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Need for liver transplants will increase fivefold if current hepatitis C trends hold, scientists say.

Deaths from the hepatitis C virus (HCV) will more than double in the next decade, with the need for liver transplants increasing by fivefold, if current trends continue, a University of Florida (UF) scientist predicts.

Reporting at a meeting of the American Association for the Study of Liver Diseases, which met last week in Chicago, Gary Davis, MD, a liver specialist at UF, projected a 223% rise in deaths from HCV, which currently stands at about 10,000 per year, together with a 528% increase in liver transplants from the 4,000 expected to be performed this year. By 2018, deaths from HCV could reach 35,000, more than twice the number of people who died from AIDS last year. The reason for this dramatic upswing, according to Davis, is that many of the 4 million Americans infected with the slow-acting virus have yet to feel its full effects.

"It's like the tip of the iceberg," said Davis. "All the physicians are overwhelmed by the virus right now, yet we're not even seeing a fraction of the real problem."

While some experts maintain that new therapies and stepped-up efforts to diagnose HCV could greatly improve the long-term picture, such advances may not benefit all patients. Another study presented at the meeting showed treatment with the drug interferon is less effective for African Americans. Only 5% of blacks responded well to interferon compared with 28% to 40% for other ethnic groups, according to William Lee, MD, a professor of medicine at the University of Texas Southwestern Medical Center in Dallas.

"It may be that we need to try different treatment regimens for separate groups," Lee said, adding that the reasons for the differences in response, although possibly genetic, remain unclear.

Studies presented at the meeting show combinations of interferon and ribavirin can reduce HCV to undetectable levels in 36% of patients who had received no previous treatment. The drug combination, approved by the FDA earlier this year for cases in which interferon alone has failed, soon could be approved for all hepatitis C patients, researchers said.
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Publication:Transplant News
Geographic Code:1USA
Date:Nov 13, 1998
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