Goods News About Hepatitis C

It seems there’s good news everywhere in the fight against Hep C. Firstly, the US congress has voted to lift the federal ban on funding syringe exchange programs after 21 years. Secondly, there has been some major breakthroughs for scientists in their search for an effective Hep C treatment. Two Australian researchers are responsible for one of the discoveries.

AIDS Activists Cheer End to Ban on Needle Exchange Funding
By Susan Sharon
MPBN

After two decades, Congress has voted to lift a ban on federal funding of needle exchange programs. AIDS activists are cheering the move, which they say legitimizes needle exchange as a weapon in the fight against HIV/AIDS.

For years, needle exchange programs in three dozen states have provided clean needles to intravenous drug users as a way to reduce the transmission of HIV/AIDS and Hepatitis C. But the programs have relied solely on state and local funding because of a longtime ban at the federal level, where some have regarded needle exchange as an incentive for drug addicts to continue to use.

"People have been afraid that this is going to conflict with some sort of zero tolerance policy," says Bill McColl, who is with the Washington D.C.-based advocacy group AIDS Action. He says the vote to lift the ban is a vote for science over outdated stereotypes.

"There are eight federal reports that show that syringe exchange will decrease HIV and Hepatitis," he says. "It doesn't increase substance abuse. You know, this is a real opportunity to do some serious outreach to a population that is often overlooked."

In some places, such as Maine, needle exchange rates have been on the rise. At the Eastern Maine AIDS Network, for example, about 4,000 dirty needles are swapped out for clean ones every month. Just three years ago, only 300 clean needles were given out monthly.

Observers credit a new director with effective outreach. But Maine has also had an increase in IV drug use. And Andrew Bossie of the Maine AIDS Alliance says that's why federal funding for needle exchange is so important -- as many as 12 percent of people being infected with HIV are getting infected by injecting drugs.

"So we're really very happy that the U.S. House and Senate have lifted this ban and that we're on our way to more sound policies that prevent the spread of HIV."

Though it's a rural state, Maine has four needle exchange programs which Bossie says are all facing funding problems. Around the country there are about 200. President Obama has previously expressed support for liftting the ban on federal funding of needle exchange as a way to reduce rates of infection.

And while his expected signing of the bill later this month won't guarantee programs get additional funding, activists say it could give more options to those affected by state and local budget cuts.


Liver-Targeted Drug Stops Hepatitis C
Durable DNA Molecule Blocks Hepatitis C Virus in Chimp Study
By Daniel J. DeNoon
WebMD Health News
Dec 2009

Hepatitis C virus can't get a grip on the livers of chimps treated with a new antisense DNA drug.

The drug, dubbed SPC3649, doesn't attack the hepatitis C virus (HCV) itself. Instead, it blocks the tiny RNA molecules in the liver -- microRNA-122 or miR-122 -- that the virus must use to make new copies of itself. HVC causes disease only when it can replicate to high liver concentrations.

HCV levels drop 350-fold in chimps treated with SPC3649, find Robert E. Lanford, PhD, of San Antonio's Southwest foundation for Biomedical Research and colleagues.

"The drug worked exceptionally well in treating HCV infections in chimpanzees," Lanford said in a news release. In an email to WebMD he said, "We were very excited with the outcome."

The researchers studied four chimps chronically infected with HCV genotype 1, the most common HCV strain in the Americas and Australia. It's also the most treatment-resistant HCV strain.

Two chimps got a low dose of SPC3649, and two got a high dose, given once a week for 12 weeks. The higher-dose treatment was remarkably effective in suppressing HCV. The lower dose showed a strong but lesser effect in one chimp, but not in the other.

As long as the animals stayed on the drug -- and for two weeks after treatment stopped -- HCV levels remained low. But after treatment ended, HCV levels eventually rebounded to pretreatment levels.

Treatment, however, made the virus much more sensitive to the antiviral effects of interferon. Interferon, combined with ribavirin, is the best current treatment for HCV, but only about half of people infected with genotype 1 HCV get long lasting control of the virus. It's hoped that SPC3649 could eventually be combined with interferon to give the virus a knockout punch.

