Hepatitis C FAQ
HepCBC - HEPV-L, Febuary 2012
This FAQ is dedicated to the memory of David H. Kehrer, LTC John Heintz (Peters) and his wife Patricia, Daniel Bodiford, Dr. Horst Irmler, Jude Saucier, Capt. Kevin Donnelly, Ron Thiel, ”Uncle Dave” Lang, Guy Thisdelle, “Apache” Pat Davis , Frank Darlington, Dave FitzGerald, Sandra Tara Balduf (Ane Palmo), Herb Moeller, Kelly O’Dell and Bruce Devenne.
Book 1. The Basics
Part 1: Hepatitis C Facts
- 1.0.1 What is Hepatitis?
- 1.0.2 What Are the Different Types of Hepatitis?
- 1.0.3 What Happens in the Body?
- 1.0.4 What is the Incubation Period?
- 1.0.5 How does Hepatitis C Usually begin?
- 1.0.6 What is the Function of the Liver?
- 1.0.7 Hepatitis C (HCV)
- 1.0.7a When was Hepatitis C Discovered?
- 1.0.8 Who gets Hepatitis?
- 1.0.9 How is it Transmitted?
- 1.0.9a How is it NOT Transmitted?
- 1.1.0 HCV and Blood Transfusion
- 1.1.1 HCV and Intravenous Drug Use
- 1.1.2 HCV and IV Immunoglobulin
- 1.1.3 Neonatal Transfer of HCV
- 1.1.4 Other Means of HCV Transmission
- 1.1.4a Sexual Transmission
- 1.1.4b Occupational Exposure (Health Care Workers)
- 1.1.4c Toothbrushes/Razors/Nail Clippers
- 1.1.4d Hemodialysis
- 1.1.5 Highly Speculative Modes of Transmission
- 1.1.5a Tears, Saliva, Urine, Other Body Fluids
- 1.1.5b Cat Scratches
- 1.1.5c Mosquitoes
- 1.1.5d Alternative Medical Procedures
- 1.1.5e Household Transmission
- 1.1.5f Unknown Causes
- 1.1.5g Is HCV Anything Like HIV?
- 1.1.6 Prevention
- 1.1.6a When and How Long Can it be Spread?
- 1.1.6b How Can the Spread of HCV be Prevented?
- 1.1.6c Cleaning Up Blood Spills
- 1.1.6d What to do in Case of an Accidental Needlestick
- 1.1.7 Whom Should I Tell?
- 1.1.8 Can You Get Hepatitis More Than Once?
Part 2: Medical issues
- 2.0.1 How Do I Find Good Medical Care for Hepatitis
- 2.0.2 Hepatologists and Gastroenterologists (see Appendix D for regional list)
- 2.1.0 How is it Diagnosed?
- 2.1.1 Antibody Tests
- 2.1.2 What is a PCR?
- 2.1.2a What is a Genotype?
- 2.1.2b The IL28B Test
- 2.1.3 Could the Test Results be Wrong?
- 2.2.0 Biopsy
- 2.2.0a What is a Liver Biopsy
- 2.2.0b What are the Dangers of Liver Biopsy?
- 2.2.0c Will it Hurt?
- 2.2.1 Chronic Active and Chronic Persistent
- 2.2.2 What Are the Main Symptoms of HCV?
- 2.2.2a Fatigue
- 2.2.2b Right-Side Pain
- 2.2.2c Loss of Libido
- 2.2.2d Red Palms
- 2.2.2e Nausea
- 2.2.2f Brain Fog (Confusion/Forgetfulness)
- 2.2.2g Itching
- 2.2.2h Vision Problems
- 2.2.2i Dizziness
- 2.2.2j Dry mouth
- 2.3.0 It’s Not All In Your Head!
- 2.3.1 What is the Evolution of the Disease?
- 2.4.0 What Other Medical Problems Are Related to HCV?
- 2.4.0a Cryoglobulinemia
- 2.4.0b Thyroid and Autoimmune Problems
- 2.4.0c Rheumatoid Arthritis-Like Symptoms
- 2.4.0d Fibromyalgia
- 2.4.0e Dermatological Manifestations
- 2.4.0f Porphyrins
- 2.4.0g Lichen Planus
- 2.4.0h Peripheral Neuropathy
- 2.5.0 Cycles and Flare-ups
- 2.6.0 Should I be Vaccinated Against Other Types?
