Co-Infections and Super-Infections of Viral Hepatitis



When a patient with one type of viral hepatitis is infected with different type of hepatitis virus at a later time, it is called a super-infection. (An HCV patient who later acquires HAV for example)

If two different types of hepatitis viruses infect the patient at the same time, it is called a co-infection. (A patient that is infected with HCV and HBV for example)

Co-infections or super-infections with a non-hepatitis virus are also possible, and for HIV population, it is quite common due to the similarities of the infection route. (About 40% of patients with HIV are co-infected with HCV.) For these conditions, the clinical symptoms and disease courses are usually more complex and serious than a single viral infection case.

Although super or co-infections can make the disease more severe and its progression faster, there is also the possibility that one of the agents, such as HCV, could help promote the clearings of the other virus, such as HBV, from the body. HCV could also take over the position of HBV and become the major virus to cause persistent chronic infection. 

The HCV and HBV co-infection is quite common, because they have the same transmission route. The co-infection rate of these two viruses is about 15 to 28%, depending on the regions among chronic hepatitis C patients. Clinically, the co-infection could have more severe symptoms, faster progression, and a higher rate of fulminant hepatitis occurrence.

HAV is usually contracted from contaminated food and water. Thus, it is often a super-infection for patients with chronic HCV or HBV infections. This super-infection can cause prolonged jaundice and ALT elevation and can also trigger inflammation activities of chronic HCV or HBV.

To prevent super-infections, it is highly recommended for chronic hepatitis C patients without antibodies for HBV and HAV to have those vaccinations done. Chronic hepatitis B and C patients should also avoid eating uncooked foods such as raw seafood and meats.

Chinese herbal treatment for co-infections of HCV and HBV is essentially the same protocol because the goal is to control liver inflammation. As such, most of the herbal treatment protocols used for treating HCV infection were borrowed from the treatments of HBV infections. The same principles are also applicable to the super-infection of HAV in HCV and HBV patients. Our treatment is designed to protect liver cell damage, enhance the body's immune response, and halt the progression of the disease. 

For co-infection with HIV, the HIV HAART (highly active antiretroviral therapy) treatments can be very harmful to the liver. After being treated with HAART, I have seen many HIV HCV co-infection patients and their liver enzyme level elevate, with obvious fat deposit in the abdomen and some developing jaundice. In our herbal treatments for HIV, we use Glycyrrhizin, which is also used for HCV and HBV infections. The other herbal remedies used for anti-viral therapies are bitter melon (MC Capsule) and olive leaf (Olivessence Capsule) extracts, and they are also used in our HCV and HBV treatments.

We have seen good results on measuring enzyme levels and symptoms with these herbal protocols, with minimal or no side-effects on the patient.