SPC3649 targets miR-122 in the liver, where it plays a role in cholesterol metabolism. The only side effect seen in the chimps was a rather dramatic lowering of LDL (bad) cholesterol. In earlier studies with green monkeys, the drug had a stronger effect on HDL (good) cholesterol. That would not be a good thing if it happens in humans, but SPC3649 affects cholesterol differently in different primate species.

"I suspect that at some point lowering HDL too much would be a problem if you did not lower LDL at the same time," Lanford said in his email. "I do not suspect that this will be a limitation of this drug, but human clinical trial data are needed to address this issue."

That data is on the way. The drug's manufacturer, Santaris Pharma of Hoersholm, Denmark, has begun a phase 1 safety trial in HCV patients. Santaris funded the Lanford study and Santaris researchers contributed to the work.

Beyond HCV: LNA Drugs vs. Cancer, Inflammation, More
SPC3649 is actually a man-made strand of nucleotides, the building blocks of DNA and RNA. The drug is actually an antisense nucleotide, meaning that it is assembled in a way that makes it complementary to its RNA target.

Antisense nucleotides inactivate their targets. But normal nucleotides quickly break down in the bloodstream. SPC3649 uses a proprietary technology to lock it together so that it does not break down. Santaris calls this a "locked nucleic acid (LNA)-modified oligonucleotide."

The LNA technology is not unique to SPC3649. Santaris has used the technology to create LNA drugs for cancer, inflammatory diseases, metabolic diseases, and rare genetic disorders. These drugs are in various stages of preclinical and clinical development with various partner companies.

The Lanford study was published online in the Dec. 3 issue of Science Express.


Aussies Aid Hepatitis C 'Breakthrough'
NineMSN
Sep 2009

An Australian-led team of international medical researchers may have scored an important breakthrough in the treatment of hepatitis C.

The team, led by Sydney molecular geneticist David Booth and Sydney University hepatitis C expert Jacob George, has identified a variant in an interferon gene which links it to the treatment of the chronic hepatitis C virus (HVC).

The gene, known as IL28B, was found to encode an interferon "lambda" involved with the suppression of viruses, including HCV.

Interferons, or proteins inhibiting the replication of viruses, are identified through the use of letters from the Greek alphabet.

The researchers said the new study showed use of the interferon-lambda in treatment could benefit those people identified as best suited to receive it and spare others the cost and side effects of their current treatments.

Prof George said the current standard treatment procedure for chronic HCV was combined therapy with pegylated interferon-alpha and ribavirin for about 11 months.

"This treatment can have side effects and only about 40 to 50 per cent of individuals infected with HCV show a positive response to it," Prof George said.

"The current study renews interest in therapies which involve this type of interferon, and suggest that combined treatment with interferon-alpha and interferon-lambda may prove a more effective treatment."

Dr Booth, a molecular geneticist with Westmead Millennium Institute who is widely recognised for his work with multiple sclerosis and genes that cause autoimmune disease, said the same principles applied to hepatitis C infection as to MS.

"We inherit from our parents subtle differences in the make-up of our immune system that can make a major difference in susceptibility to disease or how we respond to treatment," he said.

"Finding each of the few genes that have such an impact gives science an edge in the eventual prevention or control of many of the major diseases of humankind."

He said the finding that inherited differences in the interferon lambda gene has such an impact on the treatment of Hep C provided a valuable new lead into beating "an infection of epidemic proportion worldwide".

Almost 300 million people are known to have been infected with hepatitis C, which is a leading cause of liver disease.

Results of the study into interferon IL28B were published on Sunday's Nature Genetics website.

Syringe Exchange Programs Are Saving Lives

Syringe Exchange Programs (SEPs) have been controversial since they were first officially introduced in the Netherlands in 1984. Since then, the issue of giving out clean syringes to inject illicit drugs has plagued politicians worldwide. They were faced with opposition from vocal moral crusaders, an ignorant public and attacks from other politicians while there was growing scientific evidence that SEPs prevented many deaths. It was a case of losing voters or losing lives. While most of Europe, Australia, New Zealand etc. worried about losing lives to HIV/AIDS, the US worried more about losing votes. As cases of HIV/AIDS and Hep C. rocketed up in the US, early adopters of SEPs, especially Australia had much better success at minimising the spread of blood borne diseases.

