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Physician has role in major treatment advance for hepatitis C

Story Date: Sun, 13 Apr 2014 16:16:00 EDT

The world of medicine is celebrating a major advance in the treatment of hepatitis C, thanks in part to the efforts of a local physician/researcher.

Michael Ryan, MD, a Professor of Clinical Internal Medicine at EVMS and an expert in liver disease at Digestive and Liver Disease Specialists in Norfolk, helped study an experimental treatment for hepatitis C that cured 95 percent of test subjects in as little as eight weeks. It could replace the current treatment that is 75 percent effective but requires six to 12 months of weekly interferon shots with many side effects, says Dr. Ryan, co-author on an article in the New England Journal of Medicine that explains the results: “Ledipasvir and Sofosbuvir for 8 or 12 Weeks for Chronic HCV without Cirrhosis.”

The new treatment, tested in Hampton Roads and at sites around the world, consists of two medications in a single pill. New advances will all involve oral medication and may push the cure rate to nearly 100 percent, he says.

“There is a great deal of ongoing research by many companies,” says Dr. Ryan, who has studied hepatitis C extensively for years and was in London this weekend for presentation of the research results at the annual meeting of the European Association for the Study of the Liver. “We hope we can cure almost everyone, including those with advanced disease with six to 12 weeks of all oral therapy. That will reduce risks of complications from cirrhosis and liver cancer.”

An estimated 170 million people worldwide have hepatitis C in the US, that includes 3 million to 5 million people – 80 percent of those baby boomers. Most are unaware they have the virus.

Dr. Ryan was tapped by the American Gastroenterological Association to serve as National Co-Director of a hepatitis C awareness campaign in 2013-2014. He also was a member of the CDC committee that in 2013 recommended that anyone born between 1945 and 1965 undergo an inexpensive test for the virus, particularly if they have a history of high-risk behaviors such as home tattoos or piercings. New York State now requires primary care physicians to offer the testing.

Most people with hepatitis C exhibit few or no symptoms, says Dr. Ryan. “Often, fatigue is the only issue.”

Hepatitis C can cause cirrhosis of the liver, kidney disease, vasculitis and rash and lead to increased risk for diabetes and cardiac disease. It accounts for nearly half of all liver disease in the US and 45 percent of liver transplants.

It is the 10th leading cause of death, and since 2007 has killed more people than AIDS. Death and complications from hepatitis C are expected to rise three- to four-fold in the next 15 years.