Research & Treatment News
September 28, 2009
Printer-friendly version
Just in time for flu season, swine flu vaccines will be distributed and administered. If you think having Hepatitis C is cause for receiving this vaccination, become familiar with who is at highest risk from swine flu complications - and why you may want to think twice about this injection.
by Nicole Cutler, L.Ac.
Officially known as H1N1, just about everyone is aware of swine flu since its first outbreak in March of 2009. In response to the worldwide panic that H1N1 could evolve into a deadly plague, pharmaceutical companies have been racing to develop a vaccination before flu season is in full swing. As of September 2009, the U.S. Food and Drug Administration approved four vaccines against H1N1. While vaccine distribution is expected to begin by mid-October, many (including those with Hepatitis C) are unsure if they should sign up to get vaccinated.
As an influenza virus, the H1N1 strain appears to cause a comparatively mild illness. Despite having a relatively mild course, H1N1 has claimed a moderate number of lives. While the elderly are typically at a higher risk from the typical seasonal flu, swine flu has caused more flu-related complications and deaths in young people than expected.
The likelihood of there being enough vaccine doses available for everyone who desires it is slim. The Centers for Disease Control has urged hospitals and other H1N1 vaccine providers to prioritize who gets the vaccine. At Texas Health Harris Methodist Hospital Fort Worth, providers are preparing a protocol to decide who is approved for H1N1 vaccination:
· At the top of the list are those who have daily contact with patients: doctors, nurses and other healthcare workers.
· Next are people considered high risk. According to Jacie Russell, infection preventionist at the hospital, "That includes patients who have cancer or people with chronic organ disease, such as liver disease or heart disease, or people who take care of children."
· Pregnant women complete the hospital's priority list.
According to this Texas hospital, those with chronic Hepatitis C certainly qualify for receiving a potentially limited swine flu vaccine. The question then becomes, is getting this vaccine in someone with Hepatitis C's best interest?
Advantage
Obviously, the one advantage of getting vaccinated against swine flu is that your chance of getting sick with this disease is reduced. With the swine flu vaccination under your belt, you can safely go in public without worrying about whether the sneezing person next to you is infected.
Disadvantage
One of the reasons many are less than enthused about the H1N1 inoculation is that its fast-tracked status could lead to reduced effectiveness or side effects. Considering how quickly drug developers had to scramble to devise these vaccines, this is a valid concern. If clinical studies were rushed, there is a chance that the vaccine will have side effects. Such a problem arose from a vaccine developed to counter a supposed swine flu outbreak at Fort Dix, New Jersey in 1976, where four people got sick and one person died. This caused millions of people in the United States to take the swine flu vaccine available then. Unfortunately, many who received this vaccination became ill with Guillain-Barre syndrome, an autoimmune disease where parts of the nervous system are attacked.
Thus, a fast-tracked vaccine with unknown side effects is feasible. However, all flu vaccinations are typically created quickly as infectious disease specialists attempt to isolate what they presume will be the most prevalent and destructive flu virus that next season. According to Jesse Goodman, M.D., the FDA's acting chief scientist, "The H1N1 vaccines approved today (September 15, 2009) undergo the same rigorous FDA manufacturing oversight, product quality testing and lot release procedures that apply to seasonal influenza vaccines."
According to a global survey published in the August 20, 2009 issue of Eurosurveillance, at least half of the fatal swine flu cases involved underlying disease. A majority of fatalities involved people in the 20 - 49 year-old age group. In addition, the conditions most often linked to flu deaths were obesity and diabetes. Hepatitis C in and of itself was not recognized as a risk factor for swine flu complications. However, a number of fatal cases did involve people with immune suppression due to other causes, including cancer, organ transplants and autoimmune diseases.
Hepatitis C and H1N1 Vaccine
As we move into the flu season, those with chronic Hepatitis C must decide if the H1N1 vaccine is for them. While some institutions are advising those with chronic liver disease to get vaccinated, this decision is not one-dimensional. Just like with any medication, there are benefits and risks associated with a flu vaccine.
In and of itself, Hepatitis C does not imply a mandatory H1N1 vaccination. Some of the indicators of a high swine flu complication risk are age, chronic disease, diabetes, immune system strength and being overweight. There are some with Hepatitis C who are strong, have no detectable liver damage and are able to fight off pathogens. These individuals may opt to focus on lifestyle practices to stay healthy instead of receiving a shot.
