact made me shiver.
Back then I was sick, not a jolly old elf,
I now re-a-lized he'd just thought of himself;
The blank of his look and his hand on his nurse
Soon gave me to know that he thought of self-first.
He spoke not a word, but went straight to his work,
But he stopped all his writing and turned with a jerk,
When I said to him "Doctor, there's been a mistake...
I'm already treated, you're too f***in' late."
"If you give me a Bill I'll just 'blow the whistle'
So please save your bull and I'll take my milk-thistle."
And then I exclaimed, ere he drove out of sight,
"HEPATITIS TO ALL, AND TO ALL A GOOD-NIGHT!"
Copyright(C) Bill Buckels 2000, 2001
All Rights Reserved.
Copy Freely but Not For Profit
http://www.mts.net/~pb999874/hepsongs/main.htm
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Hey Dennis....... the doc here at Emory has just been given permission to do
the procedure they have been doing in Europe where they take the blood out
of your body, heat it up, kill off the virus, and then put back into you.
I am sure this is the same principle. I was hoping to be one of the first
that he did since I can't do treatment but word is that he won't be allowed
to do any cirrhotic patients for quite awhile :-( Oh well.......
something WILL come along :-) Hope all is well at your end!
Peace and Love,
·´¨¨)) -:¦:-
¸.·´.·´¨¨))
((¸¸.·´ ..·´ -:¦:-Pambi
-:¦:- ((¸¸.·´*
"I have studied many philosophers and many cats. The wisdom of cats is
infinitely superior." - Hippolyte Taine
Message: 1
Date: Sun, 30 Mar 2003 20:00:15 -0000
From: "nsolitude1" <strlgtngl@...
Subject: MARS Molecular Adsorbent Recycling System
Hi Pambi :-)
I first heard about this life saving liver dialysis system at the 'Angel
Connection' (Site is no longer up). There was a story there from Marc aka:
'Poster
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What the Doctor really means....
"Well, what have we here...?"
He has no idea and is hoping you'll give him a clue.
"Well, we're not feeling so well today, are we...?"
I'm stalling for time.
"If it doesn't clear up in a week, give me a call."
I don't know what it is. Maybe it will go away by itself.
"Let me check your medical history."
I want to see if you've paid your last bill before spending anymore
time with you.
"Well, now, we have some good news and some bad news."
The good news is, I'm going to buy that new BMW. The bad news is,
you're going to pay for it.
"This should be taken care of right away."
I'd planned a trip to Hawaii next month but this is so easy and
profitable that I want to fix it before it cures itself.
"Let me schedule you for some lab tests."
I have a forty percent interest in the lab.
"Let's see how it develops."
Maybe in a few days it will grow into something that really needs to
be cured.
"I'd like to prescribe a new drug."
I'm writing a paper and would like to use you for a guinea pig.
"That's quite a nasty looking wound."
I think I'm going to throw up.
"This may smart a little."
Last week two patients almost bit off their tongues.
"This should fix you up."
The drug company slipped me some big bucks to prescribe this stuff.
Hope it works...
"Everything seems to be normal."
Rats! I guess I can't buy that new beach condo after all.
"I'd like to run some more tests."
I can't figure out what's wrong. Maybe the kid in the lab can solve
this one.
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Hey there Mykal........ glad to hear you have a doc that you have alot of
confidence in ........ those are hard to come by.......... KEEP her :-)
Peace and Love,
·´¨¨)) -:¦:-
¸.·´.·´¨¨))
((¸¸.·´ ..·´ -:¦:-Pam
-:¦:- ((¸¸.·´*
"I have studied many philosophers and many cats. The wisdom of cats is
infinitely superior." - Hippolyte Taine

WOW! Pam Dr. Caroline Riely is my Doctor! I feel important now. (shining
fingernails on shirt) I knew by her bedside manor that I was in good hands, she
is a "no nonsense" kind of lady, that is why I follow her orders so closely. LOL

Reminder Reminder from the Calendar of HepCingles2
Chat reminder!
Wednesday April 26, 2006
9:30 pm - 1:30 am
This event repeats every week.
The next reminder for this event will be sent in 18 hours, 4 minutes.
