December 06, 2013
The statistics are staggering. According to the Centers for Disease Control and Prevention, an estimated 3.2 million individuals in the United States have chronic Hepatitis C virus infection (HCV), a viral disease that causes inflammation of the liver that can lead to diminished liver function or failure. Approximately 30 million adults have non-alcoholic fatty liver disease (NAFLD), of which 10 percent have cirrhosis.
Because they don’t look or feel sick, most people with chronic hepatitis are unaware they have the disease until liver damage becomes apparent, which may take several years. Chronic hepatitis leads to scarring and poor liver function, or cirrhosis, which over many years can lead to complications such as bleeding, jaundice (yellowish eyes or skin), fluid accumulation in the abdomen, infections or liver cancer. More than 1 million people die every year from HCV- and NAFLD-related liver disease.
Bradley L. Freilich, MD, AGAF, Medical Director of The Liver and Pancreas Institute of Kansas City at Research Medical Center and Kansas City Gastroenterology and Hepatology Physicians Group/Kansas City Research Institute, has been involved as principal investigator in nearly every pioneering HCV research study within the last 20 years.
As the only area clinician to have experience with the new generation of drugs about to be launched, Dr. Freilich has a unique perspective on the spectrum of HCV treatment. As a result, he is opening the Hepatitis Treatment Clinic at Kansas City Gastroenterology and Hepatology Physicians Group on Research Medical Center’s Brookside Campus to facilitate screening of potential HCV in patients, and provide expert care and access to drugs effective in treating chronic HCV.
In addition, clinical trials will continue to be offered for medicines to treat HCV as they are introduced.
The Hepatitis Treatment Clinic at Kansas City Gastroenterology and Hepatology Physicians Group is scheduled to open this month and will provide care to patients with any form of chronic inflammation of the liver, including NAFLD and other forms of viral hepatitis such as Hepatitis B. The Clinic will offer patients, when appropriate, non-invasive methods to determine the amount of liver scarring and identify those patients with cirrhosis at risk for liver cancer and other complications of liver failure.
The Clinic’s staff will work in coordination with the Liver and Pancreas Institute of Kansas City at Research Medical Center to provide multidisciplinary care to those patients with liver cancer and Menorah Medical Center’s bariatric services to help those patients with NAFLD.
The FDA Advisory Panel made a positive recommendation in November for the approval of two new HCV direct-acting anti-viral agents. The new drugs, when combined with older drugs such as interferon and Ribavirin, will offer a 90 percent chance for cure for most strains of the virus, along with a shortened treatment period of three to six months.
Dr. Freilich notes that even more encouraging are the positive late-phase results being generated by the ongoing trials he is performing using non-interferon, all oral agents that will cure the virus in 95 percent of patients with only eight to 12 weeks of therapy.
“These trials, representing many different pharmaceutical companies, continue to enroll for treatment experienced patients, patients never treated before and special populations,” says Dr. Freilich. “Furthermore, in June 2013, the USPSTF recommended screening for HCV infection in persons at high risk for infection, which will help identify HCV before it progresses and allow them to seek the new treatments that can cure their disease. For the millions of people living with chronic HCV, there has never been better news.”
The most important risk factor for infection with chronic HCV is past or current injection drug use. Additional risk factors include receiving a blood transfusion before 1992, long-term hemodialysis, being born to an HCV-infected mother, incarceration, intranasal drug use, and other exposures. The USPSTF also recommends screening for HCV infection to adults born between 1945 and 1965, the so-called baby boomer population segment that seems to be at increased risk either because they received a blood transfusion before the introduction of screening in 1992 or because they have a history of other risk factors from decades ago.
“It is important for anyone born in this period to be screened by their physician and for us to educate primary care physicians on screening their patients,” says Dr. Freilich. “A simple HCV test is all that is necessary to screen those at risk. Never before have people at risk or living with chronic HCV had options like this for the detection and treatment of the disease.”
Research Medical Center and Menorah Medical Center are part of HCA Midwest Health System, Kansas City’s largest healthcare provider. Kansas City Gastroenterology and Hepatology Physicians Group is part of Midwest Physicians, a network of experienced, multi-specialty physicians located throughout the greater Kansas City metropolitan area, also part of HCA Midwest Health System.
The Hepatitis Treatment Clinic will offer a 20-minute screening test that can be run through insurance or for the nominal cost of $20. For more information, call (816) 285-0535 or visit HepatitisTreatmentCenter.com.