Research & Treatment News
February 22, 2010
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Although both are required for a healthy immune response, learn why those with inflammation of the liver should favor omega-3 fatty acids over omega-6's.
by Nicole Cutler, L.Ac.
Considered to be essential fatty acids, omega-3 fatty acids and omega-6 fatty acids are both necessary for human health. There are many reasons that health conscious individuals increase their consumption of omega-3 laden foods, while reducing their omega-6's. Upon recognizing why health professionals advise consuming more omega-3's than omega-6's, those with liver disease have every reason to follow suit.
Taken for everything from depression to heart disease to arthritis, the primary therapeutic action of omega-3 fatty acids is squelching inflammation. For decades, omega-3's have proven their ability to improve inflammatory conditions. Because hepatitis falls under this umbrella, this liver condition benefits from omega-3 fatty acid consumption.
Hepatitis literally means inflammation of the liver, and is involved in most types of liver disease, including:
· Viral Hepatitis: when hepatitis is caused by a virus - this includes Hepatitis B and Hepatitis C
· Alcoholic Hepatitis: when hepatitis is caused by alcohol, common in alcoholics
· Steatohepatitis: when fatty liver disease escalates and causes inflammation
The Inflammatory Pump
To address its current needs, the body is always trying to strike the right balance between inflammation and anti-inflammation. In achieving this balance, omega-3 fatty acids and omega-6 fatty acids are known to have opposing roles. The following events maintain this inflammatory pump:
· When an infection or foreign invader is detected, the immune system triggers production of Prostaglandin II.
· To quarantine the infection or invader, Prostaglandin II produces an inflammatory response that sends white blood cells to the affected area.
· Almost immediately, the immune system also triggers the production of Prostaglandin I to suppress inflammation and begin the healing process.
The balance between omega-3 and omega-6 fatty acids can affect the inflammatory pump's balance, because of their role in making prostaglandins:
· Omega-3 fatty acids are a necessary component in the production of Prostaglandin I.
· Omega-6 fatty acids are a necessary component in the production of Prostaglandin II.
Omega-3's and Omega-6's
Consequently, omega-3's are needed to suppress inflammation and encourage healing, while omega-6's are needed to initiate the inflammatory response. Nutritionists believe that a ratio of 2:1 of omega-6 fatty acids to omega-3's help keep the inflammatory pump in balance.
A suspected culprit of today's high rate of inflammatory diseases, many of our modern day food choices are rich in omega-6 fatty acids and stingy in omega-3's. In fact, experts estimate that the typical American diet contains 14 - 25 times more omega-6 fatty acids than omega-3's.
· Omega-6's are found in certain seeds and nuts, and the oils extracted from them. Refined vegetable oils (like soybean, corn, sunflower, safflower and cottonseed oils) are high in omega-6's and are used in a majority of fast foods, snack foods, cookies, crackers and sweets. According to Dr. Andrew Weil, soybean oil alone is now so ubiquitous in fast foods and processed foods that an astounding 20 percent of the calories in the American diet are estimated to come from this single source.
· Omega-3's are found in the fat of cold water fish, such as salmon, sardines, herring, mackerel, black cod and bluefish; other seafood including algae and krill; and some plant sources, especially walnuts and flax seeds.
Because it prevents infection from spreading to nearby tissues and organs, inflammation is a crucial process. However, too much inflammation has the opposite effect - and can easily harm neighboring structures. This is frequently the case in liver disease where hepatitis (liver inflammation) damages nearby liver cells.
Omega-3 fatty acids extinguish the flames of inflammation and omega-6 fatty acids fan those flames. To keep liver inflammation at bay and prevent that inflammation from damaging the liver, those with liver disease are likely to benefit from boosting their dietary intake of omega-3's, while simultaneously curbing foods full of omega-6 fatty acids.
For more information about omega-3 fatty acids and liver disease, read Omega-3's Benefits Now Include Liver Protection.
