Hepatitis C Hope

Taking A Close Look At HepB

2006-07-06T21:24:00.000-04:00

June 26, 2006

Filed under: in the news...
Using some of the latest investigational techniques, scientists at the Scripps Research Institute have discovered pretty amazing functional morphology of the Hepatisis B virus:
Hepatitis B virions, also known as Dane particles, are approximately 40 nanometers in size, and the capsid is surrounded by a membrane envelope. While the structure of the hepatitis B capsid has been studied intensively in vitro, until this study little was known about the structure and assembly of native capsids present in infected cells in vivo, and even less was known about the structure of mature virions.
"We used cryomicroscopy and image analysis to examine the native structure of HBV [hepatitis B virus ] capsids from transgenic mice and virions isolated from patient blood samples," Yeager said. [Mark Yeager, M.D., Ph.D. is a professor at Scripps -ed.] "By rapidly freezing the samples we were able to use cryo-electron microscopy to image the particles while they were maintained at the temperature of liquid nitrogen--around--300° F--which preserves them in a state close to what exists in vivo. Image processing allowed us to derive 3-D maps that revealed for the first time how the outer lipid envelope interacts with the capsid shell. "
The 3-D maps showed that in terms of molecular size, hepatitis B virus is enormous--nearly 10 times larger than a hemoglobin molecule. Like the human genome, the genome of the hepatitis B virus is formed by double-stranded DNA and enclosed by the capsid, which has icosahedral symmetry, resembling the geometric structure of a geodesic dome. The capsid itself is contained within an outer envelope formed by a lipid bilayer, similar to the membranes that enclose all human cells. The membrane of hepatitis B virus is studded with glycoprotein spikes, which bind to receptors on liver cells that mediate infection.
In hepatitis B-infected liver cells, transcription of the viral DNA produces a type of RNA that is packaged into capsids. Within the capsid, reverse transcription produces a single-strand DNA copy that serves as the template for second strand DNA synthesis. The resulting particles bud through membranes of the endoplasmic reticulum--the part of the cell involved with protein folding, assembly, and transport--to acquire the outer membrane envelope of the virus, a step that confers infectivity.
"In the transgenic mice, we found two types of capsids with different densities," Yeager said. "While both types of capsids were assembled as similar icosahedral structures, we found that the lower density capsids did not contain any viral DNA or viral RNA, while the higher density capsids contained viral DNA intermediates. It seems likely that these lower density capsids were released from the cell nucleus. These results may offer new clues how the virus replicates in vivo."

Statins Stop Hepatitis C Virus Replication ...

2006-07-06T21:18:00.000-04:00

Japanese scientists say they've found statins, typically used as anti-cholesterol medications, can inhibit the replication of the hepatitis C virus.

The findings mean statins might be able to replace ribavirin in combination therapy with interferon. There are 170 million people worldwide infected with HCV. The standard HCV treatment is a combination therapy of interferon and ribavirin, which is effective in about 55 percent of patients. The remaining 45 percent face a threat of the disease progressing to cirrhosis and liver cancer. Aware of recent studies showing one statin, lovastatin, inhibits HCV replication, researchers led by Masanori Ikeda of Okayama University tested other statins in search of a more effective anti-HCV therapy. They evaluated the anti-HCV activities of five statins: atorvastatin, fluvastatin, lovastatin, pravastatin and simvastatin.

When the statins were tested alone, all except pravastatin inhibited HCV replication, with fluvastatin having the strongest effect; atorvastatin and simvastatin had moderate effects and lovastatin had a weak effect. The findings are reported in the July issue of the journal Hepatology.

Copyright 2006 by United Press International

Clinical Trials for Natural Hepatitis C Remedy Looking Good

2006-07-05T17:33:00.000-04:00

June 28, 2006

What can interferon non-responders do about Hepatitis c? What about people who cannot or will not tolerate the devastating side effects of interferon therapy? Find out about the positive preliminary results from a medical study of a natural Japanese prescription medicine that's available to patients now.
Progressive Alternative Medicine Solution Undergoes Clinical Trials and Holds Promise of Benefiting Millions of Americans with Hepatitis CSource: HepCare Inc. Tuesday, May 23An estimated five million Americans have been infected with hepatitis C virus (HCV) according to a study published at the Liver Meeting by the American Association for the Study of Liver Diseases (AASLD) in November 2005. Chronic hepatitis C is associated with significant morbidity (liver cirrhosis and hepatocellular carcinoma) and mortality. Current treatment is based on interferon and ribavirin. However, treatment options are limited for patients who are not candidates for interferon-based therapy, particularly for those who suffer from HCV genotype 1 infection.

Sho-saiko-to (SST), a standardized herbal formula, is under a clinical phase II trial by a leading New York Cancer Research Institute to determine its effect on hepatitis C patients. The research group has reported the preliminary results of 15 patients at the 2nd Society of Integrative Oncology Conference in San Diego on November 10, 2005. This study is titled "Sho-saiko-to for Patients with Chronic Hepatitis C Who Are Intolerant to or Have Contraindication to Interferon-Based Therapy: A Phase II Study." SST is know to have anti-fibrotic effect by inhibition of lipid peroxidation in hepatocytes and stellate cells in animal studies. It has also been shown to reduce aminotransferase levels and the incidence of hepatocellular carcinoma in hepatitis and liver cirrhosis patients.

According to the design of the clinical trial, 31 patients will receive SST daily for 52 weeks. Fifteen patients have completed the treatment and the preliminary results have been reported. No serious adverse events have been attributed to SST among any patients who enrolled in the trial. Among the 15 patients who completed the study, reductions in alanine aminotransferase (ALT) were observed in 11 patients and aspartate aminotransferase (AST) in 10 patients. In 10 patients, the liver biopsy showed 20% improvement on histological assessment of the liver. This is consistent with the findings by the Japanese researchers for its anti-inflammatory effect. More interestingly, the majority of the patients whom participated in the clinical trial were genotype 1 infection.For more information about the herbal remedy, Sho-saiko-to, visit www.shosaikoto.com.

My doctor told me I am a "non-responder." What does that mean?

2006-06-12T12:46:00.000-04:00

Hepatitis C treatment doesn't work for everyone. In some people, it works better than in others. If you are a non-responder, it means that your treatment didn't work as well as your doctor hoped that it would. There are many different kinds of "non-response." Some of the kinds that your doctor might mention include the following:

Transient response
The treatment worked only as long as you took it. When you stopped taking it, hepatitis C came back.

Breakthrough response
The treatment seemed to work at first, but then it stopped working.

Partial response
The treatment seemed to work a little bit, but it never worked completely.

Hmmm, so what should you do, if your doctor feels that your
body can withstand tx.. Keep on trying.

Get Pissed and put on your big boy or big girl pants on.

Get some Attitude and kick some ass. It's your life you're

fighting for...

Remember, I was labled a non-responder after 6 months
of mono-interferon and was told there was nothing else
I could do to rid my body of the HCV. I refused to be a victim
and found a doctor who believed in me and treatment. After doing
3 years of tx, I am Cured 8 years as of May 16, 2006.
So Please, do not give in or up!

Some Treatment Tips For Hepatitis C

2006-06-12T12:14:00.000-04:00

I would like to say, I am far from being
an expert on Hepc, nor do I claim to be....
Trust me, I am not a Chatroom Doctor!

I'm just a sister that made it through her journey
and would like to help my fellow brothers & sisters
with their's!

You might say I was the "Poster Child for Interferon"
since it took me, 3 years of interferon injections
to become Virus Free, Hey I'm a blonde want do you want, lmao

I soon realized, not at first, that if I wanted,
to get well, I would have to be in charge!

So I gathered, as much information as
I could from the liver foundation,
because at the time, I did not have access to
the internet....

I would also prepare my questions for my doc
at home & wrote them down, because the treatment
was doing havoc with my memory.
I also joined Sherring Plough's "Be in Charge Program",
they sent me some information about Hepc,
that I found useful. They also assigned a nurse to me,
and she would call once a month, to see how I was doing.
That is great especially, if live by yourself,
at least you don't feel alone.

Most important tip, I can share is water, water,
water .... drink plenty of it!

Water helps to flush the toxic chemicals that we are
putting into our bodies.

After work, I would make it about about me!
I surrended my kitchen skills, lol and handed
them over to my family, or I ordered in!
I also assigned chores to my daughter, son
and husband. If they wanted me to get well....
Well, they would have to pitch in. Was tired of being
"Wonderwoman". I needed help, and
wasn't too proud to ask.

Most nights, you would find me on my couch,
listening to my favorite cd's. My husband bought me
a cd of nature sounds, that was that relaxing.
I always had the lights out, and surrounded myself
with candles and incense. Every Saturday,
I would go to the florist and buy myself some flowers.
I desperately needed to be surrounded by beauty,
since interferon was so very ugly!

For my achy, breaky, body I took lots & lots
of long bubble baths with mineral oils,
hmm that feels good! I also had an affair with my heating pad,
for three years! I'm happy to report that I ended that,
and me & hubby are back together, lol.

I also took tylenol or comtrex flu medicine

about 1/2 prior to injection to sort of get a jump start on the sides.
I ran a fever for three years, so this helped.
I found that by taking my injections between 7-8PM
that worked great for me, as soon as the
sides kicked in, I would take a sleeping pill,
and check out.

I decided to play with my calendar,
and started putting x's on my shot days.
When, my journey seemed endless, I would look at all
the x's and forcus on how many I already taken,
not how many I had ahead of me....

For my spiritual side, I was into meditation and
visualization, I would always see myself running
along the beach, laughing, and very healthy,
looking oh, so good with a great tan.
I felt if I believed that, I would be well,
just maybe I would.

I also kept a journal, for my inner most feelings.
I was undergoing so many emotions, and didn't
want to bother my family, with all, of what,
I was feeling. Besides they would have thought
I was nuts, lol ..

So, I expressed myself in writing, not in talking...

It felt great, to really express how I was feeling,
however, as I sometimes read my journals,
of which I have many, (three years worth)
I ask myself, hmm, now what was I thinking.

I did not suffer from serious depression.
When I felt, a little "out of my dish" I would remind myself,
that these thoughts were being induced by interferon,

and was not my thinking, it was the interferon. I was lucky,
that worked for me ....

However, many experience severe depression and
need anti-depressants, please inform your doc.
There are also some that have contemplated suicide,
please take this very serious and contact
your doc immediately.

Happy Trails to you!

If You Have HCV You Need Hope~

2006-06-12T12:07:00.000-04:00

Hope is a word
that every
hurting heart
understands.
Hope shines
brighter than
the brightest star
on the darkest night.
Faith is bigger than the highest mountain.
And God is greater than any obstacle in your path.
Anything can be accomplished by those who fully
put their hearts into it. The time to start is now;
the place to start is
here. May hope
cast its special
light upon your
path and God
bless everything
you touch in the
hours, days,
and moments
still to come.

Is Working While You Have HCV The Right Decision?

2006-06-12T11:54:00.000-04:00

If you're having major problems with fatigue, mental concentration, and other symptoms that are keeping you from holding a full-time job, a part-time job may seem to be a good solution. However, keep in mind that if you change your official job status from permanent full time to permanent part time, you may also change your insurance coverage, retirement plan, and other benefits. Company policies may be less flexible for part-timers than for full-timers. It may be difficult to switch back to full-time status. If your medical condition gets worse and you need to apply for Social Security Disability Insurance (SSDI), you may not qualify for full SSDI payments if your last permanent job was part time.

Be sure to find out all the details of part-time status from the human resource department before you make the switch. Perhaps you can arrange a temporary reduction in hours (and pay) that will let you keep your full benefits while you're recovering from hepatitis symptoms or treatment.

Can I use the Family Leave Act?
The Family Medical Leave Act (FMLA) says that if you have worked for your company full time for at least a year, you are allowed to take up to 12 weeks of unpaid time off every year (either on consecutive days or on an intermittent basis) to take care of your own serious medical needs. (Your spouse, child, or parent could also claim time under the FMNLA to take care of you if you are seriously ill.) If you return within 12 weeks or your period of absence does not exceed 12 weeks, under the Act your employer must give you your job (or an equivalent job) back when you return. Make sure you talk to your boss about the FMLA, and whether it applies to you, before you take the time off. Again, many states have laws which provide similar protection. For any particular situation you should consult a lawyer in your area.

If you think that your employer isn't willing to be as accommodating as you want in adjusting your workplace, you can contact the local office of the Equal Employment Opportunity Commission (EEOC), which handles ADA complaints, to look at your situation. (See the Resource List to find out how to contact the EEOC.)

You can also contact the Department of Justice, which operates the ADA Mediation Program. The Mediation Program provides federal mediators, or peacemakers, to try to work out such disagreements. (See the Resource List under the Americans with Disabilities Act Information Line to learn how to contact the Department of Justice in your region or the central office in Washington, D.C.) Every state has at least one mediator to step in and help. If that is not successful, you may still be able to sue under the provisions of the ADA.

Can I get disability payments?
Disability payments are often available under federal and state law. The U.S. government provides disability payments to people who have mental or physical problems that the government believes will keep them from being able to work at all. The Social Security Administration (SSA) has a list of conditions that it considers to be disabilities. If what you're experiencing is not on that list, you will have to prove to the SSA that you have a physical or mental condition that keeps you from being able to work.

Proving that you are disabled takes a lot of effort. You'll need proof of that from your doctor and supervisor, and possibly from some co-workers as well. You may also have to prove that you have tried different ways of working - perhaps doing a different job for the same employer, or adjusting your hours so that you can work when you feel best. The SSA may also want to know if you could work at a completely different job that is not as hard physically - say, instead of being a truck driver, if you could work as a dispatcher, or instead of being a teacher, if you could be a secretary. The SSA will want to know about other job skills you might have - if you have a home computer and can program computers, you might be encouraged to get a job doing that.

Do all you can to make it easy for the SSA workers to understand your situation by giving them complete information. It can be frustrating, but try to be patient with the process. It may take months for your case to work through the Social Security system. If you're asked to provide additional information, do so without delay. The time you waste is yours, not theirs!

Zarqawi, Da Head Chopper Deader Than A Slab of Bacon....

2006-06-08T22:58:00.000-04:00

US air strike kills Qaeda's Zarqawi
By Mariam Karouny 45 minutes ago

U.S. warplanes killed Abu Musab al-Zarqawi, the al Qaeda leader in Iraq blamed for bombings, beheadings and assassinations, in a strike which President George W. Bush said on Thursday had delivered justice.

In one of the most significant developments in Iraq since the capture of Saddam Hussein in 2003, Jordanian Zarqawi was killed in a bombing raid on Wednesday in a U-S.-Iraqi operation helped by tip-offs from Iraqis and Jordanian intelligence.

Vowing to fight on, al Qaeda in Iraq confirmed the death of Zarqawi, who beheaded several hostages himself and appeared in a recent video firing a machinegun in the desert.

U.S. forces displayed pictures to reporters of the corpse of the bearded Zarqawi with facial abrasions and his eyes closed. Wednesday's air strike was carried out by two F-16 planes with two 500 lb (227 kg) bombs hitting Zarqawi's "safe house."

Zarqawi, in his late 30s and whom Osama bin Laden called the prince of al Qaeda in Iraq, had symbolized the radical Islamist insurgency against U.S. occupation, and British Prime Minister Tony Blair said he now expected guerrillas to seek revenge.

"There will be fierce attempts ... with the death of Zarqawi to fight back," Blair said, adding the militant's death would not end the killing in Iraq but that it was significant.

A car bomb exploded in Baghdad on Thursday killing seven people just hours after Zarqawi's death was announced.

Bush said the death of Zarqawi, who had a $25 million bounty on his head, was "a severe blow to al Qaeda," a victory in the war on terrorism, and "an opportunity for Iraq's new government to turn the tide in this struggle."

GOVERNMENT BREAKTHROUGH

In a key political breakthrough, Iraq's parliament approved Prime Minister Nuri al-Maliki's candidates for new defense and interior ministers after intense wrangling among his coalition government partners.

Followers of Zarqawi, a Sunni Muslim who had declared war on Iraq's majority Shi'ites reinforcing fears he was out to ignite civil war, pledged to continue their fight.

"We tell our prince, Sheikh bin Laden, your soldiers in al Qaeda in Iraq will continue along the same path that you set out for Abu Musab al-Zarqawi," said a statement on an Islamist Web site. "The death of our leaders ... only makes us more determined to continue the jihad."

Maliki, who was desperately in need of success to bolster his authority, announced Zarqawi's death near the city of Baquba 65 km (40 miles) north of the capital.

Bush said U.S. special forces confirmed Zarqawi's location based on intelligence from Iraqis and "delivered justice to the most wanted terrorist in Iraq."

"It truly was a very long, painstaking, deliberate exploitation of intelligence, information gathering, human sources, electronics, signal intelligence," U.S. Major General William Caldwell said, adding the operation took many weeks.

U.S. forces were trailing Sheikh Abdul-Rahman, Zarqawi's spiritual adviser, and that led them to a small house in a palm grove area and Zarqawi.

Six people, including a woman and a child, were killed in the house but only Zarqawi and Abdul-Rahman have been identified. Zarqawi was identified by his fingerprints and tattoos. A further DNA test was being carried out on Zarqawi.

BAGHDAD RAIDS

Seventeen raids were launched on suspected hideouts for Zarqawi associates in the Baghdad area hours after he was killed. They produced a "treasure trove" of information, officials said.

Zarqawi's death had an impact on oil prices. Crude futures were down more than one dollar to $68.17 a barrel.

Zarqawi, who U.S. Ambassador Zalmay Khalilzad called the "godfather of sectarian killing in Iraq" and who faced four death sentences in Jordan, one for his role in killing a U.S. diplomat, had inspired a flood of militants from across the Arab world to blow themselves up in suicide missions.

Taunting Bush during the video taped killing of a sobbing, blindfolded U.S. hostage, Zarqawi once boasted his al Qaeda fighters "love death just like you love life."

"Killing for the sake of God is their best wish," the insurgent leader said, drawing a knife to hack off the head of his kneeling victim.

Zarqawi's reputation for personal savagery stood out even in a country where brutal killings were routine, and sparked reports bin Laden and his deputy Ayman al-Zawahri were worried his homicidal zeal would undermine support for their network.

"His whole intent was to incite violence between Shi'ites and Sunnis. He wasn't interested in going after coalition forces," said Caldwell of the former street thug who had eluded repeated attempts to capture or kill him.

Some Arab citizens hailed Zarqawi as a hero for his role in the insurgency but others welcomed his death as a form of justice for a militant whose attacks killed far more Iraqi civilians than foreign troops.

Caldwell said an Egyptian militant trained in Afghanistan called Abu al-Masari, who established the first al Qaeda cell in Baghdad, may succeed Zarqawi as head of the group in Iraq.

My thanks To Our Us Military.... God Bless You.

Relative Risks Of Cirrhosis From Non-alcoholic Steatohepatitis

2006-06-06T22:01:00.000-04:00

Main Category: Liver Disease / Hepatitis News
Article Date: 06 Apr 2006 - 3:00am (PDT)

Cirrhosis related to non-alcoholic steatohepatitis (NASH) is associated with fewer complications and a lower mortality compared to cirrhosis from hepatitis C, despite NASH patients' greater risk of dying from cardiovascular events. These findings are published in the April 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published on behalf of the society by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/hepatology.

Non-alcoholic steatohepatitis can develop as a consequence of obesity and the metabolic syndrome. It is considered a "silent" disease, with most sufferers feeling well, in spite of inflammation and damage to the liver. But NASH can progress to cirrhosis in up to 20 percent of cases. With obesity becoming more prevalent in the U.S., the health care burden related to cirrhosis due to NASH is expected to rise. Up to now, however, little has been known of the natural history of cirrhosis associated with NASH.

Researchers led by Arun J. Sanyal, M.D. of Virginia Commonwealth University Medical Center in Richmond, sought to prospectively define the clinical outcomes of cirrhosis due to NASH, and compare them to those associated with hepatitis C virus (HCV) infection. They studied 152 patients with cirrhosis due to NASH and matched them with 150 patients with cirrhosis due to HCV. For each participant, the researchers collected information on mortality and morbidity, including synthetic failure, varices and variceal hemorrhage, ascites, encephalopathy and hepatocellular cancer.

Over ten years, 29 of the 152 subjects with cirrhosis due to NASH died, compared to 44 of the 150 subjects with cirrhosis due to HCV. Sepsis was the most common cause of death in both groups and was often associated with acute or chronic liver failure.

At the same time, cardiac events killed many more patients with NASH (8 out of 152) than with HCV (1 out of 150) a finding that is "noteworthy, although not unexpected," report the authors. "This group has significantly higher prevalence of risk factors for coronary heart disease and congestive heart failure than those with HCV." During the study, patients with cirrhosis due to NASH and normal liver functions developed fewer complications of cirrhosis: 14 NASH patients developed ascites, compared to 40 HCV patients. Also, fewer NASH patients than HCV patients developed encephalopathy and variceal hemorrhage, and significantly fewer developed liver cancer. However, once the liver functions declined below normal levels, the outcomes of patients with NASH were the same as those with cirrhosis from hepatitis C.

