No, I didn't just wildly hit a bunch of letters on my keyboard. SPC3649 is the research name of a promising hepatitis C treatment that's still in development.

What's all the fuss about?

SPC3649 has significantly reduced the hepatitis C virus in the blood of chronically infected chimpanzees. Of course, anytime a new drug shows promise for treating hepatitis C, it's a big deal. But the reason that new drugs are needed is because the current therapy doesn't work well for some chronic infections. It's well-known that some hepatitis C viral genotypes, such as Type I, are harder to successfully treat than others. Because of this, people with hard-to-treat forms of hepatitis C are half as likely to even start treatment (Journal article).

So when an experimental drug, such as SPC3649, produces a prolonged virological response, researchers start to think it may become a solution for these hard-to-treat forms and can be a hope to those who don't even start treatment. It's possible that this drug could be a treatment in itself; though, if successful, it could also be used in combination with peginterferon and ribavirin.

Ah, but there's more!

Another aspect of SPC3649 that's exciting for hepatitis C treatment is its high barrier to resistance. This means that the hepatitis C virus, which is notorious for its many mutations, isn't able to easily resist the treatment.

How's this drug different from the current therapy?

This drug is developed using a special kind of chemistry called "locked nucleic acid" or LNA. It's a DNA-based drug that targets specific liver molecules involved in replicating the hepatitis C virus. By this, I mean that instead of targeting the virus directly, it targets "helper" molecules in the liver. Without these "helper" molecules, the hepatitis C virus can't replicate. With no replication, the infection can't progress.

Should you get excited?

SPC3649 is getting some interesting press coverage, but it's still a long way from being prescribed by doctors. It's still in phase 1 clinical trials and won't begin its phase 2 trials until sometime next year. So stay interested, but remember, it takes awhile for new drugs to work their way through development. Here's a quick review of clinical trials.

If you're interested in learning more about this drug, here's an abstract in the journal Science. Here are two press releases, one from Santaris Pharma (the company that developed the drug) and one from SFBR, a collaborating research foundation.

We've come a long way. In the nearly three decades since HIV first became known, so many things have changed--especially with how people understand the virus and their reactions to the infection. It took five years between the first reported AIDS case and a sitting U.S. president publicly saying the word 'AIDS', but today there are success stories about delivering HIV treatments to some of the poorest nations of the world.

Even with all these successes, still there is a long way to go. World AIDS Day is held annually on December 1 to promote awareness of the realities of HIV. For example, there are more than 33 million people living with HIV worldwide. But perhaps we also need a World AIDS-Hepatitis Day. A proportion of these 33 million people are at increased risk for developing acute hepatitis, especially hepatitis B or hepatitis C. The CDC estimates that hepatitis C co-infection is common (50%-90%) among HIV-infected injection drug users. It's important for people to understand how co-infection with either hepatitis or HIV can affect the treatment and management of either disease.

For more information, check out the Word Aids Day website at www.worldaidsday.org.

Happy Thanksgiving! I hope you enjoy all the trappings of the holiday: food, family and friends.

Testing for hepatitis B usually requires interpreting the hepatitis B serologic panel. Sounds easy enough, right? But here's the catch: this panel includes a number of markers and will have multiple interpretations of the various results. Here is a helpful table for interpreting the hepatitis B serologic panel.

While we're at it, perhaps brushing up on what all those letters mean for each hepatitis B test will help. Follow the links for information about HBsAg, anti-HBc (also called HBcAb), anti-HBs (also called HBsAb), and anti-HBc.

Milk thistle is a popular remedy for liver disease. For some it's just a weed, but for many others, it's a well-known medicinal plant that helps lessen the damage of chronic hepatitis. This stout, spiny plant has an excellent reputation among alternative medicine supporters--but does milk thistle earn its two-thousand year reputation in light of 21st-century medical science?

The medical literature is unclear. Milk thistle appears to be very safe for most people, but its benefits haven't been conclusively demonstrated for hepatitis patients. Some studies conclude that milk thistle provides some kind of protection to the liver, but many other studies don't show this. Unfortunately, to complicate matters, many of these studies have design flaws. So, it's difficult to develop strong conclusions (either for or against) from the existing research. Truly, more quality research is needed.

Until this type of research is available, what's a good strategy? Certainly, talk with your doctor if you're thinking about taking milk thistle. Though this may seem like a harmless natural therapy, milk thistle is still a drug that can affect your liver. If you have liver disease, you need to be very careful about the medicines you take, including natural and over-the-counter. And, if you're currently treating chronic hepatitis, you want to be sure milk thistle doesn't interact poorly with your prescribed therapy.

