Arizona Advanced Medicine Clinic

Hepatitis C and the Baby Boomer Generation - Are Anti-Viral Drugs the Only Option?

The Centers for Disease Control (CDC) just recommended that all members of the Baby Boomer generation be tested for Hepatitis C at least once in their adult lifetime.[1] Baby Boomers are more than 5 times more likely to be infected with Hepatitis C than anyone else in the country. Baby Boomers - meaning anyone born between 1945 and 1965.

The hepatitis C virus, first identified in 1989, kills more than 15,000 Americans each year. The CDC estimates that 3.2 million Americans are currently infected with the virus. An estimated 15 - 25% of them will clear the virus from their bodies. The remaining 75 - 85% of people who become infected go on to develop chronic infection - in other words, do not heal, do not eliminate the virus, but rather simply live with it and sometimes die from it.

The virus can be spread through blood contact - i.e. sharing IV needles - or blood transfusion or organ transplantation. It can also be spread through sexual intercourse, or through sharing razors or tooth brushes.

Symptoms may be as diffuse and non-specific as fatigue, or as specific and severe as jaundice and liver failure.

Hepatitis C is currently the leading indication for liver transplantation in the United States.[2]

What is not always recognized is that symptoms may involve other organs as well.
- Vasculitis (leukocytoclastic)[3] - Glomerulonephritis (kidney failure)
- Porphyria cutanea tarda

Most of us do not indulge in IV drug use, are not exposed to needle sticks, and do not have blood transfusions or organ transplants. Unfortunately, even a single IV drug use or sharing of a razor many years ago may result in current Hepatitis C infection.

So how did the CDC determine that anyone born between 1945 and 1965 should be tested? And why is the CDC pushing for testing at this time?

First, the number of people dying of Hepatitis C doubled between 1999 and 2007.[4] Second, in 2011 the FDA approved two new drugs for treatment of Hepatitis C.

Might there perhaps be some association between the new drug approval and the push for testing?

In any case, if the CDC figures are true, we have a pretty large number of people infected with a potentially fatal disease. Three percent of Baby Boomers is a lot of people - 17 million.

Current testing recommendations are for an initial Hepatitis C antibody screen. If positive, then recommendations call for Hepatitis C antibody verification by another test.

“watchful waiting” until the victim becomes ill, or develops a high viral count or elevation of liver enzymes. Once they are sick enough, they can be treated with pharmaceutical drugs.[5]

The following drugs are currently recommended for initial therapy:
- Interferon - Peginterferon® alpha is administered by subcutaneous injection twice a week.
- Ribavirin - is administered by mouth daily. The dose depends on the genotype of the virus.

And now there are two new ones, just approved in 2011
- Boceprevir - Victrelis® - is given by mouth every 8 hours, but only after a 4-week course of interferon and ribavirin.
- Telaprevir - Incivek® - is given by mouth every 8 hours in combination with interferon and ribavirin.

So that’s easy, right? Just take some drugs and everything will be fine.

Not so fast. The recommended drugs have pretty significant side effects - which explains why they are not used early in the course of the disease.
- Interferon side effects include headache, fatigue, pain at site of injection, itching, skin rash, elevated liver enzymes (as if the hepatitis C damage wasn’t bad enough). It may cause worsening of other autoimmune diseases like Lupus, thyroid disease, psoriasis, Crohn’s disease, rheumatoid arthritis, low white count and low platelet count.
- Ribavirin side effects include fatigue, headache, anemia (from blood cells being attacked), muscle aches, joint pains, and significant effect on the fetus in pregnant women.
- Boceprevir side effects include fatigue, anemia, nausea, headache, abnormal taste, and multiple GI effects
- Telaprevir side effects include rash, fatigue, itching, nausea, anemia

Is the treatment worse than the cure? Of course, if there were an actual cure, it might be worth the misery of treatment. Unfortunately, cure rates are not high - there is decrease of viral count in only 50% of those treated, and the course of therapy is long. A minimum of 24 weeks - 6 months - is recommended, and many patients require therapy for twice that long.

What other choices are there?

At the Arizona Center for Advanced Medicine we have had good success with treatment of patients with liver disease, including Hepatitis C, with substances which support the liver detoxification mechanisms and help to rebuild the liver cells.

Many of these therapies are with large doses of substances normally produced by the body - glutathione, lipoic acid, Vitamin C and other things which the body requires for detoxification. We also use specific treatments to help bring the immune system back into balance, so that it can deal with viral infection as was originally intended.

We also, of course, work with diet and nutrition. It is easy for a virus to thrive in an environment loaded with sugar and toxic chemicals like aspartame. Viruses have a much harder time when the environment is cleaner.

We find that liver enzymes go down, health improves, and we do not have to deal with the side effects of the drugs - anemia, fatigue, skin rashes, worsening of autoimmune diseases, etc.