Giving out clean syringes to drug users existed long before SEPs was made official. In 1970, the San Francisco State University unofficially gave away clean syringes as a way to deal with yellow jaundice and abscesses from shooting heroin. This practice spread to the San Francisco General Hospital and in the early days of the HIV epidemic, some doctors and nurses would leave unopened packets of syringes in clear view of drug users then leave the room expecting the packets to be gone when they returned. Looking back now, it really hits home how draconian we can be in this so called modern civilisation.

United States

Regardless of this evidence, the use of federal funds for needle-exchange programs was banned in the United States of America in 1988. Most U.S. states criminalize the possession of needles without a prescription, even going so far as to arrest people as they leave private needle-exchange facilities. Nonetheless, every state in the United States has a program that supports needle exchange in some form or the purchase of new needles without a prescription at pharmacies.These programs were introduced during the Clinton Administration but were disbanded following negative public reactions to the initiatives. Covert programs still exist within the United States.
-Wikipedia

Although the evidence has been conclusive for decades from dozens of well established studies, the US remained defiant. At least 7 attempts to introduce federal recognition and funding for SEPs have been over turned by the reigning president of the time. President Bill Clinton promised to change the federal position but his drug czar, William Mcafferey convinced him that allowing SEPs would “send the wrong message” in their fight against drugs. it is estimated that 10,000 lives and 500 million dollars in health care could have been saved during his 8 year presidency if Bill Clinton removed the ban on federal funding.

By 2000, 36% of all AIDS cases and approximately 50% of new HIV infections had occurred among injecting drug users and their partners.

I do not favor needle exchange programs and other so-called harm reduction strategies to combat drug use. I support a comprehensive mix of prevention, education, treatment, law enforcement and supply interdiction to curb drug use and promote a healthy drug free America, not misguided efforts to weaken drug laws and needle exchange programs signal nothing but abdication, that these dangers are here to stay. America needs a president who will aim not just for risk reduction, but for risk elimination that offers people hope and recovery, not a dead end approach that offers despair and addiction.
-President G.W. Bush. Annual meeting of the AIDS foundation of Chicago. 2000

The ban on federal funding remains. In the run up to the 2008 election, Barrack Obama made a key campaign pledge to remove the ban on federal funding for SEPs. In May 2009 after being elected president, the pledge disappeared off the Obama website and when his health budget appeared shortly afterwards, the ban remained, buried deep on page 795.

Australia
It started in 1986 with a group of Sydney users who illegally distributed clean syringes at St. Vincent’s hospital under the watch of Dr. Alex Wodak. Since then, Australia has become an international leader in harm reduction with one of lowest rates of HIV/AIDS infections. Unfortunately though, with over a decade of conservative governments and strong criticism of harm reduction from the media, Australia has started to stagnate, losing it’s once impeccable reputation. While SEPs remain a major part of our health system, more recent Harm Reduction strategies are being ignored or opposed by the federal and state governments. The only major exception is the Medically Supervised Injecting Centre in Kings Cross.

In the early years of HIV/AIDS before condoms and clean needles were standard fare, the government took a pragmatic approach and spent $150 million dollars between 1988 and 2000. This prevented intravenous drug users from an estimated 25,000 cases of HIV and 21,000 cases of hepatitis C. A saving for taxpayers of up to $7.7 billion dollars.

Since then, the total lives saved and the amount of reduced costs is staggering. Surprisingly, there are still some groups who oppose SEPs and lobby the government not to increase the number of programs. The most recent controversial proposal is the introduction of SEPs into prisons but in terms of targeting susceptible groups, prisoners have the highest rate of blood borne diseases in our society. This is mostly because of a high number of intravenous drug users in prison who are also sharing hard to get needles. Those opposed to SEPs in prison use the same old reasoning that causes most of the current drug problems we have already. You have probably heard them before e.g. “it’s a prison, not a holiday camp” or “it sends the wrong message” or “we should be getting these people off drugs not encouraging them to use more” or “we should be trying to stop drugs getting into prison not making it easier for them to use drugs”. Of course, these arguments simply ignore the reality of drug use and places selfish ideology before the safety of others.