"These are the first prospective data on the relative risks of developing specific complications of cirrhosis in subjects with NASH," the authors report. NASH patients fared better overall compared to HCV patients, though many did develop complications of cirrhosis. Ascites was the most common complication contributing to mortality.

"These data are likely to be important in the design of future therapeutic interventions in this patient population," the authors conclude, "and also in the everyday management of such patients in clinical practice."

Article: "Similarities and Differences in Outcomes of Cirrhosis Due to Nonalcoholic Steatohepatitis and Hepatitis C," Arun J. Sanyal, Colin Banas, Carol Sargeant, Velimer A. Luketic, Richard K. Sterling, Richard T. Stravitz, Mitchell L. Shiffman, Douglas Heuman, Adrian Cotterell, Robert A. Fisher, Melissa J. Contos, and Alan S. Mills, Hepatology; April 2006 (DOI: 10.1002/hep.21103).

David Greenberg
dgreenbe@wiley.com
John Wiley & Sons, Inc.

DEALING WITH PRE-TREATMENT WORRIES....

2006-06-06T21:53:00.000-04:00

A person who is about to begin treatment with interferon, will likely be concerned about its potential side effects. This is understandable. After all, many people with hepatitis C feel fine, so it’s perfectly normal to worry about starting a medication that may make them feel sick. Alternatively, some people with hepatitis C already feel run down as a result of the virus. The last thing that these individuals want to do is to begin a medication that may make them feel even worse.

Side effects associated with any drug, including interferon, vary from person to person. This means that not everyone will experience a particular potential side effect. So, while some individuals feel quite ill while on interferon, others experience few, if any, side effects. And there are some individuals who actually feel better while on interferon. That’s right! This point bears repeating. It is a possibility that a person will have minimal to no side effects, or will even feel better than usual while on interferon. And, those that do experience adverse side effects usually do not experience them all the time. In fact, studies have shown that, only approximately two- to -five percent of people find the side effects of interferon so debilitating that discontinuation of therapy is necessary.

SOME GENERAL POINTS TO KEEP IN MIND

It is important to do everything you can to minimize the side effects of interferon therapy. Your objective should be to make sure that the side effects of interferon do not cause the discontinuation of therapy. Side effects of interferon therapy are usually the worst during the first few weeks of therapy. So, it’s important to try to stick with therapy for at least a month or two.

It typically takes the body this initial period of time to adjust to interferon. So, don’t assume that the way you feel after the first injection is the way you will feel every time you inject. Some people schedule time off from work for when they plan to start interferon therapy. Or, they begin therapy during their vacation week. Others plan to begin therapy when their work schedule or personal responsibilities are light, thereby making it is easier to get through the initial period.

If side effects become too severe, don’t be afraid to ask your doctor to help you apply for temporary disability. Lastly, always keep in mind that the side effects due to interferon will totally abate after interferon therapy has been discontinued

Definition of HCV PCR

2006-06-06T21:44:00.000-04:00

HCV PCR: HCV PCR (polymerase chain reaction) is a test for the hepatitis C virus (HCV).

There are three types of HCV PCR tests:

The HCV PCR viral detection test: This qualitative test is designed to detect whether the hepatitis C virus is or is not present.

The HCV PCR viral load test: This quantitative test looks for the virus and estimates the number of HCV viruses per ml of blood.

The HCV PCR genotype test: This test looks for the virus and determines the particular subtype of HCV.

The three different HCV PCR tests serve different purposes. The qualitative test is done to confirm the presence of HCV in the blood of a person with positive HCV antibody test. The quantitative test is done to estimate the length of treatment that will be needed and to monitor the effectiveness of that treatment. The genotype test is usually done before the start of treatment because it can differentiate each of the major subtypes of HCV. Knowing the subtype can be important because, for example, treatment with interferon is more often effective for people with genotype subtypes 2 or 3 than for those with genotype 1.

Chronic VS. Acute Hepatitis C infection

2006-06-06T21:35:00.000-04:00

Acute Hepatitis C infection is the period of time that begins with the intial infection, and includes the incubation period and the possible appearance of clinical illness. Because the hepatitis C virus has the ability to evade the immune response in many people, about 85 percent of patients with acute HCV infection develop persistent infection. Chronic hepatitis C, defined as persistently elevated alanine aminotransferase (ALT) levels more than 6 months after illness onset, develops in about 70 percent of cases.

Symptoms of Acute HCV Infection
Not everyone infected with the hepatitis C virus has symptoms of infection. Studies have shown that 60 to 70 percent of patients with acute HCV infection have no discernable symptoms. Approximately 20 to 30 percent of patients may be ill with jaundice. About 10 to 20 percent of acutely infected people have vague and non-specific symptoms that can be can be easily mistaken for other illnesses. When present, symptoms have been described as "flu-like" and can include: Fatigue: a feeling of weariness of exhaustion. Liver pain: discomfort or tenderness in the upper right quadrant of the abdomen, which may be associated with enlargement of the liver .Nausea and decreased appetite,
Pain in muscles and joints.

When patients with acute HCV infection seek medical attention, about 80 percent have elevated levels of bilirubin and alanine aminotransferase (ALT). Only about 15 percent of patients require hospitalization. In rare cases, HCV infection can cause fulminant hepatic failure. This complication is more likely to occur when patients have other diseases that impair their immune systems, such as HIV, or have pre-existing liver disease.

HCV Incubation and the Appearance of Symptoms

Incubation is the period of time between exposure and infection, and the manifestation of the disease. The incubation period for newly acquired acute hepatitis C ranges from two weeks to six months, with an average incubation period of six to seven weeks. Blood tests can detect the presence of the HCV virus in blood after 1 to 3 weeks of infection. By the time symptoms appear, 70 to 80 percent of patients have detectable antibodies to HCV. HCV antibodies can be detected in about 90 percent of infected people by 3 months after the appearance of symptoms. Ultimately, HCV antibodies become detectable in over 95 percent of HCV-infected persons. Although the period of acute HCV infection is variable, one of the more prominent characteristics features is fluctuating blood levels of alanine aminotransferase, sometimes by hundreds of units per week. Over time, ALT levels can return to normal, but may later be followed by prolonged, symptomless ALT elevations indicating active chronic disease.

Treating Obesity May Improve The Efficacy Of Therapy For Hepatitis C

2006-06-06T21:28:00.000-04:00

Main Category: Liver Disease / Hepatitis News
Article Date: 03 Jun 2006 - 0:00am (PDT)

According to a new study, obese patients chronically infected with the hepatitis C virus (HCV) and treated with combination drug therapy may have better outcomes if the underlying abnormalities caused by excessive fat tissue are corrected. Weight loss, medications to decrease insulin resistance and extending duration or dosage of therapy are strategies that may improve the efficacy of therapy.

The results of this study appear in the June 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/hepatology.

HCV is one of the leading causes of chronic liver disease worldwide, affecting 3 percent of the world's population. In the U.S. alone 4.1 million people have been infected with HCV, and up to 85 percent of those are chronic carriers of the virus. Up to 70 percent of chronic carriers will go on to develop some other form of chronic liver disease, from mild liver enzyme abnormalities to cirrhosis and liver cancer. While there is no vaccine for HCV, the current optimal treatment is combination therapy with peginterferon alfa (an immune stimulant) and ribavirin (an inhibitor of viral replication). However, this will cure only 55 percent of patients. One of the risk factors for treatment failure is obesity.

Obesity itself is linked to the disruption of hormone signaling pathways that affect cell function and to abnormal levels of circulating proteins and sugars. In other words, obesity is associated with a wide range of metabolic changes that affect multiple cellular and organ functions. This biochemical disregulation is linked to serious chronic medical conditions, such as heart disease, diabetes, and non-alcoholic fatty liver disease.

Given the association between obesity and metabolic abnormalities, Michael R. Charlton, M.D. of the Division of Gastroenterology and Hepatology at the Mayo Clinic and Foundation in Rochester, MN and coauthors reviewed several mechanisms by which obesity may interfere with the treatment of chronic HCV and recommend management strategies for obese patients.

The authors identify three possible ways by which obesity may interfere with peginterferon alpha and ribavirin activity. First, fat tissue actively secretes hormones that can modulate the immune system. Increases in fat tissue may disregulate immune pathways peginterferon targets, rendering the drug ineffective. Second, obesity causes insulin resistance which itself leads to the accumulation of fat in the liver. The greater the accumulation of fat in the liver, the greater the risk of fibrosis, or scar tissue formation, that alters liver function and blood flow, often permanently. Because HCV also causes liver cells to not respond to insulin, obesity may simply compound the problem and worsen liver disease. Third, fat tissue reduces the amount of peginterferon circulating in the body. The decreased circulation of the drug may also weaken peginterferon's stimulation of the immune system against HCV.

To address all of these mechanisms, the authors make three treatment recommendations. First, weight loss to reduce fat tissue would address all three hypothesized mechanisms. Weight loss in obese HCV patients is already associated with improved liver biopsy results and liver enzyme levels. Second, treatment with drugs that improve cellular sensitivity to insulin, such as the diabetes drugs metformin or pioglitazone, would lead to reduced fat accumulation in liver cells and might reverse disease progression. Third, increasing the dosages or the duration of combination therapy may increase circulating drug levels and improve drug efficacy.

"Treatment strategies that focus on improving underlying metabolic factors associated with poor response to combination therapy are thus more likely to overcome the low sustained viral response rates often observed in obese patients infected with HCV," conclude the authors.

David Greenberg
dgreenbe@wiley.com
John Wiley & Sons, Inc.
http://www.interscience.wiley.com/

Diabetes Link to Liver Disease...

2006-06-06T21:21:00.000-04:00

Most patients with diabetes know that they have an increased risk of heart disease and stroke, but few realize that their diabetes is also raising their risk of having both liver disease and liver cancer. "There is now growing evidence that some endocrine disorders, in particular diabetes mellitus, may actually cause liver disease." said Dr. Adrian M. DiBisceglie of the division of gastroenterology and hepatology at the Saint Louis University School of Medicine in a response to the new data. A pair of studies reveal that patients with type 2 diabetes have two times the risk of developing liver disease and possibly three times the risk of developing liver cancer as their healthy peers.

Because liver disease can go undetected for years, these findings emphasize the importance for those with diabetes to keep a close eye on their liver health.

Reviewing the Problem

In the first study, published in Gastroenterology, researchers followed over 170,000 patients with type 2 diabetes and over 650,000 patients without diabetes who were admitted to various VA hospitals across the country. Fifteen years after being discharged, the patients with diabetes were almost twice as likely to have chronic liver disease as the patients without diabetes.

While it is unclear whether diabetes directly causes liver disease, or if changes in liver function cause diabetes, Dr. Hashem El-Serag, study author from the Houston Veteran Affairs Medical Center, sees this study as an important warning for patients with diabetes. Because liver disease can often go unnoticed, as it causes no discernible symptoms, he recommends "regular testing of liver enzymes for patients with diabetes."

In a related study, published in the journal Gut, 2,061 patients with liver cancer were compared to over 6,000 patients without liver cancer from a Medicare database. The researchers found that 43 percent of the patients with liver cancer also had diabetes, while only 19 percent of the cancer-free control group had diabetes. When other factors that contribute to liver cancer risk, like alcoholism, were taken into account, the researchers found that patients with diabetes had three times the risk of developing liver cancer as the general population.

"Our results indicate that diabetes is associated with an increased risk of [liver cancer] among people 65 years and older." wrote El-Serag.

Chronic liver diseases, caused by hepatitis B, hepatitis C, heavy alcohol consumption and fatty liver disease have previously been shown to be major risk factors for developing liver cancer, but this is the first time that diabetes alone was seen as a risk factor for liver cancer. This correlation may explain why rates of liver cancer have been on the rise in the United States.

"The incidence of liver cancer is rising in the developed Western world at a time when obesity is also emerging as a major public health threat." said DiBisceglie. "What is the link between these two phenomena?"

© 2006 Healthology, Inc.

Can you have a "false positive" anti-HCV test result?

2006-06-06T21:14:00.000-04:00

Yes. A false positive test means the test looks as if it is positive, but it is really negative. This happens more often in persons who have a low risk for the disease for which they are being tested. For example, false positive anti-HCV tests happen more often in persons such as blood donors who are at low risk for hepatitis C. Therefore, it is important to confirm a positive anti-HCV test with a supplemental test as most false positive anti-HCV tests are reported as negative on supplemental testing. Click here for more information on Guidelines for Laboratory Testing and Result Reporting of Antibody to Hepatitis C Virus.

Can you have a "false negative" anti-HCV test result?
Yes. Persons with early infection may not as yet have developed antibody levels high enough that the test can measure. In addition, some persons may lack the (immune) response necessary for the test to work well. In these persons, research-based tests such as PCR may be considered.

How long after exposure to HCV does it take to test positive for anti-HCV?
Anti-HCV can be found in 7 out of 10 persons when symptoms begin and in about 9 out of 10 persons within 3 months after symptoms begin. However, it is important to note that many persons who have hepatitis C have no symptoms.

How long after exposure to HCV does it take to test positive with PCR?
It is possible to find HCV within 1 to 2 weeks after being infected with the virus.

Who should get tested for hepatitis C?

persons who ever injected illegal drugs, including those who injected once or a few times many years ago persons who were treated for clotting problems with a blood product made before 1987 when more advanced methods for manufacturing the products were developed persons who were notified that they received blood from a donor who later tested positive for hepatitis C persons who received a blood transfusion or solid organ transplant before July 1992 when better testing of blood donors became available long-term hemodialysis patients persons who have signs or symptoms of liver disease (e.g., abnormal liver enzyme tests) healthcare workers after exposures (e.g., needle sticks or splashes to the eye ) to HCV-positive blood on the job children born to HCV-positive women

What is the next step if you have a confirmed positive anti-HCV test?
Measure the level of ALT ( alanine aminotransferase, a liver enzyme) in the blood. An elevated ALT indicates inflammation of the liver and you should be checked further for chronic (long-term) liver disease and possible treatment. The evaluation should be done by a healthcare professional familiar with chronic hepatitis C.

Can you have a normal liver enzyme (e.g., ALT) level and still have chronic hepatitis C? Yes. It is common for persons with chronic hepatitis C to have a liver enzyme level that goes up and down, with periodic returns to normal or near normal. Some persons have a liver enzyme level that is normal for over a year but they still have chronic liver disease. If the liver enzyme level is normal, persons should have their enzyme level re-checked several times over a 6 to 12 month period. If the liver enzyme level remains normal, your doctor may check it less frequently, such as once a year.

Reliable early prediction of viral relapse

2006-06-05T18:18:00.000-04:00

NATAP http://natap.org/

Reliable early prediction of viral relapse by detection of minimal residual hepatitis C viremia at treatment week 12

DDW, Los Angeles, May 21-24, 2006 (Digestive Disease Week)

A. Bergk1; C. Sarrazin2; M. von Wagner2; G. Teuber3; P. Buggisch4; V. Weich1; B. Wiedenmann1; T. Berg1
1. Hepatology and Gastroenterology, Charite, CVK, Berlin, Germany.
2. Internal Medicine II, Universitaetsklinikum des Saarlandes, Homburg, Germany.
3. Internal Medicine II, UniversitaetsklinikumFrankfurt, Frankfurt am Main, Germany.
4. Center for Internal Medicine, Universitaetsklinikum Hamburg, Hamburg, Germany.

Introduction: Current treatment guidelines for the therapeutic management of chronic hepatitis C virus (HCV) genotype 1 infected patients include a week 12 stopping rule for nonresponders defined by a drop of viral load less than 2 log10 in patients treated with pegylated interferon and ribavirin. Nevertheless there has been no convincing prognostic tool to easily and reliably predict viral relapse after the end of 48 weeks of treatment.

Aims: Aim of the present study was to evaluate the predictive value of a minimal residual HCV viremia for a relapse in genotype 1 infected patients with early virologic response to therapy.

Patients and methods: We retrospectively analyzed viral kinetics at week 12 and response of 773 treatment naive HCV genotype 1-infected patients using PegIFNÎ±-2a/b and ribavirin treated at our outpatient clinics. For the detection of residual viremia at week 12 a quantitative real-time PCR with a lower limit of detection of 10IU/mL (TaqMan) was used.

Results: Using standard quantitative HCV-RNA assays at week 12 75% (430/773) of the patients treated with PegIFNÎ±-2a/b and ribavirin showed an early virologic response defined by week 12 viral load drop â‰¥2 log10. By re-analyzing 222 available serum samples of early virologic responders by TaqMan a residual viremia could be detected in 84 out of 222 patients (38%). The presence of viremia highly correlated with a viral relapse after the end of 48 weeks of treatment (p<0,001).>
A relapse occurred in 78% of the patients who had detectable HCV viremia at week 12 (68/88) as compared to only 19% (25 out of 134 patients) if HCV RNA was undetectable at week 12. The relative risk to suffer from a relapse was 3.5 and 0.26 in patients with and without residual hepatitis C viremia at week 12, respectively (p<0,001).>Discussion: Using a highly sensitive real-time PCR the detection of minimal residual hepatitis C viremia at treatment week 12 was in 78% associated with a viral relapse after the end of therapy and is therefore a valuable prognostic tool for the prediction of individual treatment outcome. Treatment of patients with detectable viremia at week 12 should be individually intensified by either prolonging treatment duration or preventing dose reductions by the application of erythropoetin or GM-CSF.

Noninvasive determination of HCV or other infectious liver disease

2006-06-05T18:10:00.000-04:00

The BreathID® system is unique in many ways. It is able to diagnose and monitor a multitude of functional GI and internal disorders through testing applications such as Helicobacter pylori, Liver Function and Gastric Emptying Rate. The system is ideal for a wide range of patients that suffer from functional dyspepsia, diabetes, Parkinson's disease, a wide range of liver diseases such as Hepatitis (HCV, HBV), NAFLD, NASH diseases, and those related to alcoholism. The BreathID's remarkable benefits and unbeatable performance are a result of its unique and proprietary technologies: Microstream®, MCS™ (Molecular Correlation Spectroscopy) and CRT (Continuous Real Time) technology on-line analysis algorithms. These advantages include automatic operation, immediate test results, the shortest possible testing times, no need for active patient cooperation and more clinical information in each measurement due to the continuous sampling.

http://archive.mail-list.com/hbv_research/msg09603.html

Noninvasive determination of HCV or other infectious liver disease

The Oridion BreathID®

Filed under: Diagnostics , GI , Medicine

The Jerusalem Post is reporting that an instrument manufactured by Oridion Systems Ltd. can noninvasively determine whether a patient has hepatitis C or some other infectious liver disease, with the results available in 40 minutes or so.

The instrument is named Oridion BreathID® and the description of it as follows:

State-of-the-Art Technology and Design for Every Environment

The BreathID's remarkable benefits and unbeatable performance are a result of its unique and proprietary technologies: Microstream®, MCS™ (Molecular Correlation Spectroscopy) and CRT (Continuous Real Time) technology on-line analysis algorithms. The use of these technologies enables BreathID® to offer several distinct advantages over other testing systems and methods. These advantages include automatic operation, immediate test results, the shortest possible testing times, no need for active patient cooperation and more clinical information in each measurement due to the continuous sampling.

BreathID® was designed with the needs of both the physician/operator and the patient in mind. Simple single-button operation, self-calibration and a user-friendly interface enable easy test administration by any member of the staff with no need for prior training or orientation.

http://www.medgadget.com/archives/2006/05/the_oridion_bre.html

Alternative Medicine Solution Undergoes Clinical Trials and Holds Promise of Benefiting Millions of Americans with Hepatitis C

2006-06-05T18:05:00.000-04:00

Sho-saiko-to (SST), a standardized herbal formula, is under a clinical phase II trial by a leading New York Cancer Research Institute to determine its effect on hepatitis C patients. This study is titled "Sho-saiko-to for Patients with Chronic Hepatitis C Who Are Intolerant to or Have Contraindication to Interferon-Based Therapy: A Phase II Study." SST is know to have anti-fibrotic effect by inhibition of lipid peroxidation in hepatocytes and stellate cells in animal studies. It has also been shown to reduce aminotransferase levels and the incidence of hepatocellular carcinoma in hepatitis and liver cirrhosis patients.

