#1 Hepatitis C Primer - Information about the Hepatitis C Virus

Combination Therapies for HCV
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Iron Reduction	Ribaviron	Rebatron	Amantadine	Ofloxacin	Thymosin	Zadaxin
Reticulose	UCDA	Pentoxifylline	Immune therapy	Silymarin	Other herbs	Pegasys
Other options for treating HCV

IRON REDUCTION THERAPY
A new study published in the fall issue of American Journal of Gastroenterology, Vol 89, No. 7, suggests that using "Iron Reduction Therapy" along with interferon can result in an effective cure rate in the area of 75-80% and that adding cytokines and antivirals such as ribavirin can improve effectiveness even further. The theory behind this is that viruses need iron to replicate, and by reducing the hepatic iron in the liver you prevent them from replicating. It should be noted that this new procedure is not yet FDA approved and is still in the early trial stages.

Effects of Phlebotomy in Interferon Non-Responders

Effect of liver iron content on hepatitic inflammation

RIBAVIRIN
Many hepatitis C patients show a clear-cut biochemical response to ribavirin, with a lowering of liver enzyme levels. However, the ribavirin does not clear circulating hepatitis C virus RNA and relapses occur after they discontinue taking the drug.

Side-Effects of Ribavirin Observed in HCV Patients

Ribaviron Causes Increase of Hepatic Iron

INTERFERON AND RIBAVIRIN - COMBINED (Rebatron)
Clinical trials have completed for a combination drug of interferon-alpha and ribavirin (named REBATRON), and the FDA has approved the use of the drug.
Click here for the results of recent studies using this combination.

PEGASYS
Pegasys: Regimen suppresses Hep C

Anemia
Anti-Oxidant vitamins delay anemia in combo treatment

AMANTADINE
Amantadine (trade name Symmetrel) is a drug commonly used in the treatment of Parkinson's disease, and for the prophylaxis and treatment of illness caused by the influenza A virus. It is thought to prevent viral uncoating and thus viral multiplication. Amantidine was recently tested in patients with HCV, and clinical trials will be beginning soon.

( From the 96th annual meeting of the American Gastroenterological Association, Digestive Disease Week , San Francisco, CA, May 21, 1996)

Dr. J.P. Smith presented the results of a recent trial of the antiviral agent, amantadine hydrochloride, in patients with chronic hepatitis C infection who had previously failed to respond to interferon alpha-2b. Twenty-two patients were treated with orally administered amantadine HCl, 100 mg twice a day, for 6 months. These same patients served as their own controls during two intervals of no treatment (24 months before and 12 months after previous treatment with interferon) and during interferon therapy. Twenty of the 22 patients completed the 6-month study of amantadine.

Thirty percent of those patients completing the study demonstrated a complete response to therapy as demonstrated by the normalization of serum alanine aminotransferase (ALT) levels. Forty percent of the patients achieved a partial response (defined as a reduction in ALT of greater than 50%), and 30% failed to respond to amantadine therapy. Responders and partial responders maintained therapeutic benefits 6 months after treatment was stopped.

Two patients were discontinued from the study as a precaution due to cardiac-related side effects. Two patients reported difficulty concentrating, two patients reported constipation, and one experienced insomnia, but none of these patients discontinued the study. There was no observed decrease in WBC levels, nor was there any detrimental effect on the bone marrow attributable to treatment with amantadine.

Dr. Smith noted that the comparative costs of therapy at the Hershey Medical Center were $120 for 6 months of therapy with amantadine HCl vs $3,000 for interferon.

As shown by this study in 20 patients, amantadine HCl (which has the additional benefit of being taken orally vs by subcutaneous injection for interferon) may prove to be a useful alternative to interferon in treating patients with chronic hepatitis C.

"Treatment of Chronic Hepatitis C with Amantadine", J. P. Smith, The M. S. Hershey Medical Center, Pennsylvania State University Hershey, PA

Rimantadine: A Clinical Perspective

Adverse reactions to Amantadine

Amantadine and Rimantadine Have no Effect on HCV

OFLOXACIN
On the basis of the recent report on the antiviral effects of ofloxacin (OFLX) which is antibacterial drug, a study was designed to test the efficacy of OFLX in combination with IFN by a open clinical trial method. Analysis of HCV-RNA titer revealed that it decreased markedly after the beginning of combination therapy. HCV-RNA titer became negative in 8 cases of 11, and in 1 of 8 patients HCV disappeared by OFLX. However, the effects of OFLX were not monitored by HCV-RNA titers. ALT normalised rate at the end of the study in group I and group III (control) were 87.5% and 69.0% respectively, which differences were not statistically significant. The results of the trial indicate that the combination therapy of interferon and ofloxacin may be a possible strategy for the treatment of type C hepatitis.
"Combination therapy of interferon and ofloxacin in patients with chronic type C hepatitis", Takada N.; Yamazaki Y.; Sato T.; Furukawa T.; Matsuzaki H.; Shimada K.; Iwasaki K.; Furube M.; Tomioka H., Japanese Pharmacology and Therapeutics (Japan), 1995, 23/SUPPL. 3

