Impact of race on hepatitis treatment, transmission of hepatitis from mother to infant, and missed diagnoses of liver disease described at meeting

November 06, 1999

Dallas-- The following summaries are taken from the abstracts of the more than 1,000 papers presented at the American Association for the Study of Liver Diseases (AASLD) 1999 Annual Meeting in Dallas, November 5-9.

Impact of Race on Response to Antiviral Therapy in Chronic Hepatitis C Patients

In the largest study of African-American patients looked at to date, John G. McHutchison, M.D., Scripps Clinic, found that African-American patients with chronic hepatitis C infection had a lower sustained response to antiviral therapy than Caucasians. Although they did not respond to interferon monotherapy, McHutchison said that 20 percent of the African-Americans did have a sustained response if treated with two drugs in combination--interferon and ribavirin. McHutchison suggests that these findings indicate inherent host differences among racial groups to anti-viral therapy and urges that more work needs to be done to explain these results.

Timing Important in Diagnosis of Perinatal Hepatitis C Transmission

In a study that examined the maternal risk factors for perinatal hepatitis C (HCV) transmission, Eric E. Mast, M.D., Centers for Disease Control and Prevention, found that anti-HCV testing in infants whose mothers were HCV-infected may not be reliable until the infant is two years of age. Maternal factors associated with an increased risk for HCV transmission in a statistical analysis include prolonged membrane rupture for more than six hours and internal fetal monitoring devices. Factors not associated with transmission include mode of delivery and breastfeeding. If duration of membrane rupture and invasive fetal monitoring are confirmed to be associated with perinatal HCV transmission, interventions may be possible to decrease the risk of transmission.

Deletion of ALT Removes Important Screening Tool for Liver Disease

When the Federal Government's Health Care Financing Administration (HCFA), which runs Medicare, recently mandated the deletion of ALT testing (alanine aminotransferase, ALT) from the routine serum comprehensive panel, it deleted an important screening tool for liver disease, said Fred K. Askari, M.D., University of Michigan Medical Center. Stopping liver disease screening placed our nations elderly at particular risk for suffering from undetected liver disease. Since many insurance companies follow HCFA's policies, millions of younger Americans may also have undetected liver disease as a result of the government's action. Arguing that the diagnostic yield of an elevated ALT is quite good, Askari estimates that with the ALT test, about 280 new cases of liver disease in the University of Michigan healthcare network could be discovered each year, for a total cost of $12,500 for the 70,000 comprehensive panels processed annually. This is a cost of less than $50 per case of liver disease discovered. Askari concludes, "The ALT testing should be restored to the comprehensive panel without delay."
AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver disease. Today, AASLD provides representation and education for nearly 2,400 liver researchers, physicians, and surgeons worldwide.

K-M Communications

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