Event Location: Chat Room at HepCingles2

http://www.hepatitismag.com/features/default.asp?HepStoryID=37
Balancing Act: Drugs that can help and hurt
By: Jason E. Moore
You've seen the headlines: "Tylenol overdoses linked to liver failure."
"Diabetes drug causes liver disease." "Ibuprofen [causes liver] toxicity in
patients with chronic hepatitis C."
It's inevitable. Such headlines set off alarms in people who have a liver
disease such as hepatitis C. And they should.
Many common over-the-counter (OTC) and prescription drugs can cause liver
damage, even when taken as directed. There are few drugs more commonly used than
Tylenol® and Advil®, yet even these drugs have the potential to harm your liver.
At the same time, many of these drugs are important therapies and can improve
your health and your quality of life. So, where's the balance?
We looked at some of the most common OTC and prescription drugs that can cause
liver damage and the risks that you face, as a person with hepatitis C, by
taking them.
Pain Relievers/Anti-Inflammatory Drugs
This group of drugs, which includes acetaminophen (found in Tylenol) and
ibuprofen (found in Advil), contains some of the most commonly prescribed
medicines in the world; they are used to relieve minor pain and to treat fevers.
Perhaps you've read some of the many articles on their apparent ability to cause
liver problems in some people. Reported effects of liver injury range from
insignificant changes in liver test values to severe and acute hepatitis.
Articles abound in the popular press on this possible liver damage and raise
serious questions for people with hepatitis C.
People with hepatitis C are not immune to the aches and pains that everyone
else suffers. But are they more prone to liver damage caused by taking common
pain relievers than people without hepatitis C?
The answer to this question is unknown. Usually, studies of such drugs exclude
people with chronic liver diseases, so that they are not placed at risk by
participating in the study.
What is known is that the greatest risk from these drugs appears to come from
over-dosage and from taking them with alcohol. Taken in high doses, some of
these common pain relievers can cause liver damage.
Anyone who takes large amounts of acetaminophen, for example, will have liver
damage in proportion to the amount of the drug taken. Increasing research has
also shown that combining acetaminophen with alcohol can increase the risk of
liver damage caused by acetaminophen.
According to Dr. Caroline Riely, Professor of Medicine and Pediatrics at the
University of Tennessee, Memphis, College of Medicine, who specializes in
Hepatology, chronic alcohol abuse "revs up" certain enzymes in the liver, which
then work overtime. These same overactive enzymes convert acetaminophen to toxic
substances that can harm the liver. Even doses as small as 2 gm (4 extra
strength tabs) can cause serious liver injury.
Dr. Riely makes another point about alcohol use: "Alcohol is, of course, a drug
and can definitely make hepatitis C worse. Folks with hepatitis C should drink
not at all, or very sparingly. We can't emphasize this enough."
Dr. William Lee, professor specializing in liver disease, Dept. of Internal
Medicine, University of Texas Southwestern Medical Center, Dallas, echoes the
potential risks of consuming alcohol and acetaminophen. He suggests that the
more common cause of difficulty is patients taking too many tablets in 24 hours.
He also warns against taking two or three acetaminophen-containing medications,
such as combining cough syrups and pain relievers, at the same time.
Dr. Lee, who published a 1997 article in the <I style="mso-bidi-font-style:
normal"
dosing should be cautious and should generally fall short of the dosage
recommended on the packaging, such as 2 grams per day, instead of 4.
Nonetheless, Dr. Lee adds that acetaminophen can be used appropriately by people
with hepatitis C.
Aspirin has been shown to be toxic to the liver. In fact, even low-dose (250
mg/day) aspirin therapy has been shown to cause liver abnormalities. However,
the liver damage and abnormalities are generally not fatal and are reversible
when aspirin therapy is stopped.
When considering whether to take these common OTC pain relievers, as with most
chemicals, the safest route is to avoid these drugs, as they may cause liver
damage in some people. At the same time, they can play a useful role in some
instances. If taken, they should never be combined with alcohol, and they should
be taken at or below the dose recommended on the label.
