Hepatitis C - Overview

What is Hepatitis C?

Discovered in 1989, Hepatitis C is a contagious disease which is caused by a virus that infects the liver. The hepatitis C virus (HCV) is the most common cause of chronic liver disease in the United States with prevalence of Hepatitis C virus increasing worldwide. Countries with high rates of people chronically infected with Hepatitis C are Egypt (22%), Pakistan (4.8%) and China (3.2%).

According to the World Health Organization, about 130–170 million people are chronically infected with the Hepatitis C virus, with more than 350,000 people dying from Hepatitis C-related liver diseases each year.
The Centers for Disease Control estimates that 1.8 percent or 3.9 million Americans have been infected with Hepatitis C – of which 2.7 million are chronically infected.

If left untreated, Hepatitis C can lead to liver cancer, liver damage and ultimately liver failure.

What Causes Hepatitis C?
Hepatitis C occurs as the result of percutaneous transmission of the hepatitis C virus through infectious blood. Percutaneous means the infected blood must be absorbed through the skin and enter the bloodstream of another person – in other words, blood-to-blood. Hepatitis C is approximately seven times more infectious than HIV.

Hepatitis C is most commonly transmitted in the following manner:

• Intravenous drug use (injection) – Currently, the most common means of Hepatitis C transmission in the United States, approximately 10 million injection drug users (IDUs) worldwide might be infected with the Hepatitis C virus
• Blood and Blood Product Transfusions (before 1992)
• Organ Transplants (before 1992)
• Hemodialysis (before 1990)
• Healthcare and Occupational Exposure (needle-stick injuries)
• Intranasal Drug Use (snorting drugs through a straw)
• Tattooing and Body Piercing
• Birth to an HCV infected mother
• Sexual Contact
• Household Contact (sharing of personal items such as razors, toothbrushes, scissors and manicuring equipment within the same household)
• Medical Procedures 

Hepatitis C is not transmitted by casual contact like hugging or kissing, nor is it transmitted through breast milk (unless the mother’s nipples are cracked or bleeding), food, water or sharing food or water with an infected person.

Who is at Risk for Contracting Hepatitis C?
The following individuals are at risk for contracting Hepatitis C:

• People who have injected illicit drugs, even if only one time or a few times, including those who have injected only once many years ago
• Healthcare workers who have been exposed to infectious blood on the job or have been stuck by a needle infected with the Hepatitis C virus
• People who were notified that they received blood from a donor who tested positive after they had already donated their blood
• People who received a blood transfusion or had a solid organ transplant before 1992
• People who have HIV
• People who are long-term hemodialysis patients
• People who were born to a woman infected with Hepatitis C
• People who live in a household with an infected person
• People who have/had unprotected sex with multiple partners, and/or between males, particularly where there is a history of a sexually transmitted disease
• People who engage or have engaged in anal sex without a condom
• People who have tattoos and body piercing
• People who have signs or symptoms of liver disease such as abnormal liver enzyme tests
• People who have ever worked or been housed in a prison 

What are the Signs and Symptoms of Hepatitis C? 

There are two types of Hepatitis C – acute (brief and severe) and chronic (having long duration). Individuals with acute Hepatitis C usually do not manifest symptoms and the small percentage that do (25 to 35 percent) will experience symptoms similar to the other cases of acute hepatitis, including flu-like symptoms, joint aches or mild skin rash. Individuals that are particularly likely to experience a severe course of Hepatitis C are those individuals that already have Hepatitis B and become infected with acute Hepatitis C. Other symptoms which may be experienced by individuals with acute Hepatitis C are:

• Loss of appetite
• Abdominal pain
• Dark urine
• Grey colored stoolJaundice (yellowing of the skin and whites of the eyes)

