Medications
The mainstay of treatment for hepatitis C has long been a virus-fighting drug called interferon. The medication, a protein, is given by injection and fortifies your immune system so that it can mount an attack against the virus. To boost effectiveness, interferon is often combined with a second antiviral called ribavirin which may be mixed with the interferon or given separately as a pill. Treatment may take six months to a year, or longer.
A big problem with interferon is its unpleasant side effects: it can make you exhausted, forgetful, depressed or feeling like you have a bad case of the flu. Even worse, the form of interferon that was commonly used in the past successfully eradicated the virus in only 10 to 20 percent of people who endured the gruelling regimen, and about 40 percent when it was combined with ribavirin. Not surprisingly, the drug acquired a bad reputation and many people opted to forego interferon treatments altogether.
A new and improved form of this medication called pegylated interferon is now available for people who cannot tolerate either standard inteferon or ribavirin, which makes it more tolearable. The drug remains active in your bloodstream much longer so injections are needed only once a week versus three times with the older form. About half of the people who are prescribed pegylated inteferon are cured and the success rate increases to about 60 percent with ribavirin. You may have more energy, less fatigue and pain and fewer side effects with the newer drug and so remain more motivated to stick with the treatment. If fatigue is a major problem for you, it may be due to anaemia; a medication called erythropoietin may help.
During your treatment, your doctor will likely perform regular blood tests to measure the virus levels and liver enzymes in your blood, which indicate active inflammation. If you are responding well to therapy, your liver enzymes should begin to decrease within three months. You may also have a liver biopsy in which a hollow needle is inserted through your ribs and into the liver to remove a small amount of liver tissue for analysis.
CONSIDERING THE GIFT OF LOVE?
Most donor livers are obtain from cadavers, but increasingly, family members and friends are stepping out to donate part of their livers to loved ones in need. Half or more of the healthy organ may be removed, a feat made possible by the liver's amazing ability to regenerate rapidly. Several weeks after the operation, both donor and recipient can expect to have full-sized, fully working livers. Almost 2000 of these living transplant operations have been performed in the last 10 years. The procedure is more complicated than related procedures (such as live kidney donations) and can take up to 18 hours. The vast majority of these operations are successful, which is one reason they are becoming increasingly commoplace.
Should I be vaccinated against hepatitis?
There are safe and effective vaccines against hepatitis A and B, but they do nothing if you're already sick. Hepatits A vaccine is good for travellers to countries where the disease is common. Children are routinely immunised for hepatitis B, and a combined A and B vaccine is also available.
The chameleon-like hepatitis C has eight different virus forms. This has stymied attempts to develop a vaccine, although work is progressing on it. If you have hepatitis C, your doctor may vaccinate you against hepatitis A and B so that you are not further jeopardised by those illnesses.
If you've tried the older form of inteferon in the past but did not respond, you might consider the newer form of the drug. About 20 percent of those who did not have success with the older drug are cured with the newer one. In some cases, a six- to tweleve-month course of drug therapy appears to work, but the virus later rebounds and comes back in even higher numbers. In this situaton, a second course of drug treatment may be called for. More than half of those who undergo a second course are cured. Even if you try interferon and the virus persists, the drug still helps protect your liver against inflammation. Some people with severly damaged livers stay on low does of interferon permanently since it may slow progression of the disease and forestall the need for a liver transplant.
Interferon is also commonly prescribed for hepatitis B, people with this form of chronic hepatitis may also benefit from a nucleoside analogue drug called lamivudie (Zeffix). Originally designed to combat HIV, the AIDS virus, lamivudine was also found to prevent the hepatitis B virus from reproducing, though it rarely eliminates the virus entirely. It also suppresses liver inflammation and has been found to induce remissons in more than half of those who try it. The drug may cause digestive upset, headaches or other side effects, but is generally well toleranted. It is taken as a pill once dialy. Your doctor may suggest you use it at least one to two years, and may be even indefinitely.
Procedures
If your disease progresses despite the use of medications or other therapies and you develop severe
liver scarring or cancer, you may be a candidate for a liver transplant. Over the past decade, advances in transplant surgery (see above) have made liver transplants a viable option for many of those with advanced liver disease. Nearly 2000 liver transplants have been performed in Australia and at least 150 in New Zealand since operations began.
The transplant operation is intensive, requiring up to 18 hours to complete. The diseased liver is removed through an incision in the abdomen and the new organ put in. Because of a shortage of
------------------------------------------------------------------------------------------------------------------------------
THE ABCS OF HEPATITIS
There are a number of different forms of hepatitis, each with its own treatment plan.