Due to multiple health problems, having a more advanced stage of liver disease or demonstrating other swine flu complication risk factors, there are others with Hepatitis C who are more susceptible to ill health. In these circumstances, discussing swine flu concerns with a physician can help with the decision of whether or not to receive an H1N1 vaccination this fall.
The latest flu information and public health recommendations from the CDC are available at http://www.cdc.gov/h1n1flu.
References:
http://www.hivandhepatitis.com/recent/2009/090409_e.html, HIV Infection Does Not Appear To Be a Risk Factor for H1N1 Influenza Death, but Vaccine May Be Advisable, Liz Highleyman, Retreived September 24, 2009, hivandhepatitis.com, September 2009.
http://www.hivandhepatitis.com/recent/2009/091709_aa.html, FDA Approves Vaccines for 2009
H1N1 Influenza Virus, Retrieved September 24, 2009, hivandhepatitis.com, September 2009.
http://www.testcountry.org/swine-flu-vaccine-%E2%80%93-advantages-and-disadvantages.htm, Swine Flu Vaccine - Advantages and Disadvantages, Retrieved September 24, 2009, TestCountry Articles, 2009.
http://www.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa090919_lj_stoler.198de7300.html, Why you may not be able to get the swine flu vaccine, Steve Stoler, Retrieved September 24, 2009, WFAA-TV, Inc, September 2009.
Posted by Editors at 3:51 PM --- Printer-friendly version
September 21, 2009
Printer-friendly version
Research out of Korea suggests that asparagus is a liver protector, a notion that could benefit Hepatitis C sufferers.
by Nicole Cutler, L.Ac.
Everyday choices such as what to eat for dinner can have an impact on someone with Hepatitis C. Because certain foods can help liver function while others may hinder it, nutritional awareness is a key component of any Hepatitis C health regimen. More specifically, eating asparagus has demonstrated the capability to protect the liver from toxicity.
From a basic dietary perspective, increasing the proportion of fruit and vegetables per meal is guaranteed to support your liver's health. Produce contains fiber and is packed with vitamins, minerals and antioxidants that optimize cellular function. For someone with Hepatitis C, this translates to helping fortify and protect liver cells from the inflammation and cellular damage of a chronic liver virus. However, choosing asparagus as your veggie might offer someone with Hepatitis C more help than previously thought.
According to an article published in the Journal of Food Science, "an extract from asparagus may increase the function of enzymes in the liver and boost the metabolism of alcohol." Researchers from Korea concluded that, "the leaves of A. officinalis, which are normally discarded, have the potential for use in therapy designed to protect the liver from various harmful insults."
Although the information given by investigators is insufficient to launch an asparagus eating campaign, the news comes as no surprise to many alternative healthcare providers. Due to its anticancer effects, asparagus has been used for centuries as an herbal medicine in Asia. In addition, asparagus is purported to have the following properties:
· Anti-fungal
· Anti-inflammatory
· Diuretic
Packed with high levels of folate, amino acids, potassium and Vitamins B and C, asparagus officinalis is a common vegetable that is widely consumed worldwide. According to researchers at the Institute of Medical Science and Jeju National University in Korea, asparagus extract may alleviate alcohol hangover and protect liver cells against toxins.
Researchers analyzed the components of young asparagus shoots and leaves to compare their biochemical effects on human and rat liver cells. They found that the cellular toxicities of chronic alcohol use were significantly alleviated in response to treatment with asparagus leaf and shoot extract.
However, these findings do not provide a solution for someone with Hepatitis C who wants to drink alcohol. This is because there is no amount of alcohol that is safe for someone with Hepatitis C. However, these results can be extrapolated and applied to Hepatitis C in a different way:
· Alcohol use causes oxidative stress on the liver just like Hepatitis C causes oxidative stress on the liver.
· Because asparagus extract protects liver cells from oxidation (and subsequent damage) from alcohol, it will also likely protect liver cells from oxidation (and subsequent damage) from a hepatitis virus.
When Not to Eat Asparagus
Asparagus contains naturally-occurring substances called purines. Certain individuals who are susceptible to purine-related problems should not eat a lot of asparagus. Since purines can be broken down to form uric acid, excess accumulation of purines in the body can lead to excess accumulation of uric acid. Thus, those with ailments due to uric acid buildup should be advised to limit or avoid purine-containing foods - like asparagus. Examples of such ailments include gout and kidney stones.
