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October 08, 2008

Hepatitis B Treatment May Reduce Pancreatic Cancer Risk

While several theories are attempting to explain the connection, scientists are unsure why those with Hepatitis B appear to have 2 ½ times increased risk for developing pancreatic cancer. In this article you will learn more about the link and why treatment for viral Hepatitis B may reduce the occurrence of pancreatic cancer.

Possible Link between Hepatitis B Virus and Pancreatic Cancer

Researchers from the M. D. Anderson Cancer Center in Texas have reported that exposure to the hepatitis B virus may be associated with the development of pancreatic cancer. The study was recently published in the October 1, 2008 issue of the Journal of Clinical Oncology.

The causes of pancreatic cancer remain obscure. Some of the known factors that increase the risk of developing pancreatic cancer include cigarette smoking, increasing age, certain dietary characteristics, obesity, diabetes, and pancreatitis. Hepatitis B and C are associated with chronic liver disease; however, because hepatitis is a systemic infection, the virus may travel through the bloodstream and be deposited in non-liver tissue. The proximity of the liver and the pancreas, as well as the shared blood vessels and ducts between the two organs, make the pancreas a potential target for the hepatitis virus.

In this study researchers compared blood samples from 476 patients with pancreatic cancer against those of 879 age-, sex-, and race-matched healthy controls. The blood samples were tested for both the hepatitis B and C viruses. Antibodies to hepatitis C were found in 1.5% of cases with pancreatic cancer and 1% of controls. Antibodies to hepatitis B were found in 7.6% of cases with pancreatic cancer and 3.2% of controls. Patients who were hepatitis B positive had a 2.5-fold increase in risk for developing pancreatic cancer. This risk was not increased in persons who were positive for both hepatitis B and C. Persons who were hepatitis B positive and hepatitis C negative had a fourfold increased risk of developing pancreatic cancer. Persons who were diabetic and hepatitis B positive had a sevenfold increase in risk of developing pancreatic cancer.

These researchers concluded that past exposure and possibly chronic infection with hepatitis B may be linked to the development of pancreatic cancer. This, combined with evidence from several previous studies indicating that there may be reservoirs of the hepatitis B virus in the pancreas, suggests that more research into this association is warranted. Furthermore, these researchers found that the presence of the hepatitis B antibodies create the potential for reactivation of the hepatitis B among patients when they receive chemotherapy treatment. As such, oncologists may want to check the hepatitis B status of patients before beginning chemotherapy.

Comments: Research in this field is ongoing. As researchers continue to learn more about the link between hepatitis B and pancreatic cancer, they may gain insight into the etiology of this disease. If hepatitis B is indeed a risk factor, then treatment for the virus may even decrease the risk of pancreatic cancer.

Reference: Hassan, M., Li, D., El-Deeb, A., et al. Association between hepatitis B virus and pancreatic cancer. Journal of Clinical Oncology. 2008; 26: 4557-4562.

URL for Article Source:
http://professional.cancerconsultants.com/oncology_main_news.aspx?id=42690

Posted by Editors at 09:42 AM --- Printer-friendly version

September 15, 2008

Hepatitis B Viral Load Measurement Improves

Roche’s new Hepatitis B test brings a higher level of specificity to viral load detection. For those with chronic Hepatitis B, this improvement in patient monitoring favorably impacts their therapeutic outcome.

by Nicole Cutler, L.Ac.

Infecting about two billion people worldwide each year, the Hepatitis B virus (HBV) is one of the most serious types of viral hepatitis. Over the past decade, a variety of medications have been developed and approved to help those with HBV – however, the drugs rarely provide a cure. To determine if their treatment is working and how severe their illness is, physicians continually monitor their patients’ viral load. In September of 2008, the U.S. Food and Drug Administration (FDA) approved a new, more sensitive test to determine HBV viral load in an effort to improve the HBV monitoring process.

Hepatitis B Treatment
Although they usually do not eliminate the virus, the FDA has approved seven drugs for treating chronic HBV. In order for a treatment to be considered a cure, the affected individual must have a loss of Hepatitis B virus from their body and must have developed protective antibodies against it. Despite the lack of totality, these drugs have been shown to significantly decrease the risk of liver damage from HBV by slowing down or stopping the virus from reproducing. Aside from the interferons, most of the medications must be taken for at least a year. The approved Hepatitis B drugs include:

1. Interferon Alpha – approved in 1991

2. Pegylated Interferon – approved in 2005

3. Lamivudine – approved in 1998

4. Adefovir Dipivoxil – approved in 2002

5. Entecavir – approved in 2005

6. Telbivudine – approved in 2006

7. Tenofovir – approved in 2008

When progressing with one of the above HBV treatments, doctors test their patients’ viral load:

· to establish a baseline level of infection
· during treatment as an aid in assessing the person’s response to therapy.

Viral Load Test
Because the goal of Hepatitis B therapy is to treat until the virus is undetectable, it is critical for viral load monitoring tests to be able to quantify very low levels of virus. Similarly, it is important for the test to quantify very high levels of virus (higher than 100 million IU/mL), an indicator of the need for more or less aggressive treatment.

A collective analysis of tests is used to determine a person’s HBV viral load. Joining the existing biochemical and serological viral load tests, Roche’s COBAS Taqman HBV Test has just been approved as the first nucleic acid HBV test. The first assay for quantifying HBV DNA in the U.S, the COBAS Taqman test uses real time PCR technology to determine the amount of Hepatitis B virus DNA present. By providing a significantly broader range of detection, this new technology fosters a more exact calculation of the amount of Hepatitis B virus in a person’s body.

Daniel G. Schultz, M.D., director of the FDA’s Center for Devices and Radiological Health says, “Measuring a patient’s HBV viral load is an important aspect of managing chronic Hepatitis B infections. The COBAS TaqMan test gives health care providers a new and sensitive tool for this process.”

Roche’s nucleic acid assay will help physicians fine tune HBV treatment. Knowing more specifically how much HBV is in a person’s body can better guide the therapeutic process. Although improving HBV monitoring may not seem like a big deal, it brings the likelihood of an HBV cure closer within modern medicine’s reach.

References:

http://www.biospectrumasia.com/content/050908OTH7019.asp, Roche gets FDA approval for its Hepatitis B viral load test, Retrieved September 12, 2008, BioSpectrum, September 2008.

http://www.fda.gov/bbs/topics/NEWS/2008/NEW01880.html, FDA Approves DNA Test to Measure Hepatitis B Virus Levels, Retrieved September 12, 2008, US Food and Drug Administration, September 4, 2008.

http://www.hepb.org/patients/hepatitis_b_treatment.htm, Approved Drugs for Adults, Retrieved September 14, 2008, Hepatitis B Foundation, 2008.

http://www.hivandhepatitis.com/hep_b/news/2008/090908_a.html, FDA Approves First Hepatitis B Viral Load Test, Retrieved September 12, 2008, Roche press release, hivandhepatitis.com, September 2008.

http://www.hospitalbuyer.com/medical-specialties/hematology-oncology
/hep-b-viral-load-test-cleared-2827/, Hep B Viral Load Test Cleared, Retrieved September 12, 2008, Watershed Publishing, LLC, 2008.

http://www.news-medical.net/print_article.asp?id=41212, FDA approves DNA test to measure hepatitis B viral load, Retrieved September 14, 2008, News-medical.net, September 2008.

Posted by Editors at 02:56 PM --- Printer-friendly version