One large steppe for liver research
Driving along the Pamir Highway in Tajikistan at 4000 m above sea level or through the Mongolian desert is a far cry from working on the genetics of hepatitis C in a laboratory in central Sydney.
But that’s the transition Wil d’Avigdor, a PhD student from the Liver Injury and Cancer Laboratory at the Centenary Institute is about to make in the next few weeks.
And there’s actually a link. As a member of a four-man Australian team, Hard Yak, on Saturday 14 July he will begin driving 15,000 km from London to Ulaanbaatar in the 2012 Mongol Rally—risking life and limb to raise money for liver research at the Institute.
“Chronic liver damage affects up to one Australian in five. It can lead to liver cancer, one of the fastest growing conditions in the Australian community,” Wil says. “Clearly, I have an interest in hepatitis C, which is one of the causes. There is currently no vaccine for it and it infects up to 300 million people worldwide, including more than 10% of the people of Mongolia!”
Over the past four years Wil has been studying, comparing and contrasting the gene activity of Genotype 1 and Genotype 3, the two subtypes of hepatitis C that are most common in the developed countries of the world including Australia. Genotype 1 tends to be resistant to interferon, the most prevalent treatment for hepatitis. Genotype 3 is associated with an increasingly common complication of the disease known as steatosis or fatty liver.
But it’s not only altruism that drives Wil. He and three mates, who comprise Hard Yak, decided to enter the rally because they share a common passion for travelling to destinations ‘off the beaten track’. They are looking forward to its upcoming adventure, the challenges that will arise, and the opportunity to visit new countries and meet new people.
It’s no joke, however. The Mongol Rally is unguided and unsupported. Each team is responsible for selecting its own route between London and Ulaanbaatar, and must be self-reliant. No help at all is provided by the organisers.
In the past people have been seriously injured and more. But everyone comes home with a lifetime of tales to tell. You can find out more about the Mongol Rally here: http://www.theadventurists.com/the-adventures/mongol-rally.
At Centenary Institute, Wil is supervised by Dr Nicholas Shackel in the liver research program headed by Professor Geoff McCaughan.
More information about Hard Yak and the charities it will be supporting can be found at www.hardyak.org. In addition to the Centenary Institute Liver Appeal (http://www.centenary.org.au/), Hard Yak is supporting the Lotus Children’s Centre in Ulaanbaatar (http://www.lotuschild.org/).
Hard Yak’s principal sponsors are:
- Royal Prince Alfred Transplant Institute: http://www.sswahs.nsw.gov.au/rpa/TxInst/
- Black Wolf – Adventure Gear: http://www.blackwolf.com.au/, and
- SACHS: www.zf.com/au
For further information contact:
Wil d’Avigdor, 0401 954 935, email@example.com, (Skype): williamdavigdor, (Twitter): @HardYak2012; or
Suzie Graham, the Centenary Institute, 0418 683 166, firstname.lastname@example.org
There are photos are available at www.scienceinpublic.com.au/centenary/mongolrally and on the Hard Yak Facebook page: https://www.facebook.com/MongolHardYak.
The team will be in the UK with their car on 10 July and available for photos.
What is hepatitis C?
Hepatitis C is a blood-borne viral disease transmitted mainly by injection with infected needles. While the condition can eventually lead to serious liver disease such as cirrhosis, liver cancer and liver failure, many patients with hepatitis C do not display symptoms until their liver starts to fail, which can be up to 15 years after the virus was first contracted.
Hepatitis C is a serious problem. At present, of about 220,000 Australians thought to be infected by hepatitis C, nearly a quarter are already suffering moderate to severe liver disease. But fewer than one in fifty is treated each year, and about 11,000 new cases are diagnosed annually.
Unlike hepatitis A and B, there is no vaccine for hep C, making any improvements in treatments even more important. At present the disease is overwhelmingly associated with intravenous drug use, but in the past poor infection control during blood transfusions has also been to blame.
What happens if chronic hepatitis C infection is not treated
People with chronic hepatitis C infection who do not receive treatment can progress to liver cirrhosis and, ultimately, liver failure placing them in need of a life-saving liver transplant. These patients face a long waiting list and a tight supply of livers suitable for transplant. Many do not survive the wait.
Liver cirrhosis is also responsible for 90% of liver cancer cases and ranks number 8 overall in causes of death in the world. In Australia, the rate of liver cancer has increased 4-fold in the past 20 years and liver cancer is the 3rd leading cause of cancer deaths in the world. Sadly, this trend is expected to continue.
Conventional treatment for hepatitis C
There is no vaccine for Hepatitis C and existing treatment is expensive, prolonged, has many side effects and is not largely successful. The existing therapy uses two drugs – ribavirin and pegylated interferon.
The hope is to develop new Hepatitis C anti-viral therapies that do not involve interferon, as this accounts for many of the side-effects of conventional treatment. The arrival of new direct-acting agents to target hepatitis C supports this aim.
New drugs for hepatitis C
The new drugs, boceprevir and telaprevir, are the first in a new class of direct antiviral agents which target hepatitis C. The drugs have been approved by Australia’s Therapeutic Goods Administration (TGA) so far for treatment of adults with chronic hepatitis C genotype-1 who are previously untreated or have failed previous treatment.
Patients receive the new drugs for the first 12 weeks of either a 24 or 48 week drug regimen that still includes the current Standard of care drugs Interferon and Ribavarin. Both boceprevir and telaprevir d are awaiting listing on the Pharmaceutical Benefits Scheme.
In the US at present a course of the new treatment costs between $45,000 and $85,000, but that’s a lot less than the estimated $130,000 plus $15,000 a year in therapy for a liver transplant.
Preliminary results in small numbers of patients however indicate that even newer drugs directed against different parts of the HCV can be used without Interferon .These drugs seems to have low side effects , can cure patients in up to 90% of cases and only require 3-6 months of therapy. How they will be used in combination is currently under study in many world-wide clinical trials.
About the Centenary Institute
The Centenary Institute is an independent leader in medical research seeking improved treatments and cures for cancer, cardiovascular disease, and infectious diseases. We are working to discover new prevention, early diagnosis and treatment options to enable each generation to live longer, healthier lives than the one before. Centenary’s affiliation with the RPA Hospital and the University of Sydney means that our discoveries can be quickly applied to the fight against disease in the clinic. More at: http//www.centenary.org.au.