Rezulin
Perhaps you've heard of this controversial diabetes drug. It helps the
diabetics' bodies respond better to insulin, which regulates the level of
glucose in the blood stream. As of March 1998, the FDA had counted 43 patients
who suffered acute liver failure after taking Rezulin for several months.
As a result, consumer groups have lobbied to have Rezulin removed from the
market as unsafe. And doctors are now told to test for liver damage in diabetic
people who are taking the drug. While this drug may not always be inappropriate
for people with hepatitis C, the risks and benefits of taking the drug should be
carefully weighed, with the advice of your doctor.
Certain antibiotics (Trovan®, Augmentin, Ciprofloxacin, Erythromycin)
Certain antibiotics can cause liver damage or other abnormalities. One new
antibiotic that has received media attention for its apparent potential to cause
liver injury is Trovan®.
It is used to treat a wide variety of bacterial infections, such as pneumonia,
bronchitis, sinusitis, infections in the abdomen and sexually transmitted
diseases.
This drug has been shown to cause very severe liver damage, including liver
failure requiring liver transplant, in some people. The reaction is
unpredictable and happens only in a very small population of people who take
Trovan.
Nonetheless, because of the severity of drug reaction, doctors have reserved
this drug for people who have severe, life-or limb-threatening infections.
The problem with Trovan, as with Rezulin, is that it is new. When drugs are
tested in clinical trials by pharmaceutical companies, the vast majority of
patients are healthy. It's usually only when these drugs hit the market and are
widely used that certain peculiar reactions, such as liver damage, affecting
only a relatively few people, are revealed.
Dr. Riely's advice, "When a new drug comes out, the public should be wary."
Even though people with hepatitis C are at a greater risk of having these
particular reactions, when they do occur, people with hepatitis C are likely to
have more severe reactions. The best approach: wait until a new drug is widely
used (often for several years) before giving it a try.
Other antibiotics can also cause problems. Augmentin can cause jaundice by
slowing the normal flow of bile from the liver. However, this type of reaction
is rare. Ciprofloxacin, another antibiotic, can rarely cause abnormalities in
liver laboratory tests.
Ciprofloxacin-induced liver failure has been reported, but the liver damage is
thought to be reversible when the drug is discontinued. Finally, erythromycin
can also slow the flow of bile from the liver and lead to jaundice. However,
erythromycin-caused liver changes are more common than seen with the other
antibiotics (nearly 4 in 100,000 people treated with erythromycin reported such
problems). The liver injury is reversible, and the jaundice usually subsides in
a few weeks.
Contraceptive steroids
Some contraceptive steroids, such as the estrogens, can cause changes in liver
function. Such changes include decreases in the normal flow of bile from the
liver, which causes jaundice, and decreased excretion of bilirubin, a waste
product produced in the liver.
Approximately one in 100,000 Americans has reported this reaction. These liver
changes usually go away in the weeks after the estrogens are discontinued. In
contrast to the estrogens, progesterone has no apparent effect on liver
function.
Guiding Principles for OTC and Prescription Drug Use
· Protect yourself. Always read the label. Drug labels contain
information on the most common and dangerous potential side effects.
· Follow all directions for both OTC and prescription drugs, especially
those concerning when and how much of the medicine to take. Many drugs aren't
harmful when taken in the proper amounts, but can cause serious damage when
taken in excess.
· Don't combine OTC or prescription drugs with alcohol.
· Ask your pharmacist. While your local pharmacist won't tell you what
drugs you should or shouldn't take, he is a great source of information on
possible side effects and drug interactions.
· Consult your doctor. This is the best rule whenever there is a serious
question that a drug could harm your liver. The best doctor to ask is one who
specializes in treating liver diseases. But, do not assume that your doctor
knows everything about all drugs.
· Research a drug before taking it - ask if it is a new drug and if it
has been given without adverse incidents to other patients with hepatitis B or
C.
· Read the labels and inserts included with OTC medicines.
· Read the inserts provided with prescription drugs. Make sure the
medicine you receive is what your doctor prescribed and has the correct dosage
indicated on the label.
You can also report the event to MedWatch, a Federal Drug Administration
medical reporting program. The Web site www.fda.gov/medwatch/report/consumer has
forms that can be downloaded for reporting your event, or you can call the FDA
Office of Emergency Operations at (301) 443-1240.