According to the design of the clinical trial, 31 patients will receive SST daily for 52 weeks. Fifteen patients have completed the treatment and the preliminary results have been reported. No serious adverse events have been attributed to SST among any patients who enrolled in the trial. Among the 15 patients who completed the study, reductions in alanine aminotransferase (ALT) were observed in 11 patients and aspartate aminotransferase (AST) in 10 patients. In 10 patients, the liver biopsy showed 20% improvement on histological assessment of the liver. More interestingly, the majority of the patients whom participated in the clinical trial were genotype 1 infection.

http://www.transworldnews.com/NewsStory.aspx?storyid=8446&ret=Default.aspx

Progressive Alternative Medicine Solution Undergoes Clinical Trials and Holds Promise of Benefiting Millions of Americans with Hepatitis C

PHOENIX 5/23/2006 7:46 PM GMT (TransWorldNews) An estimated five million Americans have been infected with hepatitis C virus (HCV) according to a study published at the Liver Meeting by the American Association for the Study of Liver Diseases (AASLD) in November 2005. Chronic hepatitis C is associated with significant morbidity (liver cirrhosis and hepatocellular carcinoma) and mortality. Current treatment is based on interferon and ribavirin. However, treatment options are limited for patients who are not candidates for interferon-based therapy, particularly for those who suffer from HCV genotype 1 infection.

Sho-saiko-to (SST), a standardized herbal formula, is under a clinical phase II trial by a leading New York Cancer Research Institute to determine its effect on hepatitis C patients. The research group has reported the preliminary results of 15 patients at the 2nd Society of Integrative Oncology Conference in San Diego on November 10, 2005. This study is titled "Sho-saiko-to for Patients with Chronic Hepatitis C Who Are Intolerant to or Have Contraindication to Interferon-Based Therapy: A Phase II Study." SST is know to have anti-fibrotic effect by inhibition of lipid peroxidation in hepatocytes and stellate cells in animal studies. It has also been shown to reduce aminotransferase levels and the incidence of hepatocellular carcinoma in hepatitis and liver cirrhosis patients.

According to the design of the clinical trial, 31 patients will receive SST daily for 52 weeks. Fifteen patients have completed the treatment and the preliminary results have been reported. No serious adverse events have been attributed to SST among any patients who enrolled in the trial. Among the 15 patients who completed the study, reductions in alanine aminotransferase (ALT) were observed in 11 patients and aspartate aminotransferase (AST) in 10 patients. In 10 patients, the liver biopsy showed 20% improvement on histological assessment of the liver. This is consistent with the findings by the Japanese researchers for its anti-inflammatory effect. More interestingly, the majority of the patients whom participated in the clinical trial were genotype 1 infection.

In Japan, over 75% of physicians use at least some of the traditional herbal formulas. Over 1.5 million Japanese patients with hepatitis have been treated with Sho-saiko-to. SST is available in capsules through HepCare Inc. (www.HepZone.com), a Phoenix-based company that has licensed the marketing right of SST from Honso Pharmaceutical Co. Ltd., the Nagoya-based Japanese manufacturer of the standardized herbal formula.

For more information about SST, please visit www.HepZone.com, call 800-996-4SST (778) or e-mail info@hepzone.com.

HepZone(R) is a registered trademark of HepCare Inc., 4602 E. Elwood St., Suite 6, Phoenix, AZ 85040.

HepCare Inc., Phoenix
Jennifer Healy, 800-996-4778

www.hepzone.com

CIFN Has Much Higher Biological Activity Than PegIFN

2006-05-31T22:10:00.000-04:00

Unlike alfa and beta interferons, which are naturally occurring interferons, consensus interferon is a recombinant type 1 interferon that was derived by scanning sequences of naturally occurring alfa interferon and adding the most frequently observed amino acid in each corresponding position. As a result CIFN has much higher biological activity than pegIFN so it "adheres to the virus cell more tightly than pegIFN," said Dr. Kaiser.

Daily consensus interferon plus Rebetol (ribavirin) for 72 weeks produced sustained viral response in 70% of patients with chronic hepatitis C who became refractory to Rebetron (pegylated interferon alfa 2a plus ribavirin), according to a pilot study reported here.
CIFN was given as a daily injection (9 ìg) and pegIFN (180 ìg) was given once a week. Patients in both treatment arms received weight-based Rebetol. At the end of 72 weeks the viral response was confirmed in 89% of the patients in the CIFN arm and in 76% of patients treated with pegIFN (NS). Although the CIFN was generally well tolerated, there were more injection site reactions in the CIFN arm and there was slightly higher drop-out rate in the CIFN treatment group, 18% versus 12% for the pegIFN group. When you have this sustained viral response, that's a 99% chance of a cure," Dr. Vierling said. "That's very impressive." The next step, he said, would be to confirm the results in a larger study. http://www.medpagetoday.com/InfectiousDisease/Hepatitis/dh/3357
DDW: Relapsed HCV Patients Achieve Sustained Response with 72-Week Treatment

By Peggy Peck, MedPage Today Staff Writer
Reviewed by Rubeen K. Israni, M.D., Fellow, Renal-Electrolyte and Hypertension Division, University of Pennsylvania School of Medicine
May 22, 2006

MedPage Today Action Points
Explain to interested patients that these results were based on a small study and the findings need to be confirmed in a larger clinical trial. Explain to patients who ask that consensus interferon treatment requires daily injections. This study was published as an abstract and presented in a poster at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication

Review:Stephan Kaiser, M.D.
University of Tuebingen

LOS ANGELES, May 22 — Daily consensus interferon plus Rebetol (ribavirin) for 72 weeks produced sustained viral response in 70% of patients with chronic hepatitis C who became refractory to Rebetron (pegylated interferon alfa 2a plus ribavirin), according to a pilot study reported here. The findings, presented at Digestive Disease Week sessions, compared consensus interferon (CIFN) plus Rebetol with pegylated interferon alfa 2a (pegIFN) plus Rebetol in 81 patients who relapsed after 48 weeks of treatment with Rebetron and found that extending treatment to 72 weeks resulted in good response in both treatment arms, said Stephan Kaiser, M.D., of the University of Tuebingen in Germany. But sustained response was significantly better in the CIFN group with 69% of those patients remaining virus-free for at least four months after completing treatment, versus a 44% sustained viral response rate in the pegIFN arm (P<0.05).>

At the end of 72 weeks the viral response was confirmed in 89% of the patients in the CIFN arm and in 76% of patients treated with pegIFN (NS). Although the CIFN was generally well tolerated, there were more injection site reactions in the CIFN arm and there was slightly higher drop-out rate in the CIFN treatment group, 18% versus 12% for the pegIFN group. John Vierling, M.D., president of the American Association for the Study of Liver Diseases and professor of medicine at Baylor in Houston, was enthusiastic about the results. "When you have this sustained viral response, that's a 99% chance of a cure," Dr. Vierling said. "That's very impressive." The next step, he said, would be to confirm the results in a larger study. Unlike alfa and beta interferons, which are naturally occurring interferons, consensus interferon is a recombinant type 1 interferon that was derived by scanning sequences of naturally occurring alfa interferon and adding the most frequently observed amino acid in each corresponding position. As a result CIFN has much higher biological activity than pegIFN so it "adheres to the virus cell more tightly than pegIFN," said Dr. Kaiser. Dr. Kaiser said the study was investigator initiated and did not receive any industry support.

Primary source: Digestive Disease Week
Source reference: Kaiser, S et al "Comparison of Daily Consensus Interferon versus Peginterferon alfa 2a Extended Therapy of 72 Weeks for Peginterferon / Ribavirin Relapse Patients with Chronic Hepatitis C" Abstract S1060

Coping With Your Hepatitis C Diagnosis...

2006-05-31T21:54:00.000-04:00

It's very likely that you have known that something wasn't "right" for a while. Perhaps you thought that you were just run down, out of shape or not eating well. On the other hand, you may have suspected the worst: could your symptoms be due to a tumor, or even cancer? Chances are that if you shared your concerns with family or friends they tried to reassure you. Maybe this helped, or maybe it didn't.
But now you are at the end of an extensive diagnostic process. Maybe you've had bloodwork, an ultrasound, or even a liver biopsy. And now your doctor has told you that you are infected with the Hepatitis C virus (HCV).

How do you feel? How are you supposed to feel? And what do you do now?

Understanding your Reaction...
Your new diagnosis is a life-changing event. You can expect to have a whole range of different feelings about it, feelings that may be uncomfortable and hard to predict. Some healthcare experts have applied Elizabeth Kubler-Ross' theory of grieving to help people understand their own reactions to their HCV diagnosis. Dr. Kubler-Ross' theory about the stages of grief, described in her 1969 book "On Death and Dying," was initially developed through her observations of terminally ill patients and their families. However, many mental health professionals believe that her 5-stage model can be applied to help people understand and possibly predict their emotional reactions to other events involving loss, such as loss of health, loss of relationships, loss of independence or even loss of employment. It's important to note that your progression through these stages is not rigid. People move back and forth between stages, and there's no timetable for how quickly one "should" move through the grieving process. Also, even though you may be the one with HCV, bear in mind that your diagnosis is going to touch the lives of everyone who cares about you. Your family and those close to you are going to have emotional issues to cope with, as well. In the Kubler-Ross model, the five stages of grief are denial, anger, bargaining, depression, and acceptance.

Denial

In the denial stage, one may simply not believe that the diagnosis is true. You may feel numb, or "in shock." Some people feel depersonalized, as though "it's happening to somebody else." You may feel nothing at all - for a while. Denial is not a bad thing - it helps one cope with feelings that may be overwhelming at the time, protecting the person from feeling out of control and helpless. As the shock wears off and you begin to accept the truth of your diagnosis, you will begin to experience other feelings.

Anger

In this stage, you've come to understood that your diagnosis is real and that you really have HCV, and you're angry about it. You may be angry in response to feelings of helplessness, or your anger may come from feelings that your diagnosis is "unfair." You may be angry at your own body or at God for "giving" you hepatitis. You may find yourself preoccupied with what could have been done to prevent the illness. You may also find yourself experiencing strong feelings of guilt as you struggle with the idea that you may have caused the disease can be difficult to cope with strong feelings of anger. You may be prone to lash out, or to "medicate" your feelings with alcohol, drugs or some other behavior. If you are the family member of someone with HCV, you may find the patient directing irrational anger at you.

Bargaining

As the anger subsides, you may find yourself trying to "make deals with God" to make your HCV go away. If this doesn't work, you may find yourself angry again, perhaps questioning and doubting your beliefs or spiritual relationships.

Depression

As bargaining subsides, the truth of your situation begins to "sink in." You may begin to have profound feelings of sadness and loss. Sleep disturbance, loss of appetite, lack of energy, poor concentration, and crying spells are common outward manifestations of depression. It is important to understand that this sort of depression is a normal part of the grieving process. However, depression that significantly interferes with basic activities (eating, bathing, dressing, etc.) or leads the person to thoughts of injuring themselves or others requires immediate (if not emergency) medical care.

Acceptance

Acceptance does not mean happiness. It means that you have allowed enough time and found enough support (from family, friends, or faith) to move forward in your life - your life as it is, not necessarily as you would like it - without suffering crippling emotional reactions or engaging in self-destructive coping behaviors.
Sometimes a "trigger" event will occur that will bring up strong feelings or anger of sadness months or years into the process. This can be something as small as a familiar smell or an old song.

Facilitating the Process

Coming to terms with your diagnosis is not easy, but there are some practical steps you can take to move ahead with your life: Give yourself plenty of time. Don't expect to come to terms with your diagnosis immediately. Learn all you can about HCV. Although Hepatitis C infection isn't rare, most people don't know much about it. As you learn about the disease, you empower yourself to make informed decisions about your care. Participate in a support group. Sharing your feelings and fears with other can decrease your feelings of isolation, and also provide practical advice for day-to-day coping. Use a journal to document your progress. If you tend to be obsessive, capturing your feelings and thoughts on paper can help you to "let go" and decreases anxiety.

If you are compulsively using alcohol, drugs, gambling, sex, or any other pusuit to avoid your emotions, stop. If you can't stop, get help.

Source: Hepatitis Neighborhood

Attention Hepatitis C Advocates

2006-05-31T21:48:00.000-04:00

Attention Hepatitis C Advocates,

On June 7, 2006 the fate of hepatitis C prevention funding for 2007 will be decided by the U.S. House Appropriations Labor-HHS-Education Subcommittee. We need your help!

Your Representative needs to hear from YOU that hepatitis C funding is a priority. We cannot afford another year of flat or decreased funding. The House Labor-HHS-Education Appropriations Subcommittee is the panel that will decide funding amounts for hepatitis programs.

On June 7, 2006, the House Labor-HHS-Education Subcommittee is scheduled to decide critical funding needs for health programs - including hepatitis C. Silence on this issue will result in further cuts to an already precariously small hepatitis C allocation of $16.7 million for the Division of Viral Hepatitis (DVH) at the Centers for Disease Control and Prevention (CDC). A small increase of $10 million can make a big difference. The U.S. Senate will work on the their version of the bill in the coming weeks, however, a win now will move us one step closer to securing necessary resources for hepatitis C.

Contact your Representative NOW. We have about 8 days left to educate House Appropriators about the inadequate funding for hepatitis C programs.

WHEN: Right now! Your Representative needs to hear from you by close of business June 6, 2006.

Go to: http://www.democracyinaction.org/dia/organizationsORG/IMPACTC/campaign.jsp?campaign_KEY=4011

Thank you for your support.

Sincerely,

Lorren Sandt
Hepatitis C Caring Ambassadors Program
Managing Ambassador
877-737-4372 toll-free
lorren@hepcchallenge.org
Hepatitis C: Choices now on line at: www.hepcchallenge.org

"We believe strongly in the power of people working together, and that, by doing so, we will make far more significant advances than could be made by any group or discipline working on its own."

Some Hope for Hepatitis C Treatment Non-Responders....

2006-05-30T17:32:00.000-04:00

Investigative Valopicitabine Shows Promise for Hepatitis C Treatment Non-Responders: Presented at DDW .
By Bruce Sylvester

LOS ANGELES, C.A. -- May 25, 2006 -- A new combination therapy using an investigative antiviral drug, valopicitabine, shows promise for almost half of patients who do not respond to standard interferon therapies for treatment of hepatitis C. Researchers reported this finding in a press briefing here on May 21st at Digestive Diseases Week 2006 (DDW). "This new combination might produce a viable alternative treatment for these challenging patients," said presenting investigator Paul Pockros, MD, division head, division of gastroenterology/hepatology, Scripps Clinic and Research Foundation, San Diego, California. The ongoing phase 2b trial is comparing 5 treatment regimens in nonresponsive patients with HCV (hepatitis C)-genotype 1, who did not respond to 12 weeks or more of pegylated interferon alpha 2a (peg-IFN)/ribavirin (RBV).

Treatment response was defined as negative HCV RNA using polymerase chain reaction (PCR). Subjects were randomized in a 1:2:2:2:2 design to 1 of the following treatment arms: 1) valopicitabine monotherapy 800 mg/day; 2) valopicitabine (400 mg/day, 800 mg/day, or dose-ramping 400-800 mg/day) plus peg-IFN; 3) peg-IFN/RBV retreatment (control). The Peg-IFN dose is 180 mcg subcutaneous injections per week and weight-based RBV is dosed at 1000-1200 mg daily. Virologic response criteria are stipulated for week 4 (>/=0.5log reduction), week 12 (>/=1.0log), and week 24 (>/=2.0log). Subjects who do not achieve these criteria are classified as treatment failures and discontinued from the study.

Among the 162 subjects who have completed 24 weeks, the 2 higher-dose combinations achieved higher response rates than the control group, with an average of 2.5- to 3.0log decrease in hepatitis RNA reductions by week 24. The difference compared to the control group was significant. The investigators have reported no viral breakthrough to date. They reported that the highest dose of valopicitabine (800 mg) was associated with vomiting and dehydration requiring hospitalization. Use of that dosing has been stopped. "Ongoing data from this trial will show us if these notable early results will lead to a sustained response," Dr. Pockros said. [Presentation title: Valopicitabine (NM283), Alone or With Peg-Interferon, Compared to Peg Interferon/Ribavirin (pegIFN/RBV) Retreatment in Hepatitis C Patients With Prior Non-Response to PegIFN/RBV: Week 24 Results. Abstract 4]

http://www.docguide.com/news/content.nsf/news/852571020057CCF685257179006BF65A

Are Liver biopsies Necessary??

2006-05-30T14:02:00.000-04:00

Yes, you do it is vital in caring for HCV. Don't worry, I am a chicken and I can tell you, I loved my biopsy... Just ask for a valium drip and you won't care if they take the entire liver out. Liver biopsy—The best way to measure the extent of liver damage is with a liver biopsy. This is a procedure in which a tiny sample of tissue from the liver is removed and examined in a laboratory. Liver biopsies are also important in ruling out any other forms of liver disease.

Today, liver biopsies are performed as outpatient procedures. General anesthesia is not necessary. Patients receive local anesthesia at the area where the needle will be inserted. Although the test itself only takes a few seconds, you may be monitored at the testing facility for several hours. Patients often describe the sensation they experience during the test as a feeling of strong pressure on the spot where the tissue is removed. Patients may feel tired after the test, so it is a good idea to schedule some rest time after having a biopsy.

The degree of liver damage measured from a liver biopsy is scored in stages:

Stage I—In the earliest stage of liver damage, the liver is inflamed (immune cells called lymphocytes are present), but scarring has not yet occurred. There is little damage to the liver at this point.

Stage II—In this early stage of liver damage, the liver is inflamed and scarring (fibrosis) has begun to form in one part of the liver.

Stage III—In this stage, scar tissue from one area of the liver bridges (connects) to scar tissue from other areas, leading to advanced fibrosis. This reduces the liver's ability to circulate blood and remove toxins.

Stage IV—In this advanced stage of liver damage, cirrhosis (advanced scarring) has occurred, which significantly impairs the liver's ability to function properly. At this point, the degree of damage to the liver is very serious.

The goals of therapy for hepatitis C are to delay or halt disease progression by:

delaying the progression of scarring
preventing cirrhosis
preventing liver cancer

In order to track the progression of the disease, your doctor may perform a liver biopsy every 3 to 5 years. A liver biopsy is an essential tool in monitoring hepatitis C. Other Tests—Healthcare professionals may use a variety of other blood tests and noninvasive liver imaging tests to monitor the progression of hepatitis C. Common blood tests include blood chemistry panels, platelet counts, and prothrombin times (PTs). Imaging tests may include ultrasounds and CT scans. MRIs may be ordered to diagnose liver cancer. However, none of these tests alone, or in combination, can fully measure the degree of liver damage, or fibrosis.

Hepatitis C and Symptoms

2006-05-30T13:52:00.000-04:00

Infection with hepatitis C may cause symptoms right away, not for years, or sometimes not at all. With the acute form of the disease, symptoms such as fatigue, nausea, and dark urine typically show up within six months. About one-fourth of patients with acute hepatitis C recover completely with treatment. But according to the National Institute of Diabetes and Digestive and Kidney Diseases, the other estimated 75 percent of these patients will progress eventually to the long-term, or chronic, form of the disease, with detectable HCV in their blood.Chronic hepatitis C, however, varies widely in its severity and outcome. It can lie dormant for 10 years or more before symptoms appear. Some patients will have no symptoms of liver damage, and their liver enzymes will stay at normal levels (elevated enzymes are one indication of liver disease). A liver biopsy, in which the doctor removes a tiny piece of liver with a needle, may show some degree of chronic hepatitis, but it may be mild.Other patients, however, will have severe hepatitis C, with detectable HCV in their blood, liver enzymes elevated as much as 20 times more than normal, and a prognosis of ultimately developing cirrhosis and end-stage liver disease. Another group of patients falls somewhere in the middle, with few or no symptoms, mild- to-moderate elevation of liver enzymes, but with an uncertain prognosis. According to the National Institute of Diabetes and Digestive and Kidney Diseases, at least 20 percent of chronic hepatitis C patients develop cirrhosis, but this process can take 10 to 20 years from the onset of infection. As many as 5 percent of chronic patients, after 20 to 40 years, develop liver cancer. Other studies show that those with cirrhosis develop liver cancer within 17 years.

Patients with no symptoms sometimes learn they have the disease when a routine physical or blood donation shows elevated levels of liver enzymes, which can indicate hepatitis C, as well as other liver disorders.
Other patients, however, have symptoms that prompt them to seek medical attention, including yellowish eyes or skin (jaundice)
fatigue, or an extreme feeling of being tired all the time
pain or tenderness in the right upper quadrant of the body
persistent nausea or pains in the stomach
lingering fever
loss of appetite
diarrhea
dark yellow urine or light-colored stools
If you have any of these symptoms, see a doctor right away.

Can you Cure your Hep C?

2006-05-30T13:47:00.000-04:00

The most effective medication is the combination of peg-interferon and ribavirin. Treatment with this medication is successful in eradicating HCV in about half of infected patients. This is called a sustained virologic response (SVR).

