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Carroll M. Leevy
Professor & Scientific Director at the University of Medicine and Dentistry of New Jersey
Statement on Hepatitis C
- studies of the interaction between hepatitis C and other diseases such as diabetes mellitus;
- clinical research to develop new diagnostic tests for HCV infection;
- clinical trials to identify optimal treatment regimens for those who do not respond to interferon therapy;
- research to develop a safe and effective vaccine;
- research to identify the most effective strategies for educating at-risk groups and assuring access to diagnosis and treatment. In summary, we have a long way to go and much work to do if we are to gain the upper hand in the battle against hepatitis C.
However, please keep in mind that we have developed vaccines and effective treatments for both hepatitis A and hepatitis B. We have the scientific tools to conquer hepatitis and other infectious diseases, but a special, well-funded research initiative is needed if we are to succeed. To effectively pursue the hepatitis C research agenda outlined at the NIH Consensus Conference, I recommend a multi-institute initiative at the National Institutes of Health in collaboration with the Centers for Disease Control and Prevention.
First, let me emphasize that this
effort requires additional dollars and should not be mounted at the expense of existing research on other serious diseases. I believe that Congress should call upon the NIH Director to use his discretionary fund and transfer authority to provide support for research on hepatitis C. In my opinion, the National Institute of Diabetes and Digestive and Kidney Diseases should play a leading role in this project to assure that the research focuses on the basic and clinical research questions underlying the disease caused by HCV infection. In addition, the NIH Office of Research on Minority Health should be involved in all aspects of the initiative to assure that the special impact on minorities is a focus - particularly of clinical research efforts. Little is known about the natural history of hepatitis C in minorities and other at-risk groups that have a disproportionate incidence of this infection, and - as outlined in the NIH Consensus Conference report - research programs are needed to identify effective strategies for educating these groups and assuring access to proper diagnosis and treatment. Additional NIH institutes and entities should be involved in a hepatitis C research initiative as follows:
- The National Cancer Institute should be involved in studies relating to the risk of liver cancer associated with hepatitis C;
- The National Institute of Allergy and Infectious Diseases should be engaged in aspects of the initiative pertaining to transmission of HCV and vaccine development;
- The National Heart, Lung, and Blood Institute should be involved in research related to protecting the blood supply from contamination with HCV;
- The National Institute of Drug Abuse should be involved in research related to the transmission of HCV among drug users;
- Collaboration with the research programs of the Department of Veterans Affairs and the Department of Defense should be pursued wherever possible.
Let me close by thanking this Subcommittee again for bringing the spotlight of Congressional attention to the threats to human health posed by the hepatitis C virus. I hope you will move forward with research initiatives that can lead us to a vaccine or effective therapy for hepatitis C, with an effort to assure the appropriate medical management of hepatitis C in federal health care facilities, and with a public education campaign that can serve to prevent further incidence of the disease. I would be happy to respond to questions.