References:
http://proteins-carb-fats.suite101.com/article.cfm/omega3, Omega-3: Controlling Inflammation in the Body, Linda Mundorff, Retrieved February 19, 2010, suite101.com, 2010.
http://www.drweil.com/drw/u/QAA400149/balancing-omega-3-and-omega-6.html, Balancing Omega-3 and Omega-6?, Retrieved February 21, 2010, Andrew Weil, MD, 2010.
http://www.medicalnewstoday.com/articles/40939.php, Omega-3 Fatty Acids Inhibit Growth Of Liver Cancer Cells, Retrieved February 19, 2010, MediLexicon International Ltd., 2010.
http://www.ncbi.nlm.nih.gov/pubmed/15485592, Omega-3 fatty acids and inflammation, Mori TA, et al, Retrieved February 19, 2010, Current Atherosclerosis Reports, November 2004.
http://www.ncbi.nlm.nih.gov/pubmed/17393517, Omega-3 fatty acids alleviate chemically induced acute hepatitis by suppression of cytokines, Schmöcker C, et al, Retrieved February 19, 2010, Hepatology, April 2007.
http://www.nutraingredients.com/Research/Omega-3-linked-to-lower-levels-of-inflammation, Omega-3 linked to lower levels of inflammation, Stephen Daniells, Retrieved February 19, 2010, Decision News Media SAS, 2010.
http://www.umm.edu/altmed/articles/omega-3-000316.htm, Omega-3 fatty acids, Retrieved February 19, 2010, University of Maryland Medical Center, 2010.
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Park Systems' ultra-modern imaging tool (XE-Bio) gives researchers new insight into the replication process of the Hepatitis C virus. The details revealed by the XE-Bio are likely to inspire new, highly-targeted, Hepatitis C medications.
XE-Bio From Park Systems Brings Promise in Fight Against Hepatitis C
February 16, 2010
(Nanowerk News) The fight against the liver disease hepatitis C has been something of an impasse for years, with more than 150 million people currently infected, and traditional antiviral treatments causing nasty side effects and often falling short of a cure. Park Systems' XE-Bio helped researchers at Stanford University discover a vulnerable step in the virus' reproduction process that in lab testing could be effectively targeted with an obsolete antihistamine. XE-Bio successfully imaged and analyzed two of the compounds that most potently inhibit vesicle aggregation revealed their mechanism of action on 4BAH2 function. These results provide new insight into the molecular mechanism of HCV replication platform assembly, and demonstrate the utility of a novel small-molecule anti-HCV strategy.
Continue reading this entire article:
http://www.nanowerk.com/news/newsid=14840.php
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February 19, 2010
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Developed at Texas A&M, researchers have designed a screening system that can identify which cells are infected with Hepatitis C.
New Screening System for Hepatitis C
ScienceDaily (Feb. 12, 2010) -- A newly designed system of identifying molecules for treating hepatitis C should enable scientists to discover novel and effective therapies for the dangerous and difficult-to-cure disease of the liver, says Zhilei Chen, a Texas A&M University assistant professor of chemical engineering who helped develop the screening system.
The system, Chen explains, enables researchers to study the effects of molecules that obstruct all aspects of the hepatitis C virus (HCV) life cycle.
Continue reading this entire article:
http://www.sciencedaily.com/releases/2010/02/100211100802.htm
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February 17, 2010
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Itching is a common symptom of Hepatitis C that goes underreported and undertreated. Instead of letting it drive you crazy, learn how home remedies and a physician's prescription pad can help ease your itching.
by Nicole Cutler, L.Ac.
An estimated 15 to 20 percent of people with chronic Hepatitis C experience the symptom of itching. Known clinically as pruritus, itching refers to the unpleasant sensation that causes the need to scratch. Whether localized to a specific region of the body, spread all over or relegated to the internal organs, pruritus is often guilty of plaguing those whose Hepatitis C has advanced to cirrhosis. Fortunately, there are many ways to reduce this potentially maddening symptom.
More About Pruritus
Pruritus and pain are closely related sensations, since the same nerves transmit the signals of discomfort to the brain. Known as the itch-scratch cycle, an area of skin that is scratched often becomes even itchier, leading to more scratching.
Experts believe pruritus in people with liver disease is due to the accumulation of poisons that have not been effectively filtered by a damaged liver. When liver damage impedes the flow of bile through the liver, bile acids and bilirubin get backed up in the blood. Besides causing jaundice (yellowing of the skin and eyes), high bilirubin levels often cause pruritus.
