Hepatitis C | What is Hepatitis? | The causes and Types of Hepatitis C | Hepatitis C at a Glance | How does hepatitis affect the liver? | The Life Cycle of Hepatitis C | Hepatitis C virus | Diagnosis of Hepatitis C | How does Hepatitis C develop? | Hepatitis C viruses | How will I know if I have Hepatitis C? | Transmission of Hepatitis C | Can I give the disease to others? | Treatment of Hepatitis C | Is there a vaccine for hepatitis C? | Living With Hepatitis C | Testing For Hepatitis C Virus

Hepatitis C INFORMATION

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). The infection is spread by contact with blood of an infected person. Serious for some, but not others, most people who get hepatitis C carry the virus for the rest of their lives. Research is being made concerning a hepatitis C cure.

Most have some liver damage but many do not feel sick from the disease. As a result of the liver damage, cirrhosis (scarring) of the liver and liver failure may develop.

For a slight majority of patients, the illness begins suddenly as though one had come down with the flu. Except that this "flu" doesn't seem to completely go away.

Information on hepatitis c symptoms

For many other patients, the onset appears gradually over a long period of time. Infants and young children often have no hepatitis c symptoms at all.

Many other hepatitis c symptoms may also be present, however they will typically be different among different patients. These include: fatigue, low-grade fever, headaches; slight sore throat, loss of appetite, nausea, vomiting, stiff or aching joints, and liver damage.

Many people develop a pain in the right side, over the liver area. The urine may become dark brown, and the feces may be pale. In severe acute infections, some people may develop jaundice in which the skin and whites of the eyes become yellowish. Researchers are extremely dedicated to identifying a cure.

The degree of severity from Hepatitis C can differ widely among patients, and will also vary over time for the same patient. Severity can vary between getting unusually fatigued following stressful events, to being totally bedridden and completely disabled. The hepatitis c symptom has a tendency to wax and wane over time.

Find this page in the future: type 33sititapeh in a searchbox(that's "hepatitis33 " backwards)

What is Hepatitis?

Hepatitis is an inflammation of the liver. Inflammation causes soreness and swelling. Hepatitis can be caused by many things. Lack of blood supply to the liver, poison, autoimmune disorders, an injury to the liver,  and taking some medicines can cause hepatitis. However, hepatitis is most commonly caused by a virus.

There are 2 main kinds of hepatitis, acute hepatitis and chronic hepatitis. When a person has hepatitis, the liver may become inflamed very suddenly. This is called acute hepatitis. If you have acute hepatitis, you might have nausea, vomiting, fever and body aches. Or you may not have any hepatitis c symptoms.

Most people get over the acute inflammation in a few days or a few weeks. Sometimes, however, the inflammation doesn't go away. When the inflammation doesn't go away, the person has chronic hepatitis. This resists a cure.

Virus Information

Hepatitis C virus is one of several viruses that can cause Hepatitis, which is inflammation of the liver. It is unrelated to the other common hepatitis viruses (A, B, D, and E). Hepatitis C virus is a member of the Flaviviridae family of viruses. Other members of this family of viruses include those that cause yellow fever and dengue.

Hepatitis C has been referred to as a “silent epidemic.” Millions have the condition, but many of them are not aware of it because they may not experience hepatitis c symptoms for decades after they are infected. That’s a big reason why hepatitis testing and treatment are so important.

According to the National Institutes of Health:

•           Approximately 1.8% of the U.S. population, or 3.9 million Americans, have been infected with the hepatitis C virus

•           About 35,000 new cases of hepatitis C are estimated to occur in the United States each year

•           Chronic hepatitis C is now the most common reason for liver transplantation and the leading cause in the U.S. for developing liver cancer. A cure is necessary.

“Hepatitis” is a Latin word meaning “inflamed liver.” Liver inflammation is often caused by a virus. While many viruses can affect the liver as they spread throughout the body (for example, the infectious mononucleosis virus), the hepatitis viruses infect the liver as their primary target.

There are 5 well-characterized types of viral hepatitis, but only 3 are common: A, B, and C. Hepatitis C is the most common chronic blood-borne infection in the United States.

All viral forms of hepatitis can be spread from one person to another, although the ways it is transmitted may differ for each.

Hepatitis A can be spread by contaminated food and water, and hepatitis B and C can be transmitted through blood-to-blood contact. A single person may be infected with more than one type of hepatitis.

Because of the risk of additional liver damage, people with hepatitis C should talk to their doctor about getting a vaccination against hepatitis A and hepatitis B. Unlike A and B, there is no vaccine against hepatitis C.

            http://www.hepctherapy:net/need_to_know/need_to_know.asp

The Centers for Disease Control and Prevention have told your doctor that: “anyone who wishes to know or is concerned regarding their HCV infection status should be provided the opportunity for counseling, testing, and appropriate follow-up.”

More information

What does that mean?

•           If you want the test, you should be able to get it just by asking—you don’t need to give a reason.

•           If you want information before testing, you should be able to get it.

•           After your test results are in, they should be explained to you along with a plan for your future health.

If your primary care doctor ordered your hepatitis C test, ask about referral to a GI specialist or hepatologist (liver expert). Your doctor can explain why these physicians are the right specialists for your condition.

Want another reason? Here’s a big one:

Patients treated earlier for hepatitis C may respond to hepatitis c treatment better. This is not a guaranteed cure.

There’s also the risk to those close to you if you have hepatitis C and don’t know it. There are many ways to spread hepatitis C, including through personal care items (such as a razor or toothbrush) or a household accident that brings anyone into contact with your blood.

So you owe it to yourself and your loved ones to get tested and find out about all of your hepatitis c treatment options.

Medical Dislaimer

The information contained on this site is provided for your general information only. Its author does not give medical advice or engage in the practice of medicine. The author under no circumstances recommends particular treatment for specific individuals and in all cases recommends that you consult your physician or local treatment center before pursuing any course of treatment.

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

Information on delaying treatment

It may be tempting to put off hepatitis c treatment. The course of hepatitis c 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 hepatitis c treatments available for hepatitis C?

•           Will I ever be stronger, healthier, more ready to take on prescription hepatitis c treatment than I am right now?

The answer to the first question is easy. There has never been better hepatitis c treatment available. We know more about hepatitis C than we ever have, and hepatitis c treatment has made truly significant progress. Keep looking for a hepatitis C cure.

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.”

Hepatitis is an inflammation of the liver, usually caused by a viral infection, which is characterized by jaundice (yellowing of the skin and the whites of the eyes).

There are 3 viruses that cause hepatitis. Each hepatitis virus is named with a letter of the alphabet: hepatitis A, hepatitis B and hepatitis C. Hepatitis C is usually spread through contact with blood products, like accidentally being stuck with a dirty (used) needle, using IV drugs and sharing needles, or getting a blood transfusion before 1992. Most people don't feel sick when they are first infected with hepatitis C. Instead, the virus stays in their liver and causes chronic liver inflammation.

Most people who are infected with hepatitis C don't have any hepatitis c symptoms for years. However, hepatitis C is a chronic illness (it doesn't go away). If you have hepatitis C, you need to be watched carefully by a doctor because it can lead to cirrhosis (a liver disease) and liver cancer.

I've never used IV drugs or been stuck with a dirty needle. How did I get hepatitis C?

Hepatitis C is usually spread through direct contact with the blood of a person who has the disease. Many times, the cause of hepatitis C is never found.

Sex and Bodily Contact Information

This virus can be transmitted through sex. It can also be passed from one person to another by living in the same house with someone who has hepatitis C. Sharing razors or toothbrushes can transmit the hepatitis C virus. It can be transmitted by tattoo needles. It can even be passed from a mother to her unborn baby. All of these ways of catching hepatitis C are uncommon, but they do occur.