Current studies suggest that HCV will probably never return in patients with a sustained virologic response unless they are once again exposed to this virus. No vaccine currently exists to prevent infection in an individual that is exposed to HCV. Patients who achieve a SVR following treatment with peg-interferon and ribavirin have an improvement in the degree of liver injury with loss of fibrosis and a return of the liver towards normal.This is called histologic improvement.

Histologic improvement has also been reported to occur in some patients who did not achieve a sustained virologic response following treatment with peginterferon and ribavirin.

How Can HepC Affect My Liver?

2006-05-30T13:21:00.000-04:00

The liver is the largest organ in the body. Located in the upper right side of the abdomen, it acts as a filter to remove toxins (harmful substances) and waste products from the blood. A healthy liver filters blood at a rate of about 1.5 quarts per minute. That’s 540 gallons of blood a day! The liver also stores nutrients, such as certain vitamins, minerals, and iron, and plays a role in making and controlling the amounts of certain chemicals and proteins in the body, such as cholesterol, hormones, and sugars. It helps the body digest food by producing a substance called bile, which is stored in the gallbladder. The hep C virus attacks liver cells and uses them as a host to reproduce itself. When the body attempts to fight the virus, it sends lymphocytes (a type of white blood cell) to the liver, which results in inflammation (swelling). This inflammation is a normal response to infection, but over time this process, and certain chemicals released by the lymphocytes, can damage liver cells.

When the liver cells are damaged, they cannot function well and may die. Some of these cells may grow back, but severe injury may lead to fibrosis (a buildup of scar tissue on the liver). Fibrosis slows down the liver's ability to circulate blood and remove toxins.Treatment may help prevent further damage or reduce progression of the condition. However, the longer treatment is delayed, the more likely significant and permanent liver damage will occur. Over time, hardened scar tissue can replace large amounts of normal liver tissue. This condition, called cirrhosis, seriously impairs the liver's ability to function. As a result, blood that cannot pass freely through the liver may back up into the spleen, and this may lead to the destruction of healthy blood cells. In addition, the liver may not be able to produce enough bile to aid in the handling of nutrients, such as vitamins A, D, E, and K, and most fats. If your liver is damaged, there are some important steps you can take to keep the undamaged cells as healthy as possible. You should talk to your doctor or nurse about your specific situation, but, in general, the following measures can help:

Avoid alcohol. The liver treats alcohol as a toxic substance and works to filter it out. In a person with hep C, alcohol significantly increases damage to the liver. It is especially important to avoid combining alcohol with acetaminophen (a nonprescription pain reliever). If taken together, these substances can cause additional damage to your liver. Eat healthy foods. When the liver is damaged, your body may not get all the nutrients it needs, and you may feel weak or tired. You may also lose your appetite. It is important, therefore, to meet your daily nutritional needs so you can maintain your weight and energy levels. Drink plenty of water. Water is a vital substance for all of the body's functions. It helps to remove toxins and process important nutrients. Drinking extra fluids may also help reduce side effects while on therapy. Reduce salt in your diet. When liver disease is severe, signals are sent to the kidneys that cause them to retain both salt and water. The salt acts like a sponge, causing fluid to build up in the body. A low-salt diet can help reduce fluid buildup. Get vaccinations against hepatitis A and hepatitis B. In people with hep C, infection with another strain of hepatitis can cause further damage to the liver. Though there is no vaccine for hep C, a simple series of shots can protect most people from infection with the hepatitis A and hepatitis B viruses. Although hepatitis C can lead to scarring and inflammation of the liver, treatment may help. Even if hep C therapy does not rid your body of the virus completely, it may help reduce inflammation and improve the overall health of your liver.

Willie Nelson Helps Fight HCV With A Public Service Announcement

2006-05-30T12:22:00.000-04:00

http://www.helpwithhepc.com/HepC_30.mov

Many Thanks to Willie Nelson.

Sierra HOPE Has a Limited Number of Free Hepatitis Home Testing Kits....

2006-05-30T12:20:00.000-04:00

As May is National Hepatitis Awareness Month, Sierra HOPE will make a limited number of free Hepatitis home testing kits available throughout the month. To find out more about receiving a Hepatitis Home Testing Kit or for more information about Hepatitis C, call Sami Rhodes at Sierra HOPE at 736-6792.

http://www.ledger-dispatch.com/life/lifeview.asp?c=185599
Sierra HOPE to offer free Hepatitis home testing kits

Chronic liver disease is the 10th leading cause of death among adults in the United States and Hepatitis C Virus (HCV) infection is the most common chronic blood-borne infection in the country, affecting more than 5 million Americans. Most people infected don't even know they have it because sometimes it takes 20 or 30 years to become symptomatic.

Studies indicate that 40 to 60 percent of all liver disease is related to Hepatitis C infection. Long term consequences of a Hepatitis C infection include a 75 to 80 percent chronic infection rate, 70 percent chance of chronic liver disease and a 10 to 20 percent chance of developing cirrhosis. Sadly, one out of five of every 100 Hepatitis C infections cases results in death from liver cancer or cirrhosis and Hepatitis C. remains the leading indication for liver transplants in the United States.

Known risk factors include blood transfusions obtained before 1992 or clotting factors before 1987; tattoos or body piercing done with unsterile instruments or common ink wells; having multiple sexual partners or intravenous drug users. Even a single use in the distant past and sharing toothbrushes or razors with someone infected with Hepatitis C can be a risk. As May is National Hepatitis Awareness Month, Sierra HOPE will make a limited number of free Hepatitis home testing kits available throughout the month. To find out more about receiving a Hepatitis Home Testing Kit or for more information about Hepatitis C, call Sami Rhodes at Sierra HOPE at 736-6792.

Bette's Comment: However, as we know there are many other
modes of transmission they are not noted in this article.

Data on Its HCV Protease Inhibitor

2006-05-30T11:53:00.000-04:00

InterMune Presents New Preclinical Data on Its HCV Protease Inhibitor at Digestive Disease Week of May, 2006

Strong Potency and Drug Resistance Profile of ITMN-191 Derived From Its Distinct Structure

LOS ANGELES, May 23 /PRNewswire-FirstCall/ -- InterMune, Inc. (Nasdaq: ITMN - News) announced today the presentation of research describing the preclinical characterization of ITMN-191 (previously referred to as ITMN B), its orally available hepatitis C virus (HCV) NS3/4A protease inhibitor. The preclinical findings were presented at the Digestive Disease Week (DDW) meeting in Los Angeles. InterMune expects to submit a European Clinical Trial Authorization for ITMN-191 in the third quarter of 2006. In an oral presentation and Poster of Distinction at DDW, Scott Seiwert, Ph.D., Vice President of Discovery Research at InterMune, described the characterization of ITMN-191 activity against various HCV N3/4A protease variants. ITMN-191 retains activity against variants that exhibit reduced sensitivity to other experimental HCV protease inhibitors in development. A single variant was identified that shows diminished potency to ITMN-191. However, this variant is distinct from variants that have reduced sensitivity to other HCV protease inhibitors. This demonstrates a favorable cross-resistance profile of ITMN-191 with other HCV protease inhibitors currently in development.

Also at DDW, the chemical structure of ITMN-191 was revealed for the first time, demonstrating the distinguishing characteristics between ITMN-191 and other experimental HCV protease inhibitors. InterMune and its collaborators utilized structure-based drug design to optimize drug-target binding interactions. The researchers credit the tight binding between ITMN-191 and the HCV protease for the experimentally observed high potency of ITMN-191 and activity against variants of the protease that are resistant to other HCV protease inhibitors. Structural optimization also enabled InterMune to improve compound exposure to the liver in animal models. Given that viral replication of HCV is reported to occur primarily in hepatocytes, achieving high drug concentrations in liver is believed to be critical to the clinical success of target therapies against HCV. Further in vivo studies reveal favorable high liver exposure of ITMN-191 across multiple species at potentially clinically relevant dosing concentrations. The results continue to support exploration of twice-daily, oral dosing in treatment of chronic HCV.

"Our research team's detailed characterization of ITMN-191 provides important insight regarding how our compound is distinct from other experimental HCV protease inhibitors in development and reinforces our confidence that ITMN-191 has the potential to be a superior drug candidate with favorable cross resistance and potency profiles," said Dan Welch, President and CEO of InterMune.

About HCV and HCV Protease Inhibitors According to the Centers for Disease Control and Prevention (CDC), an estimated 3.9 million Americans (1.8%) have been infected with HCV, of whom 2.7 million are chronically infected, and the prevalence of chronic HCV is increasing. Currently available therapies are insufficient, creating a need for the development of novel therapeutic approaches. HCV protease inhibitors represent a promising class of drugs for HCV, and the HCV NS3/4 protease is an attractive drug target because of its involvement in viral replication and suppressive effects on host response to viral invasion.

About InterMune

InterMune is a biotechnology company focused on the research, development and commercialization of innovative therapies in pulmonology and hepatology. InterMune has a pipeline portfolio addressing idiopathic pulmonary fibrosis (IPF) and hepatitis C virus (HCV) infections. The pulmonology portfolio includes two Phase III programs evaluating possible therapeutic candidates for treatment of patients with IPF: the INSPIRE trial is evaluating Actimmune® (interferon gamma-1b) and the CAPACITY program is evaluating pirfenidone. The hepatology portfolio includes the lead HCV protease inhibitor compound, ITMN-191, a second-generation HCV protease inhibitor program, and a research program evaluating a new target in hepatology. For additional information about InterMune and its R&D pipeline, please visit www.intermune.com.

What is Cirrhois?

2006-05-30T11:25:00.000-04:00

http://www.liverdisease.com/cirrhosis_hepatitis.html

The liver is an incredibly resilient organ, but unfortunately it isn’t indestructible. Sometimes the damage that occurs as a result of excessive alcohol, a virus, or some other chronic disease overwhelms the liver’s capacity to function. Healthy liver cells are destroyed, and scarring occurs. Scarring, known as fibrosis, is the liver’s effort to keep the damage done by alcohol or the hepatitis C virus (HCV), for example, contained. But, scar tissue can block the blood flow through the liver, resulting in an inability of the liver to perform its normal duties. If alcohol, or HCV, is not eliminated from the body, scarring becomes extensive. The liver becomes rock hard and nodular (lumpy). This condition is known as cirrhosis. Although the presence of cirrhosis does not signify that health problems will inevitably develop, a person with cirrhosis should be aware that he is at an increased risk of suffering many serious complications.

Cirrhosis is the end product of any one of a number of different liver diseases. These diseases which will be discussed elsewhere in my book. Regardless of the cause, the potential consequences of cirrhosis are the same. Whereas a healthy liver typically repairs and regenerates itself when injured (see page xx), once cirrhosis has occurred, the damage may never be undone. When I was a student at Mount Sinai Medical School in the early 1980’s, I was taught that cirrhosis was irreversible. In fact, even as recently as the publication of the first edition of this book – the year 2000, it was still the gospel belief among most liver disease experts that while cirrhosis could occasionally be slowed, or even halted, it could never reverse. However, some recent studies have shown that with removal of the cause of the underlying liver disease – alcohol or the hepatitis C virus (HCV) for example, and with effective treatment, cirrhosis can be reversed, - at least in its very early stages, when scarring is minimal. The point at which cirrhosis becomes irreversible is not clear. But, there is a broad consensus among liver disease experts that once cirrhosis has advanced to its late stages -- when complications from extensive scaring have occurred (known as decompensated cirrhosis), it can never be reversed.

Recent progress has made in the control and the reversal of cirrhosis. This is confirmed by the decline in the number of cirrhosis-related death rates in the United States over the last twenty years. Therapies such as interferon and ribavirin for chronic hepatitis C, and Epivir and Hepsera for chronic hepatitis B, have been shown to reverse cirrhosis in its early stages. There have been anecdotal reports of scarring being reversed after treatment in people with autoimmune hepatitis (chapter 14), primary biliary cirrhosis (Chapter 15) and hemochromatosis (chapter 18). Thus, cirrhosis, should no longer be considered as an irreversible condition. Still, cirrhosis continues to be the eighth most common cause of death overall in the United States and the fourth leading cause of death among Americans between the ages of thirty and sixty. But being diagnosed with cirrhosis is not necessarily a death sentence. Usually, when cirrhosis is fatal, it is because it has proceeded unchecked and untreated for many years. If, however, it is caught in its early stages, there will often be steps that the patient and doctor can take to control, and possibly even reverse, its progression. Despite having cirrhosis, many people have lived well past the age of ninety. Of course, prevention remains the best medicine; therefore, most of the treatments doctors prescribe, as well as the nutrition and exercise tips discussed in Chapter 23, are aimed at trying to keep the liver from progressing to cirrhosis in the first place.

LIVER DISEASES THAT CAN LEAD TO CIRRHOSIS
Not all liver diseases cause cirrhosis—only those that cause chronic, ongoing damage to the liver can lead to permanent scarring of liver tissue. For example, someone with hepatitis A will usually recover completely after a few weeks, and as such, will not be at risk for developing cirrhosis. But someone who has lived for decades with a chronic liver condition, such as hepatitis C or hemochromatosis, would be a prime candidate for cirrhosis.

Fortunately, in most cases, cirrhosis takes many years to develop. Therefore, just because a person is at risk for cirrhosis, it doesn’t necessarily mean that he will definitely develop this condition over the course of a normal life span. Also, the slow pace at which cirrhosis develops allows a person to obtain treatment from a liver specialist before cirrhosis occurs.
Alcoholic liver disease and chronic hepatitis C are the two most common causes of cirrhosis in the United States. However, there are other circumstances that can give rise to permanent liver damage. Even some herbal remedies and medications can trigger massive scarring of the liver (see Chapters 21 and 24 respectively). Although a discussion of every condition that has the potential to cause cirrhosis is beyond the scope of this book, some causes include the following:

• Viral hepatitis—hepatitis B, C, and D
• Autoimmune hepatitis
• Primary biliary cirrhosis
• Nonalcoholic fatty liver disease
• Excess alcohol consumption
• Hemochromatosis
• Excessive intake of vitamins, such as vitamin A
• Certain herbal remedies, such as comfrey
• Certain medications, such as methotrexate, isoniazid, Aldomet
• Primary sclerosing cholangitis
• Vascular anomalies—for example, Budd-Chiari syndrome
• Congestive heart failure (see your doctor for more information).
• Wilson’s disease, a genetic disorder of copper overload

Study Details HCV Ability To Block Immune System Response

2006-05-28T00:58:00.000-04:00

Findings could influence approaches to treatment and outcome
The study was published in an advance online edition of the Proceedings of the National Academy of Sciences on May 17.

Hepatitis C virus (HCV) is a worldwide public health problem. The World Health Organization estimates that 170 million people worldwide are chronically infected and that between 3-4 million are newly infected annually. HCV is the leading cause of chronic liver disease including hepatic fibrosis, end-stage cirrhosis, and hepatocellular carcinoma. There is no vaccine available to prevent HCV, and current therapies are costly, have serious side effects and are curative in only a fraction of patients. According to the World Health Organization, the major causes of HCV infection are use of unscreened blood transfusions, and re-use of needles and syringes that have not been adequately sterilized.

Viral infections like hepatitis C often trigger an immediate innate immune response involving release of type 1 interferon (IFN-? and IFN-?). In turn, type 1 interferon stimulates the production of a family of what are known as IFN stimulated genes that have a multitude of inhibitory effects on viral replication in infected and neighboring uninfected cells. While interferon production and other immune responses can greatly influence the course of a number of different viral infections, many human pathogenic viruses have evolved distinct strategies to inhibit the early signaling events leading to interferon production. HCV is no different.

"We have previously demonstrated that many interferon stimulated genes with antiviral activity are induced in the liver during HCV infection," said Francis V. Chisari, M.D., a Scripps Research professor whose laboratory conducted the study. "Despite their induction, the virus can persist indefinitely, indicating that it is resistant to their antiviral effects."

The current study sheds light on one strategy the hepatitis C virus uses to resist the immune system. The findings suggest that the hepatitis C virus inhibits the activity of naturally occurring interferon by shutting down a key antiviral signaling protein.

Early after HCV infection, the immune system responds to viral RNA by activating a signaling cascade in the infected cells that results in the production of type 1 interferon. One of the intermediaries in that cascade is a mitochondrial antiviral signaling protein (MAVS). HCV blocks the production of type1 interferon by using its protease activity to destroy MAVS. By preventing infected cells from producing interferon, the virus inhibits the body's immune response against HCV, enabling it to persist.

"Our new work shows that HCV does not induce interferon-? or antiviral interferon stimulated genes in the infected cells," Chisari said. "This means that the antiviral interferon stimulated genes expressed in the HCV-infected liver are likely produced by uninfected cells in some novel fashion and that the virus has other tricks up its sleeve that makes it resistant to their antiviral effects. Further study is needed to understand which cells in the liver produce the interferon and how the virus can resist the broad spectrum of these antiviral effects."

The knowledge gained from fundamental studies such as these could lay the groundwork for the development of potential new treatment strategies for this devastating global disease.

2006-05-28T00:28:00.000-04:00

Please take a few moments from your busy day to pause, reflect, and thank those who have served and are serving our country. Although this page is dedicated to veterans of our Armed Services, almost every American family, many without donning a uniform, has contributed to the preservation of the ideals of the United States of America. "Rosie the Riveter" serves as a symbol of all those who stayed behind during World War II.

Mom may have helped at the Red Cross or USO, and rolled bandages at home. School girls and boys knit scarves, socks, and mittens for the men on the front, and collected milkweed pods for life jacket fill. From the American Revolution to today's War on Terrorism, many are the untold stories and many are the unsung heroes.
Today we ask that you remember all those currently in the service of the United States and all her allies. While military conflicts are never easy to accept, neither are the denial of basic human rights. Whatever your opinions or beliefs, RESPECT and HONOR those who are answering the call to serve their country.

Drug Cuts HCV Up To 97 Percent

2006-05-28T00:20:00.000-04:00

NEW YORK (Reuters) - Viropharma Inc on Sunday said its experimental drug, being developed with Wyeth Inc., cut levels of the hepatitis C virus by up to 97 percent in a small 14-day clinical trial.

The drug was given for 14 days by itself to patients infected with the virus who had not been previously treated with other medicines. The drug is designed to block an enzyme called polymerase that the virus, which can cause fatal liver damage, needs to replicate itself.

Patients in the Phase I trial twice daily received 50 milligram, 100 milligram, 250 milligram, 500 milligram, 1000 milligram, or 1500 milligram oral doses of the medicine, called HCV-796, or received placebos.

"Peak antiviral response was achieved at doses of 500 twice daily and higher," Viropharma said in a release, and the medicine was well tolerated. Mean virus levels were cut by 1.4 log to 1.5 log -- or 96 to 97 percent -- in patient groups receiving the three highest doses of the drug.

The amount of viral reduction, however, is less than the greater than 99 percent reduction that has been shown in previous clinical trials of another experimental drug being developed by Vertex Pharmaceuticals Inc..

http://news.yahoo.com/s/nm/20060521/sc_nm/viropharma_wyeth_dc

Schering-Plough News Release

2006-05-27T00:36:00.000-04:00

Schering-Plough Initiates PEG-INTRON 'PROTECT' Study in Liver Transplant Patients with Recurrent Hepatitis C

KENILWORTH, N.J., May 23 /PRNewswire-FirstCall/ -- Schering-Plough today announced the initiation of a large multicenter clinical trial in the United States to evaluate the safety and efficacy of PEG-INTRON(R) (peginterferon alfa-2b) and REBETOL(R) (ribavirin, USP) combination therapy in liver transplant recipients with recurrent hepatitis C virus (HCV) infection. Known as the PROTECT study, the trial is targeted to enroll 125 HCV patients at approximately 28 liver transplant centers nationwide.

Hepatitis C is currently the leading indication for liver transplantation in the United States,(1) and more than 17,000 Americans are awaiting liver transplants for all diagnoses.(2) Long-term mortality rates are higher in liver transplant recipients with HCV compared to those without HCV,(3,4) and the majority of patients who receive liver transplants for hepatitis C disease will be reinfected after transplant, most likely from virus sanctuaries in the body.(5,6) Without treatment, these patients will not eradicate their virus and are prone to faster progression of their hepatitis C disease.

To date, only a few small studies have been conducted in this patient population using pegylated interferon and ribavirin, the current standard of care in treating HCV, and results of these small studies have varied widely. (7-9) It is unclear what virologic response rates can be expected in the post-liver transplant setting.

"A large multicenter study in liver transplant recipients with recurrent HCV is needed to better understand how to maximize treatment outcomes for these patients," said Fred Gordon, M.D., Division of Gastroenterology and Hepatology, Lahey Clinic, Burlington, Mass., and lead investigator for the PROTECT study. "Given the potential for diminished long-term survival and the shortage of available resources for liver transplant patients with HCV recurrence, viral eradication is an important goal of treatment and would benefit both patients and society."

