The hepatitis C virus is one of the causes of hepatitis, which is an inflammation of liver cells. It was first identified in 1989. Six different genotypes of the hepatitis C virus are known, and over 50 subtypes. Type 1 is most common in the United States, and is the most difficult to treat.

This variety of hepatitis has the distinction of being most often chronic, and most often asymptomatic, until complications arise. In North America, hepatitis C is the leading cause of cirrhosis of the liver. The majority of liver transplants are for patients who have it.

In the United States, almost 1,6% of the population is chronically infected with the hepatitis C virus. The most affected groups are found among the 40-59 year olds and people of black color, where the rate reached 6,1%.

Possible course of hepatitis C

When a person contracts hepatitis C, there will be symptoms in about 25% of cases. These occur 2 to 12 weeks after exposure. About a third of patients will eliminate the virus without sequelae, while the others will go towards chronicity.¹¹.

For patients who do not clear the virus and who have chronic hepatitis C:

• The vast majority have no symptoms.
• They constitute a reservoir of viruses and are a possible source of contamination.
• About 10 to 15% of them will have cirrhosis of the liver within 20 years.
• The risk of cirrhosis is 4 times higher in people who drink too much alcohol¹².
• Smoking also appears to be an unfavorable risk factor.
• Coinfection with HIV increases the risk of complications (cirrhosis and cancer).
• Primary liver cancer develops in 5% of subjects with hepatitis C with cirrhosis of the liver.

• Most infected people are asymptomatic.
• With acute infection, there may be loss of appetite, nausea and vomiting, stomach pain, with or without jaundice or dark urine.
• There may be non-specific symptoms: fatigue (mainly), weight loss, anorexia, joint or muscle pain.
• In a majority of cases, chronic hepatitis C will remain asymptomatic for 20 to 30 years. A cirrhosis will therefore have time to develop “in the shade” and, at an advanced stage, it will manifest itself by the following symptoms: jaundice, scant urine, neurological disorders which can lead to coma, digestive haemorrhages (with vomiting of blood and stools). black), repeated infections, swelling of the ankles.

• Among intravenous drug users, most of whom use non-sterile equipment, about 80% are infected.
• Homeless people and people living in prisons: 15-50% of them are infected.
• Blood transfusions before 1992. People who have hemophilia and received blood products before 1992 are infected in about 80% of cases. Tests for hepatitis C virus in blood products are now used and reduce the chances of getting the disease from a blood transfusion to 1 in 100.
• Work in a hospital environment: handling of blood material from infected patients. If a worker accidentally pricks himself with a contaminated needle, the risk of infection is 1 in 300.
• Sexual transmission in a heterosexual and monogamous couple is very rare.
• In 15-20% of proven hepatitis C cases, the only risk factor was found to be co-infection with HIV or to have multiple sexual partners.
• Transmission from mother to newborn if mother is infected, but the risk is only 5%. The risk is increased to 15-22% if the mother is co-infected with HIV.
• Breastfeeding is safe.

Hygiene measures

At all times :

– In healthcare settings, the principle of universal precautions must be applied. Gloves are worn, sterile equipment is used, and techniques are used to safely dispose of contaminated equipment.

– Tests are done on any donor of blood, organ or sperm.

– Systematically use a condom if you are not in a long-term, monogamous relationship.

– Ensure that sterile equipment is used during a tattoo session, body piercing, or acupuncture.

– Programs providing sterile equipment for injecting drug users reduce transmission.

In the event of cohabitation with a carrier of the virus :

– Any object soiled with blood (sanitary napkin, needle, dental floss, bandages, etc.) must be put in a resistant container which will be thrown away and put out of the reach of all;

– All toiletries (razor, toothbrush, etc.) must be strictly reserved for their owner.

But there is no risk of contamination in the following cases: simple touch (provided there is no contact with a wound), handshake, cough / sneeze, kiss, sweat, handling of objects currents (dishes, etc.).

Screening

It is recommended for the following groups:

– anyone born between 1945 and 1965¹³.

– any current or former injectable drug user (even in the event of a unique opportunity).

– residents of a prison environment.

– people with medical conditions associated with a high prevalence: HIV, hemophiliacs treated before 1992, long-term hemodialysis.

– those who cohabit with a carrier and especially the spouse.

– people with multiple sexual partners.

– children born to an infected mother.

– healthcare workers accidentally exposed to blood.

vaccination

There is no vaccine against the hepatitis C virus yet.

For acute hepatitis C

There is no specific treatment for the acute form. Medicine is content to recommend simple supportive measures:

– take rest if needed;

– have a balanced diet low in fat;

– to drink a lot of water;

– do not consume alcohol.

In rare very severe cases, hospitalization is required. Among these, there are sometimes cases of hepatitis insufficiency which require a liver transplant.

For chronic hepatitis C

– Vaccination against hepatitis A and B is recommended: adding another form of hepatitis in addition to hepatitis C can be potentially fatal.

– Abstinence from alcohol and tobacco is strongly recommended.

