Investigation of management and disease manifestations of viral hepatitis

$1,232,969ZIAFY2023DKNIH

National Institute Of Diabetes And Digestive And Kidney Diseases

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Abstract

Hepatitis C virus is both expensive to treat and a significant cause of morbidity and mortality. A major effort and project has entailed obtaining portal blood in patients with chronic hepatitis C infection. Patients were then treated for hepatitis C and portal blood was obtained after treatment and clearance. The intention of this study is to understand factors that may cause liver disease progression in patients with hepatitis C. Laboratory analysis is complete and data are currently being analyzed. Four manuscripts have been drafted, the first of which is published, 2 are in review, and one is about to be submitted. Further laboratory projects related to this work are now underway. A second type of chronic hepatitis studied is hepatitis D. Hepatitis D is the most aggressive form of viral hepatitis as well as the most difficult to treat. Although not FDA approved, interferon therapy is the standard approach. Patients are typically treated for 6 months to a year. Relapse after cessation of therapy is the norm. Treatment trials for hepatitis D have been initiated at the NIH with a prenylation inhibitor. Our workgroup showed that the therapy has promise and is safe when given for 28 days. A second study with a prenylation inhibitor was then initiated, fully enrolled, and the treatment phase is now complete. Treatment was for 3 - 6 months. Patients have completed the follow up phase. Results are analyzed and a manuscript is in the process of submission. A follow up study has been completed treating patients with a prenylation inhibitor, ritonavir, and lambda interferon for 6 months. Clinical follow up of this study is now complete and a manuscript is drafted. The next study to treat patients with a prenylation inhibitor, ritonavir, and alpha-interferon for a year is completely completed. A protocol has just been approved by the IRB to treat patients with a prenylation inhibitor, ritonavir, and lambda-interferon for a year.

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