- 2.7.0 HCV and Women’s Concerns
- 2.7.1 How Does HCV Relate to Pregnancy?
- 2.8.0 How Does HCV Affect Children?
- 2.9.0 What Are the Different Clinical Indications?
- 2.9.1 Elevated Liver Enzymes
- 2.9.1a Elevated Alpha-Fetoprotein Levels
- 2.9.2 Jaundice
- 2.9.3 Hepatomegaly/Splenomegaly
- 2.9.4 Spider Nevi
- 2.9.5 Ascites
- 2.9.6 Portal Hypertension/Varices
- 2.9.7 Hepatic Encephalopathy
- 2.9.8 Cirrhosis
- 2.9.9 Fulminant Hepatitis
- 2.9.10 Does HCV Increase the Likelihood of Cancer?
- 2.10.0 How Many of Us Are There?
- 2.11.0 Long-Term Prognosis (Am I Going to Die?)
Book 2. The Treatment
Part 3: Conventional Medicine
- 3.1.0 Standard treatment
- 3.1.1 Pegylated Interferon, Ribavirin and a Protease Inhibitor Combined
- 3.1.2 Side effects and other considerations
- 3.1.3 Is treatment worth it?
- 3.1.4 When is interferon treatment not indicated?
- 3.1.5 Interferon Breakthrough, Non-response and Relapse
- 3.1.6 Re-treatment
- 3.1.7 Transplant and post-transplant treatment
- 3.1.8 Spontaneous Clearance
- 3.2.0 Interferons
- 3.2.1 Interferon Monotherapy
- 3.2.2 Pegylated Interferon
- 3.2.2a Pegylated Intron A (Peg-Intron A)
- 3.2.2b Peginterferon Alpha-2a (Pegasys)
- 3.2.3a Consensus Interferon
- 3.2.3b Alferon
- 3.2.3c Omega Interferon
- 3.2.3d Albuferon
- 3.2.3e Belerofon
- 3.2.3f Maxygen
- 3.2.3g Locteron
- 3.2.3h PEG-interferon lambda (IL-29)
- 3.2.3i Glycoferon
- 3.2.3j IFN alpha-2b XL (Medusa IFN)
- 3.2.3k ViraferonPeg
- 3.2.3l Oral Interferon
- 3.3.0 Treatment strategies
- 3.3.1 Dosage
- 3.3.1a Mega Dosing
- 3.3.1b Maintenance Dosing
- 3.3.1c Induction Dosing
- 3.3.2 Early Treatment
- 3.3.3 Longer Treatment
- 3.3.4.Retreatment
- 3.4.0 Iron Reduction Therapy
Part 4: Research
- 4.0.1 Hepatitis C treatments in current clinical development
- 4.1.0 HCV Direct-Acting Antivirals
- 4.1.1 Protease Inhibitors
- 4.1.1a PF-03491390 (IDN-6556)
- 4.1.1b ITMN-191
- 4.1.1c TMC435
- 4.1.1d Vaniprevir (MK-7009)
- 4.1.1e Narlaprevir (SCH-900518)
- 4.1.1f PHX1766
- 4.1.1g BI 201335
- 4.1.1h ACH-1625
- 4.1.1i AVL-192
- 4.1.1j Ritonavir (ABT-450)
- 4.1.1k BMS-791325
- 4.1.1l MK-5172
- 4.1.2 Polymerase Inhibitors
- 4.1.2a R7128, R1626, GS-6130, GS-7851, GS-7977, PSI-938
- 4.1.2b MK-0608, MK-3281
- 4.1.2c Vertex Polymerase Inhibitors
- 4.1.2d Tegobuvir (GS-9190)
- 4.1.2e Filibuvir (FBV-formerly PF 00868554)
- 4.1.2f ABT-333, ABT-072
- 4.1.2g Setrobuvir (ANA598)
- 4.1.2h BI 207127
- 4.1.2i INX-189
- 4.1.2j TMC649128
- 4.1.2k Other polymerase inhibitors of interest
- 4.1.3 NS5A Inhibitors
- 4.1.3a BMS-790052
- 4.1.3b A-689
