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HepCBC - HEPV-L HEPATITIS C FAQ

Click Here to Download latest version (.pdf-format, 2Mb). Version 8.3 (September 2009) contains a completely updated section on treatment and research.

This FAQ is dedicated to the memory of David H. Kehrer, LTC John Heintz (Peters) and his wife Patricia, Daniel Bodiford, Dr. Horst Irmler, Jude Saucier, Capt. Kevin Donnelly, Ron Thiel, ”Uncle” Dave Lang, Guy Thisdelle, “Apache” Pat Davis , Frank Darlington, Dave FitzGerald and Sandra Tara Balduf (Ane Palmo).

Table of Contents

0. Administrivia

0.00 Copyright
0.01 Introduction
0.02 Disclaimer

1. THE BASICS

1.0.1 WHAT IS HEPATITIS?
1.0.2 WHAT HAPPENS IN THE BODY?
1.0.3 WHAT IS THE INCUBATION PERIOD?
1.0.4 HOW DOES HEPATITIS C USUALLY BEGIN?
1.0.5 WHAT ARE THE DIFFERENT TYPES OF HEPATITIS?
1.0.6 WHAT IS THE FUNCTION OF THE LIVER?
1.0.7 HEPATITIS C VIRUS (HCV)
1.0.7a WHEN WAS THE HEPATITIS C VIRUS DISCOVERED?
1.0.8 WHO GETS HEPATITIS?
1.1.0 HOW IS IT TRANSMITTED?
1.1.0a HOW HCV IS NOT TRANSMITTED
1.1.1 HCV AND BLOOD TRANSFUSIONS
1.1.2 HCV AND INTRAVENOUS DRUG USE
1.1.3 HCV AND IV IMMUNOGLOBULIN (GAMMAGARD/POLYGAM/FACTOR D)
1.1.4 NEONATAL TRANSFER OF HCV
1.1.5 OTHER MEANS OF HCV TRANSMISSION
1.1.5a SEXUAL TRANSMISSION
1.1.5b OCCUPATIONAL EXPOSURE (HEALTH CARE WORKERS)
1.1.5c TOOTHBRUSHES/RAZORS/NAIL CLIPPERS
1.1.5d HEMODIALYSIS
1.1.6 HIGHLY SPECULATIVE MODES OF TRANSMISSION OF HCV
1.1.6a TEARS, SALIVA, URINE, AND OTHER BODY FLUIDS
1.1.6b CAT SCRATCHES
1.1.6c MOSQUITOS
1.1.6d ALTERNATIVE MEDICAL PROCEDURES
1.1.6e HOUSEHOLD TRANSMISSION
1.1.6f OTHER
1.1.6g IS HCV ANYTHING LIKE HIV?
1.1.7 PREVENTION
1.1.7a WHEN, AND FOR HOW LONG, IS A PERSON ABLE TO SPREAD THE HEPATITIS C VIRUS?
1.1.7b HOW CAN THE SPREAD OF HEPATITIS C BE PREVENTED?
1.1.7c CLEANING UP BLOOD SPILLS
1.1.7d WHAT TO DO IN CASE OF AN ACCIDENTAL NEEDLESTICK
1.1.8 WHOM SHOULD I TELL?
1.1.9 CAN YOU GET HEPATITIS MORE THAN ONCE?