Hepatitis C can't be spread unless a person has direct contact with infected blood. This means a person who has hepatitis C can't pass the virus to others through casual contact such as sneezing, coughing, shaking hands, hugging,kissing, sharing eating utensils or drinking glasses, swimming in a pool, using public toilets or touching doorknobs.

Causes and Types of Hepatitis C

The disease is caused by several viruses, but the most common are those that cause hepatitis A (called infectious hepatitis), hepatitis B (called serum hepatitis), and hepatitis C (called non-A, non-B hepatitis). Intense study is devoted to finding a cure for them.

Hepatitis C Transmission Information

Hepatitis A is transmitted from person to person via contaminated food (either food handled by someone infected with the virus or undercooked shellfish from waters contaminated with the virus) or water or contact with the stools of an infected person.

This disease may occur in epidemics where sanitation is poor and the water supply is contaminated. The incubation period (the time between exposure and the appearance of hepatitis c symptoms) is between 14 and 40 days.

Sometimes, hepatitis A is so mild that hepatitis c symptoms never appear, but the infected person can still be a carrier and can transmit the disease to others. It doesn’t mean the infected person has experienced a cure, though.

In hepatitis B, the virus enters the bloodstream through contact with contaminated blood or other body fluids, such as semen, or with stool or through the use of contaminated hypodermic needles. Hepatitis B begins more gradually than does hepatitis A, so the disease may be present 40 to 180 days before the onset of hepatitis c symptoms. Because the virus can live in almost all body fluids, including saliva, semen, stool, and tears, hepatitis B can be transmitted by sexual contact or, rarely, by casual contact.

Additional Hepatitis C Transmission Information

Hepatitis C virus is presumed to be a major cause of what was previously known as "non-A, non-B hepatitis." The incubation period of the virus is somewhere between that of A and B, and its mode of transmission is similar to B. It's the most common cause of post-transfusion hepatitis.

Chronic hepatitis is a condition of persistent (more than six months) inflammation of the liver. It is most frequently due to infection with hepatitis B or C virus. Although some forms of chronic hepatitis can be mild, others can lead to severe liver damage and cirrhosis. Cirrhosis is a condition in which the liver is so scarred and distorted that it is no longer able to perform its functions normally.

The diagnosis of chronic hepatitis is usually confirmed by liver biopsy. In this procedure, a local anesthetic is injected into the right upper abdomen. A thin needle is inserted into the liver, and a section of tissue is removed for examination under a microscope. This procedure rarely requires a hospital stay of more than six hours. It is not a cure, but a diagnostic tool

Hepatitis that is not caused by any of the above viruses can be associated with mononucleosis and other viral illnesses; hepatitis can also be an adverse side effect of certain medications.

Hepatitis c symptoms

Early signs of acute hepatitis include general fatigue, joint and muscle pain, and loss of appetite. Nausea, vomiting, and diarrhea or constipation may follow, with a low-grade fever of 101 degrees Fahrenheit or less. As the disease develops, the liver enlarges and becomes tender.

Chills, weight loss, and a change in the perception of taste appear along with the characteristic jaundice. Jaundice results from an accumulation of yellow bile pigment in the blood, which turns the skin and the whites of the eyes yellow.

In hepatitis A, the disappearance of jaundice generally signals the clearing of the virus from the blood. However, in hepatitis B or C, the virus may persist for years or even a lifetime. That’s why it is important to find a cure.

Hepatitis C at a Glance:

•           In the U.S., hepatitis C virus (HCV) infection is the most common cause of chronic hepatitis, and the complications of hepatitis C virus cirrhosis are the most common reasons for liver transplantation.

•           Hepatitis C virus is one of several viruses (A, B, C, D, and E) that can cause hepatitis (inflammation of the liver). hepatitis C virus is distinct from these other viruses.

•           One of the major problems with hepatitis C virus is that 85% of individuals who are initially (acutely) infected with hepatitis C virus will become chronically (long duration) infected. About one third of individuals chronically infected with hepatitis C virus will progress to cirrhosis.

•           Hepatitis C virus is spread (transmitted) through the blood. Intravenous drug abuse is the most common mode of transmission, while the risk of acquiring hepatitis C virus through sexual contact is quite low.

  Signs and Symptoms

•           Generally, patients do not develop hepatitis c symptoms until they have progressed to advanced cirrhosis. Some individuals, however, may have fatigue and other non-specific hepatitis c symptoms in the absence of cirrhosis. A minority of hepatitis C virus patients may have hepatitis c symptoms coming from involved organs outside of the liver.

•           Hepatitis C is diagnosed by anti-hepatitis C virus antibody tests, which diagnosis is then confirmed by nucleic acid based tests for the virus itself. The amount of the virus in the blood (viral load) does not correlate with the severity of the disease.

•           A liver biopsy is used to assess the amount of liver damage (liver cell injury and scarring), which may be important in determining the outcome (prognosis) and in planning hepatitis c treatment.

•           Considerable progress has been made in the treatment of hepatitis C virus. For patients infected with genotype 2 or 3, successful hepatitis c treatment with combined interferon (conventional or pegylated) and ribavirin can be achieved in up to 80% of patients.

•           Treatment for patients infected with genotype 1 hepatitis C virus, for whom the success rate with combined pegylated interferon and ribavirin is just under 50%, remains a challenge.

•           Treatment is recommended for patients with detectable hepatitis C virus RNA who have persistently elevated liver tests and evidence of scarring and at least moderate inflammation on their liver biopsy, but without outward signs of liver failure.

•           Treatment results in improvement in the inflammation and scarring of the liver in most sustained responders and also occasionally (and to a much lesser extent) in relapsers and non-responders.

•           Clinical trials are underway to evaluate combinations of various antiviral agents and pegylated interferon in the treatment of hepatitis C.

How does hepatitis affect the liver?

The liver breaks down waste products in your blood. When the liver is inflamed, it doesn't do a good job of getting rid of waste products. One waste product in the blood, called bilirubin (say "billy-roo-bin"), begins to build up in the blood and tissues when the liver isn't working right.

The bilirubin makes the skin of a person with hepatitis turn a yellow-orange color. This is called jaundice (say "john-dis"). Bilirubin and other waste products may also cause itching, nausea, fever and body aches.

The Life Cycle of Hepatitis C

The hepatitis C virus must attach to and infect liver cells in order to carry out its life cycle and reproduce - this is why it is associated with liver disease. While little is known about the exact

Hepatitis C virus nucleocapsid (completed particle).

1. The virus locates and attaches itself to a liver cell. Hepatitis C uses particular proteins present on its protective lipid coat to attach to a receptor site (a recognizable structure on the surface of the liver cell).

2. The virus's protein core penetrates the plasma membrane and enters the cell. To accomplish this, hepatitis C utlilizes its protective lipid (fatty) coat, merging its lipid coat with the cellÕs outer membrane (the coat is in fact composed of a fragment of another liver cell's plasma membrane). Once the lipid coat has successfully fused to the plasma membrane, the membrane engulfs the virus - and the viral core is inside the cell.

3. The protein coat dissolves to release the viral RNA in the cell. This may be accomplished during penetration of the cell membrane (it is broken open when it is released into the cytoplasm), or special enzymes present in liver cells may be used to dissolve the casing.

4. The viral RNA then coopts the cell's ribosomes, and begins the production of materials necessary for viral reproduction. Because hepatitis C stores its information in a "sense" strand of RNA, the viral RNA itself can be directly read by the host cell's ribosomes, functioning like the normal mRNA present in the cell.

As it begins producing the materials coded in its RNA, the virus also probably shuts down most of the normal functions of the cell, conserving its energy for the production of viral material, although it occasionally appears that hepatitis C will stimulate the cell to reproduce (presumably to create more cells that can produce viruses), which is why hepatitis C is often associated with liver cancer. The viral RNA first synthesizes the RNA transcriptase it will need for reproduction.

