Zepatix: A New Compound to Sustain Hepatic and Immune Functions

© Copyright 2003 by Diane Bilodeau, Ph.D., for Atrium Biotechnologies Inc.; USA
(Explore Issue: Volume 12, Number 3)

Introduction
Hepatitis is a condition marked by liver inflammation that can be induced by a variety of factors including alcohol, drugs and chemicals, but most cases are of viral origin. Hepatitis has a long history and its description can be traced back to ancient China, in manuscripts dating from several thousands of years. However, that hepatitis could be infectious was only recognized at the beginning of the 20th century and its viral nature demonstrated for the first time in 1968. Since then, several different hepatitis viruses (A, B, C, D, E and G) have been identified and the disease is named accordingly. Viral hepatitis can be acute, short term, or chronic. Symptoms may include fatigue, nausea, vomiting, diarrhea, abdominal discomfort, muscle and joint aches, as well as changes in the color of skin, urine and stools. In chronically infected people, hepatitis may culminate into liver fibrosis, a life threatening condition. On the other hand, it is also possible to carry the disease and still be asymptomatic. A compromise immune system may precipitate or aggravate the disease. This is particularly true of the B and C forms of hepatitis.

Hepatitis B
With 200 to 300 million chronic carriers, hepatitis B remains a major worldwide public health problem. Hepatitis B is everywhere but its distribution varies greatly among nations. The disease is highly endemic in all of Africa, some parts of South America, Alaska, northern Canada and parts of Greenland, Eastern Europe, the eastern Mediterranean area, south-east Asia, China, and the Pacific Islands, except Australia, New Zealand and Japan. In the United States, Western Europe, and Australia, endemicity of hepatitis B infection is generally considered relatively low. However, in 1999, approximately 6,500 new cases of hepatitis B infection were reported in the U.S. alone, and estimates based on serologic surveillance suggest that more than 100,000 persons become infected with the hepatitis B virus each year (CDC, 2002). The use of an effective vaccine has helped to decrease the number of new cases, but some populations most in need of protection respond poorly to the vaccine and are incompletely protected (CDC, 2002; Chin, 2000).

Hepatitis B (HBV) virus spreads through contact with the blood or body fluids of an infected person. In countries were the disease is endemic, transmission from infected mother to child at birth is common. Because the immune system of newborns is immature, they cannot easily clear the virus and so, tend to develop chronic infection in adulthood with the potential for dissemination of the virus remaining high throughout their life. In countries where hepatitis B is not endemic, transmission occurs mainly through sexual contacts or when using contaminated syringes. Techniques such as acupuncture and tattooing also present a risk for contamination with HBV when recycled needles are used. Importantly for health workers, HBV is the most common viral laboratory-acquired infection (Chin, 2000; Specter, 1999).

The incubation period for HBV infection extends from 15 to 90 days. Symptoms during the acute phase of the disease may vary among infected individuals but are usually mild, presenting with anorexia, vague abdominal discomfort, nausea and vomiting. Following the initial infection, most people mount a successful immune response against HBV and clear the virus from their blood and liver. However, a substantial minority of HBV-infected individuals will become chronically infected. Chronicity inversely correlates with the age of initial HBV infection: 90% of infants infected at birth, 20%-50% of children infected during childhood and about 1%-10% of persons infected at older ages will become chronic carriers. Many of these chronically infected people are asymptomatic and show little or no clinical signs. However, a subset of these chronic carriers eventually develops chronic liver disease which can lead to cirrhosis or degenerate into a condition called fulminant hepatitis. Fulminant hepatitis is a rare complication (about 1% of cases) that results from massive liver necrosis and is almost always fatal. Moreover, chronic HBV infection is a major risk factor for the development of hepatocellular carcinoma which kills more than 500,000 people each year worldwide. (Chin, 2000; Khuroo, 1998; Liu et al, 2001; Specter, 1999).

Hepatitis C
The prevalence for hepatitis C infection (HCV) is estimated to be 170 million, worldwide. As for other types of hepatitis, its distribution varies greatly around the world. The rate of HCV infection is much higher in parts of Eastern Europe and Africa, with Egypt having the highest (15%). In most developed countries, that rate oscillates in between 1%-2%. In the USA, random sampling of the general population revealed that 1%-8% tested positive for HCV antibodies. Based on these results, the Centre for Disease Control (CDC) has estimated that nearly 4 million Americans (2%) are infected with HCV (Di Bisceglie, 1998). Up to 230,000 new cases of hepatitis C infections are identified in the U.S. every year. There is currently no vaccine for HCV.

Hepatitis C is primarily a blood-borne viral infection that was discovered in the 80’s in the context of blood transfusion. Blood screening has practically eliminated this particular source of HCV contamination. Sexual transmission is rare, although individuals with multiple sexual partners are at greater risk. Tattooing, body-piercing and household transmission (via contaminated items such as razor blades, nail clippers and toothbrushes), albeit possible, are unlikely. Occupational exposure to infected blood represents a low risk. The rate of transmission from infected mother to infant is also quite low (about 5%). At present, HCV is mainly (and rapidly) spreading among injecting-drug users (Di Bisceglie, 1998; Chin, 2000; Feitelson, 2002; Specter, 1999).

Hepatitis C (HCV) has similar symptoms to hepatitis B and serologic testing must be done to distinguish among the 2 forms. The acute phase of HCV infection develops within 6 to 7 weeks of exposure. During the acute phase, 60%-70% of HCV-infected peoples remain asymptomatic. The others will present with jaundice or mild non-specific symptoms such as anorexia, malaise, or abdominal pain. Interestingly, in 15%-30% of infected people, the disease will resolved spontaneously. Chronicity will develop in 50%-85% of HCV-infected people. Chronic infection is often asymptomatic (90% of cases) contributing to the spreading of the disease. Of the chronically infected people, about 20% will develop cirrhosis within 20 years, or hepatocellular carcinoma within 30 years. Fulminant hepatic failure following acute hepatitis C is rare, but HCV-associated end-stage liver disease is the most frequent indication for liver transplantation among adults in the U.S. (Di Bisceglie, 1998; Drazan, 2000; Feitelson, 2002; Specter, 1999).