Cured of hepatitis C? Watch your cholesterol

Hepatitis C may have done one good thing for me. It may have lowered my cholesterol for a while–or maybe being cured ramped it up.

In a 2009 study from Massachusetts General Hospital, researchers found that a significant number of people who are cured of hep see their LDL (low density lipoprotein, known as bad cholesterol) “rebound to levels associated with increased coronary disease risk.” That seems to have happened to me. My cholesterol was on the low side of normal before my treatment, but after the virus cleared it jumped into the danger zone. Here’s a chart I obtained from my ehealth, a website that reports on patients’ medical tests in British Columbia:

The chart shows an early 2014 blood test I had  before I was treated with direct-acting antivirals that summer. The next three dots on the chart show my bad cholesterol after my treatment and cure.

I may have inherited a propensity to high cholesterol from my dad. He died of heart failure, and I have no other risk factors. Perhaps, as research suggests, hepatitis C may have lowered or stabilized my inherited build up of cholesterol. The liver eliminates cholesterol through bile, and the liver changes after treatment. There’s a possibility that my liver, which regressed from fibrosis, never regained strength in cholesterol clean-up.

I’m no longer worried about my liver, but I’m worried about my heart. It’s time to get out and exercise, get rid of fatty food, and keep on top of this new health risk. Those who have been cured of hepatitis C still need to be tested–for cholesterol.

 

Two T’s and the liver

Most people who learn they have hepatitis C become more conscious of what they put into their bodies, especially the substances that are good or bad for the liver.

tumeric and tumeric roots

Tumeric powder comes from a root.

Today I’m thinking of one good and one not-so-good substance, both beginning with the letter T: turmeric and Tylenol. I’m thinking of turmeric because I am replenishing my spice shelf and have come to regard the yellow spice as one of nature’s gifts for liver health. As for Tylenol, after having been cured of hep C for two years, I’m thinking of trying it again.

Tumeric powder, which I use as a spice, comes from the root of the turmeric plant. You can grow it in your garden and keep it there through the winter, if it doesn’t get too cold. Tumeric stays hardy in zones 7b – 11. In the summer, it will grow white, tropical-looking flowers.

Studies have shown that turmeric tends to raise HDL (good cholesterol), which reduces LDL (bad cholesterol) and the strain it puts on the liver. A German study in the medical journal Gut concluded that turmeric inhibits the hep C virus from entering liver cells. My hep is gone, but cholesterol threatens my heart, so I will keep using turmeric. Also, I like its taste in cooking.

Tylenol, which has been shown to be safe for the liver in doctor-recommended doses, can injure the liver with indiscriminate use. Tylenol overdose is among the leading causes of liver failure, and the amount that would cause overdose may not be the same for everyone. Before I was diagnosed with hepatitis C I noticed that Tylenol upset my stomach, so I asked my doctor for other drugs for pain relief. That was lucky for me. Even if Tylenol would have done me no harm, I would have been worried about it throughout my treatment.

Now that I’m better and my liver has regressed, my doctor says there’s nothing wrong with Tylenol. For normal aches and pains that I’d rather avoid, I’m considering it.

Liver help flows through a filter

I wrote last year that coffee can help fend off liver damage. The latest recommendation from researchers is that the brew should flow through a filter.

coffee-filter

Dr. David A. Johnson explained in a recent post on Medscape that coffee has long been known for its ability to slow the onslaught of liver disease. Recent studies show that brewed, filtered, caffeinated coffee has the best effect.

As coffee seeps through a filter, much of its kahweol and cafestol, organic compounds that raise cholesterol, remain with the grounds. The pot fills with a healthier brew.

Dr. Johnson recommends that people with hepatitis C be treated for their disease. While waiting for treatment they should drop alcohol entirely and replace it with at least three cups of coffee per day. He says he guarantees than none of your favorite coffee shops will ask for prior authorization.