Decisions concerning the use of both OTC and prescription medication can be
complicated. However, it is possible to strike a balance. Don't be afraid to ask
your doctor or pharmacist questions.
Educating yourself about the potential problems of taking these medications,
while consulting your doctor when questions arise, can help avoid problems that
could result from taking the medications meant to improve your health and the
quality of your life.
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Hepatitis C Virus and Arthritis
Arthritis is one of the several autoimmune disorders induced by HCV infection.
There is not a specific clinical pattern of HCV-related arthritis, but two
nonerosive subsets have more frequently been described: a RA-like polyarthritis
and a less common mono-oligoarthritis involving medium-sized and large joints,
often showing an intermittent course.
This latter form is associated with the presence of serum cryoglobulins. Because
of its variable characteristics, HCV-related arthritis must be considered in the
differential diagnosis of many patients having inflammatory joint involvement.
Antikeratin antibodies and possibly IgA RF can be useful in distinguishing
between RA and HCV-related RA-like polyarthritis. In fact, these tests are
highly specific in RA patients. In any case, the search for HCV antibodies
should be more widely performed in the diagnostic approach to rheumatic
diseases.
An association between PsA and HCV infection has been described in the
literature, but the authors were unable to confirm these data. Nonsteroidal
anti-inflammatory drugs, hydroxychloroquine, and low doses of corticosteroids
are the cornerstones of the treatment of HCV-related arthritis. An etiologic
therapy with alpha-interferon and ribavirin is useful when required by hepatic
or systemic involvement; such therapy could also be considered in selected cases
of isolated arthritis that are unresponsive to other drugs.
Few case reports described the onset of polyarthritis after the administration
of alpha-interferon for HCV-related chronic hepatitis. This topic should be more
accurately studied in the future to exclude a spurious association between the
two events.
04/04/03
Reference
I Olivieri and others. Hepatitis C virus and arthritis. Rheum Dis Clin North Am
2003 Feb;29(1):111-22.
http://www.hivandhepatitis.com/hep_c/news/040403b.html
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New Liver - A New Beginning!
For seven years Debbie Barnes was very sick. Her 13-year-old niece, Kellie
Straubel, says she was on oxygen and "gray/yellowish looking - like a living
corpse. She couldn't even move. And she didn't like to eat."
For those seven years Debbie met with the local Hepatitis and Liver Disease
Support Group. "They kept me going," Debbie says, "and they gave me hope and
helped see me through the horrible process of end stage liver disease.. My liver
failed in 1995 and it wasn't until June of 2001 that I got my liver
transplant."
But all that has changed. "It's like I was given another chance at life," she
explains. "I can't even find words to express how grateful I am to the family
who gave me their loved one's liver -- the gift of another life. That family is
my guardian angel!"
Niece Kellie added, "I'm so glad she didn't die. I've lost other family members
and I'm so glad I didn't lose her." Debbie received a big hug. "She's like my
best friend."
"After words like that," Debbie exclaimed with a smile, "I guess I'll have to
take you shopping."
Debbie says, "I believe that all of this -- my Hep C and liver transplant --
happened for a reason: to help others.. As I was being rolled into the operating
room, I said to God, please give me a good liver and I'll help others in any way
I can."
She was true to her promise. Just six months after her transplant, she marched
for Hepatitis awareness in two Christmas parades. "I was really hurting, sucking
wind," she said. "But I completed both walks."
This gal's been moving ever since. She has assumed a leadership role as
vice-chair of the Tampa Bay Hepatitis Task Force and she is helping to organize
our May 10 march for Hepatitis awareness in downtown St. Petersburg. She has
also developed a new Hep C group in Bradenton and is helping with
another support group in Sarasota.
Almost shyly, this outspoken woman added, "It really makes me feel good. I feel
almost guilty when people thank me for helping them, because I get so much out
of it."
Kellie giggled, "The person who had that liver must have been a clean freak!
Debbie cleans her house all the time."
So now, after the transplant, Debbie is happy and her life is filled with
purpose, right? Her life is a bed of roses? Hardly. Debbie must take often
debilitating medications for the rest of her life -- drugs that suppress her
immune system and keep her body from rejecting the transplanted organ. This
suppression of her own systems comes at a cost: Debbie now catches many
illnesses that her body would have previously rejected easily. Her hand now has
tremors and her brain is a little foggy from the many medications.
