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HCV ADVOCATE WEEKLY NEWS REVIEW:
A Review of HCV, HBV and HIV/HCV Coinfection Related News and Highlights

Week Ending: January 1st, 2005

Alan Franciscus
Editor-in-Chief

To download pdf version click here

This Issue:

• Test to Spot Early Liver Disease
• Firefighters Will Share $600,000
• Woman in Mayo Trial of Hepatitis C Treatment May Help Patients with Hepatitis C
• CALIFORNIA: “Needle Policy to Be Eased”
• Hepatitis Claims Much-Loved Firefighter

December 28th, 2004

Test to Spot Early Liver Disease
SourceURL:http://newsvote.bbc.co.uk

A technique for identifying early liver damage could help improve detection of the deadly condition cirrhosis.

Essex University scientists teamed up with a German team to pinpoint a group of biochemical markers that indicate the disease is in its early stages.

The markers are made up of debris from damage to proteins, a well-known early sign of cirrhosis.

The Journal of Hepatology study could lead to a blood test to detect damage earlier, and stop progression.

Lead researcher Professor Paul Thornalley, who led the research, said: "It is likely that debris from this damage, leaking into the blood, will prove a novel biochemical test for early liver damage."

Cirrhosis kills an estimated 4,000 people in the UK each year. Over the last 20 years, there has been a massive increase in the numbers killed by liver damage, with fatalities among men up 121% since the early 1980s and among women by around 68%.

The disease is most commonly associated with alcohol but it can also affect anyone infected with hepatitis C.

Up to 15% of chronic alcoholics develop alcoholic cirrhosis, of whom 75% will eventually die through liver damage.

Scared tissue
It begins with the formation of scarring, known as fibrous tissue.

Left unchecked, this can gradually develop into full-blown cirrhosis, for which the only treatment is a transplant. However, there is a national shortage of donor organs.

A test that could pick up early liver damage could help identify hepatitis C sufferers and also be used to monitor whether patients are following doctors' instructions to abstain from alcohol.

The new marker is a by-product of the destruction of proteins in the liver. This destruction takes place as disease sets in.

Tests showed a 15-fold increase in the level of this marker in cases where scarring of the liver was underway.

Although the test does not differentiate between alcohol damage and other causes, it could still be used to check progress of drink-related disease.

Abstinence test
Professor Thornalley said: "Alcohol represents 50% of cirrhotic livers in the UK.

"This test could be an indication of whether people are sticking to their abstinence programmes.

"People have been looking for such a marker for many years. We've not seen one that changes so dramatically as this."

Charles Gore, of the Hepatitis C Trust, said if the test showed liver damage then patients could be given drugs to rid the body of the hepatitis virus.

But he said he doubted it would make a huge difference, because liver disease progressed so slowly treatment may not be immediately necessary.

"Damage from hepatitis C is very slow. The disease may be setting in but it could be 10 years before something happens."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/ health/4121011.stm

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CALIFORNIA: “Needle Policy to Be Eased”
Sacramento Bee
John Hill

A new California law taking effect Saturday, Jan. 1, will ease nonprescription needle sales in cities and counties that choose to participate in a five-year pilot project. Individual pharmacies can elect to participate or not in jurisdictions opting-in to the demonstration project. However, even urban districts that are preparing for the change will not be ready by Saturday.

Sacramento County Health Officer Glennah Trochet has twice convened a group to discuss project details. However, Trochet is still working to enlist key partners such as law enforcement officials, said Toni Moore, the county's alcohol and drug administrator. Once the group reaches consensus, it will take its proposal to the Board of Supervisors.

The program could gain momentum if major pharmacy chains participate, as they have in other states, said Glenn Backes, national health policy director for the Drug Policy Alliance, a proponent of the law. Chains' involvement would make selling needles to IV drug users more mainstream, so that "no one has to be a pioneer," he said.

Rite Aid has not yet been contacted by state, county or city authorities about the program, said Jody Cook, company spokesperson. "Once that happens, we would intend to participate," she said.

“Some [customers] come in and want to do it already,” said Frank Cable, a pharmacist at South Sacramento Pharmacy who supports the program. Cable suspects news of the program has spread among IV drug users by word of mouth.