In Traditional Chinese Medicine (TCM), pruritus from an unknown cause is also considered to be due to toxins built up in the bloodstream. This accumulation of toxic substances generates heat. According to TCM, the sensation of itching is the body's interpretation of excessive heat.
Pruritus can take on many different characteristics. Two of pruritus' more troublesome complications include:
· Itching that is worse at night and thus interferes with restful sleep.
· Since simple scratching typically does not relieve it, some people risk skin infection and injury by scratching themselves with sharp objects.
Help for Pruritus
Because itching is such a nonspecific, seemingly innocuous event, many with Hepatitis C don't bother discussing it with their physician. However, there are many interventions to help incessant itching. Since pruritus can be severe enough to interfere with daily activities, those with a severe case are encouraged to report their discomfort to a doctor.
If necessary, a physician can prescribe an appropriate medication to relieve the itching. Some of the drugs used for pruritus include:
· Analgesics (pain-relievers) for neuropathic pain (gabapentin)
· Antihistamines (Benadryl, Atarax)
· Cholesterol lowering agents (Questran, Colestid)
· Opiod antagonists (Narcan, Revia, Revex)
· Antidepressants (Zoloft)
In addition, ten tips are listed below to reduce itching before you get in to see a doctor:
1. Don't Smoke - Not only does smoking reduce the effectiveness of Hepatitis C therapy, but it can also lead to Smoker's Syndrome - characterized by episodes of facial flushing, warm palms and soles, throbbing headache, dizziness, lethargy, prickling sensation, joint pain and pruritus.
2. Apply Cold Packs - Cold packs wrapped in a towel and placed over the skin cools heat and seems to relieve intense itching.
3. Stay Hydrated - Drink sufficient amounts of water to keep the entire body hydrated. For more on water and liver disease, read How Much Water Does Your Liver Need?
4. Avoid Soap - Use a non-soap cleanser such as Cetaphil or a similar substitute to prevent excessive drying of the skin.
5. Take Milk Thistle - Since milk thistle protects liver cells from damage and aids in detoxification, this herb can help prevent the backup of toxins in the bloodstream.
6. A Warm Shower - Because heat aggravates itching, make sure your bathing water's temperature is not too hot.
7. Dress Carefully - Whenever possible, wear loose fitting clothes made from natural fabrics that breathe. This prevents excess heat from being trapped against your skin.
8. Moisturize - Apply moisturizing creams at least twice a day. For best results, use only non-perfumed, mild moisturizers.
9. Don't Scratch - So that you don't engage the itch-scratch cycle and don't cause damage to your skin, experiment with rubbing, vibration or applying pressure instead of scratching. Some people report good results from rubbing itchy areas with an ice cube.
10. Oatmeal - Many get pruritus relief from taking a colloidal oatmeal bath. Colloidal oatmeal is still made from oats, but compared to breakfast oatmeal, colloidal oatmeal is ground very finely or even pulverized.
Those with Hepatitis C should be aware that feeling itchy could be a manifestation of the virus. Because it can be so disruptive, this symptom deserves attention. Besides discussing severe pruritus with your doctor, take advantage of the ten tips listed above to gain some respite from incessant itching.
References:
http://allergies.about.com/od/skinallergies/a/pruritus.htm, Itching, Daniel More, MD, Retrieved January 9, 2010, about.com, 2010.
http://www.hcvadvocate.org/hepatitis/factsheets_pdf/pruritus.pdf, Extrahepatic Manifestations: Pruritis (Itching), CD Mazoff, PhD, Retrieved January 9, 2010, Hepatitis C Support Project, 2010.
http://www.liverhealthtoday.org/viewarticle.cfm?aid=164, Pruritus in its most severe form can be debilitating, Geoff Drushel, Retrieved January 9, 2010, Liver Health Today, 2010.
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February 16, 2010
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Novartis licenses alisporivir, a new drug that is currently in Phase IIb development for the treatment of Hepatitis C.
Novartis licenses Hepatitis C drug
Feb. 9, 2010
By Steve Goldstein
LONDON (MarketWatch) -- Novartis /quotes/comstock/13*!nvs/quotes/nls/nvs (NVS 53.73, +0.02, +0.04%) /quotes/comstock/06p!novn (CH:NOVN 57.80, 0.00, 0.00%) said it has licensed Debio 025, or alisporivir, a potential first-in-class antiviral agent currently in Phase IIb development for the treatment of hepatitis C. Debio 025 is the first in a new class of drugs called cyclophilin inhibitors which could become part of the future standard of care for the disease.