Study Design

PROTECT is single-arm, multicenter, open-label Phase IV study evaluating the efficacy and safety of PEG-INTRON (1.5 mcg/kg once weekly) and REBETOL (400-1,200 mg daily) in patients after orthotopic liver transplantation with chronic hepatitis C recurrence. All patients will be enrolled within the first 12 months of this 72-week study, and will be treated with up to 48 weeks of PEG-INTRON and REBETOL therapy.

Sustained virologic response (SVR),(10) the standard measure of successful response to HCV therapy, will be determined at 24 weeks following treatment. Written informed consent will be obtained and all other regulatory requirements adhered to for all patients participating in the study.

"The PROTECT study continues Schering-Plough's research strategy to conduct and support clinical studies with PEG-INTRON therapy to explore new approaches to treatment, particularly for hepatitis patients with difficult-to-treat forms of the disease," said Robert J. Spiegel, M.D., chief medical officer and senior vice president, Schering-Plough Research Institute. "These research efforts underscore our long-term commitment to this therapeutic area and the hepatitis community."

About PEG-INTRON

PEG-INTRON is approved in the United States as monotherapy and for use in combination therapy with REBETOL for the treatment of chronic hepatitis C in previously untreated patients with compensated liver disease who are at least 18 years of age. The recommended dose in the United States for combination therapy is PEG-INTRON 1.5 mcg/kg once weekly plus REBETOL 800 mg daily for up to 48 weeks.

Important Safety Information Regarding U.S. Labeling for PEG-INTRON and REBETOL

WARNING

Alpha interferons, including PEG-INTRON, cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Patients should be monitored closely with periodic clinical and laboratory evaluations. Patients with persistently severe or worsening signs or symptoms of these conditions should be withdrawn from therapy. In many but not all cases these disorders resolve after stopping PEG-INTRON therapy.

Ribavirin causes hemolytic anemia. Anemia associated with REBETOL therapy may exacerbate cardiac disease that has led to fatal and nonfatal myocardial infarctions. Patients with a history of significant or unstable cardiac disease should not be treated with REBETOL. It is advised that complete blood counts (CBC) be obtained at baseline and at weeks 2 and 4 of therapy or more frequently if clinically indicated.

REBETOL and combination REBETOL/PEG-INTRON therapy must not be used by women, or male partners of women, who are or may become pregnant during therapy and during the 6 months after stopping therapy. REBETOL and combination REBETOL/PEG-INTRON therapy should not be initiated until a report of a negative pregnancy test has been obtained immediately prior to initiation of therapy. Women of childbearing potential and men must use effective contraception (at least two reliable forms) during treatment and during the 6-month post-treatment follow-up period. Significant teratogenic and/or embryocidal effects have been demonstrated for ribavirin in all animal species in which adequate studies have been conducted. These effects occurred at doses as low as one twentieth of the recommended human dose of REBETOL. If pregnancy occurs in a patient or partner of a patient during treatment or during the 6 months after treatment stops, physicians are encouraged to report such cases by calling (800) 727-7064.

PEG-INTRON

There are no new adverse events specific to PEG-INTRON as compared to INTRON(R) A (interferon alfa-2b, recombinant) for Injection, however, the incidence of some (e.g., injection site reactions, fever, rigors, nausea) were higher. The most common adverse events associated with PEG-INTRON were "flu-like" symptoms, occurring in approximately 50% of patients, which may decrease in severity as treatment continues. Application site disorders were common (47%), but all were mild (44%) or moderate (4%) and no patient discontinued, and included injection site inflammation and reaction (i.e., bruise, itchiness, irritation). Injection site pain was reported in 2% of patients receiving PEG-INTRON. Alopecia (thinning of the hair) is also often associated with alpha interferons including PEG-INTRON.

Psychiatric adverse events, which include insomnia, were common (57%) with PEG-INTRON, but similar to INTRON A (58%). Depression was most common at 29%. Suicidal behavior including ideation, suicidal attempts, and completed suicides occurred in 1% of patients during or shortly after completing treatment with PEG-INTRON.

PEG-INTRON/REBETOL is contraindicated in patients with autoimmune hepatitis, decompensated liver disease, and in patients with hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia).

The following serious or clinically significant adverse events have been reported at a frequency less than or equal to 1% with PEG-INTRON or interferon alpha: Severe decreases in neutrophil or platelet counts, hypothyroidism, hyperglycemia, hypotension, arrhythmia, ulcerative and hemorrhagic colitis, development or exacerbation of autoimmune disorders including thyroiditis, RA, systemic lupus erythematosus, psoriasis, pulmonary disorders (dyspnea, pulmonary infiltrates, pneumonitis and pneumonia, some resulting in patient deaths), urticaria, angioedema, bronchoconstriction, anaphylaxis, retinal hemorrhages, and cotton wool spots.

In the PEG-INTRON/REBETOL combination trial the incidence of serious adverse events was 17% in the PEG-INTRON/REBETOL groups compared to 14% in the INTRON A/REBETOL group. The incidence of severe adverse events in the PEG-INTRON/REBETOL combination therapy trial was 23% in the INTRON A/REBETOL group and 31-34% in the PEG-INTRON/REBETOL groups. Dose reductions due to adverse reactions occurred in 42% of patients receiving PEG-INTRON (1.5 mcg/kg)/ REBETOL and in 34% of those receiving INTRON A/REBETOL.

REBETOL should not be used in patients with creatinine clearance less than 50 mL/min.

Schering-Plough is a global science-based health care company with leading prescription, consumer and animal health products. Through internal research and collaborations with partners, Schering-Plough discovers, develops, manufactures and markets advanced drug therapies to meet important medical needs.

Schering-Plough's vision is to earn the trust of the physicians, patients and customers served by its more than 32,000 people around the world. The company is based in Kenilworth, N.J., and its Web site is http://www.schering-plough.com.

SCHERING-PLOUGH DISCLOSURE NOTICE: The information in this press release includes certain "forward-looking statements" within the meaning of the Securities Litigation Reform Act of 1995, including statements relating to PEG-INTRON and REBETOL and the company's strategy. Forward-looking statements relate to expectations or forecasts of future events. Schering-Plough does not assume the obligation to update any forward-looking statement. Many factors could cause actual results to differ materially from Schering-Plough's forward-looking statements, including market forces, economic factors, product availability, patent and other intellectual property protection, current and future branded, generic or over-the-counter competition, the regulatory process, and any developments following regulatory approval, among other uncertainties. For further details about these and other factors that may impact the forward-looking statements, see Schering-Plough's Securities and Exchange Commission filings, including Item 1A. Risk Factors in the Company's 2005 10-K.

References
1. U.S. Centers for Disease Control and Prevention; http://www.cdc.gov/ncidod/diseases/hepatitis/c/fact.htm

2. U.S. Organ Procurement and Transplantation Network (OPTN) data as of May 2006; www.OPTN.org

3. Forman LM, Lewis JD, Berlin JA, et al. The association between hepatitis C infection and survival after liver transplantation. Gastroenterol 2002;122(4):889-96.

4. Mazzaferro V., Regalia E., Pulvirenti A., et al. Prophylaxis against HCV recurrence after liver transplantation; effect of interferon and ribavirin combination. Transpl Proc. 1997; 29:519-521.

5. Wright TL, Donegan E, Hsu HH, et al. Recurrent and acquired hepatitis C viral infection in liver transplant recipients. Gastroenterol 1992;103(1):317-322.

6. Gane EJ, Portmann BC, Naoumov NV, et al. Long-term outcome of hepatitis C infection after liver transplantation. N Eng J Med 1996;334:815-20.

7. Ghalib R, Levine C, McClelland T et al. Factors Predictive of 24 Week Viral Response to PEG IFN alfa-2b plus Ribavirin in Subjects with Recurrent Hepatitis C after Liver Transplantation. Abstract. AASLD Boston, 2004

8. Rodriguez-Luna H, Khatib A, Sharma A, et al. Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon alpha 2b and ribavirin: an open-label series. Transplantation 2004 Jan 27;77(2):190-4.

9. Gordon FD, Morin D, Davis C, et al. High sustained virologic response (SVR) in HCV treatment with Peginterferon-alpha 2B (PEG) and Ribavirin (RBV) after Liver Transplantation (LT). AM J Transpl 2005; 5 (Suppl 11): 181.

10. Sustained Virologic Response (SVR) is defined as undetectable virus (HCV RNA) 24 weeks after the end of treatment.

NOTE TO EDITORS: Schering-Plough press releases are available on the company's Web site at http://www.schering-plough.com. Schering-Plough press releases are also available on PRNewswire's Web site at http://www.prnewswire.com/comp/777050.html/

SOURCE Schering-Plough
05/23/2006

CONTACT: Media: Robert J. Consalvo, +1-908-298-7409, or Investors: Alex Kelly, +1-908-298-7436, both of Schering-Plough

Web site: http://www.schering-plough.com
(SGP)

HEPATITIS: THE SILENT PANDEMIC

2006-05-26T15:54:00.000-04:00

Press Contact: Lenore Neier
212-668-1000 x137
lneier@liverfoundation.org

More Than 500 Million People Worldwide Are Infected by These Killer Viruses...

New York, NY. The threat of avian flu may dominate the media, but its impact on human lives is miniscule compared to the reality of hepatitis B and C, the two most common forms of chronic liver disease. Together, they infect nearly five million people in the United States and, according to a World Health Organization estimate, more than 500 million people around the world. Without global intervention, the U.S. Centers for Disease Control and Prevention predicts that the impact of the disease will double over the next ten years. Yet these viruses, which are one of the top ten causes of death nationwide, are often preventable. Although a vaccine is available for hepatitis B, few people get the vaccination. Fewer still are aware that the vaccine exists.

As for Hepatitis C considered a silent killer because it often produces no symptoms during its long incubation period there is no vaccine, but infection can be avoided through common-sense precautions such as using sterile needles for tattoos or body piercing, not injecting drugs, and practicing safer sex. It is imperative that patients speak with their doctor about getting tested for hepatitis B and C and consider treatment options that will help preserve liver health, said James L. Boyer, MD, who is Chairman of the Board of Directors of the American Liver Foundation, a nonprofit organization founded 30 years ago in order to promote liver health and disease prevention. Although many people shy away from it, testing can allow for early diagnosis and treatment, preventing the virus from developing into cirrhosis of the liver or cancer.

Too often, Dr. Boyer explained, people are ashamed to be tested because of long ago drug habits or sexual activities. But shame is a terrible reason for dying an unnecessary and a painful death. Shame and ignorance go hand in hand, according to Frederick G. Thompson, President and Chief Executive Officer of the American Liver Foundation. He pointed to a recent survey conducted by the organization, which revealed that half the US. population did not even know that hepatitis was a liver disease.

In order to heighten understanding of the illness and its causes, volunteers from the 25 local chapters will present special programs during the month of May for the annual Hepatitis Awareness Month. A key weapon in this years Hepatitis Awareness Month is a Liver Wellness Toolkit. The kit consists of a professional slide presentation, complete with handouts and instructions, for use by medical and nursing staff, volunteers and healthcare educators. For more information about this presentation, call 1-800-GO-LIVER.

I hope my blog this is not a "druggie disease" is not being Misinterputed.

2006-05-26T11:06:00.000-04:00

I grew up in the sixties and by the grace of God I did not get involved with hard drugs as many of my friends and family members did. I once posted this on some HCV forums and they thought I was putting down people who were infected because of the present or past drug use and thought I thought I was an elitist. Trust me there is nothing elite about having HCV. This is not the case and hope that those who read this, do not walk away thinking that. My beef is that if the CDC and other HCV organizations mainly focus that IV Drugs users are the main source of infection, hundreds of thousands out there will not get tested.

I guess a good example would be if a heterosexual was infected by HIV and his doctor told him, the virus is contained solely to the gay community, he would not like to be labeled and would be utterly confused how he was infected. When I go to a new doctor and informed them that I had HCV, I’m still asked well, how did you get it, were you a drug user? I simply rely, how do people get cancer? The rate of sporadic (unknown origin) infections has risen from 15% since 1995 to 30% and climbing. Most importantly, in 1995 when my first dr. told me there were only two ways of getting it blood transfusions or drug use. I truly believe that I had been misdiagnosed. He insisted and all the tests proved that I had it.

However, once on TX, paranoia, would come to mind from time to time and I would think OMG, I might being doing the God awful tx for no reason. I just want the accurate ways of transmissions to reach the general population so they too will get tested. We are all in this together and I do not care how someone was infection, I just care that someone was infected.

Happy Birthday To My Son

2006-05-26T00:17:00.000-04:00

Thirty Years ago today, On May 25th you graced the world with your presence and still are.
I am very proud to be your Mother and most importantly proud of the man you have become.
I am sure that you had a great birthday, with your loving wife and children with you.

On this very meaningful day, let us also remember Grandma & Grandpa's Wedding Anniversary. Grandpa swore I gave birth to you on his anniversary to save on cakes, lol

I am sure when you see this you will be embarrassed that I blogged your Birthday, but hey,that's what Mom's do BEST... As I said you know me better than anyone, so were you not expecting this, lol

Love Always,

Mom

Shering Plough - Be In Charge Program

2006-05-25T22:26:00.000-04:00

The Be In Charge® Program* offers you information and support to allow you to deal with the concerns you face as a hepatitis C patient.

Be In Charge is a Free Service. Be In Charge is a free service of Schering Corporation for people considering treatment.

Be In Charge is designed to help you: Choose a treatment that is right for you. Cope with the side effects that often accompany interferon treatment. Understand and talk more easily with your doctor about hepatitis C . Feel confident about your therapy for hepatitis C.

Variety of Support Materials. The program also offers you support materials to help you get through therapy and adjust to living with chronic hepatitis C. The Be In Charge program support materials offered to you are based on where you are in therapy and include:

Personal Nurse Counselor - You will be teamed with your own Nurse Counselor, who will answer your questions by telephone. Plus, you can call our Nurse Counseling service toll-free, 24 hours-a-day, 7 days-a-week to speak with a nurse.

Patient Therapy Management Binder - This one-stop reference guide helps you progress through your therapy more easily.

The Hepatitis Workbook: A Guide to Living with Chronic Hepatitis B and C - This comprehensive reference book offers detailed information about hepatitis and treatment options.

Coaching Booklet - This booklet is intended for family members, close friends, or coworkers, explaining chronic hepatitis C, your therapy, and how to offer you better support. Other Educational Materials - These include educational reference materials about chronic hepatitis C and its treatment.

If you have been diagnosed with chronic hepatitis C, and are on either PEG-INTRON® (Peginterferon alfa-2b) Powder for Injection alone or in combination with REBETOL® (Ribavirin, USP) Capsules; REBETRON® Combination Therapy containing REBETOL® and INTRON® A (Interferon alfa-2b, recombinant) Injection; or INTRON® A for Injection therapy, contact Be In Charge today.

Other Available Resources

Be In Charge can Help Explore Reimbursement Options. Schering's COMMITMENT TO CARE® has been designed to aid eligible patients in receiving therapy with Schering products by exploring reimbursement options. This is available to all eligible patients taking either PEG-INTRON® alone or in combination with REBETOL®, REBETRON® Combination Therapy containing REBETOL® and INTRON® A, or INTRON® A for Injection Therapy.

This COMMITMENT TO CARE® reimbursement assistance is available to eligible patients whether you enroll in the Be In Charge program or not. Since its inception in September 1995, COMMITMENT TO CARE® has helped over 6,000 patients by providing reimbursement assistance for their medication. For information and enrollment,
call 1-800-521-7157.

To be eligible for the Be In Charge program, you must be diagnosed with chronic
hepatitis B or C, be 18 years of age or older, and be living in the U.S.

* Note: If you or someone you know may be at risk for hepatitis C, please visit

www.peg-intron.com

Can a Genetic Test Improve Hepatitis C Treatment?

2006-05-25T19:48:00.000-04:00

Written by:
Karen Barrow
Published on: May 16, 2006

Currently, patients with hepatitis C face a long road of expensive treatments, but a new test may make sorting out who needs this treatment a little easier.
A genetic test has been developed to predict which patients with hepatitis C will develop cirrhosis, or scarring, of the liver, a serious side effect of the disease that often leads to the need for a liver transplant. Since treatment for hepatitis C is costly and comes with serious side effects, this screening test may allow doctors to sort out who is most in need of immediate treatment and who can wait.

"Use of this information to select and treat the patients at highest risk for progression earlier may help prevent irreversible liver damage," said Kathy Ordonez, president of Celera Genomics, the company that developed the test.

In many patients, hepatitis C causes no symptoms and may never cause any liver damage. However, the disease can also cause a chronic liver disease, including cirrhosis, liver failure and liver cancer. Of the estimated 4 million Americans with hepatitis C, 70 percent will develop chronic liver disease and 5 to 20 percent will develop cirrhosis, a leading cause of death in hepatitis C patients.

Determining which patients will end up at this dangerous end of the spectrum is key in preventing liver damage.

According to Dr. David Speechly, determining which patient will develop liver damage as a result of hepatitis C is basically a "flip of a coin." Doctors will look at several factors to try to determine a patient's risk of developing liver disease, including age, gender and alcohol consumption. Liver biopsies, too, are often done to determine the current amount of damage done to the liver, but it cannot predict how much damage will occur in the future.

Celera's test checks for seven genetic variations that seem to increase a patient's risk of developing cirrhosis. In a study, researchers found that those with these genetic variations and particular lifestyle factors, like alcohol consumption, are more than eight times as likely to develop cirrhosis than a patient without either. The results of the study were presented at the annual meeting of The European Association for the Study of the Liver.

Currently, if a doctor does suspect that a patient will develop cirrhosis, he will likely prescribe a combination of medications that can top $30,000 a year and cause major side effects, including chronic flu-like symptoms and nausea. Therefore, if a genetic test can pinpoint which patients truly need treatment, it could prevent unnecessary pain and expense.

"This study confirms that the genetic makeup of each patient is the most important factor in determining which patients are likely to develop [cirrhosis of the liver]," said Dr. Mitchell L. Schiffman, study author and chief of hepatology of the liver transplant program at Virginia Commonwealth University Medical Center.

Celera Genomics is currently seeking FDA approval for this test, which is estimated to cost around $1,000.

© 2006 Healthology, Inc.

Be Scared, Very Scared of Our Money Hungry Medical Community... Because They Are Killing Us!

2006-05-25T12:41:00.000-04:00

This is my real passion regarding HCV. I went to Capital Hill a couple of years ago with a HCV group. I presented members of both houses with a report on this. None of them had been aware of this. I continue to apply pressure on the NY elected officials that I know and won't stop until they do.

I had stumbled upon this information by trying to find out how I had contracted HCV. My first doc had told me that I either contracted it from IV drugs or a blood transfusion which did not apply to me.. He gave me an evil smirk and said, well, that's the only way you could have gotten HCV. As fate would have it, my first Dr. from hell who's name is Dr. Rovito while performing endoscopies and colonoscopies had a wonderful Anesthesiologist who infected 19 patients with HCV by reusing IV needles.

A close friend that I grew up with, was one of them, who received a letter from the NYC health Dept, stating she needed to be tested for HIV & HCV. She had stomach cancer at the time; had surgery and chemo when she was done with that she was diagnosed with breast cancer. After treating that she found out she had HCV, gee isn't the medical filed thoughtful to give 42 patients such a lovely gift as HCV. At the present time does not feel emotionally physically
up to doing treatment.

Surgical saw blade, drill, stapler, scissors and forceps were all sold in packages clearly labeled as single-use devices. That means the manufacturer designed the device as a throwaway. Use on one patient, and then discard. So are the surgical gowns, elastic bandage, the catheter used for balloon angioplasty, the mask used for anesthesia, and plenty of other common medical equipment used in hospitals and doctors' offices.

How many times has that "non-reusable" medical device actually been reused? Is a balloon angioplasty catheter, used to treat blockages in coronary arteries, just as flexible, safe and effective the second time around? Or the third?

Does your kid care if those metal braces had a previous home in a mouth or two before they were glued to her teeth? After all, everything has been carefully sterilized. But will the metal in those used braces be more likely to break in the middle of a vacation or another inconvenient time?

Patients should be asking those questions because disposable medical devices are reused all the time. In addition, nobody knows how well devices made for one use stand up to repeated use. The practice of reprocessed and reusing "single-use devices" has become common during the last few years. The 2000 congressional study concluded that at least one-third of American hospitals reuse some disposable medical devices. Experts believe the trend is growing.

Cost-cutting efforts are one factor. A hospital or clinic can save money by reusing disposable medical devices. Sales of these devices totaled $56 billion in 1999. Use a disposable umbilical scissors to cut the cord on one newborn baby, for instance, and pay full price. Use it on two newborns, and the hospital's costs drop by 50 percent.

