Hepatitis B--Treatment,
Treatment: Acute Infection
At present, there are no specific treatments for benign acute viral hepatitis. Current therapy should be aimed to support and to maintain comfort. As with most forms of hepatitis, alcohol consumption should be minimized, if not eliminated altogether. This helps the liver recover. Use of adrenocorticosteroi ds, recommended by some, appears to have no effect curing the underlying disease. Furthermore, it appears that use of steroids in early treatment of hepatitis B virus (HBV) infection may result in the development of a persistent infection. Therapeutic effectiveness of interferon use on the prognosis and course of acute HBV infection remain unknown.
Treatment: Chronic Infection
A number of elements has been used in the treatment of chronic HBV. The goals of treatment are three-fold: to eliminate infectivity and transmission of HBV to others, to arrest the progression of liver disease and improve the clinical prognosis, and to prevent the development of hepatocellular carcinoma (HCC).
Currently, there are several treatments being used. Interferon alpha use is most common, but now lamivudine (3TC), and others are being looked at as potential therapeutic agents. Combinations of antiviral drugs are being used with some success.
Antivirals: The following list includes those which are still in their experimental stages.
1. Acyclovir (Zovirax, Glaxo Wellcome)
2. Adefovir Dipivoxil (GS 840 - Gilead Sciences Inc)
3. Adenine Arabinoside (ARA-AMP)
4. Famciclovir (Famvir - SmithKline Beecham)
5. Ganciclovir (Ganciclovir IV-Roche-Syntex)
6. Lamivudine (3TC, Epivir, Zeffix - Glaxo Wellcome PLC)
7. Lobucavir - Bristol-Myers Squibb
8. N-Acetyl-Cysteine
Immune System Modulators:
1. Hepagene - Medeva
2. Interferon Alpha
3. Thymosin Alpha (Zadaxin - SciClone Pharmaceuticals)
Mixed Treatments:
1. Interferon Alpha + Famciclovir
2. Thymosin Alpha (Zadaxin) + Famciclovir
3. Thymosin Alpha (Zadaxin) + Lamivudine
None of these treatments can be called a cure. A true cure for this disease still remains elusive.
Alternative Treatments
Since there is no cure, many individuals have sought other sources of therapy for their damaged liver. Though many swear by these alternative treatments, they should be taken with caution. One should remember that though these alternative treatments come from natural sources, harmful side-effects may also follow. Most alternative treatments do not target the virus. They typically boost the liver's health.
1. Dandelion Root
2. Liquorice Root
3. Milk Thistle (Silymarin)
Selenium
4. Vitamin E
Healthy Diet
Eating a balanced and healthy diet will minimize any excess damage done to an infected liver and may even expedite liver recovery. It should be remembered that virtually everything we eat must pass through the liver.
1. Eat a well balanced and nutritious diet (i.e. food from each of the food groups).
2. Cut down on the intake of deep-fried and fatty foods.
3. Minimize or abstain (if possible) from alcohol consumption. Alcohol is detoxified by the liver and excessive alcohol consumption results in additional levels of liver damage.
4. Minimize your consumption of smoked, cured, and salted foods. Try using alternative seasonings when cooking (e.g. lemon juice, onion, vinegar, garlic, pepper, cloves, etc.).
5. MEAT, FISH, POULTRY & ALTERNATIVES TO MEAT provide protein, vitamin A, iron, vitamin B12, niacin, fiber, and thiamin. However, it has been stated by many physicians that consumption of meat and seafood should be reduced since digesting/processin g these forms of food can further tax the liver.
6. BREAD & CEREALS provide carbohydrates, niacin, thiamin, riboflavin, and fiber.
7. FRUITS & VEGETABLES provide vitamin A, vitamin C, fiber, and folacin.
M8. ILK & MILK PRODUCTS provide calcium, riboflavin, niacin, folacin, vitamin A, and vitamin B12..
8. Increased intake of high-fiber foods (i.e. fresh fruits and vegetables, whole grain breads, rice, and cereals) is especially helpful in keeping one healthy.
9. Avoid uncooked or partly cooked food such as marjnated meat since it may carry harmful bacteria
Liver Transplants
Liver transplants are sometimes required by those with extensive liver damage due to viral (or non-viral) causes. However, there are many factors to consider before getting a liver transplant. First and foremost, transplantation is a complex operation that requires a suitable donor. Also, there is usually a long waiting list for those wishing to receive a transplant. Moreover, transplanting a liver into a chronically hepatitis B infected individual presents the likelihood that the newly transplanted liver may become reinfected unless certain preventive measures are taken like Hepatitis-B immunoglobin. Transplant operations tend to be relatively expensive procedures. Not all hospitals may be able to perform such an operation.Despite these problems, for some individuals, liver transplants may offer the only hope for a healthy life.
New Therapy of Hepatitis-B.
SciClone Pharmaceuticals today announced that results from the Company's Taiwan phase 3 trial published in Hepatology (May 1998) demonstrate that ZADAXIN(R) thymosin alpha 1 is effective and safe in the treatment of chronic hepatitis B. Importantly, the ZADAXIN complete virologic response rate (the conversion from both hepatitis B virus positive to negative and hepatitis B e antigen positive to negative) in the study continues to increase even when measured one year after the end of treatment.
The publication on the study's primary site data, written by Professor Yun-Fang Liaw, M.D. and his colleagues of the Chang Gung Memorial Hospital, Taiwan, included 98 Asian patients with chronic hepatitis B. At the start of the study, patients were randomized to receive 1.6 mg of ZADAXIN two times per week for 26 weeks, 52 weeks or no treatment. Patients were followed for a total of 18 months.