Participating pharmacists registered with local authorities must agree to educate their customers on drug treatment and safe disposal of syringes. The new law makes it a crime to dispose of a needle in a park or other public place. It also excludes from the definition of illegal drug paraphernalia containers that hold needles, a provision that does not expire as the law's others do in 2010.

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December 29th, 2004

Firefighters Will Share $600,000
SourceURL:http://www.orlandosentinel.com/
By Mark Schlueb
Sentinel Staff Writer

Orlando agrees to the settlement after 3 years of fighting in court and City Hall.

Orlando firefighters -- some with serious medical problems -- will split nearly $600,000 within the next two weeks, ending more than three years of fighting in court and City Hall.

The city's settlement with the 28 current and former firefighters closes what those involved describe as the most bitter chapter in the Orlando Fire Department's 120-year history.

"It brings closure," said Mike Morton, a former firefighter who suffers from hepatitis C that he thinks he contracted during 26 years on the job. "It's been a long time coming."

More than three years ago, Morton and more than two dozen other firefighters filed a class-action lawsuit against the city and then-Mayor Glenda Hood, claiming that doctors at the employee clinic never told them about abnormal test results.

Some of those symptoms pointed to serious maladies, including potentially fatal hepatitis, heart and lung ailments. Firefighters said they could have sought early treatment if the city clinic had shared their test results right away.

The lawsuit was eventually thrown out before it could be heard by a jury. The judge said their allegations amounted to medical malpractice rather than the conspiracy they alleged.

That didn't end the fight, though. The labor union that represents Orlando firefighters filed a grievance over the city's failure to meet safety guidelines, a complaint that covered many of the same issues raised in the lawsuit. Just before it was scheduled to go before an independent arbitrator, the city offered to settle.

Under the agreement, the city will:
•Pay $600,000 to the firefighters.
•Hire a staff doctor for the Fire Department to ensure they receive quality medical care in the future.
•Hire an outside agency to administer workers compensation claims filed by firefighters. The controversy surrounding the lawsuit eventually became so heated that union leaders said they no longer trusted the city staffers who had handled injury
claims.

The city has already closed the clinic that was the source of the accusations. Employee health care is now handled by Florida Hospital.

Firefighters also now receive annual tests for hepatitis and tuberculosis, a concession that city officials had refused to fund for years.

The settlement was approved by the City Council more than seven months ago, but languished until last week.

Union officials had to decide how to divide the money among the 28 firefighters involved. The firefighters will receive between $2,500 and $100,000 each, depending on the severity of their illness and whether they've received any other compensation from the city in the past.

Half of the firefighters will be paid $7,500 or less. Two -- Morton and Bob Flamily, who has terminal hepatitis-related liver damage -- will each receive $100,000.

"I don't think anybody in that group is getting as much
as they deserve, but that's what we had to work with," union president Steve Clelland said. "The union's goal was to see that this never happens again."

The payouts were also delayed because one of the attorneys who represented the firefighters in their class-action suit filed a lien seeking a cut of the settlement.

Winter Park attorney Mark Morsch said he lifted the lien two weeks ago because he didn't want to hold up the payments. Morsch said he and attorney Geoff Bichler
lost money on the case, but they were glad the firefighters were receiving some compensation.

"Had we not stuck our necks out, I don't believe there would have been a settlement," Morsch said. "It cost us a lot, both out of pocket and in reputation."

Mark Schlueb can be reached at mschlueb@orlandosentinel.com or 407-420-5417.

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Woman in Mayo Trial of Hepatitis C Treatment May Help Patients with Hepatitis C
SourceURL:http://www.azcentral.com
Kate Nolan
The Arizona Republic

Most people spent the Christmas holiday around family or friends thinking about anything but illness or medical treatments.

But for Kathy Sprinzl, Christmas Eve was for helping science march forward.

That was the day she injected herself for the second time with a new drug that may change her life.

The Scottsdale interior designer, who has been treated for the chronic viral infection hepatitis C for seven years, said the treatments are sometimes worse than her condition.

The illness is characterized by continual fatigue, but the injections given for therapy often induce days of chills and other flulike symptoms. The disease has no cure.

A week later, just about when the reaction wears off, it's time for another shot of interferon, the immune system booster that is the most common treatment. Hepatitis C is a liver disease that affects an estimated 100,000 Arizonans, many of them of baby boomer age; 3 million Americans have the disease.