Continue reading this entire article:
http://www.marketwatch.com/story/novartis-licenses-hepatitis-c-drug-2010-02-09
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February 8, 2010
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Upon first glance, the Valentine's Day tradition of gifting chocolates may seem counterintuitive for someone with Hepatitis C. Though, research boasts two reasons why choosing the right kind of chocolate will show you care about your sweetheart's liver health.
by Nicole Cutler, L.Ac.
Simply stepping into any grocery, drug or general retail store will remind you of the national Valentine's Day tradition of giving your loved one a box of chocolates. An annual holiday on February 14th that celebrates love and affection between intimate companions, Valentine's Day is usually associated with three things: cards, flowers and chocolates. Due to the liver health concerns of those living with the Hepatitis C virus, individuals with this infection likely assume they are better off without chocolate during this love-filled holiday.
Some Food Worsens Hepatitis C
Managing chronic Hepatitis C must be met with conscious awareness of the healthfulness of every eaten item. This is because the liver of someone with this virus is under enormous stress - and the liver is the organ that must filter out every chemical and toxin ingested. Additionally, foods loaded with fat can fan the flames of liver inflammation. Consequently, processed, fatty foods present an unnecessary challenge to a liver with Hepatitis C. In an effort to preserve the health of their liver, those with Hepatitis C are consistently advised to consume a nutritious, low-fat, whole food diet.
Chocolate
Most people lump chocolate into the candy category, relegating it as a high-sugar, high-fat and high-calorie junk food full of chemicals. This is accurate for some commercially sold chocolate bars. However, not all chocolate bars are created equally. High quality dark chocolate without nougat, caramel or other sugary fillings has the privilege of claiming a variety of health benefits.
Because chocolate is made from plants, it contains many of the same characteristics of darkly colored vegetables. Dark chocolate contains a high amount of flavonoids, antioxidant-rich compounds that have a collection of health benefits. Experts believe that dark chocolate contains a very large number of antioxidants - nearly eight times the number found in strawberries.
However, these flavonoids are specific to dark chocolate, as milk chocolate does not contain nearly the same levels of antioxidants - and white chocolate has none at all. According to Mauro Serafini, Ph.D., of Italy's National Institute for Food and Nutrition Research, the reason dark chocolate has proven to be healthier than milk chocolate, is because the milk in milk chocolate may actually interfere with the absorption of antioxidants, canceling out its positive benefits.
There are two primary reasons that dark chocolate can actually be helpful for those with Hepatitis C: stress relief and blood pressure reduction.
Stress Relief
As a potentially life-threatening disease that has just a 50 percent cure rate, living with chronic Hepatitis C is often associated with stress. Unfortunately, stress increases congestion in the liver and can thus encourage Hepatitis C-inflicted liver damage.
Researchers have found that dark chocolate is a reasonable approach for relieving stress. As published in ACS' Journal of Proteome Research, investigators found that eating about an ounce and a half of dark chocolate a day for two weeks reduced levels of stress hormones in the bodies of people feeling highly stressed.
Blood Pressure Reduction
Individuals who have more advanced cases of Hepatitis C may suffer from portal hypertension. When Hepatitis C has caused significant scarring of the liver, the blood pressure in the portal vein (the vein that carries blood from the digestive organs to the liver) rises. People with portal hypertension who also have high blood pressure are more susceptible to catastrophic health events.
Based on research published in the January 2010 edition of the American Journal of Hypertension, dark chocolate has the ability to lower blood pressure. While the ideal formulation and dosage has yet to be identified, experts believe that small amounts of dark chocolate are beneficial to people with hypertension or portal hypertension.
High-quality dark chocolate's liver benefits are not a prescription to overindulge. Chocolate is still high in calories and fat and, as with most sweets, should be consumed in moderation. A small piece of dark chocolate each day seems appropriate.
By reducing stress and blood pressure, a little bit of dark chocolate can be beneficial to someone with Hepatitis C. Thus, whether you, your valentine or both of you has this virus, February 14th can be celebrated by keeping the chocolate gifting tradition alive.