More information about milk thistle is available. Since an informed patient needs to consider the benefits and criticisms of alternative treatments, here is general information about taking alternative medicine. And if you have liver damage, some herbal medicines just need to be avoided completed. Here's a list of seven dangerous herbs for your liver.

Can drinking coffee help slow the effects of chronic hepatitis C? According to a new study, people with hepatitis C who drank three or more cups of coffee per day had a lower risk of liver disease progression (53% lower risk) than non-coffee drinkers.

The research, published in the journal Hepatology, followed 766 patients who all had chronic hepatitis C with detectable HCV RNA, advanced hepatic fibrosis (liver scarring), and interestingly, previously treated with peginterferon and ribavirin but didn't reach SVR (What Is SVR?). Compared to the non-coffee drinking patients, people who drank more coffee had less progression of liver disease. Those who drank one to three cups of coffee per day were 30 percent less likely to progress, but those who drank three or more cups each day had a 53 percent lower risk.

So what do we make of this research? Should we all start drinking coffee in hopes of a healthy liver? At this point, this is just interesting information. There are over one thousand chemical compounds in coffee and no one knows which are responsible for any potential benefit. Since this is the first study to compare the effects of coffee on people with hepatitis C, more studies are needed. However, according to the study's researchers, the idea of drinking a cup of coffee (or three, actually!) to help the liver isn't as strange as it may seem. Drinking coffee could affect liver disease by affecting insulin and glucose levels in the blood. Furthermore, coffee may actually reduce inflammation that can lead to fibrosis and cirrhosis.

Having hepatitis B is no 'fun and games' but what about a hepatitis B crossword puzzle? That can be an interesting diversion, especially if you're a devoted puzzler.

Of course, avid puzzlers usually enjoy the kind published in the Sunday New York Times, but here are some hepatitis B-themed examples you may also enjoy. To complete Hepatitis B and Me, you'll need to use your basic knowledge of hepatitis B. Likewise, here's another crossword puzzle that you'll need to use what you already know to finish. It also includes a word search where you need to find 33 hepatitis-related words hidden in a jumble of letters.

Before you start these, you can refresh your understanding of hepatitis B by reviewing this short introduction to HBV Infection.

What do you know about viral hepatitis and sex? In the alphabet soup of hepatitis viruses, it can be difficult to remember which ones spread through sexual contact and which do not. Since it's important for people to understand their risk, here's a simple outline of hepatitis virus sexual transmission.

Knowing which viruses are more likely to spread during sexual contact is just one step in protecting yourself. The second step is to understand the best way in preventing spread. Vaccination is a good prevention strategy for hepatitis A and hepatitis B. Here's more information about the hepatitis A vaccine and the hepatitis B vaccine. However, preventing hepatitis C requires a different approach because no vaccine is currently available.

Kristen Parker, the Colorado-based healthcare worker who possibly infected 35 patients with hepatitis C, was sentenced to 20 years in prison based on a plea agreement with federal prosecutors. The formal sentencing is scheduled for December 10.

Ms. Parker, a 26-year-old former surgery technician, stole syringes filled with the pain medication fentanyl. After injecting herself with the drug, she refilled the syringes with a saline solution and allowed them to be used by patients, even though she apparently knew she had hepatitis C. Sixteen people have been linked to Ms. Parker by DNA testing. However, Colorado state health officials suspect 27 people will ultimately be linked, while federal prosecutors believe 35 people will be linked.

Originally Ms. Parker plead not guilty to a 42-count indictment. However, based on last month's plea, she admitted guilt to five counts of tampering with a consumer product and five counts of obtaining a controlled substance by deceit.

For more information on these exposures, please check previous coverage on July 5, July 13 and July 21.

Of the five hepatitis viruses, the first three get all the press and attention. This is with good reason, because of these five, hepatitis A, B and C cause the most disease here in the United States and many other developed countries. However, is it worth knowing more about the viruses that cause hepatitis D and E?

These two viruses, though lesser known, are very interesting and in some locations, cause significant disease. For example, hepatitis D isn't even a complete virus capable of causing an infection. To cause disease, it must infect people who already have hepatitis B. Currently, it seems that hepatitis D is endemic in Mediterranean countries and the Far East.

Hepatitis E is like hepatitis A in many ways, but is really dangerous for pregnant women. It can cause fulminant hepatic failure in up to 25% of pregnant women. There's no vaccine yet, and it's the second most common cause of sporadic hepatitis in the Middle East and North Africa. Currently, hepatitis E is a huge public health problem in Uganda.

Neither of these viruses are common yet in the United States, but they are here. As travel becomes more common into and out of areas endemic with hepatitis D and E, the epidemiology (locations and populations) of these infections may shift. Whether this happens sooner or later, it's in the public's interest for these viruses to become better known.