New Hope for Patients with Hepatitis

By Nur Imaniah 081311533016

Hepatitis or liver cancer is silent killer disease. Hepatitis C a liver disease caused by
hepatitis C virus (HCV) infection can cause chronic and acute thus increasing mortality. HCV
incubation period is about two weeks to six months. Initial infection, approximately 80%
doesnt show any symptoms. Acute and chronic infections, symptoms are characterized by
fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, feces gray,
joint pain and jaundice (yellowing of skin and whites of the eyes). Sofosbuvir is a cure HCV
Recommended Food America and Drug Administration (FDA). However, use of these drugs
still cause side effects and decrease the life expectancy for people with hepatitis. Therefore
necessary to develop new drugs that can ease the burden of hepatitis patients by minimizing
side effects in the use of the drug.
Based on data that collected by WHO says that between 130150 million people globally
have chronic hepatitis C infection. A significant number of those who is chronically infected
will develop liver cirrhosis or liver cancer. Around 700,000, people die each year from
hepatitis C related liver diseases. WHO also noted that nearly 90% of the world community
does not realize that he had been infected with HCV. Based on that data, the strongest reason
is people can live without symptoms for many years, but when HCV has damaged the liver
and cause symptoms, they realize it and make the treatment ineffective.
Ineffective treatment is influenced by several factors, including people awareness of their
health and the treatment that can not cure without side effects. These two factors are
interconnected. Some discoveries about the treatment of hepatitis has been widely noted. The
treatment has many types including dual therapy combination of PEG-IFN (interferon) +
RBV (ribavirin), triple therapy simeprevir + PEG-IFN + RBV, and sofosbufir based triple
therapy is sofosbuvir + PEG-IFN + RBV. The time of treatment of the three types of
treatment are different. Two combination therapy of PEG-IFN + RBV may take as much as
24 weeks and the fourth week of therapy absence of detectable HCV RNA as well as triple
therapy simeprevir + PEG-IFN + RBV. Unlike the sofosbufir based triple therapy, there is no
data that says how long the treatment time. Nevertheless, this type of therapy significantly
inhibit HCV RNA. Treatment with IFN, RBV and some protease inhibitors induce side
effects that must be considered. Beside that new antiviral drugs have been developed. These

drugs, called direct antiviral agent (DAA) is much more effective, safer and better tolerated
than older therapies. Therapy with DAAs can cure most people with HCV infection and
shorter treatment (usually 12 weeks) and is more secure.
Some treatments may be regarded as a right step in reducing the amount of HCV in the liver.
But there are some issues such as the duration of treatment that affected the cost of treatment
that should be paid by the patient. For example, standard treatment duration of triple therapy
(simeprevir + peg-ifn + ribavirin) is 24 weeks. If we assumed ribavirin itself with its weight
around 200 mg per capsule is 48 dollars then we can multiply it by the number of weeks that
should be necessary only for healing and the end result is too expensive. Another example,
the use DAAS also create a problem even though the production is quite cheap. The problem
is price of this drug still very expensive in many high and middle-income countries. Prices
have dropped dramatically in some countries (mainly low-profit) due to the introduction of
generic versions of these drugs. Besides the price, there is still another worst problem, the
drug's side effects. For ribavirin treatment, the main problem is hemolytic anemia
But several years ago, some researchers began to develop new compounds that will be used
to treat hepatitis separately with DAAS is by extraction of compounds in plants. A compound
that has been found is naringenin from grapes that has been proven effective in stopping the
development of HCV. The study also noted that the use of the compound naringenin does not
cause harmful side effects. In inhibiting the secretion of apoB, naringenin reduces the activity
and expression of MTP and ACAT results showed significant, the reinjection narigenin 200
pM in host cells that have been infected with HCV within an interval of 24 hours showed
inhibition of secretion of the virus by 80% 10% and the titer of infectivity 79 % 10%. At
the same time interval of the viral RNA transcription remains unchanged. It can be caused by
inhibition of MTP activity as much as 58% 8% and the inhibition of transcription of the
HMGR and ACAT2. At concentrations greater than 1000 pM, naringenin also showed
intoksisitas when injected into healthy host cells. Based on these results, naringenin can be
used as treatment options and therapy in patients with liver cancer.
The present invention can be considered in developing a new treatment for hepatitis sufferers,
and the discovery of these compounds can be expected as a new hope for people with
hepatitis to recover when it was further developed into drugs. But it also needs to be

rethought on the unit price of drugs naringenin. Besides this solution, there should be early
prevention with blood checked regularly and do blood screening.

Outline
i. Introduction
Thesis statement : Therefore necessary to develop new drugs that can ease the burden
of hepatitis patients by minimizing side effects in the use of the drug.
ii.

Supporting paragraft I
About data chronical effect of HCV
130150 million people globally have chronic hepatitis C infection (data WHO)

iii.

The first problem paragraft II

About ineffectiveness of treatment
Ineffective treatment is influenced by several factors, including people awareness of
their health and the treatment that cant cure without side effects.

iv.

The second problem paragraft III

About drug, duration of drug usage, cost
There are some issues such as the duration of treatment that affected the cost of
treatment that should be paid by the patient
Besides the price, there is still another problem that the drug's side effects. For
ribavirin treatment, the main problem is hemolytic anemia

v.

Solution paragraft IV
A new compound fron grape fruit
A compound that has been found is naringenin from grapes that has been proven
effective in stopping the development of HCV.

vi.

Conclution
A new hope for hepatitis patient

The present invention can be considered in developing a new treatment for hepatitis
sufferers, and the discovery of these compounds can be expected as a new hope for
people with hepatitis to recover when it is further developed into drugs. But it also
needs to be rethought on the unit price of drugs naringenin. Besides this solution, there
should be early prevention with blood checked regularly and do blood screening.