Also read Combination Therapy with Interferon and Ofloxacin

THYMOSIN
Thymosin alpha 1 is a protein produced by the human body, the cow and others which is supposed to enhance the immune system. It is associated with the thymus gland, which shrinks as we get older - yet has important role in immunity. There are over the counter products which take raw cow thymus - dry - defat - and process the gland in tablet form which some claim when taken causes the human body to increase natural production of "thymosin alpha 1". Dr. Burgstiner in Savannha, Georgia, believes he cured himself of Hep B by using this formula (Telephone 912-355-5755 (ask for Pat)). That preparation is called "Thymic Fractions" and is produced by a company in California called Bio-Naturals at 800-991-7990. The reference to Dr. Burgstiner can be found in Naomi Judd's book " Love Can Build A Bridge" paperback edition - Pages (480-482) Dr. Burgstiner believes that this preparation must be taken with vitamins to act as coenzymes in order to be effective.

There is also a synthetic "thymosin alpha 1" being produced by a company called SciClone Pharmaceuticals - Telephone - 415-358-1446 available only in trials - It is given intravenously and has been - and is currently being studied for use in treating Hep B and C - in Hep B the results have been promising - and it is now being studied in combination with interferon.

Thymic Factors Comments and questions answered by Dr. Burgstiner

Study of Complete Thymic Formula for HCV

ZADAXIN

ZADAXIN U.S. Hepatitis C Trial Statistically Significant

Strong Results In Hepatitis C Trial Using ZADAXIN

Study Data on Zadaxin and Interferon

RETICULOSE

(Information provided by Commonwealth Pharmaceuticals, British West Indies, manufacturers of Reticulose) Patients with Hepatitis A and 18 patients with Hepatitis B were treated with Reticulose. 9 Patients with Hepatitis A and 17 patients with Hepatitis B were controls and treated with placebo. The treated patients received Reticulose for a 15 day period, while the control received saline. Based upon laboratory findings of several parameters: Prothrombin times, Serum bilirubin, white blood cell count, and clinical observations, Reticulose treated patients appeared to show significant improvement. The bilirubin levels of 83% of patients with Hepatitis B, treated with Reticulose for 15 days were in the normal range in 30 days. None of the control patients treated with placebo were within normal range in 30 days. Of Hepatitis A patients treated with Reticulose, 100% showed normal bilirubin after 30 days. Of control patients with Hepatitis A, only 22% were in normal range after 30 days. The findings in this preliminary trial lead to the conclusion that Reticulose appears to significantly reduce the recovery time and return to normal for patients with an acute episode of Hepatitis A or B. Further study is indicated.

Conclusions: In this preliminary Human Clinical Trial in 53 patients with Hepatitis A or Hepatitis B, one half of whom were treated with Reticulose, the results demonstrated positive clinical and laboratory effects. 18 patients with Hepatitis B and 9 with Hepatitis A were treated with Reticulose, compared to 17 control patients with Hepatitis B and 9 control patients with Hepatitis A treated with placebo. Patients were diagnosed for Hepatitis A or B by appropriate laboratory tests of blood, urine, x-ray and physical examination, with special attention to Anti-HAV IGM and HepB surface Antigen to carefully differentiate those with A from those with B. We realize, however, that liver biopsy is the positive method for hepatitis diagnosis, but physical limitations prevented our using this method in this study. Based upon laboratory findings, serum bilirubin levels of 83% patients with Hepatitis B, treated with Reticulose for 15 days were in normal range in 30 days, 50% in 15 days, and 22% in 10 days. None of the control patients were in normal range after 30 days with placebo treatment. In the Hepatitis A patients treated with Reticulose, 100% showed normal bilirubin levels after 30 days, 89% after 15 days, and 33% after 10 days. In the control patients with Hepatitis A only 22% were in normal range after 30 days, 11% after 15 days, and 11% after 10 days. In all of the Reticulose treated patients, the white blood cell count showed significant increase, indicating stimulus to the immune system. In all of the Reticulose treated patients, the prothrombin times returned promptly to normal range while the controls did not. The results appear to demonstrate significant improvement in the patients treated with Reticulose, especially those with Hepatitis B.
The use of Reticulose in the Treatment of Hepatitis A, B & C, Excerpted from: Journal of the Royal Society of Health Volume 112, No. 6, pages 266-270 December, 1992

Ursodeoxycholic acid

UCDA descreases the LFTs of chronic liver disease patients treated with SNMC

Ursodeoxycholic acid (UCDA) in the treatment of liver diseases

Combination Ursodeoxycholic Acid and Interferon

PENTOXIFYLLINE

PENTOXIFYLLINE enhances response of chronic hepatitis C to INTERFERON [alpha]2b

Immunosuppressive therapy

Immunosuppressive therapy and hepatitis C virus

Sylimarin and other herbs

List of Herbs Used to Treat HCV

Milk Thistle and Licorice in the Therapy of Liver Disease

Study on treating HCV with glycyrrhizin (licorice)