An insightful overview of the impending Hepatitis C epidemic, its causes, the most recent research, and an in-depth, detailed look at the botanical medicines that show promising results for restoring liver function. Includes formulas for using herbs to strengthen the liver and combat disease.

Stephen Harrod Buhner an adjunct faculty member of the Rocky Mountain Center for Botanical Studies

Hepatitis C: The Silent Epidemic

1

(14)

Hepatitis C, the Liver, and the Immune System

14

(10)

Botanical Medicines for Hepatitis C and the Liver

24

(31)

Botanical Support for the Immune System

55

(21)

Nutritional Supplements for Hepatitis C

76

(7)

Changing Your Diet: Giving Your Liver a Break

83

(13)

The Complete HCV Protocol

96

(6)

Epilogue: Aggressive Symbionts: The Specter of Emerging Viruses

102

(9)

Appendix 1: Tests for Hepatitis C and What They Mean

111

(2)

Appendix 2: Making and Using Herbal Medicines for Hepatitis and the Liver

113

(6)

Resources

119

(1)

Suggested Reading

120

(1)

Glossary

121

(3)

Selected Bibliography

124

(23)

Index

147

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Hepatitis C: The Silent Epidemic ((part of CHAPTER 1)) It is silent, hidden, without symptoms for years, found by accident. Five hundred million people on Earth have it. It is hepatitis C virus (HCV) infection. In the industrialized world, it's usually discovered like this: Someone goes to the doctor for a checkup, complaining of feeling tired, or he applies for insurance coverage. A routine blood test is conducted. "I am sorry," the physician or insurance company says, "you have tested positive for hepatitis C." The insurance company may deny coverage and the physician, depending on her training, will usually do one of two things. If the physician has seen some of the problems that advanced HCV infection can cause, the information she will share with her patient is often frightening and not very encouraging. She will suggest interferon therapy if the liver enzyme levels are not too high and if the patient doesn't have cirrhosis. If the physician knows little about the disease, he will often dismiss it as "nothing much." Often the patient finds, years later, as symptoms become increasingly uncomfortable, that there is something to worry about after all. Hepatitis C is in fact a serious disease, and it is here to stay. As Robert Goldstein of Baylor University Medical Center warns, "[Hepatitis C] is going to make the AIDS epidemic look pale." Infection and Disease from HCV In most cases, hepatitis C is a blood-borne disease, and the virus presumably needs to enter the body through contaminated blood in a cut or through injection. Unlike HIV, HCV is not a fragile organism. No one knows how long it can survive in microscopic traces of dried blood; after 3 months, it is still active and infectious. Fortunately, person-to-person infection, even through sex, is extremely rare (only about 2 percent of infections are transmitted this way). A more worrisome statistic is that for 10 percent of people with the disease, the route of infection cannot be determined. Some experts feel this percentage may be even higher. Incubation Period The incubation period of HCV before symptoms occur can be as long as 50 years, although the average is 15 to 25 years. If the disease goes untreated, the prognosis can be grim. Seventy percent of infected people will develop some kind of chronic liver disease, 15 percent will experience cirrhosis of the liver, and 5 percent will die. Only about 10 percent to 15 percent seem to throw off the disease and remain unaffected by it. HCV infection is now the number one cause of liver transplantation in the United States. The incubation period of HCV before symptoms occur can be as long as 50 years, although the average is 15 to 25 years. If the disease goes untreated, the prognosis can be grim. Seventy percent of infected people will develop some kind of chronic liver disease, 15 percent will experience cirrhosis of the liver, and 5 percent will die. Only about 10 percent to 15 percent seem to throw off the disease and remain unaffected by it. HCV infection is now the number one cause of liver transplantation in the United States. It is estimated that 2 percent of the population of the industrialized world is infected: this includes some 5 to 6 million people in the United States and about 1.2 million people in the United Kingdom. The incidence of infection in other parts of the world is much higher - up to 10 percent of people in China, India, and Africa. Of the 5 to 6 million infected people in the United States, only 1 million have been diagnosed. Every year, 150,000 to 170,000 new cases are found, and 8000 to 10,000 people die. The number of deaths is expected to triple by 2007. HCV infection is the most common cause of liver disease, cirrhosis, and liver cancer in the western world. Conventional Treatment Conventional medical treatment for hepatitis C focuses on the use of interferon (an immune stimulant) and ribavirin (an antiviral drug). This treatment can be quite expensive, sometimes has severe side effects, and is only partly effective. Only about half of the people with hepatitis C fit the treatment profile and will be given interferon. Of those, about half will show viral clearance after a year of treatment. In this group, half will show a resurgence of the virus after discontinuing interferon therapy. The effectiveness rate is about 15 percent. If interferon is combined with ribavirin, these rates