Initial screening requires simply a brief evaluation and a blood test, which insurance often (but not always) will cover.

If indeed the test is positive, then a more complete evaluation is in order, so that IV treatment may be initiated. It is possible to heal the liver. It is possible to strengthen the immune system so that it can deal with chronic infection - whether hepatitis or any other infection.

We can become healthy. Our bodies can heal, if we just give them the right tools - clean food, clean water, clean air (no smoking!). The choice is always ours. Of course, it is always easier to get healthy when the liver is still working. But even if we already have significant liver disease, the treatments mentioned above help the liver cells to regenerate and recover.

It is not too late to change our diet and lifestyle.

The choice is ours.


[1] http://www.cdc.gov/nchhstp/newsroom/docs/HCV-TestingFactSheetNoEmbargo508.pdf[2] http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm[3] Images of vasculitis and porphyria downloaded May 19, 2012 from http://www.dermatlas.net/ [4] Ly, K., et al. The Increasing Burden of Mortality From Viral Hepatitis in the United States Between 1999 and 2007. Annals Of Internal Medicine, 2012. 156(4): p. 271-278 [5] Yee HS, Currie SL et al. Management and Treatment of Hepatitis C Viral Infection... American Journal of Gastroenterology. doi: 10.1111/j.1572-0241.2006.00754.x
Hepatitis C and the baby boomer generation - are anti-viral drugs the only option?

What is not always recognized is that symptoms may involve other organs as well.
- Vasculitis (leukocytoclastic)[3] - Glomerulonephritis (kidney failure)
- Porphyria cutanea tarda

Most of us do not indulge in IV drug use, are not exposed to needle sticks, and do not have blood transfusions or organ transplants. Unfortunately, even a single IV drug use or sharing of a razor many years ago may result in current Hepatitis C infection.

So how did the CDC determine that anyone born between 1945 and 1965 should be tested? And why is the CDC pushing for testing at this time?

First, the number of people dying of Hepatitis C doubled between 1999 and 2007.[4] Second, in 2011 the FDA approved two new drugs for treatment of Hepatitis C.

Might there perhaps be some association between the new drug approval and the push for testing?

In any case, if the CDC figures are true, we have a pretty large number of people infected with a potentially fatal disease. Three percent of Baby Boomers is a lot of people - 17 million.

Current testing recommendations are for an initial Hepatitis C antibody screen. If positive, then recommendations call for Hepatitis C antibody verification by another test.

“watchful waiting” until the victim becomes ill, or develops a high viral count or elevation of liver enzymes. Once they are sick enough, they can be treated with pharmaceutical drugs.[5]

The following drugs are currently recommended for initial therapy:
- Interferon - Peginterferon® alpha is administered by subcutaneous injection twice a week.
- Ribavirin - is administered by mouth daily. The dose depends on the genotype of the virus.

And now there are two new ones, just approved in 2011
- Boceprevir - Victrelis® - is given by mouth every 8 hours, but only after a 4-week course of interferon and ribavirin.
- Telaprevir - Incivek® - is given by mouth every 8 hours in combination with interferon and ribavirin.

So that’s easy, right? Just take some drugs and everything will be fine.

Not so fast. The recommended drugs have pretty significant side effects - which explains why they are not used early in the course of the disease.
- Interferon side effects include headache, fatigue, pain at site of injection, itching, skin rash, elevated liver enzymes (as if the hepatitis C damage wasn’t bad enough). It may cause worsening of other autoimmune diseases like Lupus, thyroid disease, psoriasis, Crohn’s disease, rheumatoid arthritis, low white count and low platelet count.
- Ribavirin side effects include fatigue, headache, anemia (from blood cells being attacked), muscle aches, joint pains, and significant effect on the fetus in pregnant women.
- Boceprevir side effects include fatigue, anemia, nausea, headache, abnormal taste, and multiple GI effects
- Telaprevir side effects include rash, fatigue, itching, nausea, anemia

Is the treatment worse than the cure? Of course, if there were an actual cure, it might be worth the misery of treatment. Unfortunately, cure rates are not high - there is decrease of viral count in only 50% of those treated, and the course of therapy is long. A minimum of 24 weeks - 6 months - is recommended, and many patients require therapy for twice that long.

What other choices are there?

At the Arizona Center for Advanced Medicine we have had good success with treatment of patients with liver disease, including Hepatitis C, with substances which support the liver detoxification mechanisms and help to rebuild the liver cells.

Many of these therapies are with large doses of substances normally produced by the body - glutathione, lipoic acid, Vitamin C and other things which the body requires for detoxification. We also use specific treatments to help bring the immune system back into balance, so that it can deal with viral infection as was originally intended.