As is the case for acute Hepatitis C, most people who have chronic Hepatitis C do not experience symptoms in the early stages or even in the advanced stages of the disease. Therefore, it is not uncommon to find out, by surprise, that one has the virus when donating blood or during a routine blood examination. It is possible to have Hepatitis C for many years and not know it which is the reason why the disease has been referred to as a silent killer. If symptoms do occur, they will most likely exhibit as:

• Pain and tenderness in the area of the liver
• Fever
• Joint and muscle pain
• Decreased appetite
• Weight loss
• Depression
• Jaundice (yellowing of the skin and whites of the eyes)
• Fatigue
In those persons who do develop symptoms, the average time period from exposure to symptom onset is 4–12 weeks (range: 2–24 weeks).
Chronic Hepatitis C may cause signs and symptoms which manifest in other organs beside the liver as the result of the immune system’s effort to fight off the Hepatitis C infection. In some cases of Hepatitis C, the kidneys can be damaged because of a condition known as cryoglobulinemia.

Cryoglobulinemia is the presence of abnormal proteins in the blood called cryoglobulins. Cryoglobulins is a term for proteins in the blood that become solid at low temperatures. When cryoblobulins thicken or become gel-like, they block blood vessels throughout the body which may lead to complications ranging from skin rashes to kidney failure.

Is it Possible for Hepatitis C to Clear on Its Own?
It is possible for Hepatitis C to go away without treatment, however, of all people who contract Hepatitis C, only fifteen percent or less will have a self-limited case in which their immune system defeats the virus. It has not been established exactly why this happens.

Are There Different Types of Hepatitis C?
Hepatitis C is divided into six distinct genotypes throughout the world with multiple subtypes in each genotype class. A genotype is a classification of a virus based on the genetic material in the RNA (Ribonucleic acid) strands of the virus. Generally, patients are only infected with one genotype, but each genotype is actually a mixture of closely-related viruses called quasi-species. These quasi-species have the ability to mutate very quickly and become immune to current treatments, which explains why chronic Hepatitis C is so difficult to treat.

Following is a list of the different genotypes of chronic Hepatitis C:

Genotype 1a
Genotype 1b
Genotype 2a, 2b, 2c & 2d
Genotype 3a, 3b, 3c, 3d, 3e & 3f
Genotype 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i & 4j
Genotype 5a
Genotype 6a

Genotype 1 is the most common type of Hepatitis C genotype in the United States and the most difficult to treat. For physicians, knowing the genotype of Hepatitis C is helpful in making a therapeutic recommendation. Individuals with genotypes 2 and 3 are almost three times more likely than individuals with genotype 1 to respond to therapy with alpha interferon or the combination of alpha interferon and ribavirin.

Furthermore, when using combination therapy, the recommended duration of treatment depends on the genotype. For this reason, testing for Hepatitis C genotype is often clinically helpful. Once the genotype is identified, it need not be tested again as genotypes do not change during the course of infection.

Frequently Asked Questions

What is the Conventional Medical Treatment for Hepatitis C?
Not all people who have been diagnosed with Hepatitis C need treatment, especially in the case of acute Hepatitis. Medication may be prescribed, however, bed rest, drinking plenty of fluids, avoidance of alcohol and eating a healthy diet will be recommended by the doctor. It is important to work closely with one’s doctor and follow up with tests to make sure the virus has cleared the body.
Some people won’t be treated because they don’t know they have the Hepatitis C virus.
Individuals who have been diagnosed with chronic Hepatitis C will probably be treated with interferon combination therapy or interferon monotherapy. The monotherapy only consists of interferon, while combination therapy combines interferon with ribavarin. Combination therapy is the treatment of choice. However, some people will still receive monotherapy due to intolerance to ribavirin.
The type of treatment as well as the length of treatment for Hepatitis C depends on the genotype of the virus. Working closely with one’s physician, using an open line of communication will help in determining the best course of action.
People with genotype 1 have a lower rate of response to combination therapy (most studies have shown that treatment with combination therapy works for up to 50% of people with genotype 1), whereas people with genotypes 2 and 3 have a high rate of response to combination therapy (around 80%).
Current treatment options for Hepatitis C include various types of interferon - either genetically engineered or a synthetic replica of the body’s natural protein produced and secreted by special immune cells which act as an antiviral, immune-regulating chemical.
Once in the bloodstream, interferon interferes with the Hepatitis C virus’ ability to replicate. In addition, interferon appears to build up the immune system’s disease fighting T helper-1 cells so that they are strong enough to kill off the Hepatitis C viruses.
Types of interferon used in the treatment of Hepatitis C include:
- Alpha Interferon – the standard treatment for management of acute and chronic     Hepatitis C
- Consensus Interferon – a synthetic form of interferon
- Pegylated Interferon – a long-acting, time-release form of interferon
Side effects from interferon can be unpleasant and sometimes serious, leading to dose reduction or discontinuation of treatment. All side effects should be reported to one’s doctor right away for management of symptoms and to prevent serious complications from occurring.



