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Curing Hepatitis C vs. Healing From Hepatitis C

Nicole Cutler L.Ac. June 4, 2009

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Complete eradication of the Hepatitis C virus and reversal of the damage done by HCV, are the two essential steps to defeating the virus. Learn why Hepatitis C recovery is evaluated in terms of virologic and histologic responses, as well as seven valuable tips you can start using today to help support and protect your liver.

Successfully overcoming a battle with Hepatitis C is more complex than taking a simple, one time test. If you are one of the millions living with the most common blood-borne virus, understanding the terminology for its eradication and implications for a healthful future are valuable when assessing your treatment and maintenance options. Today’s conventional therapy for Hepatitis C, combined interferon and ribavirin therapy, mostly focuses on its effect on the recipient’s viral load. However, supporting the health of the organ taking the brunt of Hepatitis C’s beating is a crucial part in healing from this disease.

The ultimate goal of defeating Hepatitis C is twofold – complete eradication of the virus and reversal of the damage done by the virus. While getting rid of the virus capable of multiplying at dizzying rates appears to be medicine’s top priority, an increasing amount of attention is also being directed at helping the liver recover from Hepatitis C’s wrath.

Hepatitis C recovery is evaluated in terms of the virologic and histologic responses:

  • Virologic Response – The most common way to perceive Hepatitis C treatment success is via the virologic response. To measure virologic response, doctors use a blood test to measure how much Hepatitis C virus is in the blood. While Hepatitis C RNA may be undetectable immediately following treatment, this test must be repeated six months later to see if any of the virus remained and reproduced. Also referred to as viral load, the best outcome is a sustained virologic response (SVR). When the virus remains undetectable in the blood six months (or more) following Hepatitis C therapy, SVR is considered attained. So far, studies following Hepatitis C patients for two to three years after SVR have demonstrated a low relapse rate.
  • Histologic Response – Another way to evaluate the effectiveness of Hepatitis C therapy, a histological response indicates a diminished level of liver inflammation. Conventionally determined via biopsy, a positive histologic response that indicates reduced liver inflammation can occur even if SVR is not reached. Improvements in histologic scores directly reflect a decreased tendency toward cirrhosis, hepatocellular carcinoma and liver failure.

While a person could have both a virologic and histologic response to Hepatitis C treatment indicating virus elimination, these events do not always go together.

In a Swiss study published in the December 2006 edition of AIDS, researchers determined that while SVR generally correlated with histologic response, a substantial proportion (33 to 43 percent) of study participants achieved a histological response even though they did not achieve SVR. In this study, post-treatment biopsies were taken approximately six months after the end of treatment. There is a possibility that further fibrotic improvement would have occurred after longer durations in those who attained SVR. Because the liver’s topography changes slowly, the study’s authors concluded that looking for a histologic response two to three years after treatment may be more indicative of successful Hepatitis C treatment. Alternatively, it appears that SVR is always accompanied by histologic improvement.

Claiming SVR relieves the liver from Hepatitis C’s daily onslaught of cellular destruction, giving the person a chance to recover and return to health. However, possessing the fortitude to re-grow healthy liver cells and reverse the damage previously done is necessary for achieving optimum health. Thus, histologic improvement is an important component in overcoming Hepatitis C infection. Just as important as eliminating Hepatitis C RNA from the blood, fostering the liver’s recovery from the virus is the only protection against the development of hepatocellular carcinoma or cirrhosis.

While the pharmaceutical industry continues to race toward the best elixir for viral eradication, doing everything within your power to support and protect the liver is a person’s best hope for histological improvement. Fostering the ideal environment for the liver to re-grow healthy cells and protect the cells it has gives anyone a better chance for living with and recovering from Hepatitis C. Experts in the field agree on these seven tips for supporting and protecting the liver:

  1. Avoid alcohol and recreational drugs.
  2. Consistently use a high quality milk thistle supplement.
  3. Fill your diet with wholesome, nutritious foods.
  4. Reduce your contact with toxins (ingested and environmental) to an absolute minimum.
  5. Maintain a regular physical activity program.
  6. Find ways to relax and enjoy every moment you can.
  7. Make a good night sleep your priority.

Even though most physicians consider SVR as evidence of curing Hepatitis C, this is clearly only the first step in the fight against this virus. A positive histologic response is actually the long-term indicator of liver health recovery. In addition to striving for viral eradication, take every step possible to support and protect your liver, whether choosing to pass on combination therapy, in the middle of therapy, if you are a non-responder or if you are one of the lucky ones to achieve SVR.

References:

www.amfar.org, Dim Outlook for Hepatitis C Treatment, Daniel Raymond, amFar, 2007.

www.hepcsource.com, What is Successful Treatment?, Hoffman-La Roche Inc., 2007.

www.hivandhepatitis.com, IP-10 Levels Predict Treatment Response in Patients with Hepatitis C, Liz Highleyman, hivandhepatitis.com, 2007.

www.medicinenet.com, Doctor’s Dialogue Index, MedicineNet, Inc., 2007.

www.medscape.com, Antiviral Therapy of patients with Chronic Hepatitis C, Jenny Heathcote, MB, MS, MD, FRCP, et al., Seminars in Liver Disease, 2000.

www.medscape.com, Histological Response to pegIFN╬▒-2a (40KD) Plus Ribavirin in HIV-hepatitis C Virus Co-infection, Eduardo Lissen, et al., AIDS, December 2006.

www.medscape.com, Sustained Virologic Response Associated with Quality of Life, Maureen P. Neary, Ph.D, et al., Seminars in Liver Disease, 1999.

www.medicalnewstoday.com, New Data From Largest U.S. Hepatitis C Trial Provide Insights Into Optimizing Treatment For Patient Populations, MediLexicon International, Ltd., 2007.

www.natap.org, Predictive Value of Early Virologic Response in HIV/Hepatitis C Virus-Coinfected Patients Treated With an Interferon-Based Regimen Plus Ribavirin, Montserrat Laguno, MD, Journal of Acquired Immune Deficiency Syndromes, February 2007.

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