We also, of course, work with diet and nutrition. It is easy for a virus to thrive in an environment loaded with sugar and toxic chemicals like aspartame. Viruses have a much harder time when the environment is cleaner.

We find that liver enzymes go down, health improves, and we do not have to deal with the side effects of the drugs - anemia, fatigue, skin rashes, worsening of autoimmune diseases, etc.

Initial screening requires simply a brief evaluation and a blood test, which insurance often (but not always) will cover.

If indeed the test is positive, then a more complete evaluation is in order, so that IV treatment may be initiated. It is possible to heal the liver. It is possible to strengthen the immune system so that it can deal with chronic infection - whether hepatitis or any other infection.

We can become healthy. Our bodies can heal, if we just give them the right tools - clean food, clean water, clean air (no smoking!). The choice is always ours. Of course, it is always easier to get healthy when the liver is still working. But even if we already have significant liver disease, the treatments mentioned above help the liver cells to regenerate and recover.

It is not too late to change our diet and lifestyle.

The choice is ours.


[1] http://www.cdc.gov/nchhstp/newsroom/docs/HCV-TestingFactSheetNoEmbargo508.pdf[2] http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm[3] Images of vasculitis and porphyria downloaded May 19, 2012 from http://dermatlas.med.jhmi.edu/derm/ [4] Ly, K., et al. The Increasing Burden of Mortality From Viral Hepatitis in the United States Between 1999 and 2007. Annals Of Internal Medicine, 2012. 156(4): p. 271-278 [5] Yee HS, Currie SL et al. Management and Treatment of Hepatitis C Viral Infection... American Journal of Gastroenterology. doi: 10.1111/j.1572-0241.2006.00754.x
Hepatitis C and the baby boomer generation - are anti-viral drugs the only option?

The following drugs are currently recommended for initial therapy:
- Interferon - Peginterferon® alpha is administered by subcutaneous injection twice a week.
- Ribavirin - is administered by mouth daily. The dose depends on the genotype of the virus.

And now there are two new ones, just approved in 2011
- Boceprevir - Victrelis® - is given by mouth every 8 hours, but only after a 4-week course of interferon and ribavirin.
- Telaprevir - Incivek® - is given by mouth every 8 hours in combination with interferon and ribavirin.

So that’s easy, right? Just take some drugs and everything will be fine.

Not so fast. The recommended drugs have pretty significant side effects - which explains why they are not used early in the course of the disease.
- Interferon side effects include headache, fatigue, pain at site of injection, itching, skin rash, elevated liver enzymes (as if the hepatitis C damage wasn’t bad enough). It may cause worsening of other autoimmune diseases like Lupus, thyroid disease, psoriasis, Crohn’s disease, rheumatoid arthritis, low white count and low platelet count.
- Ribavirin side effects include fatigue, headache, anemia (from blood cells being attacked), muscle aches, joint pains, and significant effect on the fetus in pregnant women.
- Boceprevir side effects include fatigue, anemia, nausea, headache, abnormal taste, and multiple GI effects
- Telaprevir side effects include rash, fatigue, itching, nausea, anemia

Is the treatment worse than the cure? Of course, if there were an actual cure, it might be worth the misery of treatment. Unfortunately, cure rates are not high - there is decrease of viral count in only 50% of those treated, and the course of therapy is long. A minimum of 24 weeks - 6 months - is recommended, and many patients require therapy for twice that long.

What other choices are there?

At the Arizona Center for Advanced Medicine we have had good success with treatment of patients with liver disease, including Hepatitis C, with substances which support the liver detoxification mechanisms and help to rebuild the liver cells.

Many of these therapies are with large doses of substances normally produced by the body - glutathione, lipoic acid, Vitamin C and other things which the body requires for detoxification. We also use specific treatments to help bring the immune system back into balance, so that it can deal with viral infection as was originally intended.

We also, of course, work with diet and nutrition. It is easy for a virus to thrive in an environment loaded with sugar and toxic chemicals like aspartame. Viruses have a much harder time when the environment is cleaner.

We find that liver enzymes go down, health improves, and we do not have to deal with the side effects of the drugs - anemia, fatigue, skin rashes, worsening of autoimmune diseases, etc.

Initial screening requires simply a brief evaluation and a blood test, which insurance often (but not always) will cover.

If indeed the test is positive, then a more complete evaluation is in order, so that IV treatment may be initiated. It is possible to heal the liver. It is possible to strengthen the immune system so that it can deal with chronic infection - whether hepatitis or any other infection.

We can become healthy. Our bodies can heal, if we just give them the right tools - clean food, clean water, clean air (no smoking!). The choice is always ours. Of course, it is always easier to get healthy when the liver is still working. But even if we already have significant liver disease, the treatments mentioned above help the liver cells to regenerate and recover.

It is not too late to change our diet and lifestyle.

The choice is ours.

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