5. Once there is adequate RNA transcriptase, the viral RNA creates an antisense version (the paired opposite) of itself as a template for the creation of new viral RNA. The viral RNA is now copied hundreds or thousands of times, making the genetic material for new viruses. Some of this new RNA will contain mutations.

6. Viral RNA then directs the production of protein-based capsomeres (the building blocks for the virus's protective protein coat). Ribosomes create the proteins and release them for use.

7. The completed capsomeres assemble around the new viral RNA into new viral particles. The capsomeres are designed to attract each other and fit together in a certain way. When enough capsomeres are brought together, they self-assemble to form a spherical shell, called a capsid, that fully encapsulates the virus's RNA. The completed particle is called a nucleocapsid.

Liver cells infected with the hepatitis C virus.

8. The newly formed viruses travel to the inside portion of the plasma membrane and attach to it, creating a bud. The plasma membrane encircles the virus and then releases it - providing the virus with its protective lipid coat, which it will later use to attach to another liver cell. This process of budding and release of new viruses continues for hours at the cell surface until the cell dies from exhaustion.

Each surviving virus - those which are not destroyed by the immune system or other environmental factors - can produce hundreds or thousands of offspring. Over time, this endless cycle of reproduction results in significant damage to the liver, as millions upon millions of cells are destroyed by viral reproduction or by the immune system's attacks on infected cells.

The symptoms of hepatitis C are difficult to recognize, for they are progressive in nature and often very mild, at least in the early stages of infection. For more than six months following initial infection, the disease is virtually undetectable.

The most common symptom, commencing sometimes years after initial infection, is fatigue. Other symptoms include mild fever, muscle and joint aches, nausea, vomiting, loss of appetite, vague abdominal pain, and sometimes diarrhea.

Many cases go undiagnosed because the hepatitis c symptoms are suggestive of a flu-like illness which just comes and goes, or these hepatitis c symptoms are so mild that the patient is unaware of anything unusual.

A minority of patients notice dark urine and light colored stools, followed by jaundice in which the skin and whites of the eyes appear yellow. Itching of the skin may be present. Some people may lose 5 to 10 pounds.

Individuals infected with HCV are often identified because they are found to have elevated liver enzymes on a routine blood test or because a hepatitis C antibody is found to be positive at the time of blood donation.

In general, elevated liver enzymes and a positive antibody test for HCV (anti-HCV) means that an individual has chronic hepatitis C. A very small percentage of patients may recover from acute hepatitis C, but their anti-HCV test will remain positive.

Advanced cirrhosis in a human liver.

Information on Contagious Hepatitis C

Low level infection, in which the infected individual is virtually asymptomatic but still highly contagious, may continue for years, even decades, before progressing significantly.

However, more than 80% of infected individuals eventually progress to the chronic stage of the disease, which seems to eventually result in cirrhosis (scarring of the liver tissue), and end-stage liver disease. This appears to take, on average, about 20 years to develop.

At this point, the hepatitis c symptoms are commensurate with liver disease or liver failure, including jaundice and abdominal swelling (due to fluid retention called ascites), depending on the severity of the liver disease and whether or not cirrhosis has developed. Some patients with cirrhosis do well over time, while others die in 10 and sometimes 5 years.

Disorders of the thyroid, intestine, eyes, joints, blood, spleen, kidneys and skin may occur in about 20% of patients. Primary liver cancer can also develop from hepatitis C, a late risk factor which seems to be present 30 years or so after infection.

Diagnosis of Hepatitis C

To determine the extent and severity of hepatitis, a physician analyzes blood specimens from the patient. Usually, over the course of several weeks, the liver function tests (blood tests sometimes called liver enzymes) return to normal. Most individuals recover completely and are immune to reinfection with the particular virus they had.

Now that we have learned about the causes, symptoms, and diagnosis of hepatitis, let's look into the treatment and prevention in the next section.

Treatment and Prevention of Hepatitis C

There is no cure for viral hepatitis, and treatment options are limited, especially for acute hepatitis. Once the virus attacks, recovery is usually up to the body's natural defense mechanisms.

To encourage the healing process, physicians advise patients to avoid strenuous activity. Bed rest is important during the acute phase of hepatitis. More serious cases may require hospitalization to ensure adequate nutrition.

All hepatitis patients must avoid alcoholic beverages, because processing alcohol puts a tremendous strain on the liver. All medications taken, including over-the-counter (nonprescription) preparations, must first be approved by the physician, because the liver is responsible for clearing most medications from the body.

Inflammation of the liver may lessen its ability to perform this function and thus lead to increased levels of the medications in the body, which can cause toxic effects. The treatment of chronic hepatitis depends on its form as well as its severity.

Prevention and Information about Vaccines

Individuals who have been exposed to hepatitis A or who are or have been traveling to areas of the world in which it is common will probably benefit from hepatitis A vaccine. For those who will be traveling to areas where hepatitis A is common, the vaccine must be administered at least two weeks before travel begins.

Hepatitis B can be effectively prevented by a vaccine as well. The vaccine consists of three injections: right away, one month later, and six months later. The hepatitis B vaccine is recommended for all individuals at high risk of hepatitis, and recently, the vaccine has been recommended for all children as well. There is, as yet, no vaccine available for the prevention of hepatitis C.

How does Hepatitis C develop?

In general, Hepatitis C appears to be a slowly, progressive disease that may gradually advance over 10-40 years. In one study, chronic hepatitis confirmed by liver biopsy was identified on the average of ten years following blood transfusions and cirrhosis on an average of 20 years.

It also appears that HCV, like the hepatitis B virus, is associated with an increased chance of developing hepatocellular carcinoma, a type of liver cancer. Almost all HCV-related liver cancer occurs with cirrhosis (scarring) of the liver.

Hepatitis C viruses.

Although its means of transmission is fairly well documented, the hepatitis C virus itself largely remains a mystery. Hepatitis C is extremely small, even for a virus - it is only about 50 nanometers in diameter.

A nanometer is one billionth of a meter - if you placed 200,000 hepatitis C viruses end to end, they would be only a single centimeter long. (They are so small that they have no color - they are in fact smaller than the wavelength of visible light.) However, what is known about hepatitis C underscores the type of threat that it poses.

Hepatitis C is an RNA virus - which means that it mutates frequently. Once an infection has begun, hepatitis C creates different genetic variations of itself within the body of the host. The mutated forms are frequently different enough from their ancestors that the immune system cannot recognize them.

Thus, even if the immune system begins to succeed against one variation, the mutant strains quickly take over and become new, predominant strains. As a result, the development of antibodies against HCV does not produce an immunity against the disease like it does with most other viruses. More than 80% of the individuals infected with HCV will progress to a chronic form of the disease.

As a result of this, hepatitis C is usually not self-limited as a disease. In more than 85% of all cases, whether they progress to chronic liver disease or not, the infected individual carries the virus for life.

This means that they also remain contagious for a lifetime, able to transmit the virus to others. And because of the long progression of the illness, even patients who will eventually die as a result of hepatitis C carry the virus for decades before it takes their lives.

Most epidemics are self-limiting - they spread rapidly, but over a short period of time the affected population either dies or develops an immunity to the disease, and it stops spreading. Not so with hepatitis C. Much like HIV and AIDS, it lasts a lifetime, and kills slowly - giving the virus plenty of time to spread.

There are six basic genotypes of HCV, with 15 recorded subtypes, which vary in prevalence in different regions of the world. Each of these major genotypes can differ significantly in their biological effects - in terms of replication, mutation rates, type and severity of liver damage, and detection and hepatitis c treatment options. However, these differences are not yet clearly understood.

