Story Riles Those Infected with Hepatitis C Who Are Not Drug Users Tom Abate
August 06, 2001
c.2001 San Francisco Chronicle
My story last week on hepatitis C, which focused on the spread
of the virus among drug users, angered readers who have friends or
family infected by tainted blood transfusions, medical injections
of blood byproducts, ear piercings, tattoos or other ways that
spread the bug.
``Thank you for labeling my husband as a drug user,'' wrote
Dolores Otto of Manteca, Calif., furious that I waited until the
end of the story to mention other modes of transmission. ``I hope
you will have the courage to print an article clarifying who else
is at risk.''
Hepatitis C is a viral infection spread by contact with
contaminated blood. Although public health officials are most
concerned about the unchecked spread of the epidemic among drug
users, I should have emphasized sooner that this blood-borne
pathogen can be transmitted as innocently as by the nick of a
barber's infected scissors.
I had noted some of these other transmission routes, along with
hints about symptoms and treatments, in a short ``help box'' that
should have run with the article. But we left out the box in a
crunch over space and time.
Even had we run that item, however, in retrospect our choice of
photo was guaranteed to offend some readers.
``All you saw was this big 6-inch needle with a drop of heroin
glistening off the tip,'' said a reader from San Ramon, Calif., who
called to tell me about his son's fight against a hepatitis C
infection contracted through a tainted transfusion before the blood
supply started being tested.
Jean Allan of San Francisco said the article reinforced a
stereotype that makes it less likely physicians or patients will
think about hepatitis C when they have the disease's subtle early
symptoms: muscle aches, fatigue, yellowish skin color, abdominal
pains, easy bruising or confusion.
These are just a few of the comments I received. We'll run some
letters as space permits.
Meanwhile, let me apologize for being insensitive to the people
whose lives have been changed or lost by chance exposure to this
virus. I don't know how this experience will affect me the next
time I confront similar choices on a different story. Perhaps I
shouldn't say this, because I have a big job at a big paper, but
I'm still learning about the power of words and images, and what to
leave out or put in a story.
This episode has reminded me that when I sit down to write about
an ``issue'' or an ``industry,'' I'm often blundering into
someone's life. Margaret Trujillo of Menlo Park, Calif., made this
point quite eloquently when she wrote me about her mother, who is
awaiting a liver transplant for long-term damage caused by
undetected hepatitis C.
``My mother does not know for sure how she contracted hepatitis
C. Was it the many blood products she received during the cesarean
deliveries of her children? Was it the sharing of a cocaine straw
during a party in the '70s? Was it her delicate fish tattoo she
received as a rebellious teen during the Summer of Love? . . . We
know she was never an IV drug user. We know that perpetuating the
association of hepatitis C and IV drug use, without giving a
complete picture of all those suffering, causes discrimination and
alienation to all suffering from HCV.''
(For more information or for reference to a physician who
understands the disease, visit www.epidemic.org or www.hepfi.org,
or call (800) 891-0707.)
NERVOUS AT GENENTECH?: The South San Francisco, Calif., biotech
giant has had its disappointments of late, notably the Food and
Drug Administration's demand for more safety data before it will
consider approval of Genentech's asthma treatment, Xolair.
Genentech shares slumped 23 percent in July, and have lost
nearly half their value this year, so when I got tipped about
``layoffs at Genentech'' I speed-dialed the company, concerned that
biotech was about to follow Silicon Valley down the pink-slip
alley.
Research Vice President Richard Scheller said that, in the
course of refocusing the company's 500-person research and
development staff, he had recently eliminated five positions.
``We've probably hired an equal number in the same time,'' he said.
Monday, in fact, Genentech will reveal that it has hired Andrew
Chan away from Washington University in St. Louis, to take over a
beefed-up immunology program at Genentech. Chan, a 41-year-old
physician and scientist, has won support from the prestigious
Howard Hughes Medical Institute for his studies into how T-cells
and B-cells spot infectious antigens and start the immune system
counterattack.
Scheller said Chan's hiring highlights the company's renewed
focus on immune systems therapies. Xolair, the delayed asthma
treatment, and Xanelim, the psoriasis compound that is still
inching toward an FDA filing, are examples of the bets the company
has placed on immunology and the reason for Chan's recruitment.
Cancer, another Genentech focus, will have a redoubled emphasis
under the R&D reorganization. Scheller said Genentech will also do
more to tout its work in exploiting human gene discoveries. ``We've
been doing it, but we haven't made as much noise as some of the
companies back East,'' he said.
The losers in the shift were the research programs in
endocrinology, which spawned human growth hormone and follow-up
products, and cardiovascular, which gave rise to clot-buster drugs.
``We're probably not going to do as much in late-stage heart
failure,'' Scheller said. ``I felt a need to focus our efforts
elsewhere.''
These tiny shifts inside Genentech's R&D department bear
watching, not just for clues about the company's direction but as a
proxy for the health of biotech, which has so far maintained its
growth despite weakness in other industries.
There's nervousness in the valley given the employment
earthquakes shaking the region. Perhaps my seismometer was set a
little too finely given the tiny tremor at Genentech R&D. But then
a layoff of five can really shake the world if one happens to be 20
percent of the upheaval.
BIOTECH SUMMER?: The dog days of summer have been rude to
biotech, as bad politics and FDA jitters made a tough investment
season even more challenging.
The sector's slump is captured in the Burrill Life Sciences
Composite Index, which reflects the performance of biotech niches
from medicines to agricultural products, from discovery tools to
new materials.
While the Dow held steady in July and the Nasdaq declined 6
percent, the Burrill Composite fell 7 percent.
Politics is partly to blame. Biotech has suffered from the
continuing debate about stem cell research, which has cast the
industry in a far less flattering light than last summer's
adulation over the human genome.
The FDA's mood swing has been a bigger blow to investor
confidence. Stung by a rash of recalled medicines, the agency has
redoubled its scrutiny of new medicines, slowing approvals and
confounding investor expectations.
A case in point is Aranesp, the new, longer-acting blood booster
from Angen. The Thousand Oaks, Calif., firm filed for approval in
the United States in December 1999. It made the same filing in
Europe at the same time. It got European approval in March. The
company had expected the FDA's green light by the end of June. When
that failed to happen the company told investors it had quit
guessing when FDA would act and could offer no guidance on when to
expect Aranesp to contribute to sales.
The FDA's funk puts biotech companies in a lose-lose situation.
They can be aggressive in seeking approval for novel remedies.
Aviron took that tack in seeking approval for a flu vaccine
delivered as a nasal spray - even though some of its clinical
trials finished only while the application was in process. Last
month, an FDA advisory panel said it wanted more safety questions
answered, a rebuff that shaved 33 percent off the value of the
Mountain View firm's shares.
But caution didn't work any better. Titan Pharmaceuticals,
sensing FDA's safety sensitivity, said last month it would conduct
more studies before seeking approval for Zomaril, a schizophrenia
drug it is developing with the Swiss drug firm Novartis. Investors,
who had expected the partners to seek approval this year, whacked
50 percent of the South San Francisco company's shares.
Industry observers don't expect the regulatory climate to change
until President Bush appoints a new FDA director. And Capitol Hill
observers don't expect that appointment to occur until after Bush
quits playing Hamlet over the politically charged issue of federal
funding for stem cell research.
Sounds like a long, tough summer for biotech.
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