Recently Sprinzl, 55, became a participant in a new drug study at the Mayo Clinic in Scottsdale that may provide a more user-friendly regimen for hepatitis C patients.

The test drug, Albuferon, requires less frequent dosing and may produce fewer side effects.

The new drug combines interferon with albumen, a protein found in egg whites.

"What is unique about the treatment is that Albuferon can stay in your system for a month," said Dr. Vijay Balan, the liver disease specialist who heads the Mayo study being conducted with eight other U.S. hospitals.

Mayo participated earlier in an initial study assessing Albuferon for safety and toxicity.

The study is accepting patients who have not responded to earlier treatment.

Balan explained that existing treatments fail half of all hepatitis C patients. The most common strain of the disease, genotype 1, the type Sprinzl has, is also the one that is least likely to respond to treatment. So far, 17 patients have qualified for the study at Mayo. Eighty patients will be treated at participating hospitals.

In the earlier safety study, patients responded well to two treatments, but the project was short term.

The new study will run longer. Patients will be given the drug at either two-week or four-week intervals for 48 weeks. The level of the virus will be measured, along with liver function, to assess the efficacy of the drug. Patients will report on their degree of comfort. Patients who show improvement will be tracked for a half year after the test, "to make sure the sustained vital response is continuing to hold," Balan said.

For Sprinzl, the study represents a hope to give her liver a little more time to regenerate.

It also represents the fourth medication she's used to control her condition.

Sprinzl participated in the first study and the level of the virus in her blood dropped precipitously. Later when her health faded again, she qualified for the second study.

For the next year, she'll be giving herself a monthly shot in the belly and taking six pills daily of the antiviral drug Ribovarin. If treatments result in increased fatigue or shortness of breath, she may have to supplement them with injections of Procrit to increase red blood cells and reduce fatigue.

Sprinzl considers that protocol a snap, compared with the normal weekly cycle of injections.

"I used to always be chasing the next shot," said Sprinzl, who describes an evolution in her approach to having the disease, for which she has never discovered the means of transmission.

For more information on the study, call (480) 301-1735.

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January 1st, 2005

Hepatitis Claims Much-Loved Firefighter
SourceURL:http://www.canyoncourier.com
Bonnie Benjamin Skopinski

Family and friends of Ward "Chipp" Fenton, who died last Tuesday, will miss him in a big way.

The loss of his huge laugh and great sense of humor, his unending generosity with his time and talents, his unflagging dependability - even his physique, at 6-foot-3, 250-pounds, was large - all contribute to the gaping his death left in many hearts.

Fenton, 55, died of complications from hepatitis C after a long fight against the disease. Subsequent infections requiring antibiotics kept him off the liver transplant waiting list.

Fenton told family and friends that he thought he acquired hepatitis C while extricating a victim from a motor vehicle accident. The disease is passed by contact with infected blood. Fenton thought he may have had a cut on his hand when he went to the aid of the injured person.

"He is truly the first line-of-duty death for the Evergreen Fire Department, said Pete Anderson, an Evergreen firefighter, Jefferson County Incident Management Team chief and long-time friend.

Fenton grew up in Buffalo, NY, flanked by sisters - older sister Helen (Nel) Pietranczyk and younger Michelle (Shelly) DeWit. One by one, they moved to Colorado.

Pietranczyk came out last, and many of the memories that first popped into her head during an interview last week were of their childhood.

She recalled how Fenton was a typical little boy troublemaker, always getting her in the soup, too, or tickling her relentlessly. She remembered little things like how he spent a good portion of their summers on Cape Cod, digging a hole to China in the sand.

Shelly and her brother spent many years in Colorado, away from the rest of the family, and during that time they grew even closer.

"If I was in his hug; I was safe," she said.

Fenton met his wife, Pat, in Colorado and proposed to her on top of Mount Evans at sunrise.

She said he was a loving husband, sensitive to her needs.

"He was an awesome dad," Pat said.

Their son, James Douglas (J.D.) is 14.

Fenton and his son enjoyed camping and going to CJ's for hotdogs, Pat said.

Nel thinks that her brother did the right thing by not protecting his son from the every day realities of his impending death. She thinks it made J.D. better able to cope with the eventual loss of his father.