Need More Information to Get a Vaccine

The 21 current variations in genotype, complicated by the constant mutation of the virus within infected individuals, represents a major challenge for the development of hepatitis c treatments and vaccines against HCV - and even for reliable detection of the virus.

There is no guarantee that a treatment, test, or vaccine against one strain will be effective against all of them. Moreover, individuals cured of one strain will be prone to reinfection by any of the other strains.

Anatomy of the Hepatitis C Virus

Hepatitis C virus. Structure of the viral capsid is clearly visible.

The structure of the hepatitis C virus is like that of most complex viruses - a core of genetic material (RNA), surrounded by a protective shell of protein, and further encased in a lipid (fatty) envelope of celluar material.

However, the fact that the genetic information of the virus is stored in RNA, not DNA, has important consequences in the life cycle of the virus, and gives hepatitis C its dangerous ability to mutate.

All organisms, with the exception of the RNA viruses, store their permanent information in DNA, using RNA only as a temporary messenger for information. DNA is quite a stable molecule, not particularly reactive with other molecules, and the processes which reproduce it make very few mistakes in the process of copying the molecule (between one in 1 million and 1 in 10 million).

Most of these mistakes are normally corrected even when they do occur. This makes DNA an ideal format for the storage of information, for mutations (errors) only rarely occur, and most are not significant.

RNA, by contrast, is a quite reactive molecule, capable of reacting even with itself under the correct conditions. It also makes frequent mistakes during copying - averaging one mistake per 10,000 nucleotides each time it is copied. These properties make RNA very poorly suited for the storage of information.

However, these very propeties make RNA ideal for the storage of viral information. Once the immune system has learned to recognize an infecting virus and create antibodies against it (developed an immunity), it can quickly destroy it, so the virus can no longer use that host for reproduction. In order to reinfect a host - it must first change its nature enough that the immune system will no longer recognize it - in other words, it must mutate.

The unstable nature of the RNA molecule provides this mutagenic factor, allowing the Hepatitis C virus to develop new genetic variations of itself. As discussed earlier, the mutated forms are frequently different enough from their ancestors that the immune system cannot recognize them, so if the immune system begins to succeed against one variation, the mutant strains quickly take over and become new, predominant strains.

Because each surviving virus reproduces itself thousands of times, mutations in the RNA sequence occur frequently, allowing it to evolve faster than any other type of living organism. This evolution is known as antigenic drift. Mutations occur randomly across the entire length of the viral RNA, and so of course most are not beneficial, producing viruses which lack a needed protein or are otherwise disadvantaged.

However, because of the enormous number of offspring produced by each virus, even a high rate of mutation does not threaten the survival of the virus - and when advantageous mutations do occur, they are rapidly selected for and reproduced.

Hepatitis C, as an RNA virus, has a powerful reproductive strategy. Because it stores its information in a "sense" strand of RNA, the viral RNA itself can be directly read by the host cell's ribosomes, functioning like the normal mRNA present in the cell.

The virus thus needs no special abilities of its own - it uses the cell's own ribosomes to produce everything it needs for its takeover of the cell's processes and reproduction.

This means hepatitis C requires only a small amount of RNA to encode its core information, and thus has lots of room for genetic variation within the non-essential portions of its RNA.

This also gives it fewer common characteristics that can be readily identified by the immune system - or, for that matter, exploited by scientists working to create a hepatitis c treatment.

How will I know if I have Hepatitis C?

In general, individuals infected with HCV are often discovered with elevated liver enzymes (blood tests) on a routine blood test or because a Hepatitis C antibody is found to be positive at the time of blood donation.

In 1992, a more specific test for anti-HCV became available and eliminated some of the false positive reactions that were previously troublesome. In general, elevated liver enzymes and a positive antibody test for HCV (anti-HCV) means that an individual has chronic Hepatitis C.

Transmission of Hepatitis C

Table illustrating the transmission of the various forms of viral hepatitis.

Hepatitis C is believed to be transmitted only by blood. However, unlike many other blood borne viruses (like HIV) virtually any source of blood or blood products seems to be capable of carrying the virus, even if the source is indirect - like a used razor, for example. This makes hepatitis C far more transmissible than most other blood borne viruses - including HIV.

Many hepatitis C victims contracted the disease through blood transfusions in the 1970s and 1980s. Rates of post-transfusion hepatitis during this period were determined to have been between 8% and 10%.

Effective bloodscreening for the virus was developed and implemented by 1990, which lowered the rates of post-transfusion hepatitis to less than 5% from 1990-1993. Since then, improved testing has led to drastic reductions in risk, down to less than 1% after 1993.

However, anyone who had a blood transfusion prior to that time is at risk for having been infected. Incidence of hepatitis C infection among hemophiliacs remained high through 1993, because plasma used to treat hemophilia is often a mixture from many different donors.

However, incidence of new infection among hemophiliacs has rapidly approached zero as better methods have been employed.

Tattooing, as well as many body piercing practices, such as acupuncture and ear-piercing, have contributed significantly to the spread of HCV, even in industrial nations. Needle-stick injuries, contaminated medical equipment, and blood spills in health care settings are also responsible for many cases of HCV.

The most significant risk behavior for HCV infection is drug use, particularly I.V. drug use, and is responsible for about 30-40% of all identified cases of hepatitis C. As with HIV, the sharing of contaminated needles and other drug paraphernalia increases the chance of infection dramatically.

Incidence of infection among I. V. drug users has surpassed 50 percent in many studies, and reached 100 percent in others. Cocaine users have also been shown to transmit the virus by sharing snorting straws.

Heterosexual or homosexual activity with multiple sexual partners has been clearly identified as a mode of transmission, but the exact risk is unknown. Because of the lack of sufficient information, persons in long-term, monogamous relationships are not advised to change sexual practices.

Can I give the disease to others?

HCV can be transmitted through blood transfusions. Other individuals who may come in contact with infected blood, instruments, or needles, such as IV drug users, health care workers or laboratory technicians are also at risk of acquiring hepatitis C, as are those who undergo tattooing or body piercing. The risk for transmitting Hepatitis C sexually is unknown.

The Centers for Disease Control and Prevention (CDC) say there is a slight increased risk of becoming infected with Hepatitis C if you have multiple sex partners.

Could I give hepatitis C to someone else?

Yes, as far as we know, once you have hepatitis C, you can always give it to someone else. If you have hepatitis C, you can't donate blood. You should avoid sharing personal items like razors and toothbrushes. Always use a condom when you have sex. If you have hepatitis C, your sex partners should be tested to see if they also have it.

Talk to your doctor first if you want to have children. The virus isn't spread easily by sexual contact or from a mother to her unborn baby. If you're trying to have a baby, don't have sex during the menstrual cycle, because the hepatitis C virus spreads more easily in menstrual blood.

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Treatment of Hepatitis C

Discover how to help your liver naturally, right here, today

On this website you will learn what I've done over the last 14 years to help myself. I have chronic Hepatitis C, yet I am now living a normal life.

You can use the information here to help protect and support your own liver.

There are thousands of other liver patients successfully using natural remedies, just like me, who are also living normal lives. And we can prove, with published scientific evidence, everything you are about to discover.

Here I am, still alive, feeling good and looking forward to living a full and productive life. That's exactly what you want for yourself, too, isn't it?

Well, I'm here to tell you that certain natural remedies can safely and effectively help you. Just as they've helped me and thousands of others.

Powerful natural liver protection starts with milk thistle

The first scientifically-proven liver remedy I learned about was milk thistle. And I still believe it is the best general liver protecting herb available (but not just any milk thistle, as you are about to learn. Maximum Milk Thistle™ is dramatically better than the rest).*

You may already know that milk thistle is the most widely recognized natural remedy for liver health. Nearly every medical doctor in the USA is familiar with milk thistle and some even recommend it. In Germany, doctors routinely prescribe standardized milk thistle extract as a medicine for hepatitis patients.