The publication highlights that patients receiving ZADAXIN showed:
Statistically significant increase in conversion from both hepatitis B virus positive to negative and hepatitis B e antigen positive to negative.
At the end of the study, 40.6% of patients receiving 1.6 mg of ZADAXIN twice per week for 26 weeks tested negative for both hepatitis B virus and hepatitis B e antigen (an immune response to the hepatitis B virus that can indicate long lasting remission of the disease) compared to 9.4% of patients in the control group, a statistically significant result (p=.004).
Statistically significant histological improvement. Patients responding to ZADAXIN showed statistically significant improvement in liver histology (inflammation of the liver) (p<.05), consistent with the ultimate goals of therapy for hepatitis B -- to prevent progression to serious liver disease, including liver cancer and cirrhosis
Experienced no significant side effects.
Professor Liaw and his co-workers, commenting on this recent Hepatology article, said: ``Thymosin alpha 1 is safe and effective in the treatment of chronic hepatitis B. The thymosin alpha 1 response rate is statistically significant in the six month treatment group when compared to control. It also reduces liver inflammation. Thymosin alpha 1 therapy offers renewed hope in the fight against chronic hepatitis B.''
Hepatitis B is a potentially deadly liver disease and one of the most common causes of death in the world. According to the World Health Organization, approximately 350 million people, or 5% of the world's population, are chronic carriers of the hepatitis B virus in their blood. These carriers of the hepatitis B virus have a 200-fold increased chance of developing serious liver disease, including liver cancer, the most common cancer in the world, and cirrhosis. Currently, ZADAXIN and interferon (a drug that produces a sustained response in less than one third of Asian patients treated and causes debilitating side effects) are the only established therapies for hepatitis B in certain Asian markets, including the People's Republic of China.
SciClone markets ZADAXIN in the People's Republic of China, the Philippines and Singapore for the treatment of hepatitis B. The drug also has been approved in Peru and Kuwait for treatment of hepatitis B and in Argentina and Italy as an influenza vaccine adjuvant. SciClone's exclusive Japanese partner, Schering-Plough K.K., recently launched a Phase 3 study of ZADAXIN in Japan for hepatitis B. SciClone has 18 ZADAXIN hepatitis B marketing applications pending in Asia, Latin American and the Middle East. SciClone intends to file a ZADAXIN hepatitis B marketing application in Taiwan during the second quarter.
SciClone Pharmaceuticals, Inc. is an international biopharmaceutical company that acquires, develops and commercializes specialist-oriented drugs for treating chronic and life-threatening diseases, including hepatitis B, hepatitis C, cystic fibrosis, cancer and immune system disorders.
Hepatitis B Carrier Fact Sheet.
Hepatitis B Virus infects the liver. The virus is in blood, semen, menstrual blood and other body fluids.5 to 10% of adults and about 90% of babies who get hepatitis B will go on to "carry" or keep the virus for the rest of their lives. These people are called "hepatitis B Carriers". They may not be sick, but they can pass the virus on to others and make others sick with hepatitis B.
People who are hepatitis B carriers can lead normal, healthy lives Most hepatitis B carriers do not feel sick or look sick. However, carriers have a higher risk o becoming sick with liver disease and liver cancer. Carriers need to have the regular care of the doctor.
There are simple ways that hepatitis B carriers can stay healthy.
1.Do not drink alcohol, it can damage the liver.
2. Tell your doctor that you are a hepatitis B carrier; ask about any treatment or tests that might help.
4.Ask a doctor before taking any medicine, even herbal medicines or medicines that can be bought without a prescription (aspirin, for example)
5. Do not inject (shoot) drugs. This makes it easier to get two other types o hepatitis (hepatitis C & D) which also damage the liver. Get help form a drug treatment center to get off drugs.
6. Get vaccinated against hepatitis A. (different viral infection.)
There are things carriers can do to keep form infecting other with hepatitis B
1. The people who are in danger of getting hepatitis B infection from a carrier are people in close contact with the carrier. Anyone who has contact with blood, semen, or other body fluids of a carrier is a "close contact". Examples of close contacts are sexual partners, people living in the same hose as the carrier, and babies born to women who are carriers. Carriers should tell close contacts about their infection.
2.Pregnant women who are hepatitis B carriers should tell their doctor about their infection. It will be important to give the new baby shots after it is born to protect it form getting hepatitis B. it is okay to breastfeed if the baby is getting shots to protect it from hepatitis B.
3. Hepatitis B carriers who have sex should use a latex condom every time they have sex
4. Never share syringes or needles for ear and body piercing or for shooting drugs
5. Never donate blood, plasma, body organs, tissue or sperm, if you are a hepatitis B carrier.
People who are not close contacts are not at risk for getting hepatitis B. carriers do not have to talk about their infection with anyone that is not a close contact. It is okay to share meals with family and friends.
Vaccination and good hygiene can protect close infection with hepatitis B
1. There is a test to see if a person has beeninfect4ed with the hepatitis B virus. Close friends should see a doctor for this test.
2. A vaccine (shots can be given to protect people from getting hepatitis B. close contact should see a doctor to get these shots.
3. Never share anything that may have come in contact with the blood or body fluids of a carrier. Examples of things that should not be shared are cigarettes, toothbrushes, razors, scissors, nail files, or clippers.
4. Cover all cuts, blisters and open sores with a bandage.
5. Wash hands well, especially after touching blood
6. Wash and wipe up blood cells. Clean the area using a mixture of household bleach and water (1 ½ cups of bleach in a gallon of water) to kill the hepatitis B virus.
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