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Liver Care After Successful Hepatitis C Treatment

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Being cured of Hepatitis C is an exciting and more frequent occurrence thanks to improvements in antiviral therapy; however, caring for your liver afterwards is important for your liver’s longevity.
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Updated November 11, 2019

One of your most precious internal organs, the liver takes a beating from the Hepatitis C virus. Those who are on the path to recovering from Hepatitis C after antiviral therapy can be left with various degrees of liver damage. Several studies indicate that clearing the Hepatitis C virus from the bloodstream bodes well for liver rejuvenation, but many agree that relying on this trend without support is a gamble. Maintaining the liver’s health with a high quality milk thistle supplement has helped thousands of people with chronic Hepatitis C before and during treatment; however, few realize the important role milk thistle plays after successful antiviral treatment.

Hepatitis C is often regarded as the silent killer because this virus can progressively damage the liver for decades before any symptoms are noticed. As such, many are finally tested for and diagnosed with Hepatitis C after years of liver damage have accumulated. In general, liver damage can be reversed if the cause is eliminated prior to the development of cirrhosis – the permanent hardening and fibrosis (excessive scarring) of liver tissue.

Thankfully, Hepatitis C antiviral therapy has dramatically improved over the past few years. As long as a person is eligible for the treatment (and can finance it), today’s drug regimens for Hepatitis C have a very high cure rate. Being cured of Hepatitis C is defined as achieving SVR (sustained virologic response). SVR is when there is no detectable Hepatitis C RNA in the person’s bloodstream six months after completing antiviral treatment. By the time a person successfully completes treatment, the amount of liver fibrosis usually has regressed. In fact, one Swedish study demonstrated that the vast majority of the trial patients with advanced fibrosis or cirrhosis prior to treatment improved their fibrosis during long-term follow up after SVR.

Measured in stages, levels of liver scarring or fibrosis are measured between 0 (no fibrosis) and 4 (cirrhosis/advanced fibrosis). A patient who successfully completes the treatment typically improves by one or two stages during the course of treatment.  Despite cirrhosis typically being regarded as permanent liver injury, liver scarring can improve and liver failure risk is reduced when antiviral therapy is successful. However, people with cirrhosis prior to Hepatitis C treatment remain at an elevated risk for liver cancer even when SVR is achieved.

While effective Hepatitis C treatment appears to cure this infection, treatment given in the latter stages of Hepatitis C disease does not wholly reverse the damage that has occurred to the liver. So although Hepatitis C may be cured, some degree of liver damage and consequent liver disease remains. Specialists in Sweden conducted a study to examine the consequences of liver damage after successful antiviral treatment. They found that while SVR markedly reduced liver-related complications and liver cancer, some long-term risks for liver cancer remained in those who were cured of Hepatitis C. Older patients, patients with cirrhosis prior to treatment, and patients with high BMI (body mass index) were all found to be risk factors for continued advanced fibrosis after SVR.

The chance of developing liver cancer after being cured of Hepatitis C means there is still a liver vulnerability after antiviral treatment. Thus, fully recovering and returning to health is best achieved when making a proactive effort to care for the recovering liver. Besides avoiding alcohol and other known liver toxins, one of the best ways to care for the liver is by supplementing with a high quality milk thistle extract. Believed to be the most biologically active form of milk thistle, silybin phytosome contains the most potent component of the milk thistle plant and delivers it in a form that is up to ten times more absorbable than a standard milk thistle extract. Hundreds of clinical studies have demonstrated milk thistle’s ability to protect liver cells from damage and aid in regeneration of new, healthy liver cells.

Some doubt has been cast on milk thistle’s influence on the Hepatitis C virus by a study published in the July 2012 edition of the Journal of the American Medical Association. This study aimed to determine the effect of milk thistle on liver disease activity in patients with chronic Hepatitis C. The authors concluded that milk thistle did not significantly reduce liver enzyme levels more than placebo and, thus, milk thistle has little impact on the Hepatitis C virus.

Those familiar with the chemistry of milk thistle are not surprised at all about these results because the investigators in this study did not use milk thistle extract in the phytosome form. The molecular composition of milk thistle makes it difficult to be absorbed into liver cells. However, the phytosome form solves this problem by making the supplement easily miscible into cells.

Caring for the liver’s well-being should not stop – even after successfully completing Hepatitis C treatment. Even though the liver no longer must battle daily inflammation from Hepatitis C, the damage that has already occurred in the liver must be monitored by a physician and can be mitigated by the patient. Achieving SVR is cause for celebration, but continuing alcohol abstinence and silybin phytosome supplementation will help guarantee a long-term future without liver cancer or other liver-related complications.

After treatment ends. (n.d.). Retrieved November 11, 2019, from http://www.liverforeverfoundation.com/what-you-need-to-know-while-on-treatment-2/

Fried, M. W. (2012). Effect of Silymarin (Milk Thistle) on Liver Disease in Patients With Chronic Hepatitis C Unsuccessfully Treated With Interferon Therapy. Jama, 308(3), 274. doi:10.1001/jama.2012.8265

Hedenstierna, M., Nangarhari, A., El-Sabini, A., Weiland, O., & Aleman, S. (2018). Cirrhosis, high age and high body mass index are risk factors for persisting advanced fibrosis after sustained virological response in chronic hepatitis C. Journal of Viral Hepatitis, 25(7), 802-810. doi:10.1111/jvh.12879

Hepatitis C medication: An overview for patients. (2018, October 29). Retrieved November 11, 2019, from https://www.hepatitis.va.gov/products/treatment-update.asp

Hosein, S. R. (2013, June 11). Exploring the Risks of Liver Cancer After Successful Treatment for Hepatitis C Virus. Retrieved November 11, 2019, from http://www.thebodypro.com/content/71799/exploring-the-risks-of-liver-cancer-after-successf.html?getPage=1

Lillis, C. (2018, November 13). What to know about late-stage Hepatitis C. Retrieved November 11, 2019, from https://www.medicalnewstoday.com/articles/323678.php

Managing Hepatitis C as a chronic condition. (n.d.). Retrieved November 11, 2019, from https://www.reimaginewellcommunity.com/weblog/managing-hepatitis-c-chronic-condition

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