By Tyler Smith | UCH Insider
For more than a decade, Mosezella White lived a life interrupted by a virus.
In November 2002, White, now 64, had worked more than 20 years for Mountain Bell in Denver and was a manager of the company’s White Pages directory listings department. That stability vanished, however, after a full physical revealed a colon polyp and elevated liver enzymes. She was referred to a gastroenterologist, who shocked her with the news that she had hepatitis C, a blood-borne disease that causes chronic inflammation of the liver.
The infection shortened White’s working career – she was forced to retire in 2005 at age 55 – and required strength- and spirit-sapping rounds of combination therapy.
Her first round of treatment, in 2003, lasted 11 months, and required twice-daily oral doses of ribavirin and weekly injections of interferon that produced debilitating physical and emotional side effects. She endured similar challenges when she tried the regimen again for six months in 2006. In 2011, she added Telaprevir, a drug approved in 2011 that inhibits replication of the hepatitis C virus (HCV). Like the others, the last round failed.
Reluctant warrior
So White wasn’t eager when Halley Isberg, a professional research assistant with the Hepatology Section at the University of Colorado School of Medicine, called to tell her there was a clinical trial of two new hepatitis C-fighting drugs underway.
“I had said that was going to be it for me,” White said. “I was very hesitant.”
But Isberg explained the oral medication regimen would last only three months, and her family and friends urged her to give it a try.
The clinical trial at University of Colorado Hospital, led by CU Hepatology Section Chief Gregory Everson, MD, tested the efficacy of sofosbuvir, a new drug approved in December by the Food and Drug Administration (see accompanying story), in combination with another drug by manufacturer Gilead. In combination, the drugs inhibit the formation of two proteins that allow the hepatitis C virus to replicate. White was in the group to receive only the two drugs; another group received them with ribavirin.
She completed the 12 weeks of therapy Feb. 24. For several weeks before that, her blood tests had included a single but powerful word: “Undetected.” That finding held through the end of the trial and into early March. The hepatitis C virus, at least for now, is gone.
For the first time in many years, White has hopes for a disease-free future.
“The other treatments decreased the viral load, but I never went into remission,” she said. Everson said her liver biopsies show some fibrosis, but that should improve and possibly resolve with the clearance of the virus.
Difficult decade
White is an African-American, a group disproportionately affected by HCV, but she is unsure how she could have contracted it, other than to surmise that a stint drawing blood as a lab tech in the Air Force in the 1970s might have caused an infection without her knowledge.
“We didn’t use any kind of protection when we drew blood,” she said. “We didn’t even bother with rubber gloves.”
Her case illustrates not only the physical but also the emotional toll that the disease exacts.
“It was a complete surprise when I was diagnosed,” she recalled. “I was very distraught.” She was concerned not only for herself, but also for her then-teenage daughter, worrying that she might have unknowingly passed the disease on to her. Fortunately, tests revealed that she had not.
The treatment that began in April 2003 depleted her energy so severely that she sometimes had to navigate the stairs from the basement to the first floor of her home on her hands and knees. She was depressed, cried easily, found it difficult to concentrate, and had problems sleeping. She also suffered joint and muscle pain and headaches.
The side effects even denied White the solace that a walk outside might have provided. She became so sensitive to the sun that she had to cover her body completely for even a short jaunt through the park. Despite her precautions, her skin dried out and brown spots appeared. Her hair thinned to the texture of a baby’s.
She tried to return to work in 2004 after the 11-month medication ordeal ended but found she couldn’t concentrate sufficiently to do the job. After six months and consultations with her physician, she decided to retire in 2005.
“I had planned to work until 2009, when my daughter graduated from college,” White said. Difficult as the retirement decision was, it was necessary, she added. It took a few more years for her concentration to return to its old level.
Now White has high hopes for a future free of HCV. Prior to the clinical trial, she’d started part-time work at the membership desk of a sports center near her Denver home where she had worked out to recover from back surgery. Now she has picked up more hours and exercises at the gym three times a week.
“I feel great,” she said. “I’m living my life doing anything and everything I want to do.”
Tyler Smith, UCH Insider