References:
http://en.wikipedia.org/wiki/Valentine%27s_Day, Valentine's Day, Retrieved February 3, 2010, Wikimedia Foundation Inc., 2010.
http://longevity.about.com/od/lifelongnutrition/p/chocolate.htm, Health Benefits of Chocolate, Mark Stibich, PhD, Retrieved February 4, 2010, About.com, 2010.
http://www.integrative-healthcare.org/mt/archives/2006/02/dark_chocolate.html, Dark Chocolate for the Love of Life, Nicole Cutler, L.Ac., Retrieved February 4, 2010, Natural Wellness, 2010.
http://www.medicalnewstoday.com/articles/170829.php, Dark Chocolate May Improve Metabolic Stress Response Say Nestlé Researchers, Retrieved February 2, 2010, MediLexicon International Ltd, 2010.
http://www.ncbi.nlm.nih.gov/pubmed/19910929?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=5, Effect of cocoa products on blood pressure: systematic review and meta-analysis, Desch S, et al, Retrieved February 2, 2010, American Journal of Hypertension, January 2010.
http://www.ncbi.nlm.nih.gov/pubmed/20034049?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1, Increased caffeine consumption is associated with reduced hepatic fibrosis, Modi AA, et al, Retrieved February 2, 2010, Hepatology, January 2010.
http://www.rxpgnews.com/hepatitis-c-virus/Caffeine_intake_found_to_cause_less_liver_fibrosis_230400.shtml, Caffeine intake in chronic hepatitis C patients associated with less liver fibrosis, Retrieved February 2, 2010, RxPG, January 2010.
http://www.topnews.in/health/it-s-official-dark-chocolate-helps-beat-blues-25854, It's official: Dark chocolate helps beat the blues, Mohit Joshi, Retrieved February 2, 2010, TopNews.in, January 2010.
Posted by Editors at 12:26 PM --- Printer-friendly version
February 4, 2010
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Conatus Pharmaceuticals is optimistic that their developmental drug, CTS-1027, will give people with Hepatitis C a greater chance for beating the virus. In a Phase II Hepatitis C trial for previous non-responders, CTS-1027 is being paired with pegylated interferon and ribavirin.
Conatus Pharmaceuticals Initiates Phase II Clinical Trial in Combination With Pegylated Interferon and Ribavirin for the Treatment of Hepatitis C Virus (HCV)
SAN DIEGO, Jan. 28 /PRNewswire/ -- Conatus Pharmaceuticals Inc. announced today the initiation of a Phase II clinical trial evaluating CTS-1027 in combination with pegylated interferon (Pegasys®) and ribavirin (Copegus®) in refractory HCV patients. Antiviral activity, safety and tolerability of the triple combination will be assessed after up to 48 weeks of therapy.
"There is a significant unmet medical need in HCV patients who have not responded to pegylated interferon and ribavirin. These patients often progress to cirrhosis, a life-threatening condition. CTS-1027 has the potential to increase the effectiveness of the combination of pegylated interferon and ribavirin in this population," said Dr. Paul J. Pockros, Head, Division of Gastroenterology and Director of the SC Liver Research Consortium and The Scripps Clinic in La Jolla, CA.
Continue reading this entire article:
http://www.prnewswire.com/news-releases/conatus-pharmaceuticals-initiates-phase-ii-clinical-trial-in-combination-with-pegylated-interferon-and-ribavirin-for-the-treatment-of-hepatitis-c-virus-hcv-82965622.html
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February 2, 2010
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February is American Heart Month. Since Hepatitis C has been proven to be a risk factor for coronary artery disease, the usual ways to reduce heart disease risk is insufficient for those with the virus. However, there are five strategies specifically for Hepatitis C that can reduce the likelihood of impending cardiac problems.
by Nicole Cutler, L.Ac.
Besides the damage it can do to the liver, Hepatitis C also jeopardizes the heart's health. Since cardiovascular disease is the leading cause of mortality in the U.S., people are increasingly taking steps to address heart disease's primary risk factors. Through efforts unifying medications and lifestyle changes, many have successfully tempered the two biggest indicators of future cardiac problems: blood pressure and blood fat levels. Unfortunately, these measures are likely not enough to protect the heart of someone with Hepatitis C.