- 4.1.3c AZD7295
- 4.1.3d PPI-461 and PPI-668
- 4.1.3e Achilllion’s NS5A Inhibitor
- 4.1.3f IDX719
- 4.1.4 Other Direct-Acting Antivirals
- 4.1.4a Helicase Inhibitors
- 4.1.4b IRES Inhibitors
- 4.1.4c RNAi-Based Antisense Therapies
- 4.1.4d Entry Inhibitors
- 4.1.4e Cyclophilin Inhibitors
- 4.1.4f BIT225
- 4.1.5 Direct-Acting Antiviral Combos
- 4.1.5a Protease-Polymerase Combos
- 4.1.5b Danoprevir + Ritonavir + PegIFN/RBV
- 4.1.5c Clemizole
- 4.1.5d BMS-790052 Combos
- 4.1.5e GS-7977 + PSI-938
- 4.1.5f ABT-450 + ABT-333
- 4.1.5g IDX184 + IDX375
- 4.2.0 Other Therapies
- 4.2.1 Taribavirin (Viramidine)
- 4.2.2 Zadaxin (Thymosin)
- 4.2.3 Amantadine
- 4.2.4 Alinia (Nitazoxanide)
- 4.2.5 Celgosivir (MX-3253)
- 4.2.6 HCV Monoclonal Antibodies (mAb’s)
- 4.2.7 Toll-like Receptor Agonists IMO-2125, ANA773, SD-101
- 4.2.8 Interferon Alpha Gene Therapy
- 4.2.9 Oglufanide
- 4.2.10 NOV-205
- 4.2.11 JKB-122
- 4.2.12 CB5300
- 4.2.13 MitoQ
- 4.2.14 CTS-1027
- 4.2.15 Interleukins
- 4.2.16 UDCA (ursodeoxycholic acid)
- 4.2.17 Rosiglitazone
- 4.2.18 CF102
- 4.2.19 SCY-635
- 4.2.20 Fluvastatin
- 4.3.0 Vaccines
- 4.3.1 ChronVac
- 4.3.2 Chiron Vaccine
- 4.3.3 Chimigen
- 4.3.4 VIDO Vaccine
- 4.3.5 Toray Vaccine
- 4.3.6 TG4040 Vaccine
- 4.3.7 Intercell vaccine IC41
- 4.3.8 Kurume peptide vaccine
- 4.3.9 Tarmogen (GI-5005)
- 4.4.0 Hepatitis C Treatments in Current Clinical Development
Part 5: Alternative Medicine
- 5.0.0 Known Herb-Drug Interactions
- 5.0.1 Acupuncture
- 5.0.2 Chiropractic
- 5.0.3 Energy Healing
- 5.0.4 Reflexology
- 5.0.5 Homeopathy
- 5.0.6 Reticulose
- 5.0.7 Traditional Chinese Medicine (TCM)
- 5.0.8 Ozone Therapy
- 5.1.0 Herbal Treatments and Vitamins
- 5.1.1 Kombucha Tea
- 5.1.2 Reishi/Shitake Mushrooms
- 5.1.3 Dandelion
- 5.1.4 Milk Thistle
- 5.1.5 Artichoke
- 5.1.6 Licorice Root
- 5.1.7 Spirulina
- 5.1.8 Garlic
- 5.1.9 Thymic Factors
- 5.1.10 Vitamin C
- 5.1.11 Vitamin B12
- 5.1.12 Vitamin E
- 5.1.13 Natural Interferon Boosters
- 5.1.14 Other Herbs or Vitamins
- 5.1.15 Grapefruit
- 5.1.16 Water
- 5.2.0 Exercise
- 5.3.0 Stress Management
- 5.4.0 Positive Attitude
- 5.5.0 Tai Chi/Chi Kung/Yoga/Meditation
- 5.5.1 Tai Chi
- 5.5.2 Yoga
- 5.6.0 Other Ways to Keep Yourself Healthy
Part 6: Nutrition
- 6.1.0 What Should I Do About Nutrition?
- 6.1.1 Foods to Avoid
- 6.2.0 Nutrition and Cirrhosis
- 6.3.0 Coffee, Tea, Caffeine and Other Stimulants
- 6.4.0 Salt
Book 3. Living with HCV
Part 7: Drugs and Alcohol
- 7.1.0 Alcohol
- 7.2.0 Tobacco
- 7.3.0 Marijuana
- 7.3.1 Cocaine
- 7.4.0 What are the Effects of Recreational Drugs?