2. MEDICAL ISSUES

2.0.1 HOW DO I FIND GOOD MEDICAL CARE FOR HEPATITIS?
2.0.2 WHAT IS THE DIFFERENCE BETWEEN A GASTROENTEROLOGIST AND A HEPATOLOGIST?
2.1.0 HOW IS IT DIAGNOSED?
2.1.1 ANTIBODY TESTS
2.1.2 WHAT IS A PCR?
2.1.2a WHAT IS A GENOTYPE?
2.1.3 IS IT POSSIBLE THE TEST COULD BE WRONG?
2.2.0 BIOPSY
2.2.0a WHAT IS A LIVER BIOPSY?
2.2.0b WHAT ARE THE DANGERS OF LIVER BIOPSY ?
2.2.0c WILL IT HURT?
2.2.1 CHRONIC PERSISTENT OR CHRONIC ACTIVE - WHAT’S THE DIFFERENCE?
2.2.2 WHAT ARE THE MAIN SYMPTOMS OF HEPATITIS C?
2.2.2a FATIGUE
2.2.2b UPPER RIGHT QUADRANT (URQ) PAIN (SIDE PAIN)
2.2.2c LOSS OF LIBIDO
2.2.2d RED PALMS
2.2.2e NAUSEA
2.2.2f BRAIN FOG
2.2.2g ITCHING
2.2.2h VISION PROBLEMS
2.2.2i DIZZINESS
2.2.2j DRY MOUTH
2.3.0 IT’S NOT ALL IN YOUR HEAD!
2.3.1 WHAT IS THE EVOLUTION OF THE DISEASE?
2.4.0 WHAT OTHER MEDICAL PROBLEMS CAN BE RELATED TO HCV?
2.4.0a CRYOGLOBULINEMIA
2.4.0b THYROID AND AUTOIMMUNE PROBLEMS
2.4.0c RHEUMATOID ARTHRITIS-LIKE SYMPTOMS
2.4.0d FIBROMYALGIA
2.4.0e DERMATOLOGICAL MANIFESTATIONS
2.4.0f PORPHYRIA CUTANEA TARDA (PCT)
2.4.0g LICHEN PLANUS
2.5.0 CYCLES AND FLARE-UPS
2.6.0 SHOULD I BE VACCINATED AGAINST OTHER TYPES OF HEPATITIS?
2.7.0 HCV AND WOMEN’S CONCERNS
2.7.1 PREGNANCY AND BREASTFEEDING
2.8.0 HOW DOES HCV AFFECT CHILDREN?
2.9.0 WHAT ARE THE DIFFERENT CLINICAL INDICATIONS OF HCV?
2.9.1 ELEVATED LIVER ENZYMES
2.9.1a ELEVATED ALPHA-FETOPROTEIN LEVELS
2.9.2 JAUNDICE
2.9.3 HEPATOMEGALY, SPLENOMEGALY
2.9.4 SPIDER NEVI
2.9.5 ASCITES
2.9.6 PORTAL HYPERTENSION / VARICES
2.9.7 HEPATIC ENCEPHALOPATHY
2.9.8 CIRRHOSIS
2.9.9 FULMINANT HEPATITIS
2.9.10 DOES HCV INCREASE THE LIKELIHOOD OF CANCER?
2.10.0 HOW MANY OF US ARE THERE?

3. TREATMENT (Conventional Medicine)

3.1.0 INTERFERONS
3.1.1 Interferon Monotherapy
3.1.1a Interferon Alpha 2B, Recombinant (Intron A)
3.1.1b When Is Interferon Treatment Not Indicated?
3.1.1c Interferon “Breakthrough” and “Non-Response”
3.1.1d Consensus Interferon (Infergen)
3.1.1e Natural Source Interferon Alpha-N3 – Human Leukocyte-Derived (Alferon)
3.1.1f Beta Interferon, Recombinant (Betaseron, Avonex and Rebif)
3.1.1g Roferon INTERFERON ALPHA 2A, RECOMBINANT
3.1.1h Lymphoblastoid IFN
3.1.1i Mochida Interferon (Alpha IFN-alpha Mochida500)
3.1.1j Multiferon
3.1.1k Veldona Oral Alpha-IFN
3.1.1l Omega IFN (Biomed 510)
3.1.1m Albuferon
3.1.2 Pegylated Interferon
3.1.2a Pegylated Intron A (Peg-Intron A)
3.1.2b Peginterferon Alpha-2a (Pegasys)
3.1.3 Interferon Combinations
3.1.3a Interferon and Ribavirin Combined (Rebetron)
3.1.3b Pegylated IFN and Ribavirin
3.1.3c Interferon and Iron Reduction Therapy
3.1.3d Interferon and Thymosin
3.1.3e Interferon and GM-CSF
3.1.3f Interferon and NAC
3.1.3g Interferon and Amantadine
3.1.3h Interferon and Ofloxacin
3.1.3i Interferon and Histamine Dihydrochloride (Ceplene)
3.1.3j IFN and Ketoprofen
3.1.3k IFN and Ursodeoxycholic Acid (Actigall)
3.1.3l IFN and VX-497
3.1.3m IFN and Colchicine
3.1.3n Triple Therapy
3.1.4 Different Dosage
3.1.4a Mega Dosing
3.1.4b Maintenance Dosing
3.1.4c Induction dosing
3.1.4d Longer Treatment
3.2.0 INTERLEUKINS
3.2.1 Interleukin-10
3.2.2 Interleukin-12
3.3.0 HCV PROTEIN-BASED THERAPY (or GENE THERAPY or RNA INHIBITORS)
3.3.1 Protease Inhibitors
3.3.2 Polymerase Inhibitors
3.3.3 Helicase Inhibitors
3.3.4 Reverse Transcriptase Inhibitors
3.3.5 VP-50406
3.3.6 Interferon Alpha Gene Therapy
3.3.7 Ribozyme Therapy
3.3.8 IRES Inhibitors
3.3.9 Antisense Based Therapies
3.4.0 VACCINES
3.4.1 HCV Antibody
3.4.2 InnoVac-C
3.4.3 HepeX-C (formerly XTL-002)
3.4.4 Epimmune Vaccine
3.4.5 Vical technology
3.4.6 ChimeriVax Vaccine
3.4.7 Chiron Vaccine
3.4.8 Iscoprep 703 (ISCOM)
3.4.9 Therapore
3.4.10 Antigen-specific cellular therapy
3.5.0 OTHER THERAPIES
3.5.1 Nucleoside Analogs
3.5.2 ACH-126447 (Helioxanthin)
3.5.3 Ampligen
3.5.4 EHC18 (Enzo Immune Regulator)
3.5.5 Geron Telomerase Activation
3.5.6 HE2000
3.5.7 Hypericin (Vimrx, Hifritzen)
3.5.8 Immtech Mono and Dication Compounds
3.5.9 IP501
3.5.10 Macrokine (WF10)
3.5.11 S-28463 (R-848; VML-600)
3.5.12 NCX-1000
3.6.0 TRANSPLANT
3.7.0 OTHERS