Not all people experience the same side effects, nor are all side effects necessarily severe. Some people experience few or no side effects at all. Having a good support system in place prior to starting treatment will help in managing side effects whether few or many. Family, friends, and support groups can be helpful to most people during difficult times while undergoing Hepatitis C treatment.
Side effects from interferon may include:

Persistent flu-like symptoms (including body aches and headaches)
Nausea
Fatigue
Loss of appetite
Diarrhea
Insomnia
Mental and psychiatric symptoms, including depression, irritability, anxiety, mania and trouble concentrating
Bone marrow suppression
Anemia
Dehydration
Mouth sores
Changes in the way food and beverages taste
Skin rashes and itching
Dry, brittle nails
Injection site reactions (pain, irritation, swelling or infection)
Hair loss
Vision or eye problems (rare but can be serious)
Libido changes (decreased interest in sex)
Menstrual and menopausal changes

Ribavirin, an antiviral drug that suppresses the Hepatitis C virus is commonly used in conjunction with interferon to treat Hepatitis C. When used alone, Ribavirin promptly brings down liver enzymes but the results don’t last long and liver enzymes go back up. The best success for sustained results has been shown when treatment consists of pegylated interferon/peginterferon (a time-released, longer acting interferon), and Ribavirin combined. Similar to interferon side effects, Ribavirin has been known to cause anemia, thyroid disease, hypertension and depression. Pregnant women and anyone with cardiovascular disease should not take Ribavirin. Ribavirin can cause birth defects so it is important for both men and women to use an effective form of contraception.
On May 13, 2011, the U.S. Food and Drug Administration approved two prescription medications Victrelis™ (boceprevir) and Incivek™ (telaprevir) for use in combination with peginterferon alfa and ribavirin to treat chronic Hepatitis C genotype 1 infection in those who have not been treated before or who have failed previous Hepatitis C treatment.
There are contraindications with regard to both Victrelis™ and Incivek™ which should be discussed thoroughly with one’s doctor as should all treatment options.
It is important to note that not all people are candidates for antiviral drug treatment. Antiviral drug treatment for Hepatitis C may not be recommended for the following:

People who use intravenous drugs People who drink alcohol People who have advanced cirrhosis of the liver People who have received a kidney or heart transplant, since treatment will increase risk of rejection of the organ People with liver cancer Men and women who are planning to conceive a child and women who are pregnant People who are severely depressed and/or have mental health issues because antiviral medications used to treat Hepatitis C can make those issues worse People who have an autoimmune disease such as rheumatoid arthritis, lupus, or psoriasis People with advanced heart disease or diabetes People with normal aminotransferase levels (ALT less than 30 independent units per milliliter)
Finally, if the liver is severely damaged, a liver transplant may be recommended. End-stage liver disease (cirrhosis) due to chronic Hepatitis C viral infection is the number one reason for liver transplantation in the United States. During the transplant procedure, the diseased liver will be replaced with a healthy liver from an organ donor or from a live donor who donates a portion of their healthy liver. However, contrary to popular misconception, a liver transplant is not a cure for Hepatitis C. Unfortunately, the Hepatitis C virus recurs in the new liver in almost all cases, with fibrosis (scarring of the liver) or cirrhosis occurring in 10% to 30% of patients in as little as 5 years after the transplant.