Hepatitis A
The most common type, hepatitis A, may make you very sick for several weeks, but it's usually temporary, with no lasting damage. There are no specific drugs or treatments other than limiting your activities, eating small meals to keep up your strength and abstaining from alcohol and all sexual contact while you're ill. Your doctor will also review any medicines or supplements you are taking because some may compromise your liver. Members of your family and those who are in close contact with you will need a protective injection of an immune-boostig substance called immune globulin within a period of 14 days.
Hepatitis B
Spread through blood and sexual contact, hepatitis B may lead to a chronic, simmering liver infection. Long-term treatment with antiviral drugs can help that progress.
Hepatitis C
Now the leading cause of chronic hepatitis in Australia and New Zealand, hepatitis C is considered a 'stealth infection' because most people don't even know they have it. Many became infected by transfusions prior to 1990, before sophisticated blod-screening techniques were widely used. Now, effective treatment is at hand.
Hepatitis D
Also called delta virus and found in the blood, hepatitis D piggybacks on the hepatitis B virus, causing a 'super infection' that may progress quite rapidly. Antiviral interferon treatments may help.
Hepatitis E
Rare in Australia and New Zealand (but common in developing countries) and spread through tainted water, spread through tainted water, hepatitis E, may cause an acute, flulike illness. It does not usually cause lasting damage but may be especially dangerous if you are pregnant.
Hepatitis G
Discovered in 1995, hepatitis G can lead to chronic disease in 15-30% of adults.
------------------------------------------------------------------------------------------------------------------------------
donar livers, it is not uncommon to have to wait for several months for a compatible organ to become available. Doctors see to match the new organ as closely as possible with your generic make-up so that you will be less likely to reject it. Recovery from the operation takes about three months.
More than half of those who receive a donor liver are live and well two years later. You will need to take immune-suppressing drugs such as cyclosporine indefinitely. Unfortunately, sometimes the hepatitis returns.Your doctor may suggest you take hepatitis medications such as interferon over the long term.
Natural methods
Certain herbs can help strengthen your liver's fight against hepatitis; always check with your doctor about interactions first.
Milk thistle. This herb, which contains a powerful antioxidant and liver protector called silymarin, also promotes the regeneration of new liver cells and improves liver function.
Dandelion root. When this herb is taken in conjunction with thistle and the B vitamins, choline and inositol hexaniacinate, it forms a 'lipotropic combination', which helps strengthen the liver and may help it rid itself of bile and toxins.
Chinese herbs. In small European studies, a combination of the herbs schizandra, artemisia and patrinia were shown to reduce levels of the hepatitis C virus. Further study is warranted.
The mainstay of treatment for hepatitis C has long been a virus-fighting drug called interferon. The medication, a protein, is given by injection and fortifies your immune system so that it can mount an attack against the virus. To boost effectiveness, interferon is often combined with a second antiviral called ribavirin which may be mixed with the interferon or given separately as a pill. Treatment may take six months to a year, or longer.
A big problem with interferon is its unpleasant side effects: it can make you exhausted, forgetful, depressed or feeling like you have a bad case of the flu. Even worse, the form of interferon that was commonly used in the past successfully eradicated the virus in only 10 to 20 percent of people who endured the gruelling regimen, and about 40 percent when it was combined with ribavirin. Not surprisingly, the drug acquired a bad reputation and many people opted to forego interferon treatments altogether.
A new and improved form of this medication called pegylated interferon is now available for people who cannot tolerate either standard inteferon or ribavirin, which makes it more tolearable. The drug remains active in your bloodstream much longer so injections are needed only once a week versus three times with the older form. About half of the people who are prescribed pegylated inteferon are cured and the success rate increases to about 60 percent with ribavirin. You may have more energy, less fatigue and pain and fewer side effects with the newer drug and so remain more motivated to stick with the treatment. If fatigue is a major problem for you, it may be due to anaemia; a medication called erythropoietin may help.
During your treatment, your doctor will likely perform regular blood tests to measure the virus levels and liver enzymes in your blood, which indicate active inflammation. If you are responding well to therapy, your liver enzymes should begin to decrease within three months. You may also have a liver biopsy in which a hollow needle is inserted through your ribs and into the liver to remove a small amount of liver tissue for analysis.
CONSIDERING THE GIFT OF LOVE?
Most donor livers are obtain from cadavers, but increasingly, family members and friends are stepping out to donate part of their livers to loved ones in need. Half or more of the healthy organ may be removed, a feat made possible by the liver's amazing ability to regenerate rapidly. Several weeks after the operation, both donor and recipient can expect to have full-sized, fully working livers. Almost 2000 of these living transplant operations have been performed in the last 10 years. The procedure is more complicated than related procedures (such as live kidney donations) and can take up to 18 hours. The vast majority of these operations are successful, which is one reason they are becoming increasingly commoplace.
Should I be vaccinated against hepatitis?
There are safe and effective vaccines against hepatitis A and B, but they do nothing if you're already sick. Hepatits A vaccine is good for travellers to countries where the disease is common. Children are routinely immunised for hepatitis B, and a combined A and B vaccine is also available.