And some milk thistle products are far, far better than others

What you probably do not know (as I didn't) is that the most potent form of milk thistle is found in Maximum Milk Thistle™. It is dramatically more effective than ANY standardized milk thistle extract on the market today.*

Maximum Milk Thistle™ contains a patented form of milk thistle that is actually prescribed by some doctors right here in the USA. This active ingredient is also part of ongoing medical studies specifically for Hepatitis C.

Compared to common standardized milk thistle extract (the kind found in most stores), 8 to 10 times more Maximum Milk Thistle™ actually gets into your bloodstream and to your liver. This makes a HUGE difference when it comes to protecting your liver.

With those other brands you are protecting your toilet more than your liver, because the majority of any active ingredients go right through your digestive system without being absorbed.*

At this website you will learn more about Maximum Milk Thistle™ and how it provides so much more liver protection than other brands (including the clinical proof).*

By the way, Maximum Milk Thistle™ didn't even exist when I was first diagnosed. Only much weaker doses of the same powerful formula were on the market then. And those weaker ones were much more expensive than Maximum Milk Thistle™.

Here are a couple of patient comments specifically about Maximum Milk Thistle™:

"I prefer Maximum Milk Thistle™ over other milk thistle products because, after much research, I am convinced the Phytosome process dramatically improves the effectiveness of this important herbal medicine."

Kevin Krueger

Hepatitis C Survivor

Founder, National Hepatitis C Coalition

www.nationalhepatitis-c.org

"The milk thistle product you should take is Maximum Milk Thistle™…There is no more potent or absorbable milk thistle available at any price."

Vikki Shaw

Hepatitis C Survivor

Founder, www.hepatitis-central.com

Maximum Milk Thistle™ must be your first choice

If you learn only one thing by reading my words here, let this be it:

If you take only one natural remedy for your liver, you should take Maximum Milk Thistle™.

Read the expert opinions and testimonials, here. See the clinical studies, here. And order a supply for yourself as part of a special, money-saving offer, here.

Discover many more natural secrets to a healthier liver

As you are about to see, it is certainly possible to protect and support your liver through natural means. And you don’t have to just take my word for it either.

There is plenty of scientific proof regarding the safety and effectiveness of specific natural remedies for liver patients.

But it is easy to get confused, like I did, by the many mixed messages coming from various sources. Manufacturers are trying to sell you their product by insisting it is the best. Some of them are less than honest about this. And others are downright unethical and misleading.

To protect yourself from liars and cheaters be sure to download our free report, "The Things You Absolutely Must Know To Avoid Liver Remedy Rip-offs". I learned many of the facts in this report the hard way. Reading this report will save you the trouble I went through.

Clear up your confusion

Many natural substances exist that can help you have a healthier liver. So many, in fact, you couldn't possibly take them all (they’d either break your budget or you wouldn’t have time to do anything but pop pills and drink potions all day).

Of all these available substances, some may have little or no liver protection value. Some are much better than others. And a select few can be considered "must have".

So, your primary challenge at this point is to discover which liver remedies will give you the most benefit for the least cost.

You need to know which products work, which do not work at all, and which ones work well enough to be considered "essential".

You probably also want to know which ones cost too much compared to less expensive choices that can be equally helpful.

These are the same questions I faced when I was first diagnosed.

And you will discover, here, all I have learned since then.

Find out what works, what doesn't, what's worthwhile, and what’s not

You can take the time to try to figure this out all by yourself. Or, you can look to others with the same concerns as yours who have already narrowed down the selection to the best. Through other patient's experience you can quickly learn the safest, most effective and most affordable choices.

That's right, you can help yourself get the best results, at the least cost, with the exact same proven supplements that tens of thousands of other Hepatitis C patients are using today and every day. And you can start to do this for yourself right now.

All the hardest work has already been done for you.

Now you can learn what other patients have already discovered through trial and error, experience and research.

You can use what you learn here to give yourself a head start in providing your own liver with more of a fighting chance.

Consider me your own personal guinea pig

You can benefit from my many years of trial and error.

If you want to learn more about me and my personal liver experiences you can read my in-depth interview with Anna Rockenbaugh, a medical writer, here.

For more than 30 years I have had chronic Hepatitis C, genotype 1a. For over 17 years I have

known about it. I have not tried interferon therapy. I do not spend hundreds of dollars per month on supplements (like some natural health practitioners might recommend). But, to this day, I continue to be in good health.

Even my gastroenterologist is impressed and encouraged by my results.

Do you want to know exactly how my discoveries can help YOUR liver, too?

Your own personal guinea pig, continued

I call myself a Hepatitis C survivor and I'd like to help you be a survivor, too. I have learned to better assure my survival by protecting and supporting my liver with a healthier diet and saner lifestyle choices.

I also choose and use the safest, most effective and most affordable natural substances available. Some of these you can get at this website. Most of them you can get at your local health food store.

You see, I fully expect to continue to help my liver naturally until there is a more effective and less toxic medical treatment for Hepatitis C or I die of something else (preferably old age). And I’d like to help you do the same, if you want to.

I did not (and do not) want to get deathly ill and/or die before I absolutely have to. I want to stay around for a while and I want to be as healthy as I can while I’m here. This way I can better enjoy my life with family and friends. You can relate to that, can't you?

Since finding out I have this potentially deadly disease over 17 years ago, I have done extensive ongoing research to discover the best ways to help myself. It certainly seems to be working, so far.

 Information on prospects for treatment or vaccine

There is no vaccine for hepatitis C at present, and it may be a long time before one becomes available. The great variation in genotypes with hepatitis C, as well as its frequent mutation, makes the development of hepatitis c treatments and vaccines extremely difficult. Liver transplantation may be life-saving in end-stage liver disease, but is costly and involves continuing health care following the procedure.

This hepatitis c treatment option is further complicated by a shortage of liver donors. For HCV-positive patients under going transplantation, re- infection is almost universal.

There are a number of drug treatments becoming available for hepatitis C. Infected individuals should consult with their physician to see about the availability and effectiveness of these hepatitis c treatments, as well as the possibility of participating in experimental drug trials.

Is there a treatment for hepatitis C?

Good health habits are essential for those who have hepatitis C, especially avoidance of alcohol and other medications and drugs that can harm the liver.

Although there is not yet a proven cure for hepatitis C, some people benefit from drug treatment. You should discuss hepatitis c treatment with a doctor if you have hepatitis C. Standard medicines available include the following:

•           peginterferon alfa-2b (brand name: PEG-Intron)

•           peginterferon alfa-2a (brand name: Pegasus)

These medicines are given as a weekly shot. You may or may not need to use a ribavirin supplement in pill form (some brand names: Copegus, Rebetol, Virazole) along with interferon.

Other medicines available to treat hepatitis C include the following:

•           interferon alfa-2a (brand name:Roferon-A)

•           interferon alfa-2b (brand name: Intron A)

•           interferon alfacon-1 (brand name: Infergen)

•           interferon alfa-2b plus ribavirin (brand name: Rebetron)

These medicines are given as a shot every day, every other day or 3 times a week, for several months or longer. The length of hepatitis c treatment depends on how severe the infection is.

Carefully following your doctor's advice and sticking with your hepatitis c treatment plan will reduce your risk of further liver damage.

Is there a vaccine for hepatitis C?

No, not for hepatitis C. There are vaccines for hepatitis A and hepatitis B. If you have hepatitis C, your doctor may want you to take the vaccine for hepatitis B (and maybe the vaccine for hepatitis A), if you don't already have these viruses.

If you have hepatitis C, you are more likely to catch hepatitis A or hepatitis B, and that would cause more damage to your liver.