Further studies are needed to develop better strategies to prevent recurrence of infection after a liver transplant as well as better treatment protocols after reinfection of the liver has occurred.


Are There Alternative Therapies for the Treatment of Hepatitis C?






Many people who have Hepatitis C choose to follow an alternative method of treatment due to the side effects and dissatisfaction with current medical therapy. Complementary and Alternative Medicine (CAM) is chosen as a means of treatment most commonly to boost the immune system, slow disease progression and improve quality of life.






The best CAM route in the treatment of Hepatitis C appears to be the approach that focuses on protecting and supporting the liver and keeping the immune system healthy. Because Hepatitis C cannot be completely cured by pharmaceutical or natural methods of treatment, combining the two is the choice many people make in order to optimize their health.
Some of the preferred alternative therapies for Hepatitis C include:

Milk Thistle - The most popular CAM strategy chosen for treating Hepatitis C is the use of single herbal remedies – namely, milk thistle which is the most well researched and supported supplement to aid in liver health. Silymarin, milk thistle’s active ingredient, is an antioxidant, hepatoprotectant, and anti-inflammatory. Silymarin also stimulates growth of new liver cells. Silymarin has been used to treat alcoholic liver disease, acute and chronic viral hepatitis and toxin-induced liver diseases. Results of clinical trials and systematic reviews of silymarin use show high efficacy of the drug in patients with viral hepatitis. Recently shown to inhibit Hepatitis C virus infection, both in vitro (an isolated organism within glass) and in vivo (using a whole, living organism), silymarin’s antivirus action blocked cell-to-cell spread of the virus including blocking of virus entry and transmission. Studies done as recently as June, 2011, prove that silymarin, combined with interferon proves to be an effective option to treat Hepatitis C infection. Other herbal remedies include lecithin, Eclipta alba, schizandra and licorice root. Just as there are beneficial herbs to treat Hepatitis C, it is important to note that there are certain herbs and supplements that can harm the liver such as skullcap, kava kava, vitamin A, ephedra (mahuang), and comfrey.

Ayurvedic Herbal Medicine – Based on an ancient Indian medical theory wherein it is believed there are five elements – fire, water, earth, air and ether. Each has a counterpart in the elements that define the health of the human body. These bodily elements join to produce the three doshas (humors): vita, pitta and kapha. Healing is achieved by balancing the three doshas. The taste of an herb determines its healing properties – tastes being sweet, sour, salty, pungent, bitter, or astringent.

Traditional Chinese Medicine (TCM) – Also incorporates five elements – fire, earth, metal, water and wood with its own complement in the body and is also based upon taste. The taste of an herb determines its action on the body. Herbs without a distinct taste are categorized as bland. Temperature is also an indicator of herb action. TCM divides medicinal plants into hot, warm, neutral, cool and cold herbs. The aim of TCM is to achieve health through achieving balance, just as is the aim of Ayurvedic Herbal Medicine. Therefore, the concept of two complementary energies, yin and yang, is ascribed to many foods and herbs. In an attempt to restore balance of elements, tastes, temperature and yin and yang, complex herbal mixtures are prescribed by TCM practitioners.

Massage – Recognized as one of the oldest methods of healing with references in medical texts going back as long ago as 4,000 years. Also referred to as bodywork or somatic therapy, massage therapy refers to the application of various techniques to the muscular structure and soft tissues of the body that include applying fixed or movable pressure, holding, vibration, rocking, friction, kneading and compression using primarily the hands, although massage therapists do use other areas of the body, such as the forearms, elbows or feet. All of the techniques are used for the benefit of the musculoskeletal, circulatory-lymphatic, nervous, and other systems of the body. It has been shown that massage therapy positively influences the overall health and well-being of the client:
Antioxidants - Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to diseases such as cancer and heart disease. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause. Examples of antioxidants include milk thiste, n-acetyl l-cysteine, alpha r-lipoic acid, beta-carotene, lycopene, vitamins C, E, and A, as well as other substances. 