Lowering blood pressure and improving the ratio of fat in the blood is sufficient for many wishing to protect their heart from harm. Although a healthy blood pressure and lipid profile is crucial for optimal wellness, these factors are likely not responsible for the high incidence of cardiovascular disease in individuals with Hepatitis C. In fact, those with Hepatitis C appear to have a unique risk for developing cardiovascular disease requiring them to take extra steps toward cardiac protection.
The Recent Study
Although clinicians have reported a higher than usual incidence of heart disease in their patients with Hepatitis C, the association between these two health conditions has been poorly understood. However, new information helps us better realize why these problems commonly coexist.
Published in the July 15, 2009 issue of Clinical Infectious Diseases, researchers from Pittsburgh, Pennsylvania conducted a large-scale study to evaluate the relationship between Hepatitis C and coronary artery disease. Involving over 160,000 individuals receiving care at Veterans Affairs health facilities, approximately half of whom were infected with Hepatitis C, the researchers found the following:
· Study participants without Hepatitis C were more likely to have high blood pressure (50 percent) than those with the virus (42 percent).
· Study participants without Hepatitis C were more likely to have hyperlipidemia (72 percent) than those with Hepatitis C (39 percent).
· On average, study participants without Hepatitis C had higher blood plasma cholesterol (198 mg/dL) than those with Hepatitis C (175 mg/dL).
· On average, study participants without Hepatitis C had higher LDL cholesterol - "the bad cholesterol" (119 mg/dL) - than those with Hepatitis C (102 mg/dL).
· On average, study participants without Hepatitis C had higher triglycerides (179 mg/dL) than those with Hepatitis C (144 mg/dL).
Even though the traditional heart health indicators of blood pressure, plasma cholesterol, LDL cholesterol and triglycerides favored the Hepatitis C patients, the researchers found that having Hepatitis C was associated with an approximately 25 percent higher risk of coronary artery disease. The researchers suggested that this elevated cardiovascular risk could be due to increased inflammation, immune activation and blood clotting in people with Hepatitis C.
Reducing Hepatitis C Cardiac Risks
While maintaining a healthy blood pressure and blood fat ratio is crucial for preventing heart disease, the research described above demonstrates that those with Hepatitis C have more work to do. Since scientists believe that events associated with flaring of the virus (inflammation, immune activation and increased blood clotting) are also responsible for increasing cardiovascular risk. Thus, all attempts should be made to minimize Hepatitis C viral load. Such efforts may include:
1. Abstaining from alcohol (alcohol causes the virus to flare-up)
2. Battling the illness with antiviral combination therapy (approximately half of those infected can conquer the virus)
3. Keeping cells healthy with antioxidants (like NAC and/or Alpha R-Lipoic Acid)
4. Supplementing with milk thistle to protect the liver from viral replication
5. Taking Nattokinase to dissolve dangerous blood clots
Many are discouraged upon learning that it may not be enough to keep your blood pressure within normal limits and your blood lipids balanced to avoid cardiovascular disease. However, there are ways to control your health instead of letting Hepatitis C dictate your heart's future. First, following your physician's suggestions to reduce the risk of coronary artery disease is an important component to longevity. In addition, making choices to inhibit the Hepatitis C virus will benefit both your liver and your heart.
References:
http://www.aidsmap.com/en/news/FEE39D43-0C66-4EA4-8DC1-0ED557146A6D.asp, Hepatitis C increases risk of cardiovascular disease, Michael Carter, Retrieved July 26, 2009, aidsmap, June 2009.
http://www.hivandhepatitis.com/hiv_hcv_co_inf/2009/071009_a.html, Hepatitis C Raises Risk of Cardiovascular Disease, Liz Highleyman, Retrieved July 25, 2009, hivandhepatitis.com, 2009.
http://www.ncbi.nlm.nih.gov/pubmed/18957787?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum, Hepatitis C infection is associated with increased coronary artery atherosclerosis defined by modified Reardon severity score system, Alyan O, et al, Retrieved July 25, 2009, Circulation Journal, December 2008.
http://www.ncbi.nlm.nih.gov/pubmed/19508169?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum, Hepatitis C virus infection and the risk of coronary disease, Butt AA, et al, Retrieved July 25, 2009, Clinical Infectious Diseases, July 2009.
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