The issue is this — there are about 20,000 men and women being released every year. Many of them have got significant health problems, with blood-borne disease a major element of that. They are going in and out of the prison system and bringing those diseases to their families and their communities. Making clean needles accessible is one easy, relatively cheap way of dealing with that. It’s called public health.
-Gino Vumbaca. CEO of the Australian National Council on Drugs

Sterile injecting equipment in prisons is a no brainer just as a prison methadone program is. Access to these basic health resources is vital to tackling the spread of blood born disease especially in prison where the problem is most prevalent. Denying these services in prison is simply sentencing injecting drug users to a life of suffering or death. Each day that these programs are opposed, a few more fellow humans are tagged for an early grave.

Needle Program Success
The Age
By Julia Medew
October 2009

TAXI drivers, tradesmen and body builders are among the growing number of people using St Kilda's 24-hour needle and syringe exchange program - the only service that operates all night, every night in Victoria.

The manager of health services for the Salvation Army's Crisis Service, Sue White, said that since the Grey Street program started operating round the clock in late 2007, it had helped an extra 1000 people get clean equipment every month.

Aside from local sex workers, she said, tradesmen were using the after-hours service alongside truck drivers and a small number of taxi drivers.

Body builders who take steroids were also attending.

An evaluation of the 24-hour service by the Salvation Army and Monash University found it had contributed to a 51 per cent rise in the number of needles and syringes being distributed between August 2007 and September 2008. The number returned for safe disposal increased 26 per cent.

Ms White said the service had prevented people from sharing equipment - a practice known to spread viruses including HIV and hepatitis C. It had also exposed people to referrals for counselling, detox programs and other health-care services.

The evaluation found that since the service extended its hours, there had been little change in drug-related crime or complaints to the local council.

Ms White said other needle and syringe exchanges should consider expanding their hours, based on its success.

A Victorian Taxi Directorate spokeswoman said it was not aware of any drivers using drugs. She said it was working with police ''to identify drivers who may be under the influence of drugs or alcohol''.

A spokesman for the Victorian Taxi Association said he had also not heard of drivers using illicit drugs.

''It's very surprising and a bit concerning … It's something we will look at,'' he said.

I had to chuckle at the comments from the various taxi organisations. Both spokespeople claimed they had never, ever heard of a driver that used drugs.They sounded stunned!. Why wouldn’t taxi drivers be drug users? Are taxi drivers exempt from such evils in society? In my time, I have seen a taxi driver score heroin from a street dealer, had dozens of cabs drive me then wait while I score and I even purchased speed from one taxi driver. Over a 20 year period and you would expect it to happen sometime. Their responses appeared more like an instant reaction to protect their organisation than the truth. Regardless of their reasons, it had me smiling for a few minutes.

Slowly, The Wheels are Turning

Finally, some common sense is appearing in US drug policy ... albeit slowly. It’s not like the US are jumping ahead and breaking new ground but at least they are catching up with most westernised countries. The US has a stranglehold on UN drug agencies like the INCB and the UNODC which has always been a reason for concern to countries wanting to implement their own progressive drug policies. The heavily influenced UN will often overlook evidence based strategies and Harm Minimisation for US style Zero Tolerance policies. One of the major sticking points is needle exchanges which help stop the spread of blood borne diseases like HIV/AIDS and Hep C. The Obama administration recently reneged on their support for providing clean injection equipment to drug users and removed it from their web site. So what has the newly appointed “Drug Czar” or as he is officially known, the head of the Office of National Drug Control Policy got to say? What are his views on needle exchanges? What is his vision for the "War on Drugs"?

