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Hepatitis C: Patients
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A new study shows the risk of contracting hepatitis C increases significantly among people who have tattoos. Researchers from UTSouthwestern Medical Center in Dallas studied more than 600 patients. The patients were from the orthopedic spinal clinic, a setting that provided a large volume of patients seeing a physician for reasons unrelated to blood-borne infection. Participants unaware of their hepatitis status were examined, interviewed for risk factors and tested for hepatitis C. They found 18% of these patients had a tattoo. Of those patients with a tattoo, Men Talk more than 20% were infected with hepatitis C and 33% of those patients had acquired their tattoos in a commercial tattoo parlor. Few of the tattoo-associated infections could be traced to injection-drug use, transfusions or other known routes of exposure.
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In a study of integrated Chinese and Western medical treatment (8), 64 patients who had a history of blood transfusion and who tested positive for hepatitis C were divided into two groups of 32 patients each. The control group received alpha-interferon and the herb group received alpha-interferon plus herbal decoctions (depending on presenting symptoms and signs); each was treated for three months. As an example, for those classified as presenting liver-qi stagnation and spleen deficiency, the formula has 15 grams bupleurum, 12 grams hoelen, 10 grams atractylodes, 10 grams codonopsis, 10 grams peony, 6 grams chih-ko, 6 grams gardenia, 6 grams curcuma, and 5 grams licorice. For those classified as having accumulated heat toxin, the formula was 15 grams lithospermum, 15 grams hu-chang, 15 grams forsythia, 12 grams scrophularia, 12 grams gardenia, 10 grams raw rehmannia, 10 grams moutan, 10 grams red peony, 6 grams curcuma, and 5 grams licorice. Other herbs might be added to these base formulas for treating specific symptoms. Among the 32 persons treated by herbs, 4 had their antibody tests turn negative, compared to only 2 in the interferon only group.
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Hepatitis C is caused by a virus (medically abbreviated as HCV). This type of viral hepatitis is different from the others in an important way. All patients with hepatitis A and most with hepatitis B develop an acute infection, recover completely, and develop antibodies that protect them from ever getting the disease again. However, the hepatitis C virus is a "quick-change" artist. Once inside the body, it changes its form to evade discovery and attack by the immune system. Scientists have already identified many forms of HCV, and patients infected with one type are not necessarily safe from other types.
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Until more clinical work with hepatitis C and Chinese herbs is carried out in the United States, it may be difficult to convince medical practitioners and patients to try this method. Because the herbs are non-toxic, some patients may wish to utilize this therapy in place of, or in addition to, treatment by interferon. It is reasonable to begin collecting information from such patients to provide case histories in an effort to eventually develop a well-designed clinical trial.
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One of the big problems in treating hepatitis C is that it doesn't "go away by itself" as happens, for example, with the common cold virus. "The majority of people who get infected are not able to clear the virus, unlike with other types of viral infections," said Dr. Franco. "Only about 15% can, by themselves, get rid of the hepatitis C virus. In most patients - about 85% - the infection becomes chronic. This means that it persists and is documented in your bloodstream for six months or longer."
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All patients with chronic hepatitis C should be evaluated by a specialist for possible treatment with these agents. In general, adults less than 70 years old with evidence of active inflammation on liver biopsy and without advanced cirrhosis are good treatment candidates. Indications for treatment of patients with very mild disease on liver biopsy are less clear. Such individuals should be considered for possible participation in clinical studies. Patients with advanced cirrhosis secondary to hepatitis C should be referred referred for evaluation for possible liver transplantation.
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