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Al-Ahram Weekly 8 - 14 July 1999 Issue No. 437 
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Published in Cairo by AL-AHRAM established in 1875 |
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Al-Ahram Weekly 8 - 14 July 1999 Issue No. 437
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| Published in Cairo by AL-AHRAM established in 1875 |
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Egypt Region International Economy Opinion Culture Profile Features Focus Books Travel Living Sports Time Out Chronicles People Cartoons Letters Hope for hepatitis?
By Mariz TadrosHepatitis C, a viral illness communicated through blood, long seemed destined to remain incurable. It is estimated that anywhere between 15 and 40 per cent of Egyptians could be infected with HCV, which can lead to liver disease such as cirrhosis (scarring of the liver), liver cancer, or liver failure. Now, however, Abdel-Basset Mohamed, an Egyptian scientist, claims there is a light at the end of the tunnel. A professor of chemistry at the National Research Centre, Mohamed has been granted patent rights by the European Patent Office for a new drug to treat hepatitis C.
The virus has been on the increase internationally ever since its discovery in 1989, in large part because poor screening techniques have led to its propagation. Because hepatitis C is blood-borne, it can be transmitted through blood transfusions, improperly sterilised medical equipment, shared intravenous drug paraphernalia or, in a very small minority of cases, sexual intercourse. Further increasing the risk of transmission is the fact that it can take 10 to 30 years before a patient is identified as being infected with the virus. A medical source who preferred to remain anonymous suggested that the lack of sterilisation of syringes and equipment in the late 1960s and 1970s in the nationwide inoculation programmes for the eradication of bilharzia was a major source of hepatitis C transmission.
The drug for which Mohamed has received patent rights is extracted from two wild terrestrial plants. "These plants grow in the Egyptian deserts and in the coastal regions. They have long been known to be beneficial for the liver. We removed the toxic agents from them and tried them on a most resistant strain of hepatitis C," Mohamed told Al-Ahram Weekly. Experimentation on mice and chimpanzees, he explained, produced very positive results, which induced him to try the compound on humans. The drug, he said, was tested in the United States on 100 Egyptian American volunteers, whose condition ranged from mild and moderate to severe. "The results were very encouraging: 78 per cent of the patients experienced complete recovery in a period ranging between three to six months, with no relapse," he said. Mohamed added that the new treatment had no side effects, but cautioned that patients have to watch their diets and avoid all foodstuffs contaminated with insecticides and preservatives -- advice given to all liver patients.
After the treatment, however, Mohamed emphasised that the liver must be protected to avoid a relapse. "There are 150 herbs documented in the international medical literature that serve to protect the liver. We have 57 of them in Egypt. I came up with a balanced mixture and tested it on humans. In 80 per cent of the cases, the drug halted the development of cirrhosis, increased the patients' energy levels and led to overall well-being."
The potentially cataclysmic effect of this remedy, if it is proven effective, can be measured better when one considers the fact that the current treatment given to HCV patients, interferon alfa-2b, is relatively effective in 50 to 70 per cent of cases, but that the majority of patients suffer a relapse. Furthermore, side effects can include flu-like symptoms, depression, rashes, nausea and abnormal blood counts.
Mohamed says his new drug is the result of eight years of intensive work -- part conducted in research laboratories in Egypt and part abroad. Currently, he is negotiating with "some American companies" for release on the market. He believes it will be available on the market within two years, at a much lower cost than Interferon, the most common medication used for hepatitis C so far. "Whereas a course of Interferon costs LE12,000, a six-month course of my drug will cost LE500" -- a crucial consideration for low-income patients. There are rumours that the drug is already being administered to patients suffering from HCV at certain private clinics in Egypt.
Mohamed claims that his discovery was an ordeal, because of the absence of any support for his scientific ventures. "Then again, the facilities and budget in this country for research are inadequate, and there is an absence of teamwork on any project." He is a firm believer in the inherent curative properties of wild plants and herbs, which, he argues, have been ignored here despite a long and flourishing history of Arab medicine. "If sufficient scientific research were put into experimenting with these plants and herbs, we would be able to find a cure for every disease, and it could become an important source of national revenue, just as it is in China. But this, unfortunately, is not the case".
Dr Hamdi El-Sayed, head of the Doctors' Syndicate, commented that "a new discovery for the treatment of hepatitis C sounds very positive," but added that he would not take any of the results seriously until the drug went through the traditional channels. "There is a big difference between getting a patent for a drug -- which recognises that the new drug is his invention -- and its release for the public's use," said El-Sayed, expressing his anxiety at the haphazard way in which drugs often reach the market and are sold to patients as effective remedies. "I am just worried about all the press attention being given to this new miracle drug, which raises people's hopes, only for them to end up disappointed because it is not as effective as it claimed to be, or because of its side effects." El-Sayed believes that if Mohamed wants his drug to be taken seriously, and not be treated like a popular herbal concoction, he will have to wait until it goes through rigourous medical testing, and follow the traditional channels like publishing his findings in a respectable medical journal.
Dr Rifaat Rifaat Kamel, professor of general surgery at Ain Shams University and a liver specialist, also voiced suspicion. "Generally, we consider a drug safe after it has been approved by the US Food and Drug Administration. Of course, we would welcome any cure for hepatitis C -- but many non-traditional alternative cures have appeared claiming to treat hepatitis. I have seen many patients who take such medication and do actually experience a temporary improvement. They stop their check-ups because they think they are going to recover totally, only to return later with a liver tumour at an advanced stage." Part of Kamel's suspicion about these herbal-based cures, he says, has to do with the confusion between their effect and the natural course of the disease. "Hepatitis C, by its nature, goes through highs and lows. The highs could be easily be mistaken for the result of a drug, when in reality they are not. I am concerned about the sustained impact of the drug and its possible side effects, because patients infected with hepatitis C are usually very fragile."
Until the drug is proven to be safe and effective, Kamel suggests that efforts should be directed towards the prevention of HCV. "In Egypt, we have to pay special attention to making sure that dental equipment is properly sterilised. Women who go for a pedicure or a manicure at the hairdresser's should make sure that they use their own things, because this is one common way of transmitting the disease." The lack of a national screening programme in Egypt is also a serious cause for concern, noted Kamel, but the Ministry of Health has begun to set one up.
While not denying the high incidence of hepatitis C in Egypt, Kamel believes the issue has been exaggerated, especially since only five per cent of patients who contract the disease become terminally ill. If it is detected early, he claims, patients can lead normal lives.
But given the high incidence of infection in Egypt, as well as the limited treatment options, it is likely that poor and well-off patients alike will be flocking to Mohamed's office at the National Research Centre to see what he has to offer.