If you remember correctly, the previous Drug Czar, John Walters had a very dark, draconian approach to US drug policy where he heavily promoted Zero Tolerance whilst making regular attacks on Harm Minimisation. This has long been the standard procedure for the role of Drug Czar. With a change in the public’s acceptance of the "War on Drugs", Walters’ rhetoric grew along with his lies and propaganda. By the end of the Bush administration, John Walters’ messages and warnings were sounding stale especially with his intense focus on cannabis. He lied, mislead the public and argued with scientific research that contradicted his message, right up until the end. For example, Walters claimed that today’s cannabis was 10 to 20 times stronger than it was in the 1970s-1980s. The fact is cannabis potency in the US has risen from about 4% to 9% since 1983. Or this ripper, “you are also mistaken in thinking that there can be no “overdose” with marijuana”. Of course no one has ever overdosed or died solely from cannabis.

He was a true believer in the "War on Drugs" and nothing was going to change his mind - medical research, science or facts, it didn’t matter. Even today he continues to push his narrow-minded views, writing an opinion piece for the Wall Street Journal and appearing in several TV debates where he blatantly gave false statistics and fallacious information. John Walters is a disgrace and a liar, the epitome of an anti-drug propagandist. He was the perfect Drug Czar for the US but that it seems is changing. What will new Drug Czar, Gil Kerlikowske bring to the table? Hopefully some common sense and a lot less lying.

Interview-Us Drug Czar Calls For End To 'War On Drugs' By Andy Sullivan Reuters June 2009 *No plans to legalize marijuana *Substance abuse treatment to get more funds *May lift federal ban on needle exchange programs WASHINGTON, June 5 (Reuters) - The Obama administration's top drug cop plans to spend more money on treating addiction and scale down the "war on drugs" rhetoric as part of an overhaul of U.S. counternarcotics strategy. But don't expect the White House to consider legalizing marijuana, drug czar Gil Kerlikowske said on Friday. "The discussion about legalization is not a part of the president's vocabulary under any circumstances and it's not a part of mine," Kerlikowske said in a telephone interview. As head of the Office of National Drug Control Policy, Kerlikowske coordinates the efforts of 32 government agencies to limit illicit drug use. He has been in office less than a month, but the Obama administration has already taken a less confrontational approach to the nation's 35 million illegal drug users. The FBI is no longer raiding state-approved facilities that distribute marijuana for medical purposes, and the White House has told Congress to eliminate the sentencing disparity between powder and crack cocaine. Kerlikowske said he hopes to ditch the chest-thumping military rhetoric at the center of U.S. policy since President Nixon first declared a "war on drugs" 40 years ago. "We should stop using the metaphor about the war on drugs," said Kerlikowske, a career police officer who headed the Justice Department's community-policing initiative under President Clinton. "People look at it as a war on them, and frankly we're not at war with the people of this country." Nevertheless, Kerlikowske also plans to disrupt trafficking across the Mexican border through a new focus on the guns and cash that travel south, as well as the drugs coming north. U.S. drug policy has been criticized for focusing too much on fighting supplies from Colombia and other countries in South America and not enough on curbing demand at home, the world's largest drug market. BALANCING THE APPROACH Kerlikowske said a more balanced approach was needed, with greater emphasis on treatment programs, especially in prisons. "It's clear that if they go to prison and they have a drug problem and you don't treat it and they return ... to the same neighborhood from whence they came that you are going to have the same problem," he said. "Quite frankly people in neighborhoods, police officers, et cetera, are tired of recycling the problem. Let's try and fix it." Obama, who described youthful marijuana and cocaine use in his autobiography, has proposed a budget for the fiscal year starting in October that boosts funding for substance abuse programs by 4 percent to $3.6 billion. Needle exchanges for intravenous drug users, now banned at the federal level, will be considered a healthcare issue, he said. As Seattle police chief, Kerlikowske worked in a city that ran a needle-exchange program, celebrates an annual "Hempfest" that draws tens of thousands of marijuana smokers, and passed a referendum that made enforcing marijuana laws the department's lowest priority. Other state and local governments have loosened their marijuana laws as well. Medical marijuana is now legal in 13 states, and California Gov. Arnold Schwarzenegger last month welcomed a public debate about proposals to legalize and tax the drug. While that's not going to happen on the federal level, Kerlikowske suggested the government should devote less effort to prosecuting nonviolent drug users. "We have finite resources," he said. "We need to devote those finite resources toward those people who are the most dangerous to the community."