– Individualized antiviral therapy should be considered, especially if a liver biopsy shows fibrosis. Treatment is mostly based on a combination of interferon and ribavirin, with or without boceprevir (or telaprevir). The duration depends on the genotype and other factors. The decision must be made by a very knowledgeable physician, with several new treatments and protocols on the horizon.

– Since treatment with interferon often causes depression, some people offer antidepressants straight away.

Other measures:

– Tell your doctor about any over-the-counter medicines and natural products you use. Some can affect the weakened liver.

Phytotherapy

No evidence has been provided regarding herbal remedies¹⁴.

Thistle

No effect was observed in blood parameters, viral load and quality of life when using Milk Thistle¹⁵.

supplements

Vitamin K2

In a research of just 40 women with cirrhosis of the liver, over a period of 7 years, 2 of 21 patients on vitamin K developed liver cancer compared to 9 of 19 women who did not. The dosage was 45 mg per day of vitamin K2¹⁶.

Vitamin D

Patients who took vitamin D during their antiviral treatment for hepatitis C genotype 1 type doubled the cure rate.

antioxidants

A Cochrane review¹⁷ reviewed research on antioxidants for hepatitis of various origins, including hepatitis C. Antioxidants for which we have data are:

• Beta carotene (3 studies)
• Vitamin A (2 studies)
• Vitamin C (9 studies)
• Vitamin E (15 studies)
• Selenium (8 studies)

And there was no demonstrated beneficial effect on either morbidity or mortality.

Basic measures

For both acute and chronic forms of hepatitis C, the holistic approach emphasizes even more than the strictly medical approach on the importance of a healthy lifestyle that includes:

– Rest;

– food measures;

– strict vigilance in the face of the hepatotoxic effect of certain substances (drugs, industrial pollutants);

– the management of negative emotions.

For more information, see Hepatitis.

Homeopathy

It can help or relieve some symptoms in acute or chronic hepatitis. See Hepatitis.

Traditional chinese medicine

La Chinese pharmacopoeia and acupuncture are of definite interest in cases of acute or chronic hepatitis. See Hepatitis as well as Phytotherapy.

Most herbal treatments for hepatitis C are derived from those used for hepatitis B, a very common problem in China. Studies published in China show improvement in liver fibrosis and relief of symptoms and inflammation of the liver.¹⁰ According to Matthew Dolan, The Gateway Clinic, in London, is the leader in the West in the treatment of hepatitis C with TCM adapted for the West. There have been no controlled studies to verify the effectiveness of this approach, but a systematic analysis of symptoms before and after treatment shows that it produces significant relief.¹

Body approaches

In acute hepatitis, the different forms of massage act as support or relief as appropriate. See Hepatitis.

Global approach of Dr Andrew Weil. This American doctor is well known for his openness to alternative medicine, which he integrates into his daily practice. While advising vaccination against hepatitis B to avoid co-infection with it (see “Vaccination” above), here is the complete program⁸ he recommends for hepatitis C:

– do not drink alcohol;

– to avoid any overload of the liver, do not take any medication, prescribed or not by a doctor (as far as possible);

– limit protein consumption to one serving or less per meal;

– take antioxidants every day: 25 IU of beta-carotene, 000 to 400 IU of vitamin E from natural sources, 800 mg of vitamin C (twice a day), 1 micrograms of selenium;

– drink plenty of water, at least eight glasses a day;

– Go regularly to a sauna bath (two to three times a week);

– take milk thistle (Silybum marianum) at the rate of 2 capsules of standardized extract of 50 mg, twice a day. It can be consumed indefinitely; (See also Hepatitis for more on this plant.)

– also take other plants that protect the liver – such as schisandra (Schisandra chinensis), for example. Since there are no standardized extracts for this plant, Dr. Weil finds it difficult to recommend a precise dosage and instead suggests consulting a traditional Chinese medicine practitioner who has good experience in the treatment of chronic hepatitis. (See also Hepatitis, for more on this plant.)

N.B. : This approach is consistent with that of Dr. Berkson (see below) regarding the combination of herbs and supplements.

Clay. It is used externally (to relieve a painful liver) or internally (to support the liver). See Hepatitis.

Hydrotherapy. Alternating hot and cold compresses can be helpful in acute hepatitis. Cold compresses will help with chronic hepatitis. See Hepatitis.

Ayurvedic medicine. Traditional medicine from India offers solutions for both acute and chronic hepatitis (see Hepatitis).

Dr Berkson’s Triple Antioxidant Therapy. Much like Dr. Andrew Weil, Dr. BM Berkson advises a combination approach of supplements with milk thistle. According to his observations, it can give excellent results.

This approach will be particularly useful in cases of chronic hepatitis, since the effectiveness of conventional treatments remains limited, believes Dr. Berkson. Although little is known about his work, it has already been published in a scientific journal.⁹ For hepatitis C, cirrhosis or liver cancer, Dr. Berkson recommends taking:

– 600 µg (micrograms) of alpha-lipoic acid;

– 900 µg of silymarin (extract of milk thistle);

– 400 µg of selenium divided into 2 or 3 doses.

In addition, he also suggests taking every day:

– 2 mg of vitamin C;

– 800 IU of vitamin E;

– 300 mg de coenzyme Q10.

Our doctor’s opinion