John Geluardi had an article on hepatitis in the 11/30 issue which had several important errors. He quoted Jessie Wofsy, an HIV Prevention Coordinator, as saying that there is no cure for Hepatitis C. The fact is that current anti-viral treatments can clear virus from the system in 1/4 of those with type (genome) 1 and 2/3 get clearance of virus as well as normalization of liver enzyme tests with types 2 and 3 (see R Zetterman's address to the 65th annual American College of Gastroenterology proceedings, reported at Medscape.com). Followup of these patients is for probably less than five years, but this is a far cry from “no cure.”
The importance of a person with Hep C getting evaluated is that he/she can be offered treatment, if that is indicated (people with normal liver tests don't get treatment). Over time, if cirrhosis becomes an issue, they can be referred on to one of the groups doing treatment for advanced liver disease, which may include liver transplantation. The Liver Dept from Calif Pacific has an East Bay clinic for this purpose in Oakland (called East Bay Liver Clinic, I think).
Secondly, Ms. Wofsy stated that Hepatitis A and B...can be treated with vaccines. Wrong again – vaccines prevent disease, they cannot alter the course of an infection once it has gotten hold. Hep A vaccine is commonly recommended for travelers to areas with questionable food or water supplies. Hep B is given to people who will have exposure to blood or body fluids.
Robert Winshall, MD, MPH