Advances in plastics and other materials used to make the 80,000 to 100,000 different kinds and brands of medical devices are another factor. Single-use devices are made from sturdier materials, and it seems reasonable that such material can be reprocessed and safely reused. However, few studies have been done to verify that belief. In order to get U.S. Food and Drug Administration (FDA) approval to sell a single-use device, manufacturers must prove only that it is safe and effective for one use.

Manufacturers need not do studies proving that the device can be reprocessed and used multiple times just as safely and effectively as the first.
reprocessed usually means that the device is carefully cleaned, inspected, refurbished and sterilized before use on the next patient. Some hospitals reprocessed single-use devices themselves. Others send used devices to companies that reprocessed them. Cleaning and sterilizing medical devices made for one-time use may be more difficult than sterilizing devices manufactured for multiple use, according to the FDA.

FDA studies identified several theoretical problems with reused medical devices. These include possible increased risk of infection if devices are not properly sterilized before reuse, possible increased risk of failure in orthodontic products, possible loss of elasticity and durability in balloon catheter devices and possible loss of original lubricants. Studies, however, find little evidence of widespread health problems from recycling single-use devices. Only 245 "adverse events" were linked to reuse of such devices during the last three years of the 1990s, according to the FDA. Manufacturers reported seven patient deaths, 72 injuries and 147 device malfunctions. I think these numbers are bullshit, how does one know when they went for a flu years ago, that needle wasn't reused, or went to a dentist, or had a medical procedure. These numbers are the ones that were caught!

The FDA decided on stricter regulation and monitoring of single-use-device reprocessed by third-party companies and hospitals. It hinted that more regulation may be on the horizon. Patients may want to talk with their doctors about recycled medical devices before undergoing procedures and ask, too, whether such devices could have been a factor if a procedure goes bad.

Some Commonly Reprocessed Single-Use Devices
Surgical saw blade
Surgical drill
Surgical stapler
Laparoscopy scissors
Orthodontic (metal) braces
Electrophysiology catheter
Electrosurgical electrodes and pencils
Endotracheal tube
Balloon angioplasty catheter
Biopsy forceps
Umbilical scissors
Gas mask
Ophthalmic knife
Irrigating syringe
Surgical gown
needles

HCV Increases Risk of Type 2 Diabetes

2006-05-25T12:29:00.000-04:00

MAY-2006

Hepatitis C Virus Infection Increases Risk Of Type 2 Diabetes

NEW YORK (Reuters Health) - Patients with hepatitis C virus (HCV) infection who are 40 years of age or older have three times the risk of developing type 2 diabetes compared with their uninfected counterparts, according to a report in the May issue of Diabetes Care.

"HCV is a diabetogenic agent that by means of increasing insulin resistance strongly predisposes infected patients to type 2 diabetes," Dr. Rafael Simo from Hospital Vall d'Hebron, Barcelona, Spain told Reuters Health. Dr. Simo and colleagues reviewed the available evidence concerning the epidemiological association between HCV infection and diabetes.
In all studies that contained a control group, there was a higher prevalence of HCV antibodies among patients with type 2 diabetes than among nondiabetic patients, the authors report. This was not the case for patients with type 1 diabetes.

Similarly, data from the Third National Health and Nutrition Examination Survey (NHANES III) confirmed a three-fold increased risk of type 2 diabetes in patients who were at least 40 years old and infected with HCV. Again, the results indicate, there was no association between HCV infection and type 1 diabetes.

In other studies, HCV-positive patients with chronic hepatitis were three times as likely to have glucose abnormalities, compared with HCV-negative subjects with other liver diseases. Diabetes and impaired fasting glucose were also more common among patients with anti-HCV antibodies.
Research examining the mechanisms linking HCV infection and type 2 diabetes effectively ruled out autoimmunity, iron overload, and direct damage to pancreatic beta cells. Instead, insulin resistance mediated by proinflammatory cytokines appears to be the main pathogenic mechanism.

"Taking into account the clear association between HCV infection and the development of diabetes, and given that HCV is a very prevalent disease affecting approximately 3% of the world's population, it is possible that HCV infection is contributing to the increasing prevalence of type 2 diabetes," Dr. Simo said. Because HCV infection can be considered a risk factor for diabetes, screening to detect diabetes and pre-diabetic conditions (impaired fasting glucose or impaired glucose tolerance) should be done at least every 3 years.
Dr. Simo also cited results of recent studies by his group indicating that successful treatment of HCV infection can prevent the subsequent development of type 2 diabetes.
Diabetes Care 2006;29:1140-1146.

2006 Reuters Health

The Ten Commandments of Hepatitis C Survival~

2006-05-24T17:50:00.000-04:00

Thou shalt regard the word, "Hepatitis", as exactly that: a word. Nothing more, nothing less. For its original meaning has changed mightily over the years, as have such words as Smallpox, TB, and Polio, all once dreaded ailments, now non-existent as maladies. And thus shalt go thy Hepatitis. The answer shall come to those who shall be present to hear it. Be present when it comes.

Thou shalt love thy interferon, and thy other treatments even as thyself, for they are thy friends and champions. Although they exact a toll for their endeavors, they are oft most generous in the favors they bestow.

Thou shalt participate fully in thy recovery. Thou shalt learn all the details of thy ailment, its diagnosis, its prognosis, its treatments, conventional and alternate. Thou shalt discuss them openly and candidly with thy hepatologist and shalt question all thou do not comprehend. Then, thou shalt cooperate intelligently and knowledgeably with thy doctor.

Thou shalt regard thy ailment as a temporary detour in thy life and shalt plan thy future as though this detour had not occurred. Thou shalt never, at no time, no how, regard thy temporary ailment as permanent. Thou shalt set long-term goals for thyself. For thou WILL verily recover and thy believing so will contribute mightily to thy recovery.

Thou shalt express thy feelings candidly and openly to thy loved ones for they, too, are stricken. Thou shalt comfort and reassure them for they, too, needest comforting and reassurance, even as thou doest.

Thou shalt be a comfort to thy fellow brothers and sisters, providing knowledge, encouragement, understanding and love. Thou shalt give them hope where there may be none, for only in hope lies their salvation. And by doing so, thou providest comfort for thyself, as well.

Thou shalt never relinquish hope, no matter how thou may feelest at that moment, for thou knowest, in the deep recesses of thy heart, that your discouragement is but fleeting and that a better day awaits thee.

Thou shalt not regard thy ailment as the sum total of thy life but as merely a part of it. Fill your life with other diversions, be they mundane, daring, altruistic, or merely amusing. To fill your life with your ailment is to surrender to it.

Thou shalt maintain, at all times and in all circumstances, thy sense of humor, for laughter lightens thy heart and hastens thy recovery. This is not an easy task, sometimes seemingly impossible, but it is a goal well worth the endeavor.

Thou shalt have enduring and unassailable faith, whether thy faith be in a Supreme Being, in Medical Science, in Thy Future, in Thyself, or in Whatever. Steadfastly sustain thy faith for it shall sustain thee. The wit makes fun of other persons; the satirist makes fun of the world; the humorist makes fun of himself.

Tatoo Inks Are Not Regulated By The FDA And Can Be Deadly

2006-05-24T17:14:00.000-04:00

FDA.....Tatoo inks are not regulated by the FDA and many have been found to contain.....Lead, Arsenic, Antimony, Beryllium, Chromium, Cobalt, Nickel and Selenium, all toxic metal poisons known to be hazardous to human health. Some of the ink pigments are suitable for printers' ink, automobile paint or solvents, and they are not approved for skin contact at all!

News Release
September 19, 2005: State Judge Issues Preliminary Injunction Requiring Warnings on Tattoo Ink Products Sold by Largest Ink Sellers in US
American Environmental Safety Institute
For Immediate Release: Monday, September 19, 2005
State Judge Issues Preliminary Injunction Requiring Warnings on Tattoo Ink Products Sold by Largest Ink Sellers in US

Los Angeles, CA – Los Angeles Superior Court Judge Irving Feffer today issued a preliminary injunction against Huck Spaulding Enterprises, Inc. ("Spaulding") and Superior Tattoo Equipment Co. ("Superior"), the largest tattoo ink sellers in the country. New York-based Spaulding sells the "VooDoo" brand, while Arizona-based Superior sells the "Prizm" brand of tattoo inks in California. The preliminary injunction requires these companies to place the following warning on their tattoo ink labels, catalogs and Internet sites for their California customers: "WARNING: Tattoo inks and pigments contain many heavy metals, including Lead, Arsenic and others. All of these heavy metals have been scientifically determined by the State of California to cause cancer or birth defects and other reproductive harm. Pregnant women and women of childbearing age in particular should consult with their doctor before getting any tattoo. A person is exposed to tattoo inks and/or pigments when they get a tattoo because they are injected with tattoo ink under their skin or the tattoo ink is applied on their skin."

Judge Feffer granted the motion for preliminary injunction brought by the American Environmental Safety Institute in its Proposition 65 lawsuit filed in 2004 against Spaulding, Superior and seven other tattoo ink and pigment manufacturers. The lawsuit alleges that these companies are exposing teenagers and adults who are tattooed using their inks to dangerous levels of Lead and seven other toxic metals.

The Institute’s President, Deborah A. Sivas, stated that, "Our scientific research shows that tattoo inks sold by these companies contain Lead, Antimony, Arsenic, Beryllium, Chromium, Cobalt, Nickel and Selenium, all toxic metal poisons known to the State of California’s health experts to be hazardous to human health. Tattoo customers have a right to know about this danger – before they get their tattoo." The Institute demonstrated in its preliminary injunction motion that these companies’ tattoo inks violate California’s Proposition 65, the state’s landmark consumer public health initiative statute that requires warnings be given to individuals before they are exposed to hazardous chemicals. Ms. Sivas observed that teenagers and adults in California are exposed to toxic metals in these tattoo inks when they are tattooed on or under their skin. Citing from a July 2003 Harris Poll, Ms. Sivas observed that tattoos are widely accepted and increasing in popularity in our modern culture, enhancing their potential for unknown and unwarned health risks, because, at least sixteen percent (16%) of Americans have at least one tattoo, with approximately equal numbers of men and women reporting that they have a tattoo. That means that approximately 40,000,000 million Americans, and perhaps 4,000,000 California adults, have one or more tattoos; and among younger adults, the numbers climb dramatically – in the age range from 25 to 29 years, 36% report they have at least one tattoo, while in the age range from 30 to 39, 28% similarly have at least one tattoo.The numbers are not significantly different for teenagers, Ms. Sivas pointed out, citing reports in the academic literature showing that thirteen percent (13%) of teenagers have at least one tattoo, with 5% reporting more than one tattoo. 29% of these respondents got their first tattoo before they were 17 years of age. Unlike among adults, the teenage girl respondents in these studies had tattoos far more often than boys (17% versus 8%, respectively).

"Against this background of rising popularity of tattoos among our teenagers and young adults, these tattoo ink sellers failed to take appropriate actions to either reduce the dangerous levels of these toxic metals in their products or warn these young tattoo consumers or their parents of the health risks from being tattooed with these inks. At levels found in the inks, these dangerous heavy metals, many of which cause birth defects or developmental toxicity while others cause cancer, pose an especially clear and present danger". American Environmental Safety Institute is a non-profit California organization founded in 1998 to investigate environmental and public health hazards affecting children and adults. Based upon its scientific research, both alone and working with other organizations, the Institute undertakes appropriate public education and/or legal action before state and federal government administrative agencies and the courts to correct violations of public policy and/or law. In addition to serving as the Institute’s President, Deborah A. Sivas is an attorney and serves as the Director of the Earthjustice Environmental Law Clinic and a Lecturer on Law at the Stanford University Law School in Palo Alto, California.

April 11, 2006

Tattoos and Permanent Makeup
FDA considers the inks used in intradermal tattoos, including permanent makeup, to be cosmetics and considers the pigments used in the inks to be color additives requiring premarket approval under the Federal Food, Drug, and Cosmetic Act. However, because of other public health priorities, FDA has not traditionally regulated tattoo inks or the pigments used in them. FDA is aware of more than 150 reports of adverse reactions in consumers to certain permanent ink shades, and it is possible that the actual number of consumers affected was greater. In some cases, the effects reported caused serious disfigurement. In addition, concerns raised by the scientific community regarding the pigments used in these inks have prompted FDA to investigate the safe use of tattoo inks. FDA continues to evaluate the extent and severity of adverse events associated with tattooing and is conducting research on inks. As new information is assessed, the agency will consider whether additional actions are necessary to protect public health.

In addition to the reported adverse reactions, areas of concern include tattoo removal, infections that result from tattooing, and the increasing variety of pigments and diluents being used in tattooing. More than fifty different pigments and shades are in use, and the list continues to grow. Although a number of color additives are approved for use in cosmetics, none is approved for injection into the skin. Using an unapproved color additive in a tattoo ink makes the ink adulterated. Many pigments used in tattoo inks are not approved for skin contact at all. Some are industrial grade colors that are suitable for printers' ink, automobile paint or solvents.

What Risks Are Involved in Tattooing?
The following are the primary complications that can result from tattooing:
Infection. Unsterile tattooing equipment and needles can transmit infectious diseases, such as hepatiti C. The risk of infection is the reason the American Association of Blood Banks requires a one-year wait between getting a tattoo and donating blood.

Removal Problems. Despite advances in laser technology, removing a tattoo is a painstaking process, usually involving several treatments and considerable expense. Complete removal without scarring may be impossible. Allergic reactions.

FDA has received reports of numerous adverse ractions associated with certain shades of ink. When they happen they may be particularly troublesome because the pigments can be hard to remove. Occasionally, people may develop an allergic reaction to tattoos they have had for years. Granulomas, These are nodules that may form around material that the body perceives as foreign, such as particles of tattoo pigment. Keloid formation. If you are prone to developing keloids -- scars that grow beyond normal boundaries -- you are at risk of keloid formation from a tattoo. Keloids may form any time you injure or traumatize your skin

MRI complications. There have been reports of people with tattoos or permanent makeup who experienced swelling or burning in the affected areas when they underwent magnetic resonance imaging (MRI). There also have been reports of tattoo pigments interfering with the quality of the image. The cause of these complications is uncertain. Some have theorized that they result from an interaction with the metallic components of some pigments.

What About Temporary Tattoos?
Temporary tattoos, such as those applied to the skin with a moistened wad of cotton, fade several days after application. Most contain color additives approved for cosmetic use on the skin. However, the agency has issued an import alert for certain foreign-made temporary tattoos. The temporary tattoos subject to the import alert are not allowed into the United States because they don't carry the FDA-mandated ingredient labels or they contain colors not permitted by FDA for use in cosmetics applied to the skin. FDA has received reports of allergic reactions to temporary tattoos. In a similar action, FDA has issued an import alert for henna intended for use on the skin. Henna is approved only for use as a hair dye, not for direct application to the skin. Also, henna typically produces a reddish brown tint, raising questions about what ingredients are added to produce the varieties of colors labeled as "henna," such as "black henna" and "blue henna." FDA has also received reports of allergic reactions to products applied to the skin that contain henna.

Drug Companies Making a Bundle On HCV, Vertex Stock On The Rise.....

2006-05-23T22:15:00.000-04:00

Vertex jumps on hepatitis C drug advancement - UPDATE 1

BOSTON (AFX) -- Shares of Vertex Pharmaceuticals jumped Tuesday on news that the company was preparing to initiate three key Phase IIb clinical trials for its hepatitis C drug candidate VX-950.

According to Vertex chief executive officer Joshua Boger, Vertex has already started a large-scale Phase IIb trial clinical trial in the U.S. that will test to see how long VX-950 can keep the body clear of the liver-destroying virus. A similar trial will be launched next month in Europe. The trials will consist of hepatitis C patients who have not yet received therapy for their condition.

Shares of Vertex closed up 4% at $30.75 after hitting a session high of $31.65.
Boger also said that Vertex will be initiating a Phase IIb trial later this year to see how the drug performs in patients who have already failed standard therapy for the disease. The three Phase IIb studies will all be monitoring patients for three to six months after therapy to see if the virus returns.

'We expect the first Phase II data in early 2007,' said Boger, adding that the company will have about 1,000 patients in VX-950 clinical trials by the beginning of 2007. 'We anticipate we'll be running some sort of Phase III trials starting in mid-2007.'

About 3.4 million Americans have hepatitis C, the company said. Currently, the standard hepatitis C therapy calls for bombarding a patient's body with two powerful drugs -- pegylated interferon and the antiviral medication ribavirin -- for up to a year.
Despite the treatment, which can be highly debilitating, the virus returns in about 50% of recipients. Patients are considered to have been treated successfully if their bodies show no sign of the virus six months after the treatment has ended.

Because of the need for better treatments, analysts have forecasted the market for hepatitis C drug could reach $8 billion in 2010, and that VX-950 should have peak sales of around $4 billion, if approved.Boger said the earliest Vertex could probably file to have VX-950 approved would be in 2008. He said the company still hopes to have the drug on the market in 2009.

Schering-Plough , meanwhile, also has a hepatitis C drug, SCH 503034, in Phase II clinical testing. Like VX-950, SCH 503034 belongs to a class of drugs known as protease inhibitors.
Boger said despite the similarities, that he remains confident that VX-950 is superior to Schering-Plough's candidate. 'The data so far suggests that our drug is as much as 100 times more effective as an antiviral agent,' said Boger.

This story was supplied by MarketWatch. For further information see www.marketwatch.com

Growing Concern Link to Tattoo Ink & Body Piercing

2006-05-23T20:37:00.000-04:00

Some good news for a change, it's great to see this type of humanity as well as accuracy.
Sixteen patients at Beckley Health Right will participate in a new Hepatitis C treatment program beginning this week. An orientation Tuesday will acquaint them with an overview of the program and stress the importance of keeping scheduled appointments and having regular lab work done. “We need to monitor these patients carefully through blood work and regular, consistent follow-up as they progress through the program,” said Cheryl Winter, a certified family nurse practitioner at Beckley Health Right. Participants have already been identified by the clinic through testing. For 12 weeks, they will undergo a combined therapy of injections and oral medications. If the treatments are successful, they will improve the quality of life for patients with this life-threatening disease, Health Right Director Jeff Graham said. “This is one more step in trying to make life better for patients with Hepatitis C. We already have a similar program designed to help diabetic patients. The whole goal is to better the lifestyle of these patients,” he said. Not everyone will get the same results from the treatment, however. “There are different types of Hepatitis C. Type 1 is most resistant to medication therapy,” Winter said. “Patients also have to be committed to the program and follow through with their role in the program.” Hepatitis C is a blood-borne virus that damages the liver. The disease can lie dormant for many years and presents no symptoms. “Usually, Hepatitis C is found accidentally through blood work that shows an elevated liver enzyme,” Winter said. “Some of these patients could have contracted the disease 20 years ago.” Some cases have resulted from blood transfusions performed in hospitals years ago before stricter blood screening measures were put into place. “There is extensive screening done today, so blood products used by hospitals are safer than ever before.

There is growing concern about its possible link to tattoo ink and body piercing, she said. “Even if tattoo artists use a clean needle each time, there is a possibility that the ink itself may become contaminated if the artist tattoos someone who has the disease. The needle is placed back into the ink, and that’s where the contamination could take place,” Winter said.
The disease is also spread through internasal cocaine use and can be transmitted by blood transfer during unprotected sex, she said. Community support has made the Hepatitis C education and treatment program possible, Winter said. Roche Pharmaceuticals is donating the medication and starter packs and offers a 24-hour hotline service. Beckley optometrist Dr. Mark Holliday provides free eye exams. Beckley-ARH provides free ultrasounds for the diagnosis of Hepatitis C, and Raleigh General Hospital provides free lab work for the patients. “Without this kind of help, we would not be able to help these patients,” Winter said. “The community support and the volunteer efforts and free services make it possible for these patients to take part in this program.”http://www.register-herald.com/features/local_story_134213119.html?keyword=topstory

Free Beckley clinic begins Hepatitis C treatment program
Bev DavisCNHI News Service
— Sixteen patients at Beckley Health Right will participate in a new Hepatitis C treatment program beginning this week. An orientation Tuesday will acquaint them with an overview of the program and stress the importance of keeping scheduled appointments and having regular lab work done. “We need to monitor these patients carefully through blood work and regular, consistent follow-up as they progress through the program,” said Cheryl Winter, a certified family nurse practitioner at Beckley Health Right. Participants have already been identified by the clinic through testing. For 12 weeks, they will undergo a combined therapy of injections and oral medications.
If the treatments are successful, they will improve the quality of life for patients with this life-threatening disease, Health Right Director Jeff Graham said. “This is one more step in trying to make life better for patients with Hepatitis C. We already have a similar program designed to help diabetic patients. The whole goal is to better the lifestyle of these patients,” he said. Not everyone will get the same results from the treatment, however.
“There are different types of Hepatitis C. Type 1 is most resistant to medication therapy,” Winter said. “Patients also have to be committed to the program and follow through with their role in the program.”

