Green tea flavonoid may prevent reinfection with hepatitis C virus following liver transplantation

Public release date: 1-Dec-2011
Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell

German researchers have determined that epigallocatechin-3-gallate (EGCG)—a flavonoid found in green tea—inhibits the hepatitis C virus (HCV) from entering liver cells. Study findings available in the December issue of Hepatology, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases, suggest that EGCG may offer an antiviral strategy to prevent HCV reinfection following liver transplantation.
HCV infection can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) or primary liver cancer. HCV is one of the most common causes of chronic liver disease and a primary indication for liver transplantation, affecting up to 170 million individuals worldwide according to estimates from the World Health Organization (WHO). Prior studies report that nearly 2% of the world population is infected with chronic HCV and up to 20% of the population in some countries.
While standard treatment with interferon with ribavirin and newer protease inhibitors may clear infection in some individuals, a substantial number of patients still may not respond to these therapies. For individuals receiving liver transplants due to complications from HCV, reinfection of the healthy donor liver remains a significant concern. Antiviral strategies that target HCV in its early stages are urgently needed to prevent graft reinfection and improve long-term outcomes for patients.
To address this critical issue, Dr. Sandra Ciesek and Dr. Eike Steinmann from the Hannover Medical School in Germany investigated the effect of the EGCG molecule, which is a major component of green tea, in preventing HCV from attaching to liver cells. "Green tea catechins such as EGCG and its derivatives epigallocatechin (EGC), epicatechingallate (ECG), and epicatechin (EC) have been shown to exhibit antiviral and anti-oncogenic properties," explains Dr. Ciesek. "Our study further explores the potential effect these flavonoids have in preventing HCV reinfection following liver transplantation."
Results showed that unlike its derivatives, EGCG inhibits entry of HCV into liver cells. The authors suggest that EGCG may impede HCV cell entry by acting on the host cell as the green tea catechin was not found to alter the density of virus particles. Pretreatment of cells with EGCG before HCV inoculation did not reduce the infection; however application during inoculation inhibited the rapid spread of the HCV. Lastly, researchers showed that EGCG inhibits viral attachment—the initial step in the HCV infection process. "The green tea antioxidant EGCG inhibits HCV cell entry by blocking viral attachment and may offer a new approach to prevent HCV infection, particularly reinfection following liver transplantation." concludes Dr. Ciesek.
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Full Citation: The Green Tea Polyphenol Epigallocatechin-3-Gallate (EGCG) Inhibits Hepatitis C Virus (HCV) Entry." Sandra Ciesek, Thomas von Hahn, Che C. Colpitts, Luis M Schang,Martina Friesland, Jörg Steinmann, Michael P. Manns, Michael Ott, Heiner Wedemeyer, Philip Meuleman, Thomas Pietschmann and Eike Steinmann. Hepatology; Published Online: November 30, 2011 (DOI: 10.1002/hep.24610); Print Issue Date: December 2011. http://onlinelibrary.wiley.com/doi/10.1002/hep.24610/abstract.
Author Contact: To arrange an interview with Dr. Sandra Ciesek or Dr. Eike Steinmann, please contact Jo Schilling at jo.schilling@twincore.de.
This study is published in Hepatology. Media wishing to receive a PDF of the article may contact healthnews@wiley.com.
About the Journal
Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Hepatology's current impact factor is 10.885.Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1527-3350 .
About Wiley-Blackwell
Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

Thank you Hepatitis C news and Research.
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100 Nutrition facts about 25 popular foods

Very interesting information!!

Dandilion Greens are good for the liver

http://www.mercola.com/nutritionplan/foodalert.htm


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L.A.s Liver Life Walk

Join. Raise Funds. End Liver Disease.

Event Date: September 18, 2011
Event Location: Ocean View Park, Santa Monica

Event Schedule: Registration 7-9am
Walk Begins at 9am

Did you know that 1 in 10 people in the United States face a future with liver disease? The American Liver Foundation® is working toward a world free of liver disease and we need your help! Together we will make a difference. Take the first step today by registering to walk in our local Liver Life Walk event.