A note about vaccines

Sometimes the amount of a certain vaccine cannot keep up with the number of people who need it. 

Treatment of HCV¬Infected Patients

Treatment with interferon is generally recommended for patients with chronic hepatitis C who are at the greatest risk for progression to cirrhosis.11-13

These patients have persistently elevated alanine aminotransferase (ALT) levels, detectable HCV RNA and liver biopsy results showing either portal or bridging fibrosis or at least moderate degrees of inflammation and necrosis.

Indications for hepatitis c treatment in patients with persistently elevated ALT levels but with less severe histologic changes are less clear. In these patients, observation, including serial ALT measurements and a liver biopsy every three to five years, may be an acceptable alternative to hepatitis c treatment with interferon, because progression to cirrhosis is likely to be slow, if it occurs at all.

Similarly, patients with compensated cirrhosis might not benefit from interferon therapy.

Interferon is not recommended in patients with persistently normal ALT values or advanced cirrhosis. Treatment of patients who drink significant amounts of alcohol or who inject illicit drugs should be delayed until these habits have been discontinued for at least six months. Interferon is contraindicated in patients with major depressive illness, cytopenias, hyperthyroidism, renal transplantation or evidence of autoimmune disease and in those who are pregnant.4,11

How should a patient be managed who is anti-HCV¬positive (verified by supplemental test) and has normal liver enzyme levels?

Patients should be periodically assessed by monitoring serum ALT values several times over six to 12 months. If ALT values are persistently normal, it is then reasonable to assess ALT values annually.

When should a gastroenterologist or hepatologist be consulted in the management of HCV¬infected patients?

A specialist in liver disease should be consulted for the management of anti-HCV¬positive patients with elevated ALT values. Further evaluation may include determination of HCV RNA level and liver biopsy.

Based on these findings, hepatitis c treatment with interferon may be recommended.

Do all patients who are considered for antiviral hepatitis c treatment need to have a liver biopsy?

Liver histology is the gold standard for assessing the severity of liver disease and the only means of diagnosing well-compensated cirrhosis.

It is useful in determining not only inflammatory activity but also extent of fibrosis. Histologic grading of inflammatory activity and staging of fibrosis have also been shown to correlate with the risk of subsequent progression to cirrhosis.

In addition, fibrosis score and cirrhosis have been identified as the most important independent predictive factors for response to interferon hepatitis c treatment.14

Because of the potential for adverse reactions, interferon is contraindicated in patients with a major depressive illness, hyperthyroidism, cytopenias, autoimmune disease, history of a kidney transplantation, and in those who are pregnant.

Should interferon hepatitis c treatment be considered for children with chronic hepatitis C?

Currently, interferon is only labeled for hepatitis c treatment of adults with chronic hepatitis C. It is not labeled by the U.S. Food and Drug Administration for use in children under 18 years of age; however, limited experience with interferon therapy for chronic hepatitis C suggests an efficacy similar to that observed in adults.

Referral of a child with chronic hepatitis C to a pediatric hepatologist or gastroenterologist for management should be considered if serum ALT levels are persistently elevated and there is evidence of active viral replication, such as HCV RNA detected by polymerase chain reaction testing. Because of limited experience with interferon therapy in children, enrollment into a clinical trial, if available, should be considered if this step is contemplated.11

What is the recommended regimen for interferon therapy?

The recommended regimen for interferon therapy is 3 million U administered subcutaneously three times a week for 12 months. If patients have persistently abnormal ALT levels and detectable serum HCV RNA after three months of interferon therapy, hepatitis c treatment should be discontinued. The advisability of entering these patients into clinical trials for other hepatitis c treatments should be explored.11

What percentage of patients respond to interferon therapy?

Approximately 50 percent of treated patients have an initial response, with normalization of serum ALT activity and a loss or decrease of serum HCV RNA at the end of therapy. After interferon therapy is discontinued, however, more than one half of patients who responded to hepatitis c treatment relapse, with recurrence of elevated ALT levels and reappearance of serum HCV RNA. Thus, only 15 to 25 percent of treated patients have a sustained response one or more years after therapy ends.11,15

Are there other hepatitis c treatment options for patients with chronic hepatitis C?

Ribavirin (Virazole), a nucleoside analog, has been evaluated in clinical trials alone and in combination with interferon.16

In studies of patients treated with ribavirin alone, results demonstrated a decrease in ALT activity in about one third of patients, but no change in viral replication. In addition, when hepatitis c treatment was withdrawn, all patients relapsed, with recurrence of elevated ALT levels. Thus, monotherapy with ribavirin is not useful in the treatment of chronic hepatitis C.

The results of studies of patients treated with a combination of ribavirin and interferon, however, demonstrated a substantial increase in sustained response rates, reaching as high as 40 to 50 percent compared with interferon therapy alone.

As with interferon-alone therapy, however, combination therapy in patients with genotype 1 (the most common strain of HCV in the United States) is not as successful; sustained response rates among these patients are still less than 30 percent.

Combination therapy with interferon and ribavirin is now licensed for the treatment of chronic hepatitis C in patients who have relapsed following interferon hepatitis c treatment and for use in naive patients.

What are the side effects of interferon therapy?

Most patients experience flu-like hepatitis c symptoms early in hepatitis c treatment, but these hepatitis c symptoms diminish with continued therapy. Later side effects include fatigue, bone marrow suppression and neuropsychiatric effects such as apathy, cognitive changes, irritability and depression.

The interferon dosage must be reduced in 10 to 40 percent of patients because of severity of side effects, and hepatitis c treatment must be discontinued in 5 to 15 percent.11,13

Can anything be done to reduce some of the side effects of interferon therapy?

Pretreatment with acetaminophen and administering interferon at night may help to alleviate the side effects.11,13

Are there additional side effects associated with ribavirin?

Yes. Ribavirin can induce hemolytic anemia, and use of this drug can be problematic in patients with preexisting anemia, bone marrow suppression or renal failure. Therefore, in these patients, combination therapy should be avoided, or attempts should be made to correct the anemia.

Hemolytic anemia caused by ribavirin can also be life-threatening in patients with ischemic heart disease or cerebrovascular disease.16 Ribavirin is teratogenic, and female patients should avoid becoming pregnant during therapy.

Are there data on the efficacy of interferon or other antiviral hepatitis c treatment in preventing the long- term

morbidity and mortality of hepatitis C?

No. Effects of antiviral hepatitis c treatment on important clinical outcomes, including quality of life and disease progression, have not been determined.

Living With Hepatitis C

            Living with hepatitis C can be a difficult and frustrating experience. Constant fatigue and low-level illness is common, and the hepatitis c symptoms can increase the emotional toll of dealing with long-term disease.

Available treatments are painful, uncomfortable, and often worse than the symptoms of the disease itself. However, because of the long course of the infection, infected patients have long life expectancies, and with proper hepatitis c treatment, many of them can recover completely.

Coping with fatigue is a common problem for infected individuals. Finding a happy balance between relaxation and activities is helpful. Frequently, short naps between activities or outings prevent overwhelming fatigue at the end of the day, and limiting tiring activities on a day-by-day basis seems to help people find time to regroup.

Many vitamins and common pharmaceuticals are toxic unless rendered harmless by the liver.

Many things can worsen damage to the liver. It is important to avoid increasing the stress on an already overworked and damaged liver.

Alcohol, in particular, must be avoided. Studies have shown that alcohol massively increases damage to the liver in hepatitis C victims. Other dangerous substances include many toxins, such as copper, many over-the-counter and prescription drugs, including aspirin, and vitamins, including Vitamin A.

Many infected individuals find that the hardest thing about hepatitis C is the social stigma associated with the disease, and others' fears of becoming infected as a result of contact. Traditionally, hepatitis has been regarded as a disease of the poor and a disease of alcoholics, and these prejudices have outlived the progression of hepatitis into the population at large.

