Acupuncture & Chinese Medicine    
          Center of Fort Worth

                                           About Hepatitis C

 The World Health Organization estimates 170 million individuals worldwide are infected with
hepatitis C virus (HCV). There are 3.9 million Americans having been infected with the virus
and about 35,000 new cases of hepatitis C are estimated to occur in the United States each
year

Most patients infected with HCV have chronic liver disease, which can progress to cirrhosis
and hepatocellular carcinoma. Chronic infection with HCV is one of the most important
causes of chronic liver disease

There are 5 well-characterized types of viral hepatitis, that is A, B, C, D, and E. Hepatitis C is
the most common type in the United States, and  hepatitis B is more common  in China. Both
hepatitis B and C predominantly transmitted through blood-to-blood contact.  Unlike A and B,
there is no vaccine against hepatitis C.
Six major HCV genotypes and numerous subtypes have been identified. The major HCV
genotype worldwide is genotype 1, which accounts for 40-80% of all isolates. Genotypes 1a
and 1b are prevalent in the United States. HCV genotype 1, particularly 1b, does not respond
to therapy as well as genotypes 2 and 3. Genotype 1 also may be associated with more
severe liver disease and a higher risk of HCC.

The goals of treatment of chronic HCV infection are to (1) achieve sustained eradication of
HCV  (2) prevent progression to cirrhosis, HCC, and decompensated liver disease requiring
LT.

Combination therapy with PEG-IFN alfa and ribavirin is the current western medical standard
of care in patients infected with HCV. Patients with HCV genotype 1 have a much less
favorable response to therapy  compared with patients infected with genotypes 2 and 3. The
cost of PEG-IFN plus ribavirin for women ranged from $32,000 to $90,000 per QALY (quality-
adjusted life-year) for genotype 1 and from $12,000 to $42,000 for other genotypes.(1).
Randomized clinical trials have not been performed showing that successful western therapy
decreases liver transplantation rates or improves survival.(2)

Adverse effects are common with IFN and ribavirin combination therapy, with approximately
75% of patients experiencing one or more of the following:

Interferon - fatigue, headache, myalgias, fever, depression, neutropenia, thrombocytopenia,
memory and concentration disturbances, visual disturbances, hypothyroidism,
hyperthyroidism, nausea, vomiting, eczema, alopecia, and interstitial fibrosis.

Ribavirin - hemolytic anemia, birth defects, cough, rash, and gout.

Our center offers combined acupuncture and special Chinese herb treatment for
hepatitis C. Our goal is to prevent progression to cirrhosis, and break off the fibrosis or
cirrhosis if it happened. We believe that fibrosis further to cirrhosis is the most important point
for the progress of hepatitis C. Cirrhosis is the key cause of portal hypertension and ascites
which result in Gastrointestinal bleeding, Jaundice, and ever hepatic encephalopathy.

There are many Chinese herbs that have shown to inhibit the HCV virus, such as Ku Shen,
Long Dan Cao, Zhi Zi, and Huang Gin.(3). Those herbs usually have very little side effect
compared to PEG-IFN or ribavirin. The Chinese herb formula Fusheng Huayu 319 has shown
the good effect of Hepatitis B and prevent the progress of hepatic fibrosis.(4) Dan Shen, Tao
Hong, Chuang Xiong, Huang Qi have the effect of anti-fibrosis(5) The study indicated the
Chinese herb formula Kangxian Recipe can protect the liver cell.(6).

 Acupuncture combined Chinese herb treatment provide the patient with an alternative
treatment option. In the mean time, We also recommend:

  • Patients with hepatitis C should be advised to abstain from alcohol use.
  • Optimally, patients should use barrier protection during sexual intercourse.
  • Patients should be vaccinated for hepatitis A virus and HBV
  • Eat a balanced diet with adequate calories and protein. You also may want to take a
    daily multivitamin if your doctor agrees.
  • Avoid medications that may be harmful to your liver, such as acetaminophen (Tylenol),
    or your kidneys, such as ibuprofen (Advil, etc).
  • Emotional happiness. Your brain happy so does your liver.









References
(1) Salomon et al. Cost-effectiveness of treatment for chronic hepatitis C infection in an evolving patient population. JAMA.
2003;290:228-237
(2)Flamm.Chronic hepatitis C virus infection. JAMA. 2003;289: 2413-2417
(3)Tang et al. Screening 20 Chinese herbs often used for clearing heat and dissipating toxin with nude mice model of
hepatitis C viral infection. CJITWM 2003;23:447-448
(4)Liu et al. Effect of Fuzheng Huayu 319 recipe on serological parameters of fibrosis in treating chronic hepatitis B.
CJITWM 1996;16:587592
(5)Hu et al. The studies of anti-fibrosis effect  of Single Chinese herb.  CJITWM 2002;22:396-397
(6)Zhang et al. Experimental study of inhibitory effect of Kangxian Recipe on TGF-b induced hepatocyte apotosis. CJITWM
2001;21:37-39




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Hepatitis C