HEPATITIS
DOCTOR HOME since
October 1998
Welcome to patients with chronic viral hepatitis
B or C and to their loved ones. The FDA
approved
Incivek (telaprevir) on May 23rd. It allows us to cure 2/3 of patients. Most will only need 24 weeks
of
treatment instead of 48 or longer since Incivek (telaprevir) rapidly reduces HCV-RNA. If you are
cured, your viral level falls to undetectable
during treatment and stays undetectable the rest of
your life, after
you stop the medications. If
your HCV-RNA level becomes detectable in your blood,
you were not cured. If your HCV-RNA is undetectable 6 months after your last injection of
interferon, you have a 99%
chance of permanent cure. Liver damage stops and liver healing starts.
This
improves survival and often restores health. You can read the PDF file of my
poster from AASLD,
that demonstrates improved survival
when HCV is cured. PDF file of AASLD poster
2011
I add information to this web site
as often as I can, and I want to make it a resource for patients whom
are often incorrectly told that they cannot be helped. The opinions expressed here
are entirely my
own, and are based on my experience in treating more
than 3,000 patients with hepatitis C.
I am especially excited about the new
oral medicines for patients with hepatitis C. I am a board
certified in internal medicine and gastroenterology.
In addition, I completed 2 years of residency
in pathology at Duke University Medical Center. I have been
a physician for 34 years. I spend about
95% of my time treating patients with chronic viral hepatitis
C. I enjoy helping as many patients as
possible cure this infection.
I am very excited about the HCV protease inhibitor from
Vertex Pharmaceuticals called VX-950. The
generic name is
.
The brand name is Incivek. It is
taken by mouth every 8 hours and drops
the viral level by about 99.9% in less
than a week. When combined with Pegasys plus ribavirin, it
greatly
improves the cure rate in genotype one patients.
Telaprevir plus Pegasys and ribavirin eliminated HCV
in 75% of patients in the
ADVANCE study with only 24 weeks of therapy. This treatment was
successful in 62% of African-American patients and 62% of patients
with stage 3 or stage 4 fibrosis
(cirrhosis). Only 7% of patients had to stop the treatment because of
side effects. Another HCV
protease inhibitor, , from
Merck is also promising. We expect 2011 to be a happy year for
patients with HCV now that the FDA has approved these medicines.
Incivek Prescribing
Information Link
My office: 1009A Dupont Square North, Louisville KY 40207 phone:
502-894-9950
If you have previously failed or could not tolerate standard antiviral
therapy, you should consider
individualized therapy. Some patients need to start with lower doses of interferon.
If there is no
response, Infergen 15 mcg daily plus
ribavirin eliminates HCV in about 10% of patients
as demonstrated in
the DIRECT Trial.
Ribavirin does not add much to the fall in the viral level.
It is the interferon that is the muscle drug.
Ribavirin does not transform
a nonresponder into a responder. What ribavirin does is greatly
reduce
the chance of viral breakthrough (HCV-RNA falls with treatment,
but then rises even
though treatment is continuing) or relapse in patients
who respond to interferon. A relapser
is a
patient who became undetectable for HCV-RNA on her previous treatment,
but the virus came back
when the treatment ended. Cirrhotic patients who
take telaprevir or boceprevir plus pegylated
interferon plus ribavirin have more
success with shorter duration of treatment. Many succeed with
only six months of treatment.
The CDC now recommends that
Americans be tested for HIV routinely. They should have also
recommended that all American middle aged persons be tested for HCV
and HBV.
Their data indicate
that 7.1% of men and 2.3% of women between 45 and 49 are infected
with HCV. Identify infected
persons and offer treatment is the logical strategy. We can lower the death rate from HCV if we are
aggressive in identifying infected patients. Cure the
curable patients and lower the death toll.
Five million Americans are infected and we can cure TWO MILLION
TODAY with currently available
medicine.
I am an advocate for patients infected with HCV. The
medical insurance companies place too many
obstacles to block patients
from going on or staying on the medications. I have seen many curable
patients fail because of this. Medicaid
cancels Rx Even though treatment is now less expensive and
more effective,
the insurance companies are shifting more of the cost of treatment to
patients.
Stage 3 and stage 4 HCV liver disease is life threatening and
should be covered like cancer treatment,
coronary artery bypass surgery
and kidney dialysis. HCV cirrhosis is just as deadly as these other
life-threatening diseases. Insurance companies should not discriminate against treatment
of HCV, just
as they are forbidden to discriminate against treatment of HIV/AIDS.
I can give information, but cannot
practice medicine over the internet. Patients with HCV should
consult
a knowledgeable medical provider who treats large numbers of HCV infected
patients
Bennet Cecil, MD
03/04/2012 07:41 PM
You can find more HCV information in the links below and the links
on the left side of this page.
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