Hepatitis C is a blood-borne virus that damages the liver. The disease can lie dormant for many years and presents no symptoms. “Usually, Hepatitis C is found accidentally through blood work that shows an elevated liver enzyme,” Winter said. “Some of these patients could have contracted the disease 20 years ago.”

Some cases have resulted from blood transfusions performed in hospitals years ago before stricter blood screening measures were put into place. “There is extensive screening done today, so blood products used by hospitals are safer than ever before,” Winter said.Hepatitis C can be contracted through IV drug use and the sharing of needles. There is growing concern about its possible link to tattoo ink and body piercing, she said.

“Even if tattoo artists use a clean needle each time, there is a possibility that the ink itself may become contaminated if the artist tattoos someone who has the disease. The needle is placed back into the ink, and that’s where the contamination could take place,” Winter said.
The disease is also spread through internasal cocaine use and can be transmitted by blood transfer during unprotected sex, she said.Community support has made the Hepatitis C education and treatment program possible, Winter said.

Roche Pharmaceuticals is donating the medication and starter packs and offers a 24-hour hotline service. Beckley optometrist Dr. Mark Holliday provides free eye exams. Beckley-ARH provides free ultrasounds for the diagnosis of Hepatitis C, and Raleigh General Hospital provides free lab work for the patients.“Without this kind of help, we would not be able to help these patients,” Winter said. “The community support and the volunteer efforts and free services make it possible for these patients to take part in this program.”

Dr. Olivio Romani, assistant medical director at Summers County Health Right, is writing and overseeing the medical protocol for the program under medical director Dr. Jorge Gordino.

May is National Hepatitis Awareness Month

2006-05-23T17:01:00.000-04:00

As May is National Hepatitis Awareness Month, Sierra HOPE will make a limited number of free Hepatitis home testing kits available throughout the month. To find out more about receiving a Hepatitis Home Testing Kit or for more information about Hepatitis C, call Sami Rhodes at Sierra HOPE at 736-6792.

http://www.ledger-dispatch.com/life/lifeview.asp?c=185599 Sierra HOPE to offer free Hepatitis home testing k Chronic liver disease is the 10th leading cause of death among adults in the United States and Hepatitis C Virus (HCV) infection is the most common chronic blood-borne infection in the country, affecting more than 5 million Americans. Most people infected don't even know they have it because sometimes it takes 20 or 30 years to become symptomatic. Studies indicate that 40 to 60 percent of all liver disease is related to Hepatitis C infection. Long term consequences of a Hepatitis C infection include a 75 to 80 percent chronic infection rate, 70 percent chance of chronic liver disease and a 10 to 20 percent chance of developing cirrhosis. Sadly, one out of five of every 100 Hepatitis C infections cases results in death from liver cancer or cirrhosis and Hepatitis C. remains the leading indication for liver transplants in the United States. Known risk factors include blood transfusions obtained before 1992 or clotting factors before 1987; tattoos or body piercing done with unsterile instruments or common ink wells; having multiple sexual partners or intravenous drug users.

Even a single use in the distant past and sharing toothbrushes or razors with someone infected with Hepatitis C can be a risk. As May is National Hepatitis Awareness Month, Sierra HOPE will make a limited number of free Hepatitis home testing kits available throughout the month. To find out more about receiving a Hepatitis Home Testing Kit or for more information about Hepatitis C, call Sami Rhodes at Sierra HOPE at 736-6792.

Courage Does Not Always Roar~

2006-05-22T21:09:00.000-04:00

Courage Does Not Always Roar~
Sometimes, it is the quiet voice
at the end of the day saying,
"I will try again tomorrow".

Results In Long Term Clearance of the Virus & Cure

2006-05-22T20:54:00.000-04:00

EU Label Change for INTRON(R) A (interferon Alfa-2b) Incorporates Long-Term Efficacy Data in Patients with Chronic Hepatitis C

Five-Year Follow-Up Data Demonstrate Sustained Viral Response Results in Long-Term Clearance of the Virus and Clinical 'Cure'

KENILWORTH, N.J., April 26 /PRNewswire-FirstCall/ -- Schering-Plough Corporation (NYSE: SGP) today reported that the European Commission has adopted changes to the European Union (EU) label for INTRON(R) A (interferon alfa-2b) based on long-term efficacy data from a large, five-year follow-up study to evaluate the durability of sustained virological response (SVR)(1) in patients treated for chronic hepatitis C virus infection (HCV). This large study confirms that sustained loss of serum HCV RNA six months following the completion of treatment with nonpegylated interferon alfa-2b (with or without ribavirin) is a strong predictor of long-term clearance of the virus, providing resolution of the hepatic infection and clinical "cure" from chronic HCV. However, long-term clearance of the virus does not preclude the occurrence of hepatic events in patients with cirrhosis, including hepatocarcinoma.

"This large study involving more than 1,000 hepatitis C patients demonstrates that, even with close follow-up over a five-year period, patients who have achieved an SVR have essentially no evidence of clinical or virological disease," said John McHutchison, M.D., Duke University, and lead investigator of the study. "Recognition of this durability of response underscores the efficacy of interferon-based antiviral therapy. Furthermore, it may help motivate hepatitis C patients to seek treatment and provides physicians confidence that they are giving their patients a meaningful chance for a cure."

In the study, 1,071 patients were enrolled after completing prior treatment with nonpegylated interferon alfa-2b (with or without ribavirin). Of these, 492 patients achieved an SVR and only 12 relapsed during the follow- up period. In all, 446 patients completed at least five years of long-term follow-up. The Kaplan-Meier estimate for continued sustained response over five years for all patients in the study is 97 percent with a 95 percent Confidence Interval of [95 %, 99 %].

A similar long-term follow-up study with pegylated interferon alfa-2b (PEG-INTRON(R)) is ongoing. About Interferon Alfa-2b Interferon alfa-2b is a recombinant version of naturally occurring alpha interferon, which has been shown to exert both antiviral and immunomodulatory effects. Schering-Plough markets interferon alfa-2b (brand name INTRON A in most countries) for 16 major antiviral and anticancer indications worldwide. Schering-Plough also markets a longer-acting, once-weekly pegylated version of interferon alfa-2b called PEG-INTRON (peginterferon alfa-2b), for use as monotherapy or in combination therapy with REBETOL(R) (ribavirin, USP) for the treatment of chronic hepatitis C in patients with compensated liver disease who are at least 18 years of age.

Chronic hepatitis C is estimated to affect more than 10 million people in major world markets, including 5 million in Europe. It is a leading cause of chronic liver disease and one of the most common reasons for liver transplant in Europe.

Important Safety Information Regarding U.S. Labeling for PEG-INTRON and REBETOL
WARNING...Alpha interferons, including PEG-INTRON, cause or aggravate fatal or life- threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Patients should be monitored closely with periodic clinical and laboratory evaluations. Patients with persistently severe or worsening signs or symptoms of these conditions should be withdrawn from therapy. In many but not all cases these disorders resolve after stopping PEG-INTRON therapy.

Ribavirin causes hemolytic anemia. Anemia associated with REBETOL therapy may exacerbate cardiac disease that has led to fatal and nonfatal myocardial infarctions. Patients with a history of significant or unstable cardiac disease should not be treated with REBETOL. It is advised that complete blood counts (CBC) be obtained at baseline and at weeks 2 and 4 of therapy or more frequently if clinically indicated.

REBETOL and combination REBETOL/PEG-INTRON therapy must not be used by women, or male partners of women, who are or may become pregnant during therapy and during the 6 months after stopping therapy. REBETOL and combination REBETOL/PEG-INTRON therapy should not be initiated until a report of a negative pregnancy test has been obtained immediately prior to initiation of therapy. Women of childbearing potential and men must use effective contraception (at least two reliable forms) during treatment and during the 6- month post-treatment follow-up period. Significant teratogenic and/or embryocidal effects have been demonstrated for ribavirin in all animal species in which adequate studies have been conducted. These effects occurred at doses as low as one twentieth of the recommended human dose of REBETOL. If pregnancy occurs in a patient or partner of a patient during treatment or during the 6 months after treatment stops, physicians are encouraged to report such cases by calling 800-727-7064.

PEG-INTRON
There are no new adverse events specific to PEG-INTRON as compared to INTRON A (interferon alfa-2b, recombinant) for Injection, however, the incidence of some (e.g., injection site reactions, fever, rigors, nausea) were higher. The most common adverse events associated with PEG-INTRON were "flu- like" symptoms, occurring in approximately 50% of patients, which may decrease in severity as treatment continues. Application site disorders were common (47%), but all were mild (44%) or moderate (4%) and no patient discontinued, and included injection site inflammation and reaction (i.e., bruise, itchiness, irritation). Injection site pain was reported in 2% of patients receiving PEG-INTRON. Alopecia (thinning of the hair) is also often associated with alpha interferons including PEG-INTRON.

Psychiatric adverse events, which include insomnia, were common (57%) with PEG-INTRON, but similar to INTRON A (58%). Depression was most common at 29%. Suicidal behavior including ideation, suicidal attempts, and completed suicides occurred in 1% of patients during or shortly after completing treatment with PEG-INTRON.
PEG-INTRON/REBETOL is contraindicated in patients with autoimmune hepatitis, decompensated liver disease, and in patients with hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia).

The following serious or clinically significant adverse events have been reported at a frequency less than or equal to 1% with PEG-INTRON or interferon alpha: Severe decreases in neutrophil or platelet counts, hypothyroidism, hyperglycemia, hypotension, arrhythmia, ulcerative and hemorrhagic colitis, development or exacerbation of autoimmune disorders including thyroiditis, RA, systemic lupus erythematosus, psoriasis, pulmonary disorders (dyspnea, pulmonary infiltrates, pneumonitis and pneumonia, some resulting in patient deaths), urticaria, angioedema, bronchoconstriction, anaphylaxis, retinal hemorrhages, and cotton wool spots.

In the PEG-INTRON/REBETOL combination trial the incidence of serious adverse events was 17% in the PEG-INTRON/REBETOL groups compared to 14% in the INTRON A/REBETOL group. The incidence of severe adverse events in the PEG- INTRON/REBETOL combination therapy trial was 23% in the INTRON A/REBETOL group and 31-34% in the PEG-INTRON/REBETOL groups. Dose reductions due to adverse reactions occurred in 42% of patients receiving PEG-INTRON (1.5 mcg/kg)/ REBETOL and in 34% of those receiving INTRON A/REBETOL.

REBETOL should not be used in patients with creatinine clearance less than 50 mL/min.
Schering-Plough is a global science-based health care company with leading prescription, consumer and animal health products. Through internal research and collaborations with partners, Schering-Plough discovers, develops, manufactures and markets advanced drug therapies to meet important medical needs. Schering-Plough's vision is to earn the trust of the physicians, patients and customers served by its more than 32,000 people around the world. The company is based in Kenilworth, N.J., and its Web site is http://www.schering-plough.com/.

SCHERING-PLOUGH DISCLOSURE NOTICE: The information in this press release includes certain "forward-looking statements" within the meaning of the Securities Litigation Reform Act of 1995, including statements relating to INTRON A, PEG-INTRON, and the potential market for these drugs. Forward- looking statements relate to expectations or forecasts of future events. Schering-Plough does not assume the obligation to update any forward-looking statement. Many factors could cause actual results to differ materially from Schering-Plough's forward-looking statements, including market forces, economic factors, product availability, patent and other intellectual property protection, current and future branded, generic or over-the-counter competition, the regulatory process, and any developments following regulatory approval, among other uncertainties. For further details about these and other factors that may impact the forward-looking statements, see Schering- Plough's Securities and Exchange Commission filings, including Item 1A. Risk Factors in the Company's 2005 10-K. (1) SVR is the accepted criterion for assessing efficacy in HCV therapy and is defined as undetectable virus (HCV RNA) levels 24 weeks after the end of treatment.

Company News On-Call: http://www.prnewswire.com/comp/777050.html
Website: http://www.schering-plough.com/
http://sev.prnewswire.com/medical-pharmaceuticals/20060426/NYW06126042006-1.html

FootNote: Hope this will put an end to da naysayers
that continue to say HCV cannot be cured....

Bette's Journey~

2006-05-22T19:19:00.000-04:00

I would like to begin by thanking my family for their unconditional love & support. My Doctor Zimbalist, for his continued support and determination that together we could beat the Dragon. Last, but not least my husband who gave me his love, hope, strength and courage when I had lost mine! My name is Bette and I live in Brooklyn, New York. I have a daughter and a son. I am blessed with 3 beautiful grandsons, and 1 princess. I was diagnosed on April 14, 1995 with the HCV during a routine medical check-up. I had my biopsy in May, and thank God, there wasn't any liver damage, only mild inflammation. I was informed that my viral load was 4 million and that I could start mono-interferon treatment immediately or wait until I was sicker. It didn't seem it matter either way to him if I treated or not. But he sure did fill my head with all the horrible things that HCV can do to you.

He also told me maybe one day you might need a liver transplant. He also told that I only had a 10-15% chance that the treatment would work! I looked him right into his beady eyes and asked "Dr. who makes up that percentage'? He looked back at me like I was a moron and said people who take the tx make up that percentage. I smiled at him and said so why shouldn't I be one of those people? He asked me if I had a blood transfusion or if I was an IV Junkie. I replied no. He smirked at me and said well, those are the only ways you could have been infected. I felt so happy, and asked if perhaps the tests were wrong, he assured me they weren't. That my primary had diagnosed me, he ran tests and the biopsy confirmed it. I was so confused at this point and thought this was all a bad dream, how could I have HCV, if the only way of getting it didn't apply to me.

I might be a blonde, but hell I'm not that blonde. For me it was a "no brainer" why wait until I was sicker. I informed Dr. Creep that I preferred not to wait until I was sicker and that I would begin treatment at once. Well, that is, after I went on vacation to Puerto Rico. Although, I didn't know anything at all about Hep-C, I did realize that I needed time to digest all that was thrown at me. I felt before I could heal my body. I would need to heal my soul~

I began my journey on August 7, 1995. I made a decision to continue working, for I wanted to keep my life as normal as possible. I did not want to be a victim. I vowed to live my life with Hep-C and not make Hep-C my life! My six-months of treatment were extremely difficult, I did not have the support of that man who called himself a doctor. He had me taking my injections at 9am, which was real nice, the sides would kick in while I was at work. I also had every side effect that you can imagine and they were being ignored by him. For six months I was told, they are only flu-like symptoms.. Yeah, like hell they were. When I complained that I was depressed, he firmly stated that it was NOT from interferon, and and asked if I or any member of my family had a history of mental problems. He made me question my own mental health. He was a Doctor from hell and by the way, his name is Dr. Rovito, who made worldwide news, about 4 years ago, he was the doctor who was responsible for infecting 42 patients with hepc during endoscopy procedures at his Brooklyn Clinic. A very close friend of mine was one of those 42.

At the end of six months he labeled me a non-responder and told me, sorry there isn't anything more I can do for you. I was determined to find a Doctor who would truly care about me and would help me get well. After interviewing several doctors. I found Dr. Zimbalist who is the most caring and supportive doctor I have ever known. It is vital to have a doctor who will be in partnership with you, and also one that with help ease any side effects that you may have. Doc Zimbalist promised me, that together, we would beat this! He soon put me back on interferon, this time for one year, but most importantly, I was told to take my injections in the evening so that I could sleep some of the sides away~ He also provided me with an escape hatch, ambien sleeping pills, when the sides became too intense, I took one and checked out. Most importantly, I told him, you might think I'm lying but I never did IV drugs or had a blood transfusion. He asked me why was I saying that and when I told him Dr. Rovito said those are the only two ways of getting it. His face turned red and he was outraged, he said presently there are about 15% that have HCV and are unknown origins, we call that sporadic infections and that is the category you fall into.

After completion of one year, I went into remission for 7 months. However, I relapsed or as I call it "my fall from grace." That is when I did loose Hope, I had been on tx for a total of 18 months and thought after my six month PCR I was home free.

Strange but when I was first diagnosed I never had any symptoms, but about 2 weeks after my 6 months post tx PCR I felt real sick and called my doc and asked for another PCR, he thought I was crazy but said if it will make you feel better I'll run another one. He was stunned it was back... I felt like I was free falling from the Empire State building and was convinced that I would one day die from HCV. I told my Dr. that I was done. I didn't want to try, and was so sick of feeling sick. He tried his very best to convince me that the "3rd would be the charm." However, it was my son, who knows just how to push my buttons.. He told me if I did not continue to fight this disease and I died; he would buy me the biggest tombstone that would read "My Mom died because she was a quitter and the biggest loser I ever knew." I got mad at that remark and even madder at HCV. Plus I just had to prove my son I called my Dr. and told him bring it on I'm ready for round three.

My Doctor decided that I should try 18 more months of tx. This time, I vowed it would be my last time, and as "they" say "da 3rd is da charm." I truly felt like the poster child for Schering Plough, I think I heard they have my face on their vials. Doing 3 injections a week for 3 years was a bitch, but back then it was the only game in town and I was willing to play.

Trust me, I know tx is hard, but no pain, no gain. So for those who are able, not all are, please just do it. I have lost too many because they wanted to wait for a tx without these horrible sides.. But remember time waits for no one! Today there are several choices and there is at least a 60% chance, now that's hope! For those who read this, please don't ever give in or give up, for there is always Hope~

May 16th, 2006 I celebrated being cured 8 years

Hmmm, What does HCV Look like?

2006-05-20T14:46:00.000-04:00

Have HCV & Still Waiting to Treat?

2006-05-20T03:15:00.000-04:00

I am a very strong advocate for Hepatitis C treatment. When possible I do my best to encourage my brothers and sisters to get onto treatment. For those who haven’t responded I have also tried to encourage them to re-treat. However, as of late I’ve been listening to those who will not consider the current treatment as an option and I guess I need to vent.

Some are newly diagnosed; some have been diagnosed for years now. I personally have lost too many friends to this insidious and serious disease; as I’m sure most of you have too. It really annoys the hell out of me, when I hear oh I don't want a tx with sides, well I'm sure people who are suffering with other illness's feel that way too. I would love to be a billionaire, but oh well I'm not.

You must deal the playcards you are given, or you will surely loose the game. There are many people that cannot take treatment for various reasons, I am not addressing you. Some have other medical conditions that prevent them from doing tx, there are also those who have tried tx and had adverse effects and had to stop. I am addressing those that can, or have not yet tried. At times I feel that the HCV forums may be doing more harm than good, because it seems that many hear the “horror “ stories of tx, non-responding stories, relapse stories, people in denial, or post tx problems. Some forums think because they have tons of HCV material posted on their forums they are EXPERTS, they are NOT. Your Doctor is and if he or she is not that knowledgeable about the disease; please find one that is.

I ask you, not to listen to ME, but discuss this with your doctor. When I asked why they have made this decision I’m told, the sides are too harsh, they are not that sick, they are waiting for better treatments, they have time. Please take heed and if you have the opportunity to do HCV treatment, please do it.

There are many that are dead now because they didn’t, there are also many that are on waiting lists for a liver transplant. Treatment does not always work the first time, or the second, it took me 3 attempts and 3 years. What if I had waited until I was “Sicker” as my first doc suggested, I might be blonde, but I'm not that blonde. Would my liver be damaged now, hell yes it would. May 16, 2006 I celebrated being "cured" 8 years. Yes, I dare to use the "C" word!

Just because there are some new treatments currently in clinical trials does not mean they will be better or the side effects are milder. They might even be worse. There are no guarantees in life, only chances and if you have the chance to do treatment just do it....

TIME WAITS FOR NO ONE....

Conclusions About Milk Thistle

2006-05-20T03:05:00.000-04:00

January 17, 2006

Conclusions About Milk Thistle

A May 2005 review of clinical studies which casts doubt on milk thistle's value has recently been re-released into the press. Alternatively, an extensive amount of research supports the continued usage of this herb at higher dosages. Researchers of the Cochrane Review examined 13 randomized, clinical trials assessing the impact of silymarin (the extract of milk thistle) on liver disease. It is important to note that a current search of silymarin clinical studies on Medline.com results in 846 entries. According to the National Institutes of Health and hundreds of in-vitro studies, silymarin demonstrates a marked hepato-protective effect. In addition to concluding that milk thistle is perfectly safe, the researchers in this Cochrane Collection Review also concede that studies using higher dosages are required to accurately determine silymarin's effect on liver function.

Those concerned with optimal liver protection should look for the following characteristics in a quality milk thistle product: * A high dosage* A delivery system which enhances absorption* Use of the most beneficial constituent of silymarin. Medical researchers concur that silybin, which comprises 50 percent of silymarin, is responsible for the majority of milk thistle's liver-protective qualities. While the standard dose of silymarin is 420 mg per day, higher dosages of the more specific form, silybin, demonstrate correspondingly higher levels of liver protection. Furthermore, when silybin is in a phytosome complex, liver cells can absorb 8 to 10 times more than a standard preparation. The daily recommended dosage of UltraThistle provides 1,080 mg of silybin phytosome, far exceeding the levels of bio-available milk thistle used in this scientific review. For more information on UltraThistle, visit www.UltraThistle.com.
The article below urges researchers to conduct studies with higher dosages of milk thistle extract.