Occasional alcohol after hepatitis C

Since my hepatitis C cleared after treatment with direct-acting antivirals, my liver went back to normal. My alcohol habits regressed somewhat too. I stopped drinking entirely when I was infected with hep, but now I’ve gone back to drinking a glass or two of wine on the weekend or when guests come by for dinner. Still, I remain wary about alcohol. I usually enjoy my beverage as a spritzer: half wine, half soda water.

circle and slash over beer mugs mean no drinkingFor those whose hep is yet to be cured even that much alcohol can accelerate the rate of liver damage. By how much? It’s impossible to predict. Yet some averages are known:

According to the U.S. Department of Veterans Affairs, the average man who is infected at age 40 or later and drinks a lot can expect a cirrhotic liver in thirteen years. The slowest progression occurs among non-drinking women under 40 who contract the disease early. It can take 40 years before their disease turns deadly.

But again, those are averages and everyone is different. The best bet for anyone who has hep is to drink no alcohol at all. For those who have been cured, be very cautious.

 

Black licorice and hepatitis C


I’ve always loved black licorice. My family, who prefer chocolate, thinks my craving for the black, rubbery treat is odd, but being nice people, they often bring me licorice for birthdays and other celebrations. It turns out that licorice may be good for people with hepatitis C. My sweet tooth for the treat may have fended off the worst of the disease.liquorice all sorts

The U.S. Department of Veterans Affairs says there’s evidence that licorice root (the flavoring in most black licorice candies) may reduce liver damage in people who have hepatitis C. Glycyrrhizin, an acid that gives licorice its sweetness, may help prevent liver cancer, the department says in its website.

A study in the Journal of Viral Hepatitis that tested glycyrrhizin on patients with hepatitis C found significantly lower ALT levels and inflammation among test patients.

Veterans Affairs warns, though, that licorice root supplements may lead to high blood pressure and ascites (a build up of fluid in the abdomen), which can increase with cirrhosis. It can also be harmful to eat the candy. According to the Federal Drug Administration, eating two ounces of black licorice per day for two weeks straight can disrupt your heart beat and send you to the hospital.

If you are considering taking licorice root extract, first ask your doctor. As for me, on special occasions I still eat twisters.licorice

 

Valentines and Hepatitis Testing

With Valentine’s Day approaching, I’ve been thinking about the man I love and how I’m happy that in our 32-year relationship, he stayed free of HCV. I didn’t know I had it until last spring, and once I did he got tested. So did my daughters. Everyone was free and clear—except me.

Now I’m probably free and clear. I’ll get my final viral count in March, and the virus has been non-detectable since August. But even though my family didn’t contract hepatitis C, I’m wondering about the decade before I met my husband. Did I infect anyone? I wasn’t celibate.heart

In one of the earliest studies of transmission between heterosexual partners, researchers at the Red Cross Blood Bank in Amsterdam, Netherlands, found absolutely no transmission from persons with HCV to their sexual partners. They tested 50 heterosexual couples who had a median relationship duration of 13 years.*

In another study, published in 2004 in The American Journal of Gastroenterology, not one of 776 persons with HCV who remained monogamous for 10 years, transmitted the virus to their heterosexual partner. The couples did not use condoms, which would reduce transmission. They didn’t engage in anal sex or sex during the woman’s period, which might increase transmission. Three of the partners contracted HCV, but the gene sequence of their virus was different from their partner’s. That means they must have contracted their virus from some other source.

Still, some sex is risky, and studies show that sex with multiple partners is riskier. On Valentine’s Day that’s a lot to think about. It would be hard to locate a person you hooked up with for a week, some 35 years ago, and according to the studies, it’s extremely unlikely the virus would have spread. But urging your partner to be tested, no matter what, will get rid of that teeny-tiny doubt. If your partner is a Baby Boomer, he or she should be tested in any event. After my husband got his results, he smiled and life went on as usual.

* The studies referred to on this page are listed in the Readings page.