IN THE NEWS: Hope for Hep C?

From Al-Ahram Weekly

Hope for hepatitis?

By Mariz Tadros

Hepatitis C, a viral illness communicated through blood, long seemed
destined to remain incurable. It is estimated that anywhere between 15
and 40 per cent of Egyptians could be infected with HCV, which can
lead to liver disease such as cirrhosis (scarring of the liver), liver
cancer, or liver failure. Now, however, Abdel-Basset Mohamed, an
Egyptian scientist, claims there is a light at the end of the tunnel.
A professor of chemistry at the National Research Centre, Mohamed has
been granted patent rights by the European Patent Office for a new
drug to treat hepatitis C.
The virus has been on the increase internationally ever since its
discovery in 1989, in large part because poor screening techniques
have led to its propagation. Because hepatitis C is blood-borne, it
can be transmitted through blood transfusions, improperly sterilised
medical equipment, shared intravenous drug paraphernalia or, in a very
small minority of cases, sexual intercourse. Further increasing the
risk of transmission is the fact that it can take 10 to 30 years
before a patient is identified as being infected with the virus. A
medical source who preferred to remain anonymous suggested that the
lack of sterilisation of syringes and equipment in the late 1960s and
1970s in the nationwide inoculation programmes for the eradication of
bilharzia was a major source of hepatitis C transmission.
The drug for which Mohamed has received patent rights is extracted
from two wild terrestrial plants. "These plants grow in the Egyptian
deserts and in the coastal regions. They have long been known to be
beneficial for the liver. We removed the toxic agents from them and
tried them on a most resistant strain of hepatitis C," Mohamed told
Al-Ahram Weekly. Experimentation on mice and chimpanzees, he
explained, produced very positive results, which induced him to try
the compound on humans. The drug, he said, was tested in the United
States on 100 Egyptian American volunteers, whose condition ranged
from mild and moderate to severe. "The results were very encouraging:
78 per cent of the patients experienced complete recovery in a period
ranging between three to six months, with no relapse," he said.
Mohamed added that the new treatment had no side effects, but
cautioned that patients have to watch their diets and avoid all
foodstuffs contaminated with insecticides and preservatives -- advice
given to all liver patients.
After the treatment, however, Mohamed emphasised that the liver must
be protected to avoid a relapse. "There are 150 herbs documented in
the international medical literature that serve to protect the liver.
We have 57 of them in Egypt. I came up with a balanced mixture and
tested it on humans. In 80 per cent of the cases, the drug halted the
development of cirrhosis, increased the patients' energy levels and
led to overall well-being."
The potentially cataclysmic effect of this remedy, if it is proven
effective, can be measured better when one considers the fact that the
current treatment given to HCV patients, interferon alfa-2b, is
relatively effective in 50 to 70 per cent of cases, but that the
majority of patients suffer a relapse. Furthermore, side effects can
include flu-like symptoms, depression, rashes, nausea and abnormal
blood counts.
Mohamed says his new drug is the result of eight years of intensive
work -- part conducted in research laboratories in Egypt and part
abroad. Currently, he is negotiating with "some American companies"
for release on the market. He believes it will be available on the
market within two years, at a much lower cost than Interferon, the
most common medication used for hepatitis C so far. "Whereas a course
of Interferon costs LE12,000, a six-month course of my drug will cost
LE500" -- a crucial consideration for low-income patients. There are
rumours that the drug is already being administered to patients
suffering from HCV at certain private clinics in Egypt.
Mohamed claims that his discovery was an ordeal, because of the
absence of any support for his scientific ventures. "Then again, the
facilities and budget in this country for research are inadequate, and
there is an absence of teamwork on any project." He is a firm believer
in the inherent curative properties of wild plants and herbs, which,
he argues, have been ignored here despite a long and flourishing
history of Arab medicine. "If sufficient scientific research were put
into experimenting with these plants and herbs, we would be able to
find a cure for every disease, and it could become an important source
of national revenue, just as it is in China. But this, unfortunately,
is not the case".
Dr Hamdi El-Sayed, head of the Doctors' Syndicate, commented that "a
new discovery for the treatment of hepatitis C sounds very positive,"
but added that he would not take any of the results seriously until
the drug went through the traditional channels. "There is a big
difference between getting a patent for a drug -- which recognises
that the new drug is his invention -- and its release for the public's
use," said El-Sayed, expressing his anxiety at the haphazard way in
which drugs often reach the market and are sold to patients as
effective remedies. "I am just worried about all the press attention
being given to this new miracle drug, which raises people's hopes,
only for them to end up disappointed because it is not as effective as
it claimed to be, or because of its side effects." El-Sayed believes
that if Mohamed wants his drug to be taken seriously, and not be
treated like a popular herbal concoction, he will have to wait until
it goes through rigourous medical testing, and follow the traditional
channels like publishing his findings in a respectable medical journal.
Dr Rifaat Rifaat Kamel, professor of general surgery at Ain Shams
University and a liver specialist, also voiced suspicion. "Generally,
we consider a drug safe after it has been approved by the US Food and
Drug Administration. Of course, we would welcome any cure for
hepatitis C -- but many non-traditional alternative cures have
appeared claiming to treat hepatitis. I have seen many patients who
take such medication and do actually experience a temporary
improvement. They stop their check-ups because they think they are
going to recover totally, only to return later with a liver tumour at
an advanced stage." Part of Kamel's suspicion about these herbal-based
cures, he says, has to do with the confusion between their effect and
the natural course of the disease. "Hepatitis C, by its nature, goes
through highs and lows. The highs could be easily be mistaken for the
result of a drug, when in reality they are not. I am concerned about
the sustained impact of the drug and its possible side effects,
because patients infected with hepatitis C are usually very fragile."
Until the drug is proven to be safe and effective, Kamel suggests that
efforts should be directed towards the prevention of HCV. "In Egypt,
we have to pay special attention to making sure that dental equipment
is properly sterilised. Women who go for a pedicure or a manicure at
the hairdresser' s should make sure that they use their own things,
because this is one common way of transmitting the disease." The lack
of a national screening programme in Egypt is also a serious cause for
concern, noted Kamel, but the Ministry of Health has begun to set one up.
While not denying the high incidence of hepatitis C in Egypt, Kamel
believes the issue has been exaggerated, especially since only five
per cent of patients who contract the disease become terminally ill.
If it is detected early, he claims, patients can lead normal lives.
But given the high incidence of infection in Egypt, as well as the
limited treatment options, it is likely that poor and well-off
patients alike will be flocking to Mohamed's office at the National
Research Centre to see what he has to offer.