Yet this woman does not fixate on these unpleasantries. There is little
resentment and "why me?" at what's been lost to disability. Instead, she has put
her illness in perspective and she leads a rich and rewarding life.
Sometimes people with chronic or terminal illnesses allow themselves to become
totally self-focused. They allow bitterness and sadness to enter their
lives, as if it's an expected and natural behavior. And hope begins to
disappear. The outside world fades, a distant reality to them. In a sense, life
ends. They become prisoners of their illness. All they can see is what they can
no longer do. They forget that life is lived now, in this moment, not in the
past or future.
For Debbie and many others with chronic disabilities, a grateful heart doesn't
have time nor inclination to feel self-pity. In the face of life's inevitable
miseries, a positive stance can help transform life's bitter pills
into a renewing perspective.
I've learned that finding purpose for your life is like discovering a healing
salve for your battered body. It takes us outside ourselves, changes our focus
and gives us a life of meaningful joy!
Written by Steve Kersker and
edited by Tom Krug
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Progenics Discovers First Liver-specific Receptor for Hepatitis C Virus
Scientists from Progenics Pharmaceuticals may have solved a longstanding riddle
concerning hepatitis C disease: How does HCV target the liver for infection?
Researchers today reported discovering the first-ever liver-specific receptor,
called L-SIGN, for hepatitis C virus (HCV). The company also reported the
identification of specific inhibitors, including a monoclonal antibody, which
blocked HCV from binding to the L-SIGN receptor.
Preventing HCV from binding L-SIGN on liver cells represents a new and targeted
strategy for treating this serious disease. The studies are reported in a paper
published today in the Proceedings of the National Academy of Sciences USA. The
publication is scheduled to be available online this week in the PNAS Early
Edition at http://www.pnas.org/.
"In recent years, various cellular receptors for HCV have been proposed, but
until now, none had been found that occurred specifically in the liver and was
capable of binding with HCV," said the paper's senior author William C. Olson,
Ph.D., Progenics' Vice President of Research and Development.
"As we reported in today's PNAS article, L-SIGN efficiently binds and captures
naturally occurring hepatitis C virus particles. We further demonstrated that
L-SIGN binds to a viral protein called E2 that is present on the surface of the
HCV particle. L-SIGN is found on specialized liver cells. These cells are the
first to contact HCV as it enters the liver via the bloodstream.
Thus, L-SIGN is uniquely positioned to capture blood-borne virus and
concentrate it in the liver, thereby potentially facilitating initial and
subsequent rounds of infection."
HCV infection afflicts nearly 3% of the world's population and causes serious
liver disease, including cirrhosis and cancer. No vaccine is available to
prevent new infections. Current therapies are largely non-specific, effective in
only about half of all cases, and have a high relapse rate. New treatment
strategies are urgently needed to combat this debilitating disease.
The research further demonstrated that HCV bound to a related receptor, known as
DC-SIGN, that is expressed on dendritic cells, which are specialized cells of
the immune system. L-SIGN and DC-SIGN are also expressed in placental tissue,
and thus the findings may also explain why HCV is readily passed from mothers to
their newborn children."
"Our previous discoveries of the cellular receptors utilized by HIV have
translated directly into novel therapeutic agents, and we are eager to leverage
this expertise for HCV therapy," added Dr. Olson.
"We have shown that HCV binding to L-SIGN can be blocked in the laboratory using
specific inhibitors, including monoclonal antibodies. In addition, HCV appears
to bind L-SIGN at a site different from that of its natural ligand (ICAM-3),
which is a protein that mediates adhesion between cells.
"Thus, it may be possible to block HCV without blocking the natural activity of
L-SIGN. These findings provide proof-of-concept for targeted therapy. Our
current goals are to develop increasingly potent and drug-like inhibitors while
concurrently exploring the role of L-SIGN in natural infection."