4. TREATMENT (Alternative Medicine)

4.0.0 KNOWN HERB-DRUG INTERACTIONS
4.0.1 ACUPUNCTURE
4.0.2 CHIROPRACTIC
4.0.3 ENERGY HEALING (Reiki, Hands of Light, Touch Therapy etc)
4.0.4 REFLEXOLOGY
4.0.5 HOMEOPATHY
4.0.6 RETICULOSE
4.0.7 TRADITIONAL CHINESE MEDICINE (TCM)
4.0.8 OZONE THERAPY
4.1.0 HERBAL TREATMENTS AND VITAMINS
4.1.1 KOMBUCHA TEA
4.1.2 MEDICINAL MUSHROOMS (REISHI / MAITAKE, SHITAKE)
4.1.3 DANDELION (Taraxacum officinale)
4.1.4 MILK THISTLE
4.1.5 ARTICHOKE (cynara scolymus)
4.1.6 LICORICE ROOT (glycyrrhiza glabra)
4.1.7 SPIRULINA (BLUE-GREEN ALGAE)
4.1.8 GARLIC
4.1.9 THYMIC FACTORS
4.1.10 VITAMIN C
4.1.11 VITAMIN B12
4.1.12 VITAMIN E
4.1.13 NATURAL INTERFERON BOOSTERS
4.1.14 OTHER HERBS OR VITAMINS
4.1.15 WATER
4.2.0 EXERCISE
4.3.0 STRESS MANAGEMENT
4.4.0 POSITIVE ATTITUDE
4.5.0 TAI CHI / CHI KUNG / YOGA / MEDITATION
4.6.0 OTHER WAYS TO HELP KEEP YOURSELF HEALTHY

5. NUTRITION

5.1.0 WHAT SHOULD I DO ABOUT NUTRITION?
5.1.1 FOODS TO AVOID:
5.2.0 NUTRITION AND CIRRHOSIS
5.3.0 COFFEE, TEA, CAFFEINE AND OTHER STIMULANTS
5.4.0 SALT

6. DRUGS AND ALCOHOL

6.1.0 ALCOHOL
6.2.0 TOBACCO
6.3.0 MARIJUANA
6.3.1 COCAINE
6.4.0 WHAT ARE THE EFFECTS OF RECREATIONAL DRUGS?
6.4.1 INTRAVENOUS DRUG USE PRECAUTIONS
6.4.2 CLEANING FITS
6.4.3 METHADONE AND HEPATITIS C

7. HOW CAN HCV AFFECT MY EMOTIONAL LIFE?

7.1.0 HOW IS DEPRESSION RELATED TO HEPATITIS?
7.1.1 MOOD CHANGES
7.1.2 DEALING WITH A CHRONIC DISEASE
7.1.2a ACCEPTING
7.1.3 DEALING WITH A LOWER LEVEL OF ENERGY
7.1.4 IRRITABILITY
7.1.5 HOW CAN HCV AFFECT MY SEX LIFE?
7.1.6 HELPING A FRIEND OR FAMILY MEMBER WITH HEPATITIS C
7.1.6a WHAT SHOULDN’T I SAY?
7.1.6b WHAT SHOULD I SAY?

