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ANSWER TO QUESTION OF THE WEEK: (2/10/06)
Yes.
It is estimated that 375,000 Americans with HCV will develop cirrhosis by the year 2015. Of these patients:
3.6 to 6.0%/year will experience decompensation.
1.4 to 3.3%/year will develop a hepatoma.
2.6 to 4.0%/year will die.
Cirrhotics with HCV who experience decompensation have a 5-year survival of only 50%. Hepatitis C is currently the most common reason that people in the United States undergo liver transplantation. After translantation, HCV inevitably recurs. Progression to cirrhosis is often rapid and severe forms of liver disease (fibrosing cholestatic hepatitis) may occur. Graft loss can also occur esp in recipients of LD. Ttreatment of HCV post-transplant with pegylated interferon plus ribavivirn is difficult, has yielded suboptimal results, and carries a risk of graft rejection
Therefore, it is crucial to be treated agressively with antiviral therapy- - pegylated interferon plus ribavirin, even if cirrhosis is already present. In fact, response rates with 48 weeks of treatment are only slighly lower than response rates in individuals without cirrhosis : Overall SVR: 50% Geno 1: 41% Geno 2/3: 73%.
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Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. She maintains perhaps the largest private medical practice devoted to liver disease in the United States. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City. She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.
She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis.Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis. She also serves as a liver consultant to five major pharmaceutical companies.
Dr. Palmer is a board member of the New York chapter of the American Liver Foundation, and she sits on the nutrition subcommittee of the national chapter of the American Liver Foundation, the medical advisory board of the Latino Organization for Liver Awareness (LOLA) and the medical advisory board of the Primary Biliary Cirrhosis Organization (PBCers). She has also been a member of the practice guidelines committee of the American Association for the Study of Liver Disease(AASLD) and currently sits on the enduring educational materials committee of AASLD.
Dr. Palmer has performed trials on various experimental medication for the treatment of hepatitis. She is currently conducting research on new therapies for liver disease, specifically in the area of hepatitis C.
Her practice is located on Long Island, New York. (Main office located at: 1097 Old Country Road, Suite 104, Plainview, N.Y. 11803.
Satellite office located at 500 Portion Rd. Lake Ronkonkoma, N.Y. 11779)
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If you are interested in arranging an appointment with Melissa Palmer, M.D., please call (516) 939-2626.
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