In truth, the risk of transmission to co-workers or other household members seems to be quite low, and even sexual transmission is rare. The CDC recommends the use of sexual prophylactics by anyone infected with hepatitis C or any other sexually transmissible disease, but common contact is not dangerous.

While it should be kept in mind that there is no known mode of transmission for approximately 10% of cases, this should not be taken as a statement that it can be easily casually acquired. Routine precautions around blood, and avoiding the sharing of toothbrushes, razors, and other personal items should provide adequate protection.

Hepatitis & Hepatitis C

Hepatitis is a disease characterized by inflammation of the liver, usually producing swelling and, in many cases, permanent damage to liver tissues. A number of different agents can cause hepatitis, including infectious diseases, chemical poisons, drugs and alcohol.

Viral hepatitis refers to a set of at least six viruses that are known to cause hepatitis: hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), hepatitis E (HEV), and hepatitis G(HGV). Recent scientific evidence also suggests the existence of other, as yet unidentified hepatitis viruses.

The most common types of viral hepatitis are hepatitis A, B, and hepatitis C. Both hepatitis B and C can lead to serious, permanent liver damage, and in many cases, death.

There are two primary types of viral hepatitis, food-borne and blood-borne hepatitis. The former, which is spread through contaminated food and water, does not cause chronic liver disease.

By contrast, bloodborne viral hepatitis may lead to long-term, persistent infections and chronic liver disease that has lethal consequences many years after infection.

The Silent Epidemic: Hepatitis C

Micrograph of liver cells afflicted with the mysterious non-A non-B Hepatitis. Hepatitis C was found to be responsible for many of these cases.

The identification of the hepatitis C virus in 1989 solved a growing mystery. Over the past ten years, large numbers of hepatitis victims had begun to appear, apparently with a virally caused disease. But when examined, these patients tested negative for both hepatitis A and B. The unknown disease was known as non-A, non-B hepatitis.

When a test was developed in 1990 to identify individuals infected with hepatitis C, hepatitis C was found to be responsible for the majority of these cases - and it has quickly proved to present a frightening challenge.

In contrast to most other types of hepatitis, more than 80% of hepatitis C (HCV) infections become chronic and lead to liver disease. Hepatitis C, in combination with hepatitis B, now accounts for 75% of all cases of liver disease around the world. Liver failure due to hepatitis C is the leading cause of liver transplants in the United States.

Since hepatitis C infection is typically mild in its early stages, it is rarely diagnosed and is often not recognized until its chronic stages when it has caused severe liver disease. With a typical cycle of disease from infection to symptomatic liver disease taking as long as 20 years, the true impact of this disease on our growing infected population will not be apparent for many years. For this reason, it is often referred to as the "silent epidemic".

It is suspected that there are, at present, more than 4.5 million people in the United States that are infected with hepatitis C, and more than 200 million around the world - making it one of the greatest public health threats faced in this century, and perhaps one of the greatest threat to be faced in the next century.

Addional Information about Vaccines

A vaccine against hepatitis C may not be available for many years to come, and there are already many times more people infected with HCV as have HIV (the virus that causes AIDS). Without prompt intervention to treat infected populations and prevent the spread of disease, the death rate from hepatitis C will surpass that from AIDS by the year 2000 - and it can only get worse.

Day-to-day contact with another household member that has hepatitis C has also been strongly implicated. Maternal-infant transmission has also been documented as a mode of spread.

Certain specialized risks have also been identified - such as manicures, shared toothbrushes, or straight razors in barber shops.

In more than 40% of all cases, the infected individuals cannot identify a source for their infection. It is believed that most of these are due to known risk factors - however, in more than 10% of all cases, no risk factor can be identified. There are clearly other, as yet unidentified modes of transmission.

You gain from my pain with Hepatitis C

The information I have to share with you is the sum of 14 years of seeking and searching, trial and error. To better protect my own health I have personally interviewed doctors (including internists, gastroenterologists and hepatologists), medical experts, clinical researchers and nutritional manufacturers. I've tried a wide range of vitamins, minerals, herbs and other supplements.

Now I am offering you access to all the knowledge I have gained.

I sincerely wish I had someone do this for me when I was first diagnosed, but back then there was very little information available anywhere. Even doctors didn't have a clue of what they were dealing with.

I didn't learn all this for you. I did it for me. I was afraid of getting really sick and dying of this disease. And now you get to benefit from all my hard work.

You'll get reasons, research and recommendations, too

By the way, you won't have to take my word for any information I share with you. I will also be providing you with the reasons and research behind my recommendations.

I demanded proof when I was searching and I will provide the same to you. I urge you to look closely at all the scientific proof, clinical studies and other relevant data I have gathered together.

Ask me questions if you need to. Then make up your own mind.

In my humble opinion, you'd be crazy not to listen very carefully to someone who has been on the very same search as you, for the very the same reasons. Especially if they are more than 10 years ahead of you.

Remember, I did all this research over the past 17 years to save myself from the same concerns as yours. I just started before you.

So, where do you start?

Let's keep it simple. Start with Maximum Milk Thistle™. It would be easy to overwhelm you with helpful information at this point, but I am not sure how valuable that would be in the long run.

Taking this a step at a time might serve you much better.

Of course, you can feel free to look around the website more to get an overview, but then come back to the basics here.

As you will see, there is quite a lot of information available on this site and elsewhere.

You have my word you will not be disappointed. Maximum Milk Thistle™ really is that much better than any other milk thistle product out there.*

Is there a treatment for Hepatitis C?

The combination of interferon and ribavirin (Rebetol) is the hepatitis c treatment that has been approved by the FDA for Hepatitis C patients who have never had any interferon therapy and patients who have relapsed following interferon therapy.

Six months after hepatitis c treatment, about 46 % of patients who received the combination therapy had undetectable virus levels. The recommended duration for the combination therapy is 24 weeks.

What recommendations should be provided for follow-up care of a health care worker who has experienced a percutaneous or permucosal exposure to blood?

Individual institutions should establish policies and procedures for HCV testing of persons after such exposures. Institutions should ensure that all personnel are familiar with these policies and procedures.

Health care professionals who provide care to persons exposed to HCV in the occupational setting should be knowledgeable about the risk for HCV infection and able to provide appropriate counseling, testing and medical follow-up.

Immune globulin and antiviral agents are not recommended for postexposure prophylaxis of hepatitis C. Limited data indicate that antiviral therapy might be beneficial when started early in the course of HCV infection, but no guidelines exist for administration of therapy during the acute phase of infection.

When HCV infection is identified early, the patient should be referred for medical management to a specialist knowledgeable in this field. Recommendations for follow-up care for HCV infection in exposed health care providers are listed in Table 1.4,10

Are there recommended practice restrictions for anti-HCV¬positive health care workers?

There are currently no recommendations regarding restriction of health care workers with hepatitis C. The risk of transmission from an infected employee to a patient appears to be very low.4,10

Should hepatitis A and hepatitis B vaccines be given to persons with chronic hepatitis C?

Susceptible patients with chronic liver disease should receive hepatitis A vaccine.

 Susceptible patients in a high-risk group for which hepatitis B vaccine is recommended should also receive hepatitis B vaccine.4-6

How should I take care of myself if I have hepatitis C?

You should eat a healthy diet and start exercising regularly. A dietitian can help you plan a diet that is healthy and practical. Talk to your doctor about medications that you are taking, including over-the-counter medications.

Many medicines, including acetaminophen (brand name: Tylenol) are broken down by the liver and may increase the speed of liver damage. It is very important that you drink only a minimal amount of alcohol. An occasional alcoholic drink is probably OK, but check with your doctor first.