Every step you take and every dollar you raise helps the American Liver Foundation® fund research grants, public education and advocacy in an effort to increase awareness and progress in the fight against liver disease. Walk for Fun...Walk for Life!

That is not just our motto, it is exactly what participants do when they participate in the Liver Life Walk. Join tens of thousands of supporters from coast to coast as we pound the pavement to put an end to liver disease!

Thank you for supporting the American Liver Foundation®. Together we can make a difference!

 Click here sign up for the Liver Life Walk or to donate to ALF!

To learn more about ALF or to find a walk in your area go to: www.liverfoundation.org

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Update on HCV treatments Telaprevir/Boceprevir

Both Drugs Have Been Recommended By The FDA Advisory Panel For The Treatment Of Hepatitis C.

Both of the new medicines work by blocking a protein called protease that the virus needs to replicate.

April 28 The FDA advisory panel unanimously backed the approval of Vertex Pharmaceuticals proposed hepatitis C-drug telaprevir.

April 27 - VICTRELIS (boceprevir) was unanimously recommended for approval by the FDA Advisory Committee .

Merck & Co. expects to launch boceprevir in May, pending U.S. regulatory approval

The FDA is not required to follow the panel's recommendation, though it usually does. The FDA will make the final approval decision which is expected by May 23.


Highlights;

Telaprevir
1-The cure rate for new patients taking telaprevir ranged between 75 and 79 percent, compared with 60 and 65 percent for boceprevir.
2-Most panelists said that patients who had previously failed treatment could likely achieve a cure within six months — half the time needed with older drugs — when taking telaprevir
3-As for Merck's drug Boceprevir those same patients would likely need a full year's worth of treatment with triple therapy. 4-Vertex executives said they were exploring a twice-daily regimen of telaprevir.
5-The agency said the risks of telaprevir were associated with skin reactions, such as rash, and anemia. The main safety concern discussed by the panel was severe rashes in a small number of patients, including three suspected cases of Stevens-Johnson Syndrome, a life-threatening outbreak of blisters. Vertex said the rashes disappeared when telaprevir was stopped.
Panelists urged Vertex to warn about the problem and tell doctors and patients how to spot a serious rash and when to stop treatment if needed.
Vertex offered rashes were managed in most patients with antihistamines and topical corticosteriods

Boceprevir
1-Mentioned by the panel is the concern for the complexity of prescribing the new Hepatitis C drug. The other concerns are safety, risk, and resistance variance.
2-Labeling; The panelists were split on using boceprevir in (null responder) patients. These patients were not included in Phase III trials, therefore no data is available. Also raised was the concern over the labeling allowing for treatment in advanced liver damage; Grade 3 Stage 4 patients.
3-Longer treatment duration was discussed in the difficult to treat patients; African Americans, patients with liver damage and for those people who have failed prior standard therapy.
4-Members of the FDA panel appeared to support shorter treatment for patients who show early responses to boceprevir.
5-Boceprevir's main risk is blood disorders such as anemia, a lack of red blood cells that causes fatigue and other symptoms, FDA reviewers said. Panelists said the problems needed monitoring but were manageable and usually not severe.
6-Some voiced concern that patients would find it challenging to stick with the three-times-a-day dosing for boceprevir on top of the two older medicines. (PEG-IFN plus RBV)
To read the article in its entirety, please visit HCV New Drug Research

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You are not alone - kids with HepC

A fellow mom  pointed out this website (hepatitisc kids) for kids with HepC. It also has a chat forum for teens battling the disease, which I wish was around when I was younger.
I personally am very interested in hearing how other parents are dealing with having a child with Hep C? Are you doing treatments, or waiting for something better? Do you have a special diet for them, do they take special supplements? Besides keeping my sons diet healthy, giving him vitamins w/ extra C, and really keeping medications away unless completely necessary. (He has to be really miserable or have a pretty high fever to get anything.) I am also waiting a little while on treatments for him. I think in a few more years they will have things fine tuned and may not even have to include interferon. Would love to hear from some other mommas (or dads).

