Comprehensive Care for Chronic Viral Hepatitis

There are very few specific treatment options open to patients with chronic viral hepatitis. Thus, non-specific, or general health supportive treatment, should play a major role in the care of chronic viral hepatitis and because chronic viral hepatitis is a complicated disease, supportive care must deal with various types of conditions.

1. For etiological anti-viral treatment, interferon (IFN) based treatment has an efficacy rate around 30 to 50% for the most common HCV genotype 1a and 1b; for some genotype of HCV, such as genotype 2 and 3, this rate is around 60 to 70%. However, because the side effects related with this treatment can be quite severe, many patients want to try other approaches. 
I have treated a number of patients who did respond to IFN based treatments and had their HCV test level turn “undetectable.” But, due to the accumulated damage and still present on-going damage, (detectable does not equate to total eradication)  symptoms such as fatigue, fibrosis, bilirubin metabolic disorders, and indigestion can still be major problems in the patient’s life.These problems still need to be treated.

2. Side-effects reduction.
For etiological anti-viral treatment, herbal treatment is not very effective and hence is not emphasized.  But, we found clinically that when IFN based treatment is combined with herbal treatment, patients experience much less side effects and can tolerate the IFN based treatment much better. There are some patients experimenting with using smaller and  more frequent doses of IFN together with herbal treatment and have found much less side effects.

3. Our Chinese herbal protocol aims to control the liver inflammation, release jaundice, facilitate bile secretion, improve micro-circulation, regulate abnormal immune reactions (joint pain, rashes), restoring the liver functions, and preventing or halting the progression of fibrosis.
It is a comprehensive approach and can help to slow down or reverse accumulated liver damages.

4. General health supportive treatments such as multi-mineral vitamins, Alpha-lipoic acid, anti-oxidants.

5. Diet: Absolutely no alcohol is the most important diet rule. In the compensated stage of liver disease, sufficient protein and calories are important. Avoid fatty and fried foods. Eat more fresh vegetables and fruits. 

6. Emotional support for chronic hepatitis patients is very important. To have a supportive family relationship, participate in support groups (Do make sure that the support group offers positive information.) To establish a mutual trust relationship with your health care provider(s) and participate in your treatment and decision making. 

7. Proper exercise and rest are very important during a chronic disease like viral hepatitis. Exercise should be gentle, not exhaustive. Don't let fatigue accumulate and over-exert yourself. Proper rest is an important part of the treatment. Many hepatitis C patients still work normally but they should reduce their work-load stress as much as possible and set aside some time each day for relaxation and rest.

8. Weight control is also important. Over-weight patients can cause fat deposits in the liver to build, which can promote fibrosis. About 20% of over-weight people will have fatty liver and among them, about 20% will develop cirrhosis. For hepatitis C patients, regulating the body weight will also help prevent the progression of fibrosis.