Testing For Hepatitis C Virus

Follow-up testing for anti-HCV (at four to six months) and ALT activity. (If earlier diagnosis of HCV

infection is desired, testing for HCV RNA may be performed at four to six weeks.)

Confirmation by supplemental anti-HCV testing of all anti-HCV results reported as positive by enzyme immunoassay.

Anti-HCV=hepatitis C virus antibody; HCV=hepatitis C virus; ALT=alanine aminotransferase.

Information from references 4 and 10.

 For the source patient--baseline testing for anti-HCV

For the person exposed to an HCV¬positive source--baseline and follow-up testing, including the following:

natural processes of hepatitis C, like other viruses, it must complete eight key steps to carry out its life cycle:

Dealing With Hepatitis C

How can I cope with my feelings about having hepatitis C?

Coping with hepatitis C isn't easy. You may feel sad, scared or angry, or you may not believe you have the disease. These feelings are normal, but they shouldn't keep you from living your daily life.

If they do—or if they last a long time—you may be suffering from depression. People who are depressed have most or all of the following hepatitis c symptoms nearly every day, all day, for 2 or more weeks:

•           Feeling sad or crying often (depressed mood)

•           Losing interest in daily activities that used to be fun

•           Changes in appetite and weight

•           Sleeping too much or having trouble sleeping

•           Feeling agitated, cranky or sluggish

•           Loss of energy

•           Feeling very guilty or worthless

•           Problems concentrating or making decisions

•           Thoughts of death or suicide

Talk to your doctor if you notice any of these hepatitis c symptoms. Your doctor can help by recommending a support group or a therapist, and/or by prescribing a medicine for you to take.

An estimated 3.9 million Americans are infected with hepatitis C virus (HCV), and most do not know that they are infected. This group includes persons who are at risk for HCV¬associated chronic liver disease and who also serve as reservoirs for transmission of HCV to others.

Vaccine Information

Because there is no vaccine to prevent HCV infection and immune globulin is not effective for postexposure prophylaxis, prevention of HCV infection is paramount. Patients who are at risk of exposure to HCV should be advised on steps they might take to minimize their risk of infection.

Patients who are infected with HCV should be counseled on ways to prevent transmission of HCV to others and to avoid hepatotoxins. They should also be examined for liver disease and referred for hepatitis c treatment, if indicated.

There is no vaccine to prevent hepatitis C virus (HCV) infection, and immune globulin is not effective for postexposure prophylaxis.1 In the absence of effective preventive measures and considering the long-term infectious nature of the disease, it is important that those who test positive for hepatitis C antibody (anti-HCV) be advised on how they can avoid infecting others.

Because no tests are available to determine infectivity, it should be assumed that anyone testing positive for anti-HCV is potentially infectious.2 Primary health care professionals should obtain a history of high-risk exposures associated with the transmission of HCV and other blood-borne pathogens from all patients.

HCV¬specific information and prevention messages should be provided to infected patients by health care professionals who are knowledgeable about HCV transmission. All such patients should be told that HCV is transmitted primarily by exposure to blood, serum-derived body fluids and body fluids that are visibly contaminated with blood.

They should be told what this information means in terms of their day-to-day living and in terminology that they can understand. Patients who are at risk of exposure to HCV should be advised about steps they might take to minimize their risk of becoming infected.

The primary measures available to prevent HCV infection are screening of blood, organ and tissue donors; modification of high-risk practices; and use of blood and body-fluid precautions.2

What prevention messages should be given to patients with high-risk drug or sexual practices?

Currently no tests are available to determine infectivity; therefore, anyone who is positive for hepatitis C antibody has the potential to transmit the virus to another person.

Persons who use or inject illegal drugs should be advised to stop using and injecting drugs. They should be strongly urged to enter and complete substance abuse treatment, including relapse prevention programs.3,4 If they continue to inject drugs, they should be advised never to reuse or share syringes, needles, water or drug preparation equipment.

If injection equipment has been used by other persons, the equipment should be cleaned first with bleach and water. Only syringes obtained from a reliable source (e.g., pharmacies) should be used. A new, sterile syringe should be used to prepare and inject drugs.

If possible, sterile water should be used to prepare drugs; otherwise, clean water from a reliable source, such as fresh tap water, can be used. A new or disinfected container ("cooker") and a new filter ("cotton") should also be used to prepare drugs.

The injection site should be cleaned before the injection with a new alcohol swab. Syringes should be safely disposed of after one use.3,4 These persons should be advised to get vaccinated against hepatitis A5 and hepatitis B.6

Patients who are at risk for sexually transmitted diseases (STDs) should be advised that the surest way to prevent the spread of HIV infection and other STDs is to have sex with only one uninfected partner or not to have sex at all.

 Patients should be advised to use latex condoms correctly and every time to protect them and their partners from diseases spread by having sex. These patients should also be vaccinated against hepatitis B6 and, if appropriate, hepatitis A.5

What information should be given to patients who are HCV-positive?

The average rate of HCV infection among infants born to HCV¬infected women is 5 percent. Breast feeding is not a source of hepatitis C virus transmission.

To protect their liver from further harm, HCV¬positive patients should be advised to avoid alcohol,7,8 not to start taking any new medicines, including over-the-counter and herbal medicines, without checking with their doctor and to get vaccinated against hepatitis A if liver disease is found to be present.5 To reduce the risk of transmission to others, HCV¬positive patients should be advised not to donate blood, organs, tissue or semen, not to share toothbrushes, dental appliances, razors or other personal care articles that might have blood on them and to cover cuts and sores on the skin to keep from spreading infectious blood or secretions.

2 HCV¬positive patients with one long-term, steady sex partner do not need to change their sexual practices. They should, however, discuss the risk (which is low but not absent) with their partner.

If they want to lower the small chance of spreading HCV to their partner, they may decide to use barrier precautions such as latex condoms. These patients should also discuss with their partner the need for counseling and testing.4

Treatment with interferon is currently recommended for patients who have a consistently elevated ALT level, detectable levels of HCV RNA and a liver biopsy showing evidence of fibrosis or active inflammation and necrosis.

HCV¬positive women do not need to avoid pregnancy or breast feeding. Potential, expectant and new parents should be advised that about five of every 100 infants born to HCV¬infected women become infected.

This infection occurs at the time of birth, and no hepatitis c treatment can prevent this from happening.4,9 Infants infected with HCV at the time of birth seem to do very well in the first few years of life.

More studies are needed to find out if these children will be affected by the infection as they grow older. There is no evidence that mode of delivery is related to transmission; therefore, the need for cesarean section versus vaginal delivery should not be determined on the basis of HCV¬infection status.

Limited data on breast feeding indicate that it does not transmit HCV, although it may be prudent for HCV¬positive mothers to abstain from breast feeding if their nipples are cracked or bleeding.

Infants born to HCV¬ positive women should be tested for HCV infection and, if positive, evaluated for the presence or development of chronic liver disease (see the section on testing of children born to HCV¬positive women in part I of this article).

If an HCV¬positive woman has given birth to any children since becoming infected with HCV, she should consider having these children tested.4

Other messages should be given to all patients with HCV infection: that HCV is not spread by sneezing, hugging, coughing, food or water, sharing eating utensils or drinking glasses, or casual contact.

Persons should not be excluded from work, school, play, child care or other settings on the basis of HCV infection status. Involvement with a support group may help patients cope with hepatitis C.4 HCV¬positive persons should be evaluated (through referral or consultation, if appropriate) to assess for biochemical evidence of chronic liver disease.

These patients should be assessed for severity of disease and possible hepatitis c treatment according to current practice guidelines in consultation with, or by referral to, a specialist knowledgeable in this field. The need for hepatitis A vaccination should be determined.4,5

Postexposure Follow-up of Health Care, Emergency Medical, and Public Safety Workers for HCV Infection

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