8. LIVING WITH HCV

8.1.0 LIFE PROBLEMS CREATED BY HCV

9. DEALING WITH INTERFERON THERAPY

9.1.0 GENERAL TIPS FROM SCHERING
9.2.0 HOW DOES INTERFERON WORK?
9.2.1 WHAT WILL INTERFERON ACHIEVE:
9.2.2 CLINICAL TRIALS:
9.2.3 WILL I BE ABLE TO CONTINUE WORKING WHILE I’M TAKING INTERFERON:
9.2.4 HOW WILL I KNOW IF THE INTERFERON IS WORKING?
9.3.0 SIDE EFFECTS
9.3.0a NAUSEA
9.3.0b HAIR LOSS
9.3.0c FATIGUE
9.3.0d MOUTH PROBLEMS
9.3.0e INFECTIONS
9.4.0 IMPORTANCE OF WATER
9.5.0 STORAGE
9.5.0a TRAVELING WITH INTERFERON
9.6.0 TIMING OF INJECTIONS
9.7.0 INJECTION HINTS
9.7.0a INJECT-EASE:
9.7.0b BRUISING AND DILUENT AMOUNTS
9.7.0c NEEDLE SIZE
9.8.0 HELP! I THINK I HIT A VEIN!
9.9.0 WHAT TO DO WHEN YOU CAN’T AFFORD THE INTERFERON
9.10.0 INTERFERON TREATMENT OF HCV WITH CIRRHOSIS

10. WHERE DO WE GO FROM HERE?

10.1.0 LONG TERM PROGNOSIS (WILL I EVER GET CURED? AM I GOING TO DIE?)
10.2.0 CURRENT RESEARCH, TESTING AND CERTIFICATION OF NEW DRUGS AND TREATMENTS IN THE U.S. AND ABROAD

11. EMPLOYMENT AND DISABILITY

11.1.0 INCOME SECURITY: JOB AND/OR DISABILITY BENEFITS
11.1.1 HOW DO I HANDLE PROBLEMS ABOUT MY JOB?
11.1.2 WHAT PROBLEMS DO I FACE IN SEEKING DISABILITY BENEFITS?
11.1.3 APPLYING FOR SSI / SSDI
11.1.4 Winning Your Social Security Disability Claim: 15 Mistakes You Cannot Afford to Make! by Scott E. Davis, Esq. and Scott M. Harris, Esq.
11.1.5 Hepatitis C and Disability Benefits in British Columbia

12. IMPORTANT INFORMATION

12.1.0 WHAT ELSE IS IMPORTANT FOR ME TO KNOW ABOUT HCV?
12.1.1 HCV INFORMATION RESOURCES AND SUPPORT GROUPS
12.1.1a NATIONAL (USA)
12.1.1b CANADA
12.1.1c ARGENTINA
12.1.1d AUSTRALIA/NEW ZEALAND
12.1.1e ENGLAND / SCOTLAND
12.1.1f GERMANY/AUSTRIA
12.1.1g SPAIN
12.1.1h URUGUAY
12.1.1i ISRAEL
12.1.2 WHAT HCV RESOURCES ARE AVAILABLE ON THE INTERNET AND USENET?
12.1.3 BIBLIOGRAPHY: SUGGESTED READING
12.1.4 WHAT NEWSLETTERS, MAGAZINES AND VIDEOS ARE AVAILABLE?

A. APPENDIX A: WHERE TO GET THE CURRENT VERSION OF THIS FAQ

B. APPENDIX B: COMMON ABBREVIATIONS

C. APPENDIX C - SOME RECOMMENDED WEB SITES (in no particular order) ARE:

D. APPENDIX D – A List of Canadian Doctors Specializing in the treatment of HCV

E. APPENDIX E: History of Blood Safety, Canada’s Track Record, and Compensation Issues

F. APPENDIX F: The Double Challenge of HIV/HCV Co-infection

List of Tables
10-1. Drugs specific for Hepatitis C
10-2. Existing drugs and nonspecific drugs being tested for Hepatitis C & Drugs for related conditions

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