Acupuncture – Originating in China over 5000 years ago, acupuncture is a component of Chinese Traditional Medicine or Oriental Medicine. The aim of acupuncture is to restore and maintain health through the stimulation of specific points of the body by inserting thin, solid, metallic needles through the skin which then are manipulated by the hands or by electrical stimulation. Acupuncture is based on the belief that living beings have a vital energy, called "qi", that circulates through twelve invisible energy lines known as meridians on the body. Each meridian is associated with a different organ system. An imbalance in the flow of qi throughout a meridian is how disease begins, therefore, adjusting qi through acupuncture, helps the body heal itself.

Hepatitis C Natural Remedies




Maximum Milk Thistle® Support and protect your liver by using a milk thistle formula which is clinically proven to be up to 10x more absorbable and up to 20x more effective than standardized milk thistle formulas. UltraThistle® Formerly available ONLY through medical doctors and other licensed healthcare professionals UltraThistle® has the same great benefits as Maximum Milk Thistle® but at a higher dosage Sho-Saiko-To (SST) The all natural, prescription strength liver formula from Japan, Sho-Saiko-To (SST) is available in North America without a prescription in capsule form! Clinical Multi-Vitamin

Individuals with compromised liver function can have vitamin deficiencies for many reasons, including poor diet, malabsorption and underlying compromise of hepatic function itself. Many with liver ailments are prone to vitamin deficiencies and must take vitamin supplements. For those with liver concerns, a vitamin mix should be made to include a gernerous amount of water-soluble vitamins while avoiding iron and excessive fat-soluble vitamins. Whereas water-soluble vitamins are generally safe for the liver, iron and fat-soluble vitamins get processed through and stored in the liver and excessive amounts could lead to toxicity.


With Clinical Multi-Vitamin, you are provided with a balanced, physician formulated blend of vitamins, antioxidents and vital nutrients that is appropriate for nutritional supplementation for those with liver concerns. 

Liv.52®

Through the protection of the hepatic parenchyma, and by way of its potent antioxidant properties, Liv.52® acts as a powerful detoxification agent. It neutralizes toxins and poisons from food, water, air and medications - all sources causing detrimental effects on the liver. 




Alpha R-Lipoic Acid

Alpha R-Lipoic Acid, known as the "universal antioxidant" due to its unique ability to access all parts of the body's cells, is a powerful antioxidant that decreases oxidative stress - the damage caused by free radicals, supports liver enzymes and improves mitrochondrial function. It also serves to regenerate other antioxidants such as glutathione, vitamin E, and vitamin C and aids in supporting and maintaining eye, brain and cardiovascular health - which are all key components to healthy aging. 


N-Acetyl L-Cysteine (NAC)
N-Acetyl L-Cysteine (NAC), a powerful antioxidant that scavenges free radicals and supports the immune system, also increases glutathione synthesis and helps neutralize and remove toxins from the body. The majority of glutathione manufactured in the body occurs in the liver. Those with liver concerns most likely are not producing enough glutathione to support the body’s needs. Because NAC helps restore glutathione levels, experts recommend that supplementing with this amino acid can help support and protect the liver and the body and help defend it against damaging toxins.


Fatigue Relief Plus™ Fatigue Relief Plus™ replenishes, renews and restores your energy. This product contains a natural, safe ingredient proven to reduce fatigue by up to 40% in as little as six weeks - without stimulants. By also including an antioxidant and detoxifier, Fatigue Relief Plus™ also promotes healthy liver function which is vital to energy production and fighting fatigue.