Clues and cure sought for HCV in Hispanics

Article Abstract:

Non-A, non-B hepatitis, most cases of which are the result of infection by what is now known to be hepatitis C virus (HCV), occurs among Hispanics four times as often as among whites or blacks in the US. The reasons for this ethnic difference are unknown. Although blood transfusion represents one route of infection, as many as 40 percent of HCV infections are acquired via unknown routes. Interferon alfa therapy, costing $1,500 per treatment course, led to improvement in as many as half of all patients, but half of these relapse when treatment ends. In addition, the drug produces unpleasant side effects that resemble flu symptoms. Most patients do not know they are infected with HCV until the blood bank where they have donated blood tells them so (HCV screening is now carried out by blood banks). Thus, it is difficult to advise patients who may not develop symptoms for many years to take an expensive, perhaps ineffective, and certainly unpleasant drug. If patients have symptoms, treatment is clearly indicated, and some without symptoms will become ill very quickly. Liver biopsies provide the best evidence regarding disease severity. Short-term studies cannot determine whether disease progression can be prevented or slowed. Without treatment, slightly fewer than one third of the patients with non-A, non-B hepatitis improve, but another one fifth develop cirrhosis (chronic degenerative liver disease) within 10 years. Hispanics' rate of infection is 26.8 per 1,000, compared with rates of 6.2 and 6.5 per 1,000 whites and blacks, respectively. People in their 30s have particularly high HCV infection rates. Patients with symptoms of hepatitis should be tested for all possible viral agents, with repeat testing six months later if non-A, non-B hepatitis seems a likely diagnosis. HCV infection is associated with liver cancer, so patients should be monitored with ultrasonography and blood tests. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Diagnosis, Diseases, Hepatitis C, Hispanic Americans

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Two-way street links ever-smaller world spanned by CDC's epidemiologic efforts

Article Abstract:

The Centers for Disease Control (CDC) employs an army of epidemiologists who investigate unusual health problems as they arise virtually anywhere in the world. During the past year, these investigators visited 20 countries to examine 20 medical emergencies. Scientists from abroad also visit the CDC, located in Atlanta, Georgia. In general, relationships between the CDC and foreign professionals are highly positive. The agency assists other countries attempting to establish services similar to those of the CDC, and, according to an internal evaluation draft report, greater efforts are planned. First and foremost, the CDC attempts to avoid the importation of infectious diseases. Research in other countries is also a strong commitment of the CDC. Efforts are concentrated on diseases that might be present in the US, but at too low a rate to make research possible. Examples are malaria and heterosexual transmission of human immunodeficiency virus (HIV), which is endemic in parts of Africa, but currently infrequent in the US. (HIV is associated with AIDS, acquired immunodeficiency syndrome.) The evaluation report states that the CDC has been passive in the area of policy, and increased international involvement could come in the areas of child survival, maternal health, and the global environment. The CDC has evolved to its present position from its initial role as an inspection agency for travelers arriving in the US. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, International aspects, Communicable diseases, Epidemiology, United States. Centers for Disease Control and Prevention

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Infants, science may lose as liability is blamed for company pullout from HIV prevention trial

Article Abstract:

A promising new treatment to prevent pregnant, HIV-infected women from transmitting the virus to their infants is in limbo now after the company that produces the drug pulled out. A spokesperson for Abbott Laboratories says the company will not go ahead with a clinical trial of HIV immune globulin (HIVIG) until Congress passes a law releasing the company from any liability during the trial. An AIDS activist suspects the company wants to get out of the trial because it perceives the treatment will not be profitable. He says the company's action can be considered a breach of contract, and several lawyers who have reviewed the documentation written during the planning stages agree. In the meantime, several other companies have expressed an interest in supplying the drug, but it could still take a year for the trial to begin.

Food preparations, not elsewhere classified, Pharmaceutical preparations, Health aspects, Product liability, Drug therapy, Ethical aspects, HIV infection in children, Pediatric HIV infections, Immunoglobulins, Products liability, Product discontinuation, Abbott Laboratories (Abbott Park, Illinois)

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