Even though the Korean research focused on how asparagus could protect the liver from the effects of alcohol, the biological mechanism of aiding liver function applies to all potential liver toxins - including Hepatitis C. Exempting people with purine-related health concerns, those managing chronic Hepatitis C will do themselves a favor when considering asparagus to star in their meals.
References:
http://www.hcvadvocate.org/news/newsLetter/2009/advocate0909.html#5, Blueberries, Asparagus and HCV, C.D. Mazoff, PhD, Retrieved September 13, 2009, Hepatitis C Support Project, 2009.
http://www.medicalnewstoday.com/articles/160722.php, Fight The Dreaded Hangover: Asparagus Extracts May Protect The Liver, Retrieved September 13, 2009, MediLexicon International Ltd., August 2009.
http://www.whfoods.com/genpage.php?tname=foodspice&dbid=12, Asparagus, Retrieved September 13, 2009, The George Mateljan Foundation, 2009.
Posted by Editors at 4:26 PM --- Printer-friendly version
September 9, 2009
Printer-friendly version
In an effort to circumvent the spread of Hepatitis C, many drug users assume they are safe from viral acquisition if using a non-injection drug delivery system. However, new research shows that a pipe passed between people is capable of transmitting the Hepatitis C infection.
by Nicole Cutler, L.Ac.
As the Hepatitis C virus (HCV) increases in prevalence, so does concern about avoiding this potentially chronic liver disease. In order to reduce the number of new infections, campaigns to educate the public about possible routes of transmission are crucial. While a few obvious routes capable of transmitting the virus have been widely publicized, new research shows that a previously unsuspected item may be passing HCV to new hosts.
Hepatitis C Transmission
Because HCV is primarily a blood-borne virus, transmission occurs when blood of an infected individual makes contact with the blood of someone who is not infected. Although intravenous drug use and tainted blood transfusions are suspected in most cases of acquiring HCV, there are many more ways one can come into contact with infected blood. Experts estimate that approximately 20 to 40 percent of those infected with HCV have not been able to accurately identify the manner in which they contracted their illness. Due to this statistic, previously unrealized routes of viral acquisition must exist.
Although the likelihood of acquiring Hepatitis C is highest with intravenous drug use and tainted blood transfusions, there are many possible routes of infection. According to the U.S. Centers for Disease Control, Hepatitis C transmission could occur in any of the following ways:
1. Injecting street drugs, whether it was done once, a thousand times, yesterday or 40 years ago.
2. Being the recipient of treatment for clotting problems with a blood product made prior to 1987.
3. Being a blood transfusion or solid organ (e.g., kidney, liver, heart) recipient from an infected donor.
4. Being a recipient of long-term kidney dialysis.
5. Working in health care with frequent contact with blood in the work place, especially accidental needle sticks.
6. Being born to a mother who had Hepatitis C at the time of your birth.
7. Having sexual contact with an HCV-infected person.
8. Living with someone who was infected with HCV and sharing items such as razors or toothbrushes that might have had blood on them.
In addition to the eight high risk categories listed by the Centers for Disease Control, sharing drug delivery items other than needles have been implicated in HCV transmission.
Drug Delivery Systems
Although there is a wide variety of drugs and corresponding delivery systems in use, the target for any illicit drug remains the bloodstream. Drugs that are taken orally must pass through the digestive system before reaching the bloodstream. However, injection, inhalation and snorting provide the drug quicker access to circulating blood, thereby creating a faster high. As it turns out, any paraphernalia used to inject, smoke or snort drugs can become contaminated with blood thus rendering it a potential HCV transporter.
1. Injection Materials - While sharing drug paraphernalia has long been implicated in the spread of infectious disease, most people assume that this only refers to intravenous injection equipment. When evaluating the potential transmission of blood through injection drug use, items that could be tainted with blood - such as syringes, cotton and cookers - can all be vehicles for spreading this virus.
2. Snorting Materials - Drug sniffing and/or snorting has also been implicated as a major risk factor for the acquisition of HCV. Due to nasal irritation and trauma, snorting cocaine and heroin can cause bleeding in the nose. Although the amounts could be microscopic, blood from the nose can remain on the surface of sniffing and snorting equipment, such as straws or rolled money, which can be passed on to the next person. Because snorting drugs easily damages the nose's delicate lining to cause bleeding, a previously uninfected person is instantly vulnerable to viral transmission through this activity.
