Hepatitis - Symptom Management

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Patients are considered cured when there is no evidence of hepatitis C on lab testing for 2 years. For most patients who have a response, viral loads remain undetectable indefinitely. However, some patients can become re-infected after drug therapy.

Patients who develop cirrhosis or liver cancer from chronic hepatitis C may be candidates for liver transplantation. Unfortunately, hepatitis C usually recurs after transplantation, which can lead to cirrhosis of the new liver in at least 25% of patients 5 years after transplantation. The issue of retransplantation for patients with recurrent hepatitis C is a matter of debate.

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Patients with chronic hepatitis C should abstain from alcohol as it can speed cirrhosis and end-stage liver disease. Patients should also check with their doctors before taking any non-prescription or prescription medications, or herbal supplements. It is also important that patients who are infected with HCV be tested for HIV, as patients who have both HIV and HCV have a more rapid progression of liver disease than those who have HCV alone.

Herbal Remedies and Liver Disease

Popular herbal remedies for hepatitis include ginseng, glycyrrhizin (a compound in licorice), catechin (found in green tea), and silymarin (found in milk thistle). However, there is no evidence that these herbs are helpful for hepatitis or other liver diseases.

Milk thistle is the most studied of these herbs and evidence of its benefit has been mixed. Some studies have indicated that milk thistle may help improve liver enzyme levels. However, recent rigorous reviews have found that the herb does not reduce deaths from liver disease caused by hepatitis B or C.

Patients with hepatitis should be aware that some herbal remedies may cause liver damage. In particular, kava (an herb used to relieve anxiety and tension) may be dangerous for people with chronic liver disease. Other herbs associated with liver damage include chaparral, kombucha mushroom, mistletoe, pennyroyal, and some traditional Chinese herbs.