double for patients who fit the treatment profile, up to about 35 percent effectiveness. Ribavirin alone (600 mg orally twice daily) for 12 months reduces alanine aminotransferase levels (although these levels rise again after treatment ceases) but does not affect viral levels in the blood. Researchers comment that "ribavirin clearly has no antiviral effect" on HCV. However, interferon plus ribavirin seems to have a synergistic effect. Interferon or interferon plus ribavirin is usually indicated for patients with low liver enzyme levels and no signs of cirrhosis. The most common side effect of interferon (for about 80 percent of patients) is similar to a moderate case of the flu - for the whole year of treatment. Diarrhea and depression can also occur. The primary side effect of ribavirin is hemolysis (destruction of red blood cells). The treatment is quite expensive for patients without insurance, up to $10,000 or more per year. And, again, it is effective only for about one-third of those treated. Furthermore, both interferon and ribavirin are designed only to deal with the presence of the virus; they do nothing to heal damage to the liver or other systemic effects of the disease. For most of the people in the world, for those without insurance, those who are not candidates for interferon-ribavirin therapy, and those in whom the therapy fails, no other medical options are available. The Hepatitis C Virus HCV is a remarkable virus. (I know, I have it.) It is one of the tiniest known. In comparison, the smallpox virus is one of the largest; it can actually be seen through a microscope, although even with the best lenses it is only a tiny speck. By a not-too-far stretch of the imagination, smallpox looks like a knobby, squarish brick. (Some researchers actually call the virus that.) And if you took three million smallpox viruses and laid them down like brick pavers for a patio floor, they would just about cover the period at the end of this sentence. So, if a smallpox brick were the size of a real brick, then a cold virus would be a blueberry sitting on top of it. HCV is one-third the size of that blueberry, about 30 to 35 nanometers (thousands of a millionth of a meter). This incredibly small size has made HCV very hard to study. Only now is it coming to be understood. Discovery of HCV Hepatitis simply means "inflammation of the liver." It is a combination of two words: "hepato" from the Greek hepatikos, meaning "liver," and "-itis," meaning "inflammation of." A great many things can cause inflammation in the liver: viruses, bacteria, chemicals, alcohol, and trauma. It's confusing, especially when the hepatitis alphabet diseases (hepatitis A through G) are discussed. The diseases sound related but they aren't. The structure, nature, and communicability of the viruses that cause each of them are very different. These viruses are all fairly new to human science: The hepatitis B virus (HBV) was isolated in 1965, HAV in 1973. HCV took a little longer to isolate. Japanese researchers realized as early as the 1970s that an unknown pathogen was causing severe liver disease in their patients. The liver problems they were seeing could not be attributed to the A or B viruses. As it became clear that another distinct pathogen was involved, medical texts began referring to this new condition as "non-A, non-B" hepatitis. It was not until 1989 that the specific virus was isolated; shortly afterward it was genetically mapped by researchers in the United States. By 1991, a test for determining the presence of HCV antibodies had been created (from the blood of an Australian aborigine whose people have, disturbingly, never received reimbursement for their contribution), thereby allowing blood supplies around the world to be tested for the presence of the virus. Until that time, there was no way to determine whether blood supplies used for transfusions were contaminated. And many were. Spread by Infected Blood The spread of the virus got a boost during and after World War II, as blood transfusions became common. Asian, African, American, and European blood supplies were liberally mixed during and immediately after the war as technological medicine was spread throughout those areas for the treatment of injured and displaced populations. This extensively spread the virus in human populations throughout the world (the 1940s - the First Wave). As soldiers and displaced people returned home, the widespread use of vaccines, needles, blood donation, and various surgical procedures (from dental visits to cesarean sections) helped spread the virus throughout the general population of each country (the 1950s and '60s - the Second Wave). Intravenous drug use, needle sharing, and contaminated blood banks (some addicts sell their blood weekly to get money for drugs) spread the virus even further (the 1970s and '80s - the Third Wave). Because HCV is a relatively benign and slow-acting virus in its initial effects on the body (it rarely causes acute disease symptoms or discomfort at the time of infection), it takes a long time to notice. The disease really wasn't recognized until the late 1960s and early 1970s, when people contaminated in the First Wave began to show signs of liver disease. It is estimated that one-twelfth of the world population, or 500 million people, is now infected with HCV. In comparison, HIV infects 33 million people worldwide.

Excerpted from Herbs for Hepatitis C and the Liver by Stephen Harrod Buhner
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