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Flushing doctor studying drug to combat West Nile

By Courtney Dentch

A doctor at New York Hospital Medical Center of Queens in Flushing is leading the fight against the West Nile virus with a drug treatment trial that could suppress the virus’ attack on the human body.

Dr. James Rahal, director of the infectious disease division at NYHQ, initiated a national study last week to see if prescribing alpha-interferon to patients hospitalized with the virus could minimize the disease’s effect on the central nervous system.

So far this year, the virus, which causes West Nile encephalitis, or inflammation of the brain tissue, has infected an 84-year-old Rosedale man, the city’s first case, and killed a Suffolk County man, the state’s first death. The nationwide death toll has reached 16, and more than 370 people have contracted the disease.

West Nile virus was discovered for the first time in the Western Hemisphere in Queens’ Powell’s Cove in August 1999. The first patients were diagnosed at Flushing Hospital near NYHQ.

Rahal got the green light from the U.S. Food and Drug Administration last week to test alpha-interferon, which goes by the brand name Intron A, he announced at a news conference Aug. 21. The drug is used to treat hepatitis C, a disease that is structurally and genetically similar to West Nile virus, Rahal said.

“It’s the same virus family” he said. “We thought there could be a possibility that the agent that works for hepatitis C could work for West Nile virus.”

Patients who enroll in the study will be receive a two-week course of injections of the drug, which is the same protein compound produced by the human body when it initially encounters a virus, Rahal said. The drug is expected to reinforce the immune system, helping it to create antibodies against the virus, and slow the circulation of the virus, he said.

“The body’s response against the virus will be strengthened,” Rahal said. “Less of the virus will get into the central nervous system.”

Since the alpha-interferon is an initial response to the virus, patients should begin the injections within four days of being hospitalized, Rahal said. Patients over 50 years old who have flu-like symptoms associated with West Nile virus in areas that have confirmed cases will be eligible for the study. The shortened timetable will not give doctors enough time to get tests back to confirm if the patient has West Nile virus, he said.

“The earlier the Interferon is administered the better the effectiveness,” Rahal said. “If we waited until the lab results came back, we’d be wasting time.”

Rahal is unsure if the drug could have an effect on the mortality rate for the disease, which stands at about 15 percent of those who develop a serious infection. But he is hoping that it will reduce some of the disease’s long-term effects among the survivors, including confusion, weakness, paralysis or speech problems, he said.

“Hopefully we can minimize the neurological problems we’re seeing,” Rahal said. “We don’t know if it will eradicate the virus from the blood.”

Alpha-interferon does have some side effects, Rahal said, such as a lowered white blood cell count and heightened depression and anxiety.

The treatment course of daily injections over a two-week period costs more than $2,500 per patient, Rahal said. The study will be conducted through next summer.

“We have something that is promising, but we truly do not know,” he said. “That’s why we’re doing the study.”

Reach reporter Courtney Dentch by e-mail at TimesLedger@aol.com, or by phone at 229-0300, Ext. 138.