Milk Thistle Does Not Lower Mortality in Liver Diseases, Best Studies Find By Lise Stevens, Contributing Writer Health Behavior News ServiceMilk thistle, a widely used alternative medicine, is not proven effective in lowering mortality in alcoholic or hepatitis B or C liver disease, according to a systematic review of current evidence. While some studies found that liver-related mortality may be significantly reduced in patients treated with milk thistle, these findings were not duplicated in the higher quality clinical trials.

However, milk thistle was found safe to use with no serious side effects and with participants perceiving improvement in symptoms — although no more than with placebo. Dr. Andrea Rambaldi, visiting researcher at the of the Centre for Clinical Intervention Research at Copenhagen University Hospital, led a team that reviewed 13 randomized clinical trials involving 915 patients who were treated with milk thistle or its extracts.

Participants had acute or chronic alcoholic liver cirrhosis, liver fibrosis, hepatitis and/or steatosis, and viral-induced liver disease (hepatitis B and/or hepatitis C). Patients with rarer specific forms of liver disease were excluded. All the trials compared the efficacy of milk thistle or any milk thistle constituent versus placebo or no intervention in patients with liver disease. “There is no evidence supporting or refuting milk thistle for alcoholic and/or hepatitis B or C virus liver diseases,” the authors found.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic. According to the Centers for Disease Control and Prevention, 170 million people worldwide are infected with hepatitis C, and 2 billion are infected with hepatitis B. While a vaccine exists to prevent hepatitis B, there is no vaccine for hepatitis C.

Although the virus can be cleared in a handful of patients, many strains are resistant to treatment. Drug therapies that focus on long-term suppression of the virus are expensive, and many patients develop a resistance. The current gold standard treatment, which combines injections of interferon and ribavirin, has serious side effects and is hard for patients to tolerate.
With lack of effective treatment for liver disease, researchers have been looking for alternative therapies that curb symptoms with minimum adverse effects on patients.

Milk thistle and its extracts have been used since the time of ancient Greece for medicinal purposes, are currently widely used in Europe for liver disease, and are readily available in the United States at alternative medicine outlets and outdoor markets. G. Thomas Strickland, M.D., Ph.D., professor at the University of Maryland School of Medicine, has been studying the role of silymarin, an extract of milk thistle, in preventing complications of chronic hepatitis virus infection. Strickland says that the exact mechanism of action of silymarin is unclear.
A problem with current trials, according to Dr. Strickland, is that the dose of silymarin administered, typically 140 mg three times daily, is too low. “I would certainly double it,” he says, “especially since at the current dose we’re not seeing any improvement in acute viral or chronic hepatitis, and we’ve shown that silymarin is totally safe.”“ The problem is, there is no cure for viral hepatitis except bed rest and diet, and treatments like silymarin are worth pursuing,” Strickland says, calling for more research funding.“ We should consider doing randomized clinical trials with higher doses of silymarin,” Dr. Rambaldi concurs.
According to the National Center for Complementary and Alternative Medicine , a part of the National Institutes of Health, studies in laboratory animals suggest that silymarin may benefit the liver by promoting the growth of certain types of liver cells, demonstrating a protective effect, fighting oxidation (a chemical process that damages cells) and inhibiting inflammation.
In their review, Dr. Rambaldi and colleagues conclude, “Milk thistle could potentially affect alcoholic and/or hepatitis B or C virus liver diseases.

Therefore, large-scale randomized clinical trials on milk thistle for alcoholic and/or hepatitis B or C liver diseases versus placebo may be needed.”- Rambaldi A, Jacobs BP, Iaquinto G, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. The Cochrane Database of Systematic Reviews 2005, Issue 2.

Sleep and Fatigue in Patients with Chronic HCV

2006-05-20T02:56:00.000-04:00

Sleep and Fatigue in Patients with Chronic Hepatitis CFatigue and disordered sleep have been shown to affect quality of life in patients with chronic illnesses. The purpose of this study was to evaluate fatigue and sleeping behavior reported by patients with Chronic Hepatitis C (CHC).

Subjects completed the Fatigue Severity Scale (FSS) resulting in a total average fatigue score derived from 9 Likert type scale items assessing disabling fatigue (range 1-7). Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) in which a global score (ranging from 0-21) and 7 component scores were derived. In both cases a high score indicated more severe complaints.

Subjects were 59 CHC patients attending UCSD Adult Liver Clinics who completed both the FSS and PSQI questionnaires. CHC patients were 49% males, 57.6% Caucasian, 35.6% Latino, and 3.4% African-American.

Age and education were 51.9 ± 9.18 and 12.4 ± 3.31 years respectively. 24 patients were non-cirrhotic, 31 were cirrhotic (Child-Turcotte-Pugh Score A=16, B=11, C=3, 1-unknown), and 4 were unknown. No patients were receiving antiviral therapy at the time of assessment.

Results
The FSS score was 4.69 ± 1.88 indicating greater fatigue than past reports of normal healthy adults (2.3) and patients with CHC (3.8). The mean PSQI global score was 8.97 ± 5.38.
64.4% of the patients were found to be ‘poor sleepers’ as defined by a global PSQI score of > 5. There was no significant difference between males and females on both measures. Significant correlations were found between the FSS score and the global PSQI score (r=0.58, p < r="0.46," r="0.39," r="0.26," p =" 0.05)," r="0.44," r="0.62," r="0.65," p="0.10)." n =" 24)" n =" 31)">

A Letter to Healthy People

2006-05-19T18:52:00.000-04:00

Having hepatitis C virus, as with any invisible chronic illness means that your life as you once knew it is changed. Just because you can't see those changes doesn't mean they are not there and felt by us.

Most people don't understand hepatitis C and cannot imagine what living with a chronic illness means. With the hope that there are some who wish to understand, these are some of the things I'd like you to know about us.

Please understand that being sick doesn't mean we are not still human with all the same emotions that healthy people experience. Some of us must spend our time carefully so that we conserve what little energy we possess. If you visit we may not be much fun, but we still love and appreciate company. Some of us worry about our jobs, schooling and families. Most of the time we'd like to hear what is going on in your life as well as sharing our lives.

Please understand that one can be happy but not healthy. When you have the flu you feel fairly miserable, but we've been ill for years. We can't be miserable all the time, in fact most of us work hard at not being miserable. So when you speak with us and we sound happy, it means we are happy. That's all. It doesn't mean we are not sick, in pain and extremely fatigued, or that a miracle cure has been found and we are all healthy once again. Please don't say, "Oh you're sounding better!" We are not sounding better, we are sounding happy. Feel free to remark about our happiness. Just don't assume that it means we are better.

Please understand that being able to stand up and participate in an activity for 15 or 20 minutes, doesn't necessarily mean that we can participate for 30 minutes or an hour. It's quite likely that doing that 15 minutes has exhausted our resources and we may need time to recover. Remember the last time you played a swift game of tennis or softball. You couldn't repeat that feat over and over again. This applies to every thing we do.

Please understand that chronic illness is variable. It's quite possible that one day we are able to walk to the park, or shop in the mall, while the next day we may have no energy at all. Please don't say, "But you did it yesterday." If you want us to do something, just ask and we will tell you if we are able. If it is necessary to cancel an appointment with you at the last moment , please don't take it personally. There are days when we feel great and all of a sudden that changes and the fatigue is overwhelming.

Please don't ask us how we got this disease. There are many ways to acquire hepatitis C. Some of us made a foolish choice to experiment with IV drugs when we were young and invincible. Some of us were born with hemophilia and need to use blood products to stay alive. Some of us were given blood transfusions before 1992. Some of us are veterans who fought proudly for our country and some of us are kidney dialysis patients as well. Many of us have no risk factors at all and do not know where we got hepatitis C. If we wish to share our medical history with you, we will. Please don't be afraid to hug us, kiss us or hold us. You cannot "catch" hepatitis C from us unless there was a mixing of our blood with yours.

Please understand if we tell you that we have to sit down, lie down or take our meds, that we have to do it now. Chronic illness doesn't wait for a convenient time. It does not feel good to have to stop what we are doing to tend to our health. Remember that we didn't ask for this. We mourn for our lives before illness, when we were free to pursue all our dreams and hopes. We hope you understand.

It's Not Easy To Give A Mouse HCV

2006-05-19T18:42:00.000-04:00

It's not easy to give a mouse Hepatitis C. Scientists must modify the creature's liver and coax a virus to infect it. It's even harder to rid a mouse of hepatitis - a crucial step before curing people. Scientists at Sirna Therapeutics in , however, have done both. In July, Sirna published a paper that rocked the biotechnology world. Company researchers conquered a major problem in using RNA interference, one of the most promising new drug-discovery techniques: how to deliver RNA drugs to the right place in nontoxic doses. RNA, a genetic material similar to DNA, helps regulate a cell's activities. Since July 22, the last trading day before Sirna's announcement, the stock price has climbed about 66 percent to $4.36 Thursday. The shares, which traded at $8.28 in June 2002, had dropped to $1.67 at the beginning of July. "This is important. For RNA (interference) to be successful as a technology, it's all about delivery," said biotechnology analyst Michael King with Rodman and Renshaw Inc.

Sirna researchers crafted snippets of RNA that can switch genes on and off, or thwart nasty viruses by slicing up their genes, company officials said. They've also figured out how to "decorate" their RNA drugs with fat-like molecules, to keep them stable and nontoxic in the body - a breakthrough. The work was published in Nature Biotechnology July 24. The technique has worked now in Petri dishes, mice and monkeys, which have been cured of hepatitis with no side effects, Sirna officials said. "To be able to do selective gene silencing, that's the Holy Grail of medicine," said Howard Robin, Sirna's chief executive. Such claims for new techniques have been made before, said Barron Lerner, a medical historian and internist at in . Gene therapy, for example, has not delivered on its clinical promise, Lerner said, while bone marrow transplants for leukemia have... "This is going to change medicine," said John Rossi, a researcher with the Beckman Research Institute, a biomedical research center in "What they did was innovative." RNA, a genetic material similar to DNA, helps regulate a cell's activities. Since July 22, the last trading day before Sirna's announcement, the stock price has climbed about 66 percent to $4.36 Thursday. The shares, which traded at $8.28 in June 2002, had dropped to $1.67 at the beginning of July. "This is important. For RNA (interference) to be successful as a technology, it's all about delivery," said biotechnology analyst Michael King with Rodman and Renshaw Inc.

Sirna researchers crafted snippets of RNA that can switch genes on and off, or thwart nasty viruses by slicing up their genes, company officials said. They've also figured out how to "decorate" their RNA drugs with fat-like molecules, to keep them stable and nontoxic in the body - a breakthrough. The work was published in Nature Biotechnology July 24. The technique has worked now in Petri dishes, mice and monkeys, which have been cured of hepatitis with no side effects, Sirna officials said. "To be able to do selective gene silencing, that's the Holy Grail of medicine," said Howard Robin, Sirna's chief executive. Such claims for new techniques have been made before, said Barron Lerner, a medical historian and internist at in . Gene therapy, for example, has not delivered on its clinical promise, Lerner said, while bone marrow transplants for leukemia have...

The Importance of Treatment

2006-05-19T18:25:00.000-04:00

Treating (or not treating) your hep C is one of the most significant decisions you will ever make. For many people, treatment helps reduce the amount of hep C virus in the blood to a level where it can no longer be detected. Often, treatment has a positive effect on the liver—an impact that your doctor can see right away.

It may be tempting to put off treatment. The course of treatment can be difficult for many people, and it always seems easier to do nothing—to wait until a better, more convenient time in the future. But ask yourself these questions:

Have there ever been better, more successful treatments available for hep C? Will I ever be stronger, healthier, more ready to take on prescription treatment than I am right now? The answer to the first question is easy. There has never been better treatment available. We know more about hep C than we ever have, and treatment has made truly significant progress.

The answer to the second question is up to you and your doctor. Make sure you ask the tough questions and get good information and advice from your healthcare team. They may tell you what they have probably told many of their patients: “You’ll never be stronger than you are right now—today.”

How Can HepC Affect My Liver?

2006-05-19T18:12:00.000-04:00

The liver is the largest organ in the body. Located in the upper right side of the abdomen, it acts as a filter to remove toxins (harmful substances) and waste products from the blood. A healthy liver filters blood at a rate of about 1.5 quarts per minute. ThatÂs 540 gallons of blood a day!

The liver also stores nutrients, such as certain vitamins, minerals, and iron, and plays a role in making and controlling the amounts of certain chemicals and proteins in the body, such as cholesterol, hormones, and sugars. It helps the body digest food by producing a substance called bile, which is stored in the gallbladder.

The hep C virus attacks liver cells and uses them as a host to reproduce itself. When the body attempts to fight the virus, it sends lymphocytes (a type of white blood cell) to the liver, which results in inflammation (swelling). This inflammation is a normal response to infection, but over time this process, and certain chemicals released by the lymphocytes, can damage liver cells.

When the liver cells are damaged, they cannot function well and may die. Some of these cells may grow back, but severe injury may lead to fibrosis (a buildup of scar tissue on the liver). Fibrosis slows down theliverss ability to circulate blood and remove toxins.

Treatment may help prevent further damage or reduce progression of the condition. However, the longer treatment is delayed, the more likely significant and permanent liver damage will occur.

Over time, hardened scar tissue can replace large amounts of normal liver tissue. This condition, called cirrhosis, seriously impairs theliverss ability to function. As a result, blood that cannot pass freely through the liver may back up into the spleen, and this may lead to the destruction of healthy blood cells. In addition, the liver may not be able to produce enough bile to aid in the handling of nutrients, such as vitamins A, D, E, and K, and most fats.

If your liver is damaged, there are some important steps you can take to keep the undamaged cells as healthy as possible. You should talk to your doctor or nurse about your specific situation, but, in general, the following measures can help:

Avoid alcohol. The liver treats alcohol as a toxic substance and works to filter it out. In a person with hep C, alcohol significantly increases damage to the liver. It is especially important to avoid combining alcohol with acetaminophen (a nonprescription pain reliever). If taken together, these substances can cause additional damage to your liver.

Eat healthy foods. When the liver is damaged, your body may not get all the nutrients it needs, and you may feel weak or tired. You may also lose your appetite. It is important, therefore, to meet your daily nutritional needs so you can maintain your weight and energy levels.

Drink plenty of water. Water is a vital substance for all of the body's functions. It helps to remove toxins and process important nutrients. Drinking extra fluids may also help reduce side effects while on therapy.

Reduce salt in your diet. When liver disease is severe, signals are sent to the kidneys that cause them to retain both salt and water. The salt acts like a sponge, causing fluid to build up in the body. A low-salt diet can help reduce fluid buildup. Get vaccinations against hepatitis A and hepatitis B. In people with hep C, infection with another strain of hepatitis can cause further damage to the liver. Though there is no vaccine for hep C, a simple series of shots can protect most people from infection with the hepatitis A and hepatitis B viruses.

Although hepatitis C can lead to scarring and inflammation of the liver, treatment may help. Even if hep C therapy does not rid your body of the virus completely, it may help reduce inflammation and improve the overall health of your liver.

Is HCV A Druggie Disease?

2006-05-19T17:57:00.000-04:00

Hell no, it isn't....I refuse to wear the stigma that says ours is a "druggies" disease. True, Hepatitis C can be transmitted through the use of illicit drugs, as can many other blood-borne diseases and I don't deny that. However hepatitis C can also be spread in lots of other ways as well, through blood to blood contact.

There are at least 25% of HCV cases that are known as sporadic HCV which simply means unknown origin. It's no secret that prior to the 1990's, hepatitis C was unintentionally transmitted through blood transfusions and improper sterilization practices within the medical community. This is why it's so unfair to "paint every sufferer with the same brush!" and automatically assume that anyone infected with hep C is a former drug user. The truth is any situation where infected blood can enter the bloodstream of another person is a potential mode of transmission for hepatitis C. No test exists that can tell us when, where, or how a patient was infected, and in most cases, does it really matter?

The hepatitis C virus lives outside of the body for an undetermined time (depending on where you read) and can (and often does) remain infectious to others until infected tools used during invasive procedures are properly heat-disinfected as in an auto-clave. Not to point fingers but this was NOT routine practice within the medical community prior to the 1990's, and this may be why so many people are being diagnosed without a known source of infection. So please, do not feel ashamed of this disease, it is not your fault or a punishment from God, its a damn awful disease and EVERYONE is at risk....

Can HCV Live Outside the Body & Transmit Infection

2006-05-19T17:47:00.000-04:00

Recent studies suggest that HCV may survive on environmental surfaces at room temperature at least 16 hours, but no longer than 4 days.

I Have HCV, So What's Next

2006-05-19T17:38:00.000-04:00

If your doctor suspects you may have it, he or she will most likely perform a variety of tests to diagnose and monitor your condition. Four main types of tests are used to diagnose and monitor hepatitis C: Serologic Assays, Two types of tests are often used to screen for hepatitis C: enzyme linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA*). Both of these tests check for hepatitis C antibodies in the blood, which are produced by the body's immune system in response to the hepatitis C virus. ELISAs are suitable tests for screening patients who are at risk of infection, and are recommended as initial tests for patients who are showing symptoms of liver disease. In the past, doctors would often use RIBA tests to confirm a positive ELISA test. This was because ELISAs had a relatively high rate of false-positive results. However, new advances in ELISA tests have greatly reduced the need to confirm the results with additional tests. Therefore, RIBA tests are used less frequently today.The outcome of an antibody detection test (ELISA or RIBA) will be either positive or negative. A positive antibody detection test tells the doctor that the person has been exposed to the hepatitis C virus, but it does not reveal how much (if any) virus is currently in the blood.
Qualitative HCV Assays-If an ELISA test shows that you have been exposed to the hepatitis C virus, your doctor may perform a qualitative HCV Polymerase Chain Reaction (PCR) test.

This new technique specifically checks for hepatitis C viral RNA and is helpful in situations where the ELISA test is unreliable. The PCR is considered more definitive than the serologic assay tests, although the qualitative PCR test does not indicate how much virus is in the blood, just that the virus is present. Genotype Tests-Genotype testing finds out the type of hepatitis C virus a person has. At least 6 different genotypes, or varieties, of HCV have been identified. The major genotypes (1, 2, and 3) are found in most countries of the world, while the other three (4, 5, and 6) are found mainly in certain geographic areas. In the United States, approximately 72% of people infected with hepatitis C have genotype 1, and most others are types 2 or 3 (genotypes 4, 5, and 6 are not common in the United States). For details on the distribution of these genotypes, see The Question of Genotype. Genotyping may be important in determining treatment options, and also predicting how the virus will respond to therapy. For example, genotype 1 infections require therapy for 48 weeks, whereas shorter treatment may be possible for genotypes 2 and 3. In fact, in PEGASYS clinical studies, doctors found that patients who took PEGASYS along with COPEGUS responded to therapy just as well after 24 weeks as they did after 48 weeks. However, there is no conclusive evidence that the genotype influences the severity or outcome of the disease, or your risk of transmitting it.If you have been tested for HCV genotype, it may be important for you to know which genotype you have when discussing treatment options with your physician. Liver Health Tests, If you are diagnosed with hepatitis C, your healthcare provider may continue to perform a variety of tests to see how well your liver is functioning using one of the following methods. Many doctors now feel that doing treatment 72 weeks gives you better odds at beating the virus and I agree.

ALT (Alanine Aminotransferase)—A blood test is used to measure alanine aminotransferase (ALT), an enzyme that is normally found in the liver cells and in the blood. An increase in ALT levels indicates acute liver damage. Monitoring ALT levels is considered to be an inexpensive way of following the progression of HCV. However, a single ALT test will not reveal the severity of liver damage. Many individuals with chronic hepatitis C have normal ALT levels, so this test is not considered a completely accurate marker of progression. Liver biopsy—The best way to measure the extent of liver damage is with a liver biopsy. This is a procedure in which a tiny sample of tissue from the liver is removed and examined in a laboratory. Liver biopsies are also important in ruling out any other forms of liver disease.

Today, liver biopsies are performed as outpatient procedures. General anesthesia is not necessary. Patients receive local anesthesia at the area where the needle will be inserted. Although the test itself only takes a few seconds, you may be monitored at the testing facility for several hours. Patients often describe the sensation they experience during the test as a feeling of strong pressure on the spot where the tissue is removed. Patients may feel tired after the test, so it is a good idea to schedule some rest time after having a biopsy.

What this Blog is all about

2006-05-01T23:09:00.000-04:00

This blog will serve as an information outlet, regarding hep c.