3. Smoking Materials - A new study by the University of Victoria's Centre for Addictions Research suggests that HCV could be passed on between crack smokers who share pipes. Although not typically considered an item susceptible to blood exposure, many crack users have chronic burns and sores in their mouth that may facilitate oral HCV transmission. However, this smokable form of cocaine is not the only drug that uses the pipe as a delivery system. While further proof is necessary to conclude the dangers of pipe-sharing, just about any drug smoked through a shared tool could be a potential HCV spreader. Because a common HCV symptom is dry mouth, which can easily cause cracked and bleeding gums or lips, passing a pipe could spread more than a drug's effects.
Ironically, many individuals snort or smoke drugs in an attempt to avoid acquiring HCV and other infectious viruses through injection. Regardless of the method used, people who share drug paraphernalia place themselves and others at risk of HCV infection.
Since such a large proportion of individuals infected with Hepatitis C do not know how they became infected, all suspected avenues - including sharing pipes - must be made public knowledge. By thoroughly educating society about all of the places HCV transmission can potentially occur, real strides to minimize this disease's impact will be seen.
References:
Fischer, et al., Hepatitis C virus transmission among oral crack users: viral detection on crack paraphernalia, European Journal of Gastroenterology & Hepatology, January 2008.
www.cdc.gov, If You Have Hepatitis C, U.S. Department of Health and Human Services, 2007.
www.hepatitisaustralia.com, Hepatitis C: How People Get It, Hepatitis Australia, 2007.
www.hepcaz.net, Hepatitis C and Harm Reduction, Arizona Hepatitis C Coalition, 2007.
www.hivandhepatitis.com, Risk Factors for Hepatitis C in People with Unknown Transmission Routes, Liz Highleyman, hivandhepatitis.com, December 2006.
www.phac-aspc.gc.ca, Hepatitis C virus transmission in the prison/inmate population, Public of Health Agency of Canada, August 2004.
www.physorg.com, Shared Crack Pipes May Spread Hepatitis C Virus, PhysOrg.com, 2007.
www.thebodypro.com, Canada: British Columbia Health Officials Welcome Crack Pipe Study and Link to Hepatitis C, US Centers for Disease Control and Prevention, December 2007.
Posted by Editors at 3:25 PM --- Printer-friendly version
September 8, 2009
Printer-friendly version
To ease the exhaustion typical of hepatitis, people are constantly looking for an energy booster. Find out if vitamin B-12 could help power you through your fatigue.
by Nicole Cutler, L.Ac.
Anyone living with chronic hepatitis knows that fatigue is one of this illness's biggest challenges. Thus, rumors of vitamin B-12 shots or supplements miraculously restoring energy levels have generated a lot of interest in the hepatitis community. Before beginning a campaign to find and receive this shot, pill or tablet, learn about the situations that actually warrant taking vitamin B-12.
Essential for many of the body's functions, vitamin B-12 is known as the "energy vitamin." While vitamin B-12 deficiency was previously regarded as rare, recent studies from the U.S. Framingham trial show that one in four adults in the U.S. don't have enough of this vitally important nutrient.
About Vitamin B-12
Present only in animal food sources, vitamin B-12 is an essential water-soluble vitamin that is found in fish, shellfish, meat and dairy products. Also known as cobalamin, this nutrient plays many roles including helping to:
· Maintain healthy nerve cells
· Create red blood cells
· Produce DNA, the genetic material in all cells
Bound to the protein in food, hydrochloric acid in the stomach releases vitamin B-12 from protein during digestion. Once released, B-12 combines with intrinsic factor so that it can be absorbed into the bloodstream.
Vitamin B-12 Deficiency
There are two primary ways to become deficient in vitamin B-12: not getting enough in your food and losing the ability to absorb it.
· Diet - While most Americans get plenty of cobalamin from their diet, those who are strict vegetarians or vegans have trouble getting enough B-12 from their food.
· Age - With advanced age, the likelihood of a vitamin B-12 deficiency rises. This is because the stomach's lining gradually loses its ability to produce hydrochloric acid.
· Drugs - The use of antacids or anti-ulcer drugs will lower stomach acid secretion, thus decreasing the ability to absorb vitamin B-12.
