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

 

Mom, coffee, and hepatitis C fibrosis

A recent study told me something I could have learned from my mother. My mother is 97 years old. She’s thin and spry. She tells jokes and does card tricks that baffle onlookers. The odd thing is that there’s nothing in her diet that would suggest great health, wits, and longevity. She eats very little and a lot of what she eats is processed food. Her favorite meal is canned soup.

But my mother’s favorite drink has hit the good-for-your-liver chart. She drinks coffee with every meal and between meals. Her coffee maker always holds a warm brew. The dozen or so cups she drinks each day may be too much for most of us, but a recent study has shown at least some coffee may help stave off liver fibrosis.

In the journal Clinical Gastroenterology and Hepatotogy researchers Natalia Khalaf, Donna White, and others studied veterans who have hepatitis C. They found that those with a higher intake of coffee showed less fibrosis. The researchers concluded that as little as 100 mg. of caffeine a day may protect against advanced advanced fibrosis in people who have hepatitis C. An eight-ounce cup of coffee contains 95-200 mg of caffeine.coffee

Let’s all join my mother in a toast for better liver health–with a good cup of coffee!

Blog writer (me) writes a post for another hep C blog

I just wrote a post for this blog: HepatitisC.net. The blog covers diagnosis, treatment, symptoms, and how to deal with life when you have hep. I’ve taught workshops on writing plain English, and I was impressed by the writing in HepatitisC.net. It explains the complexities of hepatitis C in clear, concise language. There are hundreds of hep C blogs out there. This one is worth reading.

Chinese Medicine and hepatitis C

I just spoke with an amazing woman from San Francisco. Misha Cohen is an acupuncturist and practitioner of Chinese Medicine. Misha studied acupuncture at Lincoln Hospital in New York City and went on to study in San Francisco and establish a practice there. She wrote The Hepatitis C Help Book with Dr. Robert Gish, hepatologist and recipient of a Humanitarian of the Year award for his work with Vietnamese people infected with hepatitis B.

Misha advocates a combination of Western and Eastern medicine for dealing with hepatitis C. “It takes a very strong medicine to clear the virus,” she says, and there’s no conclusive evidence that herbs or other alternative medicine can do it. She advises hep C patients to proceed with anti-viral treatment through accomplished hepatologists.

In addition, she says, it’s tremendously helpful for patients to follow Chinese methods while undergoing treatment and after the virus is cleared. Chinese medicine can improve blood circulation through the liver and can calm the patient, she says. This can help a virus-cleared liver to regenerate. Also, Chinese medicine could help stabilize a cirrhotic liver after treatment, she says.

“I think we can help a substantial number of people,” she says, but adds that she can only guide her patients toward better health. “They are doing a huge amount of work on their own. Every single day of their lives.”

I found just talking to Misha helpful. My virus has been cleared, but I have to live with my liver for the rest of my life. Chinese medicine could make it longer.

Check out Doc Misha’s Chicken Soup Chinese Medicinechicken soup

Ontario approves hepatitis C drugs

This week has seen some big developments in drug availability in Canada. I mentioned in my last post that B.C. had approved Harvoni and Solvaldi for hepatitis C treatment. Ontario followed suit today.

When I heard the news I was writing a profile of Dr. Curtis Cooper, director of the Ottawa Hospital and Regional Hepatitis Program. It seems that the Ottawa Citizen scooped me on the drug news by two hours and included some comments from Dr. Cooper. Here’s the article. 

As for the profile, it will be in my book, to be published in fall 2016. That’s a long wait but less of a wait than we’ve had for these miracle cures.

Those acronyms in hep C virological response — what they mean

This coming week I will be getting my six-month viral count, which should determine whether my hep C has been cured. I’m confident I’ll achieve SVR. That’s because I had an RVR, an EVR and an ETR. Here’s what all those acronyms mean:

RVR: Rapid virological response means that hep C RNA is undetectable after 4 weeks of treatment.

EVR: Early virological response means the virus is undetectable after 12 weeks of treatment.

ETR: End of treatment response means no hep can be found in the blood at the end of treatment, which used to be 6 months to a year. Now, it’s often 12 weeks or less, so EVR and ETR could be determined by the same test.

SVR: Sustained virological response means the viral RNA can’t be found 6 months after treatment.

I’m hoping for SVR, and I have a good chance of it. Researchers say achieving an RVR is a predictor of treatment success. I’ll write more on this in the next post. In the meantime, I welcome comments on how your acronyms have been going.

A hockey hero who tackled hepatitis C

"Billy" Demish plays hockey in Medicine Hat. This photo was taken a few years ago when Bill was in his mid-70s, playing for an old timers team.

“Billy” Demish plays hockey in Medicine Hat. This photo was taken a few years ago when Bill was in his mid-70s, playing for an old timers team.

Last night I had the pleasure of talking with Bill Demish. Bill is a hero. Heroes, in my book, are people who have endured hepatitis C, health professionals and advocates who support the hep C community, and in particular, people who went through treatment with interferon. Bill went through treatment twice with the dreaded drug.

A hockey injury in 1986 led to his infection. He took a hard fall that caused internal bleeding. That led to a transfusion. Fifteen years later he received a letter suggesting he get tested for hepatitis C. Bill learned he had hep, was treated twice before he was cured, and was left with cirrhosis. He was among thousands of Canadians who were part of the class action suit against the Red Cross, the Government of Canada, and the provinces, which were accused of allowing transfusions of tainted blood.

Bill received a small settlement from the law suit. Although the deadline for initial claims is over, if you have just learned of your infection, you can still make a claim.

