Hepatitis is a serious inflammation of the liver. Viral hepatitis, the most common form, usually appears as type A, B, or C. Type B (HBV) and Type C (HCV) affect people of all ages. Hepatitis can result from long-term alcohol abuse, infection, or exposure to various chemicals and drugs. We are in the midst of an epidemic of Hepatitis B and C infections. Between 1% and 5% of the world's population is infected chronically with one or more of these two viruses. In some parts of the world, such as Egypt and the Far East, up to 15% of the normal population suffer from infections with these viruses. The Center for Disease Control estimates that 4 million Americans are infected with the hepatitis virus alone.

Because hepatitis is potentially very dangerous, a healthcare professional should be involved in its treatment. If hepatitis is suspected, your health care provider will feel and tap your chest and back to determine if your liver or spleen is enlarged or tender. Your provider will request a blood test, possibly a urine test and, in a few cases, a liver biopsy.

The different types of hepatitis have many similarities and are therefore discussed here as a whole. If you know that you are infected only with a particular form, you can safely skip to the appropriate section below.

HEPATITIS A
Infectious (viral) hepatitis type A (HAV), is the most common hepatitis, often affecting school children. Good hygiene is necessary to avoid spreading this infection. Epidemics are frequent, as the virus is spread easily through food that is handled by infected individuals and water; therefore, people with hepatitis A should wash their hands very carefully after using the restroom and should not handle food at work. It is contagious during the incubation period of 2-6 weeks but only for a few days once symptoms appear. It typically lasts for 4-8 weeks.

Unlike the other hepatitis types which are seen in all ages equally, hepatitis A in seen mostly in children and young adults. Immunity is life-long following infection. HAV does not become chronic like hepatitis B and C can, does not create a carrier state, and does not lead to chronic liver disease. Often, the disease may be so mild it is unrecognized. The vast majority (99%) of people infected with HAV get rid of the infection on their own, and fatalities are rare.

While there is no specific treatment for HAV (most of the treatments mentioned below are for the other types), supportive care is helpful while you fight the infection. Alcohol should be avoided. Coconut milk, not water, is antiviral and said to help in any hepatitis. Bed rest, lots of water, liver supportive herbs such as milk thistle or dandelion would be appropriate.

HEPATITIS B
Hepatitis B (HBV) is usually transmitted by injection of contaminated blood, through intravenous (IV) drug use, or through sexual activity. HBV can be transmitted during pregnancy or childbirth and is a known risk factor for primary liver cancer.

Following an acute infection caused by hepatitis B virus, fewer than 1% of patients develop fulminant hepatitis and die. 85 to 90% experience complete resolution of their physical findings and develop protective levels of antibody. 10 to 15% of patients become chronically infected. Of these, 15 to 30% subsequently develop chronic active or persistent hepatitis or cirrhosis, and about 20% of those with cirrhosis will develop liver cancer.

The following are risk factors, which your doctor should be told about:

• Work in health care, such as in a medical laboratory or in dialysis
• Engage in promiscuous unprotected sex
• Inject drugs
• Have a poor selenium status
• Have a parent, sibling, or child infected with hepatitis
• Live in or are exposed to unsanitary conditions
• Consume possibly contaminated food or water
• Eat or handle raw shellfish

HEPATITIS C
Hepatitis C (HCV) is spread by blood, most commonly through shared needle use, and may lead to a chronic carrier state. Carriers of hepatitis B and C often do not know that they are infected. Receiving a tattoo can also increase your risk of contracting the infection. HCV infections and other chronic viral infections are associated with a variety of immune system defects leading to effective transmission of the viruses through blood exposure and possibly sexual contact. HCV can be transmitted during pregnancy or childbirth.

Hepatitis C is a serious infection. If you do not make continued efforts at maintaining a significant level of liver health, a chronic degenerative process will take its toll eventually. Although the disease may be moderate in expression, a carrier state can follow in 10-50% of patients. Infection with Hepatitis B or C often leads to liver failure or liver cancer and is the leading indication for liver transplantation.

There are 6 known genotypes and more than 50 subtypes of hepatitis C. Patients with genotype 2 and 3 are almost three times more likely to respond to therapy with alpha interferon or the combination of alpha interferon (IFN) and ribavirin (RBV). Knowing the genotype also determines the recommended duration of treatment. For patients with genotype 2 and 3, a 24-week course of combination treatment is adequate, whereas for patients with genotype 1, a 48-week course is recommended. Genotypes do not need to be tested over again because they do not change during the course of an infection. Seventy percent of hepatitis C cases in the US are genotype 1.

The sustained response rate for IFN and RBC combined is 31% for 6 months of treatment and 38% for 12 months of treatment. [N Engl J Med, 1998] A greater viral load suggests that longer or higher dose therapy may be required. [Patients Network, Inc. May 8, 2000]

Examination of liver tissue under the microscope taken from patients with chronic active HCV infection has revealed the presence of NK cells. Indirect evidence for the importance of high NK cell function in limiting chronic hepatitis C infection was demonstrated by two studies of infected patients treated with alpha interferon. Patients that responded clinically to therapy also demonstrated significantly greater enhancement of NK activity than controls after the initial dose of interferon. NK activity was not improved in those who did not respond to treatment, indicating the importance of NK activity.

There are only limited conventional treatments for HCV: it is a disease that can be greatly benefited by natural therapies. Since the persistence of a virus is due in part to lowered immunity, non-toxic immune enhancers (especially those which stimulate NK cell function) should help to resolve or control the infection.

Several nutrients and herbs have been shown to inhibit viral reproduction, improve immune system function, and greatly stimulate regeneration of the damaged liver cells. A therapeutic approach should focus on both immune system enhancement and liver support.

Unlike other white blood cells, inadequate numbers of NK cells are rarely a problem. Instead, it is the activity of the cells that is important. NK activity can be significantly enhanced by natural products or drugs such as IP6 (Inositol hexaphosphate), MGN3 (a commercial rice bran product modified with mushroom extracts), thymus extracts, low dose Naltrexone, zinc, DHEA, glutamine, a good multiple vitamin-mineral over time and others such as astragalus, cordyceps (chinese fungus), and MCP (modified citrus pectin). NK activity can be impaired by surgery and chemotherapy. Moderate exercise does not depress the immune system, but very strenuous exercise does.

Other treatments that have been beneficial include the use of Vitamin C, liver extracts (which promote hepatic regeneration) and Reishi mushrooms. Licorice root, cysteine and glycine together have produced a 40% cure rate. Silymarin (milk thistle) reverses liver cell damage, increases protein level in the blood, lowers liver enzymes and generally improves symptoms such as abdominal discomfort, decreased appetite and fatigue.