· Pathogen - Infection with Helicobactor pylori, a common contributor to stomach ulcers, can also result in vitamin B-12 deficiency.
· Cobalamin malabsorption syndrome - This newly coined term is when the stomach lining loses the ability to produce intrinsic factor (which enables vitamin B-12 absorption). The suggested reasons for this syndrome span atrophic gastritis, Helicobacter pylori infection and long-term ingestion of antacids and biguanides.
Fatigue
Because it is involved with red blood cell production, cobalamin is crucial for bringing oxygen throughout the body to provide energy. This is why many people with anemia (insufficient red blood cells) are energized after taking a vitamin B-12 supplement or receiving a shot. However, those with hepatitis can have many causes for their fatigue.
Before someone with hepatitis assumes that cobalamin is the answer to his/her prayers, a physician must first look carefully at what factors could be responsible for the person's fatigue. For more information about why someone with Hepatitis C might be tired, read Fatigue and Hepatitis C. While most people with hepatitis have fatigue for reasons unrelated to vitamin B-12, there are some exceptions:
· Alcohol - Those with alcoholic hepatitis who obtain the bulk of their nutrients from alcohol are likely to develop a vitamin B-12 deficiency. In addition, alcohol can interfere with the absorption of vitamin B-12. Thus, a cobalamin deficiency may develop if a person consumes alcohol even if a well-balanced diet is maintained.
· Encephalopathy - Those with hepatitis who have progressed to chronic encephalopathy are instructed to avoid eating red meat. Because they may be vegetarians, a vitamin B-12 deficiency can occur in individuals with chronic encephalopathy.
· Diminished absorbability - Due to advanced age (over 60 years old) or a history of medications that block stomach acid, those with diminished ability to absorb vitamin B-12 could be tired due to cobalamin deficiency.
B-12 and Hepatitis C
Although there are only a few reasons that someone with hepatitis could benefit from vitamin B-12 for an energy boost, there is some interesting evidence tying this nutrient to Hepatitis C suppression.
· As published in the April 2001 Proceedings of the National Academy of Science of the United States of America, Australian researchers found that in those with Hepatitis C, high concentrations of cobalamin inhibited Hepatitis C viral replication. While these results have not been implemented into a treatment strategy, they do demonstrate a favorable relationship between vitamin B-12 and Hepatitis C suppression.
· According to a study by researchers from the Karolinska Institute in Stockholm presented at the 2009 Digestive Disease Week meeting in Chicago, Hepatitis C combination therapy was more effective in recipients who had high serum levels of vitamin B-12. While this provides more recent evidence that cobalamin could restrict Hepatitis C from replicating, there is not yet enough data to make this conclusion.
Hepatitis-induced fatigue can be severe. Understandably, those affected often try a wide range of products in search of a safe and effective energy boost. Whether administered by a syringe-yielding physician or purchased in a grocery store, vitamin B-12 could be a step in the right direction. Especially if you have reason to believe that you are not getting cobalamin from your diet or are not properly absorbing it, involve your doctor in your consideration of vitamin B-12 deficiency.
References:
http://products.mercola.com/vitamin-b12-spray/?source=nl, Why You Don't Want to Run Low on Vitamin B-12, Joseph Mercola, MD, Retrieved September 6, 2009, mercola.com, 2009.
http://www.hivandhepatitis.com/2009icr/ddw/docs/060509_b.html, Vitamin B12 Levels May Help Predict Response to Interferon-based Therapy for Chronic Hepatitis C, Liz Highleyman, Retrieved September 6, 2009, hivandhepatitis.com, 2009.
http://www.liverdisease.com/fatigue_hepatitis.html, Fatigue and Liver Disease/Hepatitis, Retrieved September 6, 2009, Melissa Palmer, MD, 2009.
http://www.mayoclinic.com/health/vitamin-B12/NS_patient-vitaminb12, Vitamin B12, Retrieved September 6, 2009, Mayo Foundation for Medical Education and Research, 2009.
http://www.ncbi.nlm.nih.gov/pubmed/11296247, Vitamin B12 and hepatitis C: molecular biology and human pathology, Lott WB, et al, Retrieved September 6, 2009, Proceedings of the National Academy of Science of the United States of America, April 2001.
Posted by Editors at 4:25 PM --- Printer-friendly version