Hepatitis C Search for Cost-Effective Cure

VIRAL hepatitis is caused by five different viruses known by alphabets – A, B, C, D and E. Of these, hepatitis A and hepatitis E are food-borne and are cured by the body’s immunity. While hepatitis B, C and D are blood-borne and often go unnoticed for up to 20 years in the body, the hepatitis C virus (HCV) can cause fibrosis, or scarring of the liver, and worse, chronic cirrhosis. There is no vaccine for it.

A blood-to-blood disease, scientists are currently not too sure if HCV is also passed on through sexual contact. What they do know is that it is passed on through infected syringes or even infected blood touching an open wound on Tattooing with unsterilised and reused equipment is a definite route of transmission for hepatitis B and C as well as HIV. There is also a rising concern about beauty treatments where abrasive material removes dead cells.

HCV thrives for days even on work surfaces where dead skin cells may have fallen. If the spa or salon does not use stringent sterilisation techniques, clients may be exposed to the virus. Nail cutters, which are commonly shared in family, can also be a source of transmission of hepatitis.

Hepatitis C can occur in two phases:

Acute: Acute hepatitis C refers to the first six months after infection with HCV. Most people suffer no symptoms upon infection, but for those who do, the main symptoms are generally mild and non-specific, and rarely lead to a specific diagnosis of hepatitis C. Symptoms of acute hepatitis C infection include decreased appetite, fatigue, abdominal pain, jaundice, itching, and flu-like symptoms. Persistent infections are common and most patients develop chronic hepatitis C – infection lasting more than six months.

Chronic: Chronic hepatitis C is defined as an infection with the hepatitis C virus persisting for more than six months. Clinically it is often asymptomatic, and is mostly discovered accidentally (e.g. usual check-up).

Once chronic hepatitis C has progressed to reach the stage of cirrhosis, signs and symptoms may appear that are generally caused by either decreased liver function or increased pressure in the liver circulation, a condition known as portal hypertension.

Possible signs and symptoms of liver cirrhosis include ascites (accumulation of fluid in the abdomen), bruising and bleeding tendency, varices (enlarged veins, especially in the stomach and esophagus), jaundice and a syndrome of cognitive impairment known as hepatic encephalopathy.

Treatment

The current treatment option includes a combination of pegylated interferon-alpha-2a or pegylated interferon-alpha-2b, and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on the genotype of hepatitis C virus. Treatment is generally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests.

A large number of patients will experience side-effects ranging from a flu-like syndrome (experienced for a few days after the weekly injection of interferon) to severe adverse events, including anaemia, cardiovascular events and psychiatric problems such as suicide or suicidal ideation. The latter are exacerbated by the general physiological stress experienced by the patient. Moreover, there are a large number of patients who don’t respond to the antiviral therapy leading to the need for a cost-effective alternative therapy.

But the current therapy couldn’t get much popularity in India, China, Bangladesh and Bhutan as it is very expensive and the treatment may be physically demanding, particularly for those with a prior history of drug or alcohol abuse. It can qualify for temporary disability in some cases.

Herbal Treatment

Some herbs have been found to be effective for the treatment of Hepatitis C. These can be classified as hepatoprotective (these protect liver cells against the harmful effects of HCV and normalise liver enzymes), immunomodulator (increase the body’s immunity and boost our fight against virus) and antiviral (which stops virus from multiplication). In one clinical study it was found that if these three types of herbs are given in one go they are very effective to decrease the viral load as well as in the normalisation of liver enzymes. These herbs need further clinical data and research. These can prove to be a ray of hope for a cost-effective interferon-free treatment.