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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we have some startling news: Only a third of people in the U.S. with hepatitis C get cured of it, and thousands are still suffering liver failure and dying from the disease every year despite the availability of antiviral medications, according to the U.S. Centers for Disease Control and Prevention. We also have some cheerier news regarding use of artificial intelligence to help find rare healthy sperm in infertile men and an experimental drug combination that might improve treatment of pancreatic cancer. 

We won't be publishing Health Rounds on Tuesday, July 4th. We'll see you next Thursday!

In breaking news, see these stories from our Reuters journalists: Consumers, food-makers face choice as WHO cancer agency set to warn on aspartame sweeteners; Human gene can fend off most bird flu viruses; Spanish researchers develop artificial womb for premature babies; Russians target homosexuality, other 'disorders' under new rules; and U.S. judges block bans on transgender youth healthcare in two states.

Modern medications can cure hepatitis C, but the vast majority of infected people in the U.S. are not getting the treatment, the U.S. Centers for Disease Control and Prevention said. REUTERS/Tami Chappell.

A decade after a cure for hepatitis C became available, millions of Americans are still infected with the deadly virus, the U.S. Centers for Disease Control and Prevention (CDC) said on Thursday.

Between 2013 and 2022, the hepatitis C virus (HCV) was cleared from the blood in only one in three infected people, either by treatment with medication or by the patient's immune response, the CDC said, calling that number "jarringly low."

"The development of a safe and highly effective cure for hepatitis C is one of the most stunning medical achievements of the past 20 years," Dr. Francis S. Collins of the National Institutes of Health, who leads the White House National Hepatitis C Elimination Program, said in a statement. "But unfortunately, too many people in our country still face insurmountable barriers to accessing this treatment."

Among Americans without health insurance, only one in four with HCV had clearance of the virus. That proportion fell to one in six among uninsured people under age 40, according to data published in the CDC’s Morbidity and Mortality Weekly Report.

Left untreated, HCV can cause liver cancer and liver failure. In 2020, the virus contributed to more than 14,800 U.S. deaths, the researchers said.

The drugs cost tens of thousands of dollars. Some state Medicaid programs and commercial insurance carriers won’t pay for treatment until patients have severe liver damage or have abstained from drugs or alcohol for months, which contradicts medical guidelines, the CDC said.

Writing in JAMA earlier this year, Collins and Rachael Fleurence of the Executive Office of the President at the White House outlined a proposal for a national program for eliminating hepatitis C by developing better tests and improving access to treatment.

"It is rare to have the opportunity, using a simple and safe oral medication, to eliminate a lethal disease," they wrote. "But that is the situation facing the United States with hepatitis C."

An artificial intelligence (AI) algorithm found sperm in severely infertile men faster and more accurately than doctors in preliminary experiments, researchers reported on Tuesday at the annual meeting of the European Society of Human Reproduction and Embryology in Copenhagen.

"This tool has the ability to give patients who have very little chance of fathering their own biological children an increased chance," study leader Dale Goss from the University of Technology Sydney in Australia said in a statement.

Currently, embryologists must use microscopes to look for sperm in biopsy samples from the patient’s testes and then extract the sperm manually. This "antiquated" approach, which has "not been updated in decades," is a mentally and physically fatiguing process that can take up to six hours, Goss said.

When researchers tested the AI tool on samples of testicular tissue from seven patients with so-called non-obstructive azoospermia, an embryologist found 560 healthy sperm, the AI found 611, and altogether they found 688.

The algorithm identified sperm for each sample in less than one-thousandth of the time taken by the embryologist and was 5% more accurate.

These results are from a proof-of-concept test, and now a clinical trial is needed to confirm the findings, the researchers said.

A new combination of drugs may be a more effective way to treatment pancreatic ductal adenocarcinoma, a lethal cancer with a low survival rate, early experiments suggest.

The drug combo targets two mutant proteins in cancer cells known as KRAS and ERBB.

KRAS-inhibiting drugs have been used to treat pancreatic cancer, but they only work for a short time before the cancer becomes resistant, the researchers noted in a report published on Wednesday in Cancer Research.

Because ERBB contributes to that resistance, the researchers combined a drug that inhibits ERBB - afatinib (Gilotrif from Boehringer-Ingelheim) - with MRTX1133, an investigational KRAS inhibitor from Mirati.

In human pancreatic cells in test tubes, the combination of the two drugs reduced the number of surviving cells more than the KRAS inhibitor alone – and the benefits of using the KRAS and ERBB inhibitors together were larger than the sum of each drug’s individual effect, the researchers found.

In mice with pancreatic cancer, survival was significantly longer after treatment with both drugs than after treatment with either drug alone, the researchers also reported.

"KRAS inhibitors have the potential to completely change the landscape of treating pancreatic cancer," study coauthor Herve Tiriac of UC San Diego School of Medicine said in a statement. "However, we need to ... optimize KRAS therapy" to improve patients’ outcomes.

This newsletter was edited by Mark Porter. 

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