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Two Supplements May Strengthen Hep C Antiviral Treatment

Nicole Cutler L.Ac. January 19, 2011

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Although many have heard of the supplements SAMe and betaine, their potential benefits to those on Hepatitis C treatment are not yet widely known.

For the estimated four to five million American adults with chronic Hepatitis C, attempts to conquer the virus can be challenging. This illness’ current antiviral treatment, pegylated interferon and ribavirin, is only about 50 percent effective in those infected with the most common strain of Hepatitis C in North America. Thus, investigators are constantly seeking ways to boost the success of these medicines. Building on previous knowledge about S-adenosyl-L-methionine (SAMe) and betaine, researchers from Switzerland have found two potential, seemingly non-toxic contenders for supporting Hepatitis C antiviral therapy.

Those unable to rid themselves of all Hepatitis C genetic material are burdened by the prospect of chronic liver disease progressing, a process that could eventually lead to liver cirrhosis, liver failure or liver cancer. Until better treatment options actualize, people in this situation typically seek experimental, innovative or alternative solutions to preserve their health. There are several ways health professionals attempt to help those who are not responsive to Hepatitis C treatment, such as:

  • Developing more potent drugs that have a higher success rate for eliminating the Hepatitis C virus.
  • Guiding infected individuals toward herbal supplements and lifestyle choices that strengthen liver cells to better protect them from the virus.
  • Adding certain substances to pegylated interferon and ribavirin that enhance their success rate.

While true progress against Hepatitis C is likely to involve all three of these approaches, the research from Switzerland focuses on the latter – enhancing pegylated interferon and ribavirin.

About the Research

A research team from Basel, Switzerland identified viral interference with interferon signal transduction as an important factor explaining the mediocre success of Hepatitis C treatment. Because prior experiments with SAMe and betaine have shown these substances can increase interferon signal strength, the researchers investigated if adding SAMe and betaine to Hepatitis C treatment would increase its efficacy.

As published in a November 2010 edition of the journal PLoS ONE, the researchers tested this concept in Hepatitis C patients who had previously failed antiviral therapy. For their trial, the participants were treated with pegylated interferon, ribavirin, SAMe and betaine.

Compared with their first attempt at antiviral treatment consisting of just pegylated interferon and ribavirin, study participants fared better in their second therapy attempt that included SAMe and betaine. This improvement was measured by a higher percentage of participants achieving an early virological response – undetectable viral load 12 weeks after starting treatment.

The researchers concluded that adding SAMe and betaine to pegylated interferon/ribavirin therapy improves early virological response in chronic Hepatitis C. Based on the fact that the inability to detect Hepatitis C genetic material after 12 weeks increases the chances of treatment success, some clinicians are recognizing the potential therapeutic application of SAMe and betaine.

About SAMe and Betaine

Both considered to be natural substances, SAMe and betaine are nutrients known as methyl donors. Other methyl donors include folic acid and vitamins B6 and B12. These substances carry and donate methyl molecules in the body to help make chemical processes work. Donation of methyl molecules is involved in proper liver function and cellular reproduction.

  • SAMe is a synthetic form of a compound formed naturally in the body from the essential amino acid methionine and adenosine triphosphate (ATP), the energy-producing compound found in all cells in the body. Besides studies supporting SAMe’s use for relieving the pain of osteoarthritis and helping depression, trials examining this supplement also suggest that it may help to normalize liver enzyme levels.
  • Betaine can be obtained in the diet from beets, broccoli, grains, shellfish and spinach. Besides studies supporting betaine’s use for heart disease and homocystinuria, there is also evidence that betaine may help protect against fatty deposits in the liver.

The research from Switzerland on these two supplements is encouraging, but there is far more evidence needed to accept SAMe and betaine as worthy and valuable additions to Hepatitis C treatment medications. Although not yet open to participant recruitment, one related follow-up study is being conducted at the University of Nebraska. This pilot study will examine betaine’s addition to Hepatitis C antiviral therapy in those who have either not responded to previous treatment or who have relapsed. More information on this study can be found at www.clinicaltrials.gov.

As the quest to help people conquer the Hepatitis C virus intensifies, expect to see more research into substances that aid pegylated interferon/ribavirin efficacy. SAMe and betaine are two such contenders, and the Hepatitis C community will be keeping a close eye on future developments involving these nutrients.

References:

http://altmedicine.about.com/od/treatmentsfromatod/a/SAMe.htm, SAMe, Cathy Wong, Retrieved December 6, 2010.

http://clinicaltrials.gov/ct2/show/study/NCT00882193, Pilot Study of Betaine + Combination Antiviral Therapy for Chronic Hepatitis C Genotype 1 Non-Responder/Relapsers, Retrieved December 10, 2010, US National Institutes of Health, 2010.

http://www.ncbi.nlm.nih.gov/pubmed, S-Adenosyl Methionine Improves Early Viral Responses and Interferon-Stimulated Gene Induction in Hepatitis C Nonresponders, Feld JJ, et al, Retrieved December 10, 2010, Gastroenterology, September 2010.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0015492, S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse, Magdalena Filipowicz, Christine Bernsmeier, et al, Retrieved December 6, 2010, PLoS ONE, November 2010.

http://www.umm.edu/altmed/articles/betaine-000287.htm, Betaine, Retrieved December 6, 2010, University of Maryland Medical Center, 2010.

http://www.umm.edu/altmed/articles/cirrhosis-000037.htm, Cirrhosis, Retrieved December 10, 2010, University of Maryland Medical Center, 2010.

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