About Progenics
Progenics Pharmaceuticals, Inc. of Tarrytown, NY, is a biopharmaceutical company
focusing on the development and commercialization of innovative therapeutic
products to treat the unmet medical needs of patients with debilitating
conditions and life-threatening diseases.
The Company applies its expertise in immunology and molecular biology to develop
biopharmaceuticals to fight viral diseases, such as human immunodeficiency virus
(HIV) infection, and cancers, including malignant melanoma and prostate cancer.
In symptom management and supportive care, therapies are being developed to
provide patients with an improved quality of life. Progenics' most clinically
advanced product is methylnaltrexone, a compound in phase-3 clinical testing
that is designed to block the debilitating side effects of opioid analgesics
without interfering with pain palliation.
The Company is conducting multi-dose phase-2 clinical trials with its lead HIV
product, PRO 542, a viral-entry inhibitor and is in preclinical development with
PRO 140 and other follow-on product candidates in HIV infection. The Company is
developing cancer immunotherapies based on PSMA (prostate-specific membrane
antigen) technology and currently is conducting phase-1 clinical studies of a
therapeutic prostate cancer vaccine. GMK is a cancer vaccine in phase-3 clinical
trials for the treatment of malignant melanoma.
Additional information on Progenics is available at http://www.progenics.com
04/04/03
Source
www.businesswire.com
http://www.hivandhepatitis.com/hep_c/news/040403a.html
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First and Only FDA-Approved Quantitative HCV Viral Load Assay
Bayer Receives FDA Approval After Expedited Review For Hepatitis C Viral Load
Assay, VERSANT(R) HCV RNA 3.0 Assay (bDNA)
TARRYTOWN, N.Y., April 3 /PRNewswire-FirstCall/ -- The Diagnostics Division of
Bayer HealthCare LLC, a member of the Bayer Group (NYSE: BAY), announced today
that it has received premarket approval after expedited review from the U.S.
Food and Drug Administration (FDA) for its VERSANT(R) HCV RNA 3.0 Assay (bDNA)*,
a predictive test that directly measures hepatitis C
virus RNA levels in serum or plasma. The VERSANT(R) HCV viral load assay is the
first and only FDA-approved quantitative test to measure HCV viral load levels,
and will aid physicians by guiding therapeutic decisions early in
treatment.
Approximately 4 million people in the United States(1) and 170 million
people worldwide(2) are infected with HCV. The level of viral load, or HCV
RNA, in a patient's blood can identify, early in treatment, patients who may not
respond to further therapy. Utilizing an accurate HCV RNA quantitative
assay such as the VERSANT(R) HCV viral load assay can help clinicians decide if
therapy should be discontinued, thereby avoiding the unnecessary side
effects of prolonged treatment.
"Current therapeutic recommendations rely on the accurate determination of
HCV viral levels to assess a patient's potential response to treatment. This
is evidenced by a 2 log(subscript 10) (100 fold or 99 percent) reduction in
viral load at week twelve of therapy," said Eugene R. Schiff, MD, Director,
Center for Liver Diseases, University of Miami School of Medicine. "Since this
viral measurement is essential to the clinical decision to continue or
discontinue therapy, a reliable result as generated by the Bayer HCV bDNA assay
affords great confidence in patient care."
The VERSANT(R) HCV viral load assay is intended as an aid in the management
of HCV-infected patients undergoing antiviral therapy.
NIH Recommendations
The importance of quantitative assessment of HCV RNA levels in predicting
patient response to antiviral therapy is reflected in the recent (2002)
National Institutes of Health (NIH) Consensus Development Conference Final
Statement on Management of Hepatitis C. The NIH Statement notes that "early
viral response (EVR), defined as a minimum 2 log decrease in viral load during
the first 12 weeks of treatment, is predictive of sustained viral response (SVR)
and should be a routine part of monitoring patients with genotype 1.
Patients who fail to achieve an EVR at week 12 of treatment have only a small
chance of achieving an SVR even if therapy is continued for a full year.
Treatment need not be extended beyond 12 weeks in these patients."(3) Thus, the
NIH recommends that testing for an EVR should be a routine part of
patient monitoring.
Expedited Review
FDA granted Bayer an expedited review of its premarket approval application
on July 26, 2002. The FDA grants such reviews for products that
provide treatment o