The chameleon-like hepatitis C has eight different virus forms. This has stymied attempts to develop a vaccine, although work is progressing on it. If you have hepatitis C, your doctor may vaccinate you against hepatitis A and B so that you are not further jeopardised by those illnesses.
If you've tried the older form of inteferon in the past but did not respond, you might consider the newer form of the drug. About 20 percent of those who did not have success with the older drug are cured with the newer one. In some cases, a six- to tweleve-month course of drug therapy appears to work, but the virus later rebounds and comes back in even higher numbers. In this situaton, a second course of drug treatment may be called for. More than half of those who undergo a second course are cured. Even if you try interferon and the virus persists, the drug still helps protect your liver against inflammation. Some people with severly damaged livers stay on low does of interferon permanently since it may slow progression of the disease and forestall the need for a liver transplant.
Interferon is also commonly prescribed for hepatitis B, people with this form of chronic hepatitis may also benefit from a nucleoside analogue drug called lamivudie (Zeffix). Originally designed to combat HIV, the AIDS virus, lamivudine was also found to prevent the hepatitis B virus from reproducing, though it rarely eliminates the virus entirely. It also suppresses liver inflammation and has been found to induce remissons in more than half of those who try it. The drug may cause digestive upset, headaches or other side effects, but is generally well toleranted. It is taken as a pill once dialy. Your doctor may suggest you use it at least one to two years, and may be even indefinitely.
Procedures
If your disease progresses despite the use of medications or other therapies and you develop severe
liver scarring or cancer, you may be a candidate for a liver transplant. Over the past decade, advances in transplant surgery (see above) have made liver transplants a viable option for many of those with advanced liver disease. Nearly 2000 liver transplants have been performed in Australia and at least 150 in New Zealand since operations began.
The transplant operation is intensive, requiring up to 18 hours to complete. The diseased liver is removed through an incision in the abdomen and the new organ put in. Because of a shortage of
------------------------------------------------------------------------------------------------------------------------------
THE ABCS OF HEPATITIS
There are a number of different forms of hepatitis, each with its own treatment plan.
Hepatitis A
The most common type, hepatitis A, may make you very sick for several weeks, but it's usually temporary, with no lasting damage. There are no specific drugs or treatments other than limiting your activities, eating small meals to keep up your strength and abstaining from alcohol and all sexual contact while you're ill. Your doctor will also review any medicines or supplements you are taking because some may compromise your liver. Members of your family and those who are in close contact with you will need a protective injection of an immune-boostig substance called immune globulin within a period of 14 days.
Hepatitis B
Spread through blood and sexual contact, hepatitis B may lead to a chronic, simmering liver infection. Long-term treatment with antiviral drugs can help that progress.
Hepatitis C
Now the leading cause of chronic hepatitis in Australia and New Zealand, hepatitis C is considered a 'stealth infection' because most people don't even know they have it. Many became infected by transfusions prior to 1990, before sophisticated blod-screening techniques were widely used. Now, effective treatment is at hand.
Hepatitis D
Also called delta virus and found in the blood, hepatitis D piggybacks on the hepatitis B virus, causing a 'super infection' that may progress quite rapidly. Antiviral interferon treatments may help.
Hepatitis E
Rare in Australia and New Zealand (but common in developing countries) and spread through tainted water, spread through tainted water, hepatitis E, may cause an acute, flulike illness. It does not usually cause lasting damage but may be especially dangerous if you are pregnant.
Hepatitis G
Discovered in 1995, hepatitis G can lead to chronic disease in 15-30% of adults.
------------------------------------------------------------------------------------------------------------------------------
donar livers, it is not uncommon to have to wait for several months for a compatible organ to become available. Doctors see to match the new organ as closely as possible with your generic make-up so that you will be less likely to reject it. Recovery from the operation takes about three months.
More than half of those who receive a donor liver are live and well two years later. You will need to take immune-suppressing drugs such as cyclosporine indefinitely. Unfortunately, sometimes the hepatitis returns.Your doctor may suggest you take hepatitis medications such as interferon over the long term.
Natural methods
Certain herbs can help strengthen your liver's fight against hepatitis; always check with your doctor about interactions first.
Milk thistle. This herb, which contains a powerful antioxidant and liver protector called silymarin, also promotes the regeneration of new liver cells and improves liver function.
Dandelion root. When this herb is taken in conjunction with thistle and the B vitamins, choline and inositol hexaniacinate, it forms a 'lipotropic combination', which helps strengthen the liver and may help it rid itself of bile and toxins.
Chinese herbs. In small European studies, a combination of the herbs schizandra, artemisia and patrinia were shown to reduce levels of the hepatitis C virus. Further study is warranted.
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