A hepatitis C treatment picture that’s worth 1,000 words

I’ve just heard from Deb Schmitz, operations/program manager at the Pacific Hepatitis C Network. She sent me a link to the network’s treatment site. It’s the best I’ve seen that summarizes the newest hep C drugs. An expandable sidebar shows a visual list of treatments, along with the steps in the drug approval process in British Columbia. Helen Platt of Charged Multimedia created the graphics.

I won’t write much more because the pictures on the site are worth 1,000 words. Check it out: Hepatitis C Treatment Information Project.*

By the way, I’d welcome comments from anyone who has seen such a site in the United States. I haven’t been able to find one.

* Also posted on the Links page.

Lessons I learned at the Banff symposium on hepatitis C

Sometimes you get so bombarded with knowledge that it’s hard to sort out. A few days after the Banff symposium, I’m still sorting things. But one piece of information jumps out. Developments in HCV treatment are occurring so quickly that no one, not even health professionals, can keep up with all of the fine details. But they do their best to fill their minds with hepatitis C knowledge at events like the one I just attended.

That brings me to the point of this post: when I see more than 200 nurses, doctors, and researchers attend a conference that is packed with scientific information, I get a sense that there are people out there who are firmly dedicated to curing hepatitis C. The 4th Canadian Symposium on Hepatitis C took place on a sunny weekend in the glorious town of Banff, amid the chiseled-top Rockies in Banff National Park. Not one person out of the many dozen I spoke with was willing to forgo a day of the weekend hepatology conferences–there were more than one–to ski Lake Louise or to traipse over to the hot springs just up the road from the conference centre.

I got a sense that the attendees were yearning for every bit of knowledge they could grab. I also get a sense that they would cheer if hepatitis C were eradicated from the earth. These are very smart people; they could get new jobs in an eye blink.

Take the nurses, for example. According to Curtis Cooper, director of the Ottawa Hospital Viral Hepatitis Program, “In the old days nurses’ main responsibilities were trying to get patients through the awful side effects (of interferon).”

With the new anti-virals, most of those side effects are gone. In my treatment with simeprevir and sofosbuvir, I had a tiny tummy ache for three or four days, much less than I get from antibiotics.

But as Magdalena Kuczynski from the Toronto Western Hospital pointed out, nurses are as necessary as ever. Several attendees expressed concerns about people who fail to achieve a 12-week SVR even with the new one-pill, non-interferon regimens. Although trials have achieved upwards of 96% (and even 100%) cure rates, things could change. Once the drugs move out of trials and patients have less guidance from nurse practitioners, they could become over-confident. Adherence to drug-taking schedules could falter, and SVR rates could drop.

Moreover, researchers at the conference didn’t see an end to the disease coming soon.  Dr. Rob Myers recently moved from teaching in the Liver Unit at the University of Calgary to working as senior director in the Liver Diseases Therapeutic Area of Gilead Sciences, Inc. As one of the foremost researchers in hepatitis C, he predicted the disease could (note the italics) be eradicated within 20 years. That’s a long time for people facing serious liver disease, but Meyers pointed out that the prevalence of hepatitis C is starting to decline.

Meanwhile, Daryl Luster, president of the Pacific HepC Network, warned that we are living in an age of austerity. “I hear that our health system will collapse if we come forward and treat everyone with a hep C diagnosis,” he said.

But eventually health care could indeed treat everyone. Dr. Sharon Hutchinson, from Glasgow Caledonian University, demonstrated that Scotland has been moving toward that goal much quicker than Canada. Canada treats only 1.4% of it’s hepatitis C cases each year, while Scotland treats 3%. Either of those percentages seem tiny, but as more people learn they have hepatitis C, more are bound to get treatment.

The big message for Baby Boomers is to get tested.

Treatment or planes? Debate stirs up symposium

I said I’d let you know the outcome of a debate that took place at the 4th Canadian Symposium on Hepatitis C in Banff, Alberta. Two eloquent researchers defended opposing sides of the proposition, “Be it resolved that new HCV treatments should only be used on the sickest patients (F2 and above).” Judged by a strong round of audience applause, the “no” side won.

At the 4th Canadian Symposium on Hepatitis C, keynote speaker Dr. Mark Sulkowski from John Hopkins University talks about clinical trials of hep C drugs. Next to him is Dr. Curtis Cooper. Dr. Jordan Feld is on the right.

At the 4th Canadian Symposium on Hepatitis C, keynote speaker Dr. Mark Sulkowski from John Hopkins University talks about clinical trials of hepatitis C drugs. Next to him is Dr. Curtis Cooper. Dr. Jordan Feld is on the right. –photo by Al Hyland

This was a heartening result for a serious topic, but the debate was less than serious.  The organizers wisely decided that attendees needed a respite from brain-straining presentations about cutting-edge research and public health.

The debaters were Dr. Curtis Cooper, an associate professor with the University of Ottawa and director of the Ottawa Hospital Viral Hepatitis Program, and Dr. Jorden Feld, a gastroenterologist, assistant professor, and scientist at the University Health Network in Toronto. Both have many more designations and could also claim spots on The Last Comic Standing.

They hurled facts at each other, and meanwhile threw barbs at their opponent. Cooper warned the audience, “I might lie. All with the goal of winning this debate.”

But in the end he lost. Cooper noted that treatment for everyone with HCV would cost $15 billion, which Canada couldn’t afford. But Jordan suggested that the government take a second look at spending $56 billion on defense aircraft. “Do we really need these planes?” he asked. “If we took away just two of them we could pay for all the hepatitis treatment in Canada.”