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Advanced Hepatitis C Infection: Six Tips to Temper Cirrhosis

June 17, 2009

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Discover six useful tips for people with Hepatitis C who are also managing liver cirrhosis. These tips can help prevent their condition from worsening.

by Nicole Cutler, L.Ac.

By combining prescribed medications, alternative medicine and lifestyle modifications, many people with Hepatitis C are able to triumph over this liver infection. However, Hepatitis C can cause irreparable damage to the liver if it is not detected and addressed early enough. Characterized by the hardening and shrinking of the liver, cirrhosis is the late stage of liver disease where this organ is unable to properly function. Unfortunately, cirrhosis not only presents challenges to Hepatitis C treatment, but it is also a leading cause of mortality. While no simple solution exists to help cirrhosis, experts offer several suggestions to help a person live with this Hepatitis C complication.

Globally, approximately 170 million people are chronically infected with Hepatitis C, with an estimated four million living in the U.S. The longer a person harbors this virus, the more opportunity it has to cause liver damage. Although it typically takes one or two decades, researchers estimate that about one in five Americans with chronic Hepatitis C develops cirrhosis.

Combination Therapy
Consisting of pegylated interferon and ribavirin, combination therapy is the current standard of treatment for Hepatitis C infection. Although this treatment has a success rate of approximately 50 percent, those whose liver disease has advanced to cirrhosis don't fare as well. There are two main reasons for this disadvantage:

1. Every Viral Particle - For treatment to be effective, every single viral particle must be eliminated. The scar tissue in a cirrhotic liver provides many places for the Hepatitis C virus to hide. Because some surviving viral particles dodge the treatment, it is common for people with cirrhosis to relapse after combination treatment.

2. Side Effects - Even though the originally prescribed dosage offers the best hope for success, the severe side effects of combination therapy prohibits many from persevering through treatment at full strength. Unfortunately, those with cirrhosis typically don't tolerate full doses of interferon and ribavirin very well. Because of a cirrhotic liver's limitations, white blood cell and platelet counts often drop quickly, causing many people with cirrhosis to become anemic on combination therapy.

Six Tips for Managing Cirrhosis
In order to prevent cirrhosis from shutting down the liver, those affected must prioritize their health. As such, learning about and incorporating the following tips will help those with advanced liver disease to prevent complications and maintain their health for as long as possible:

Tip 1: Alcohol Abstinence - Alcohol is a well-known toxin and accelerator of liver damage and Hepatitis C viral replication. Thus, there is no amount of alcohol that is safe for someone with cirrhosis.

Tip 2: Multivitamins in Moderation - While many take vitamins to support their health, certain ingredients can be dangerous with cirrhosis.

· Vitamin A is toxic to the liver, so those with cirrhosis should not exceed 5,000 units per day. When ingested in the form of beta-carotene, there is no liver toxicity.

· If taken in doses over 1,200 IU per day, Vitamin E could cause bleeding. Because bleeding varices is a common complication of cirrhosis, Vitamin E intake should be carefully monitored.

· Since iron promotes the formation of scar tissue in the liver, those with cirrhosis who are not iron deficient should not take multivitamins with iron.

Tip 3: Milk Thistle - Those with cirrhosis don't want to lose any more functioning liver cells. Because milk thistle has been shown to strengthen and thus protect liver cells from damage, supplementing with this popular herb may help shield this organ from further scarring.

Tip 4: Immunizations - Because multiple hepatitis infections will worsen cirrhosis, patients with Hepatitis C should be immunized against Hepatitis A and Hepatitis B. In addition, influenza and pneumococcal vaccines are advised because those with cirrhosis are more likely to die from these infections than otherwise healthy people.

Tip 5: Yearly Dentist Visits - Dental care is crucial to those with advanced liver disease. Gingivitis or infection of the gums can leak bacteria into the blood stream, causing potentially severe infections in those with cirrhosis. Additionally, if a liver transplant is needed, the presence of gingivitis is cause to deny that person from receiving a liver.

Tip 6: Diabetes Awareness - People with Hepatitis C and cirrhosis have a higher incidence of diabetes. Thus, those with cirrhosis are urged to adopt lifestyle changes, such as a low sugar diet and regular exercise, to prevent diabetes. In addition, detecting, monitoring and treating diabetes is essential for maintaining good health.

Managing cirrhosis and chronic Hepatitis C infection requires learning about these illnesses and being committed to staying as healthy as possible. There is no magic pill to simplify this process. However, the six tips described can help a person with advanced liver disease to persevere until a better treatment to eradicate Hepatitis C - even with cirrhosis - is finally devised.

References:

http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/, Chronic Hepatitis C: Current Disease Management, Retrieved May 10, 2009, National Institutes of Health, 2009.

http://www.hcvadvocate.org/hcsp/articles/Cecil-2.html, HCV cirrhosis is a life threatening disease, Bennet Cecil, MD, Retrieved May 10, 2009, Hepatitis C Support Project, 2009.

http://www.hcvadvocate.org/hcsp/articles/Herrera.html, Cirrhosis in Chronic Hepatitis C Infection, Jorge L. Herrera MD, Retrieved May 10, 2009, Hepatitis C Support Project, 2009.

Posted by Editors at June 17, 2009 3:00 PM