Hepatitis, the miracle drug
Nov. 9th, 2001 03:15 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rivkaI've just been reading the September 6th issue of the New England Journal of Medicine - and looking at graphs that leave me speechless.
There's a virus, sometimes known as Hepatitis G, more formally known as GB Virus C. Like other forms of hepatitis, it's transmitted through contact with blood or bodily fluids. About 2% of the general blood donor population, 15-20% of IV drug users, and 33% of people with HIV test positive for Hepatitis G. Ordinarily, that would be a bad thing. But, unlike Hep A, B, and C, Hep G doesn't cause liver disease.
Instead, it appears to slow the progression of HIV disease and sharply reduce the risk of death from AIDS.
In one study averaging four years of follow-up, people with Hep G and HIV coinfection were nearly four times more likely to survive the follow-up period. Among the very sickest patients (CD4+ T-cell count less than 50, where a healthy person has over 1000), 25% of the non-coinfected group survived - compared to 56% of the Hep G coinfected group. Among the very healthiest patients (CD4+ T-cell count greater than 500 at study entry) 93% of the coinfected group lived through the follow-up period, compared to 79% of the non-coinfected group.
The other study followed 197 patients for several years, with the introduction of the "HIV cocktail" medicines in 1996 coming right in the middle of the follow-up period. Here's what they say:
In 1996, 98 of the 197 patients were still alive and undergoing folow-up. Of these patients, 24 (24.5%) had died by March 2000. A higher risk of death was significantly associated with the absence of GBV-C RNA [translation: active presence of the Hep G virus in the blood], since only 1 of 27 GBV-C-positive patients (3.7%) died, as compared with 17 of 56 (30.4%) anti-E2-positive patients [translation: people who had once been infected with Hep G, but whose bodies had cleared the virus from their systems] and 6 of 14 unexposed patients (40.0%).
The graphs in the paper show Cox survival analyses, numbers which I always have trouble interpreting. But there's no difficulty interpreting the lines, which diverge sharply from each other on page after page. Here are people with Hep G, not progressing to AIDS. Here are non-coinfected people, progressing rapidly to AIDS and dying. Even on anti-retroviral meds, here are people with Hep G coinfection, living and living, while there's slow but steady erosion in the non-coinfected group.
Five years from now, if not sooner, we're going to be deliberately coinfecting people. That's my prediction. And with a form of hepatitis... who could have imagined it?
There's a virus, sometimes known as Hepatitis G, more formally known as GB Virus C. Like other forms of hepatitis, it's transmitted through contact with blood or bodily fluids. About 2% of the general blood donor population, 15-20% of IV drug users, and 33% of people with HIV test positive for Hepatitis G. Ordinarily, that would be a bad thing. But, unlike Hep A, B, and C, Hep G doesn't cause liver disease.
Instead, it appears to slow the progression of HIV disease and sharply reduce the risk of death from AIDS.
In one study averaging four years of follow-up, people with Hep G and HIV coinfection were nearly four times more likely to survive the follow-up period. Among the very sickest patients (CD4+ T-cell count less than 50, where a healthy person has over 1000), 25% of the non-coinfected group survived - compared to 56% of the Hep G coinfected group. Among the very healthiest patients (CD4+ T-cell count greater than 500 at study entry) 93% of the coinfected group lived through the follow-up period, compared to 79% of the non-coinfected group.
The other study followed 197 patients for several years, with the introduction of the "HIV cocktail" medicines in 1996 coming right in the middle of the follow-up period. Here's what they say:
In 1996, 98 of the 197 patients were still alive and undergoing folow-up. Of these patients, 24 (24.5%) had died by March 2000. A higher risk of death was significantly associated with the absence of GBV-C RNA [translation: active presence of the Hep G virus in the blood], since only 1 of 27 GBV-C-positive patients (3.7%) died, as compared with 17 of 56 (30.4%) anti-E2-positive patients [translation: people who had once been infected with Hep G, but whose bodies had cleared the virus from their systems] and 6 of 14 unexposed patients (40.0%).
The graphs in the paper show Cox survival analyses, numbers which I always have trouble interpreting. But there's no difficulty interpreting the lines, which diverge sharply from each other on page after page. Here are people with Hep G, not progressing to AIDS. Here are non-coinfected people, progressing rapidly to AIDS and dying. Even on anti-retroviral meds, here are people with Hep G coinfection, living and living, while there's slow but steady erosion in the non-coinfected group.
Five years from now, if not sooner, we're going to be deliberately coinfecting people. That's my prediction. And with a form of hepatitis... who could have imagined it?