Smiles returned to the three women's faces when they recounted how they pulled off a surprise birthday party for Fenton in March 1999.

They flew Ward Fenton Sr. out from Buffalo and hid him at Shelly's house. Then Shelly's husband, Greg asked Chipp to come over and help him move a old, heavy piece of furniture, and he obliged.

"We knew he would," Shelly said.

They also knew he would figure his father's visit was his birthday surprise. So a couple of days later, when his dad invited him for a beer at the Little Bear, he didn't have a notion that when he walked in the bar more than 100 people would be there to wish him a happy birthday.

Fenton had spent a miserable year wrangling with hepatitis C, and this joyous show of support meant a lot to him, Shelly said.

Chipp Fenton's death also is a major blow to Evergreen Fire and Rescue, where he volunteered for more than 20 years, serving as a firefighter, rescue squad chief, and assistant chief, as well as logistics chief for the Jefferson County Incident Management Team over the years.

He retired from full-time duty with the Evergreen Department in about 1999 or 2000 but remained active with the incident management team.

Pete Anderson was Fenton's roommate for four or five years when the latter first came to Evergreen. Pat lived with them after a while, too.

"I could tell you a thousand stories, but most of them I don't want to have printed," Anderson said.

One story he did tell involved driving a fire engine to Brook Forest in response to a fire call one icy day. The truck slid from the driveway, across the road and down through the woods, knocking down 15 or more trees.

From then on, Fenton was dubbed "the tree-slayer."

"He was probably the best friend anyone could ever have," Anderson said. "I'll miss him forever."

His sentiments are shared by other firefighters.

Evergreen Deputy Chief Kenny Erhardt took over the rescue squad when Fenton retired after working under him on the squad since 1991.

"I think he made the rescue squad what it is today," he said.

He credited Fenton with raising squad standards and introducing techniques like low-angle rope rescue and new vehicle extrication techniques.

Fenton created the rescue academy, an optional curriculum that firefighters may take after they graduate firefighter training.

Evergreen Asst. Chief Mark Davidson worked with Fenton in Evergreen and on the Incident Management Team.

Fenton was the logistics chief, Davidson the operations chief. Fenton may not have been the best about the paperwork associated with his assignment of finding resources, Davidson recalled with a laugh, but just tell him what you needed, and "things would magically materialize. He could find anything."

For several years and without any fanfare, Fenton also represented Evergreen Fire and Rescue on the Jefferson County Fire Council, where departments share information and coordinate policies among themselves and with other emergency agencies.

"He was a great guy to go have a beer with," Davidson said. "He would do anything for you."

Former Evergreen firefighter, district administrator and fire marshal Carol Small, presently with Jefferson County Emergency Management, would receive Fenton's phone calls during his searches for whatever was needed at wildfires.

She recalled he always warmed up her and her co-worker before he made his requests with, "Well, hi, Sunshine" or "Hi, honey." "Guess what I have for you."

"We knew it was Chipp on the other end," Small said.

She appreciated his knowledge and dependability on at fire scenes, too. "When you saw Chipp, you knew things were going to go right."

Evergreen firefighter and department chaplain Marty Lake felt the same way. "I could follow him into a fire anytime; he was so efficient and professional."

Fenton worked mostly as a maintenance man for the Tall Grass Aveda Spa in Evergreen.

Owner Gail Sharp thinks it takes a special guy to deal with 80 women paging him all the time for everything from a doorknob falling off to a well running dry. That was Fenton, and he was always nice about it, too.

The spa could not have become what it did without Fenton, Sharp said.

Fenton loved plays on words, music, and cooking. A few years ago, he won first prize in the annual Big Chili Cook-off with his Chainsaw Chili.

Fenton used his chili, chicken wings, barbecued ribs and other specialities to entice friends to his wood-splitting parties, Pat and his sisters said.

Accompanying Fenton into the forest to cut down the trees before the parties was one of Shelly's favorite times, she said.

The sisters said their brother acquired his love of the outdoors during vacations at Muskoka Lake in Ontario and hiked a lot in upstate New York.

He also loved western novels and cowboy poetry. This year, Chipp was going to initiate Nel into the family ritual of attending the cowboy poetry festival at the Arvada Center.

She's going to attend anyway in honor of her brother.

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