- 7.4.1 Intravenous Drug Use Precautions
- 7.4.2 Cleaning Syringes
- 7.4.3 Methadone
Part 8: How can HCV affect my emotional life?
- 8.1.0 How is Depression Related to Hepatitis?
- 8.2.0 Dealing with a Chronic Disease
- 8.2.0a Accepting
- 8.2.0b Dealing with a Lower Level of Energy
- 8.2.0c Irritability
- 8.3.0 How Can HCV Affect My Sex Life?
- 8.4.0 Helping a Friend with Hepatitis C
- 8.4.0a What Can I Say?
- 8.4.0b What Shouldn’t I Say?
Part 9: Living with HCV
Part 10: Dealing with interferon therapy
- 10.1.0 General Tips From Merck
- 10.2.0 How Does Interferon Work?
- 10.2.1 What Will Interferon Achieve?
- 10.2.2 Clinical Trials
- 10.2.3 Will I Be Able To Continue Work?
- 10.2.4 How Will I Know If The Interferon Is Working?
- 10.3.0 Importance of Water
- 10.4.0 Timing of Injections
- 10.5.0 Traveling With Interferon
- 10.6.0 What do I do when I Can’t Afford the Interferon
- 10.7.0 Side Effects
- 10.7.0a Nausea
- 10.7.0b Hair Loss
- 10.7.0c Fatigue
- 10.7.0d Mouth Problems
- 10.7.0e Infections
- 10.8.0 Injection Hints
- 10.9.0 Help! I Think I Hit a Vein!
Part 11: Employment and disability
- 11.1.0 Income Security: Job and/or Disability Benefits
- 11.1.1 How Do I Handle Problems About My Job?
- 11.1.2 Problems in Seeking Disability Benefits
- 11.1.3 Applying for SSI/SSDI
- 11.1.4 Winning Your Social Insurance Claim: 15 Mistakes You Cannot Afford to Make
- 11.1.5 Applying for Disability in British Columbia
Part 12: Important information
- 12.1.0 What Else is Important to Know about HCV?
- 12.2.0 HCV Information Resources and Support Groups
- 12.2.1 USA
- 12.2.2 Canada
- 12.2.3 Argentina
- 12.2.4 Australia
- 12.2.5 Austria
- 12.2.6 Belgium
- 12.2.7 Bulgaria
- 12.2.8 Columbia
- 12.2.9 Croatia
- 12.2.10 Egypt
- 12.2.11 France
- 12.2.12 Germany
- 12.2.13 Israel
- 12.2.14 Italy
- 12.2.15 Netherlands
- 12.2.16 New Zealand
- 12.2.17 Poland
- 12.2.18 Portugal
- 12.2.19 Romania
- 12.2.20 Russia
- 12.2.21 Spain
- 12.2.22 Sweden
- 12.2.23 Uruguay
- 12.2.24 United Kingdom
- 12.2.25 Others
- 12.3.0 HCV Resources on the Internet and Usenet
- 12.4.0 Bibliography: Suggested Reading
- 12.5.0 Newsletters, Magazines and Videos
APPENDIX A: Where can I get the current version of the FAQ?
APPENDIX B: Common Abbreviations and Medical Terms
APPENDIX C: Some Recommended World Wide Web Sites
APPENDIX D: A List of Canadian Doctors Specializing in the treatment of HCV
APPENDIX E: History of Blood Safety, Canada’s Track Record, and Compensation Issues
APPENDIX F: The Double Challenge of HIV/HCV Co-infection
APPENDIX G: What is a Clinical Trial?
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NOTE. Please remember that the above is not medical advice. It is opinions, mostly from different members of this Listserv. Always see your doctor, before trying anything unusual.
HepCBC/HEPV-L Hepatitis C FAQ copyright 1996-2012 by Dr. C.D. Mazoff, PhD, squeeky@pacificcoast.net, Patricia Johnson, hepvl@comcast.net, and
Joan King.
info@hepcbc.ca
www.hepcbc.ca
Go soothingly on the greasy mud, for therein lies the skid demon. - Chinese Road Sign
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