Hepatitis C

Many people believe that they do not fall into risk categories for contracting hepatitis C (HCV). They have never used intravenous drugs, snorted cocaine or had surgery requiring a blood transfusion. But did you know that you could have had a blood transfusion during surgery and not been told? Did you know that somewhere between 20 to 40 percent of the people infected with HCV don't have any of these risk factors? It's called sporadic transmission. We need to look closer at the little we do know.

We know that the virus requires blood-to-blood contact to be transmitted. Have you ever had a manicure or pedicure? Did the esthetician autoclave her equipment (because that's the only way to kill this virus)? Do you have tattoos? Have you ever shared toothbrushes, nail clippers, manicure equipment, electric razors? Have you had multiple sex partners (defined as greater than five) in your lifetime? If you answered yes to any one of these questions, you should be tested for hepatitis C. The British Columbia Centre for Disease Control estimates that 40,000 British Columbians have hepatitis and many don't know it.

As co-program manager for the Hepatitis C and Human Immunodeficiency Virus (HIV) Education (HEPHIVE) project, I see people infected with hepatitis C every day. We go into the prisons where HCV runs rampant and provide information to inmates and prison staff on how to stop the spread of this disease. In an immuno-compromised HIV individual, false negatives to the antibody test for HCV are possible.

Hepatitis C is in the same family as Yellow Fever, Dengue Fever, hepatitis G and the most recently discovered West Nile virus. It's a ribonucleic single strand virus and its host cells are in the liver. This is where it replicates. The virus makes about one trillion copies of itself in one day and is prone to mutations. These mutations are what allow it to escape the immune system. The liver cell is destroyed when the virus reaches a critical mass and breaks out of the cell to infect other liver cells. This leads to cell death and inflammation in the liver. The contents of its cells spill out into the blood and one of these enzymes is called alanine transaminase. This is one of the common tests ordered by doctors and should be monitored on a regular basis (every three to six months).

Chronic infection of the hepatitis C virus leads to scarring in the liver, which in 25 percent of infections may lead to cirrhosis. The presence of cirrhosis increases the risk of liver cancer by 25 per cent. Hepatitis C is the leading cause of liver transplantation.

So what can we do to minimize the damage? We are not powerless in this situation. We can make lifestyle changes that help slow the progression of the disease and improve the quality of life for those that are symptomatic. Living a healthy lifestyle was never as important as now.

Take Positive Steps

The intake of alcohol tops the list of things you need to change if you have hepatitis C. For many people, the easiest thing to do is stop drinking altogether. Alcohol has been shown to cause an increase in the rate of progression of scarring. However, many people feel that a glass of wine for dinner is an important part of their lives and the debate over whether a glass or two is harmful continues among the medical community.

Some multivitamins contain certain ingredients that are not good for the HCV-infected liver. However, in a regular strength tablet, we do not feel that this risk is excessive. Further iron supplementation should be stopped. Iron is used by the virus and speeds up its replication. Furthermore, hematomochrosis can be found in association with hepatitis C and leads to excess iron storage in the liver, which increases the scar tissue formation.

Hepatitis can cause a condition known as steatosis (fatty liver) and this leads to increases in scar tissue. Sugar should be avoided as there are problems with a glucose metabolism. In fact, there is a significant increase of diabetes in people with hepatitis C.

So what's okay? Good wholesome food, preferably organically grown. Lots of fruits and vegetables and the more different colours you choose, the more enzymes and protective antioxidants you're getting.

Complex grains and breads are okay. But there have been anecdotal reports from a number of people who have wheat allergies that a gluten-free diet may relieve the bloating, gas and pain.

Cultured milk and milk products that include yogurt and kefir with live bacteria are fine. They help improve the gut flora, which can aid digestive problems.

We also recommend what we call the antioxidant cocktail. Antioxidants in general stop the oxidative damage that leads to the cascade of events causing scarring. We've done a lot of research and most of these antioxidants are also decreased in the liver tissue of people with hepatitis C. They include alpha lipoic acid (100-600 mg), vitamin E (800-1,200 mg), folic acid (one mg), selenium (1/2 mcg), vitamin B₁₂ (1,000 mcg sublingual) and coenzyme Q₁₀ (60 mg). All of these together seem to improve fatigue and therefore increase the quality of life.

And we can't forget milk thistle, which is known to improve regeneration of liver tissue and acts as a powerful antioxidant. The phosphotidyl choline-bound milk thistle was superior in clinical trials on HIV at Bastyr College of Naturopathic Medicine.

Tylenol is harmful to the liver. So are non-steroidal anti-inflammatories like ibuprofen and aspirin. Even small doses of Tylenol, when taken in conjunction with alcohol, can be deadly to the HCV-infected liver. There is a three-fold increase in liver cancer in people with hepatitis C who smoke.

For more information please see hepcvsg.org.

For more in-depth information read Liver Cleansing Handbook by Rhody Lake, number four in the alive Natural Health Guide series. Available in your health food store or through alive books (800-661-0303).