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Gastroparesis - one more possibility for that nausea

Gastroparesis Diet for Delayed Stomach Emptying

Author:  Frank W. Jackson, M.D. Prebiotics in your diet or in a supplement naturally restore digestive balance and health.  Learn more . . .

Purpose

Gastroparesis is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed. This results in bothersome and sometimes serious symptoms, as well as malnutrition, because food is not being digested properly. Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral infection is suspected in some. Usually, the physician prescribes medication to stimulate the stomach to contract. The purpose of the gastroparesis diet is to reduce symptoms and maintain adequate fluids and nutrition. There are three steps to the diet.

STEP 1 DIET consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals.   STEP 2 DIET provides additional calories by adding a small amount of dietary fat -- less than 40 gm each day. For patients with gastroparesis, fatty foods and oils should be restricted, because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount.   STEP 3 DIET is designed for long-term maintenance. Fat is limited to 50 gm per day, and fibrous foods are restricted, because many plant fibers cannot be digested.

Nutrition Facts

The STEP 1 Gastroparesis Diet is inadequate in all nutrients except sodium and potassium. It should not be continued for more than three days without additional nutritional support. STEP 2 and STEP 3 Gastroparesis Diets may be inadequate in Vitamins A and C, and the mineral iron. A multi-vitamin supplement is usually prescribed. Special Considerations Diets must be tailored to the individual patient. This is because the degree of gastroparesis may range from severe and long-standing to mild and easily corrected. Patients may also have various medical conditions to be considered. For example, diabetes patients with gastroparesis are allowed sugar-containing liquids on the Step 1 diet, because that is their only source of carbohydrate. On the Step 2 and Step 3 diets, these patients should avoid concentrated sweets. These are noted with an asterisk (*) on the food lists. On all of the diets, liquids and food should be eaten in small, frequent meals. This helps to maintain nutrition. Step 1 Food Groups Group Recommend Avoid Milk & milk products none all Vegetables none all Fruits none all Breads & grains plain saltine crackers all others Meat or meat substitutes none all Fats & oils none all Beverages Gatorade and soft drinks (sipped slowly throughout the day) all others Soups fat-free consommé and bouillon all others Sample Menu Step 1 Breakfast Lunch Dinner Gatorade 1/2 cup ginger ale 1/2 cup bouillon 3/4 cup saltine crackers 6 Gatorade 1/2 cup Coke 1/2 cup bouillon 3/4 cup saltine crackers 6 Gatorade 1/2 cup Sprite 1/2 cup bouillon 3/4 cup saltine crackers 6 This Sample Diet Provides the Following Calories 790 Fat 9 gm Protein 11 gm Sodium 3531 mg Carbohydrates 156 gm Potassium 244 mg Step 2 Food Groups Group Recommend Avoid Milk & milk products skim milk, products made with skim milk, low-fat yogurt, low-fat cheeses whole milk products, creams (sour, light, heavy, whipping), half & half Soups fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed vegetables soups made with cream, whole milk, or broths containing fat Bread & grains breads & cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackers oatmeal; whole grain rice, cereal, bread Meat & meat substitutes eggs, peanut butter (maximum 2 Tbsp/day) beef; poultry; fish; pork products; dried beans, pea, & lentils Vegetables vegetable juice (tomato, V-8); well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams) all raw vegetables; cooked vegetables with skins; beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini Fruits apple juice, cranberry juice, grape juice, pineapple, prune juice, canned fruits without skins (applesauce, peaches, pears) citrus juices, all fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons) Fats & oils any type of fat, but only in small amounts none Sweets & desserts* hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves Beverages Gatorade*, soft drinks* (sipped slowly throughout the day) all others, except allowed juices *Concentrated sweets Sample Menu Step 2 Breakfast Lunch Dinner skim milk 1/2 cup poached egg 1 white toast slice apple juice 1/2 cup  mozzarella cheese 2 oz saltine crackers 6 chicken noodle soup 3/4 cup Gatorade 1/2 cup peanut butter 1 Tbsp saltine crackers 6 vanilla pudding 1/2 cup grape juice 1/2 cup  Morning Snack Afternoon Snack Evening Snack ginger ale 1/2 cup canned pears 1/2 cup  skim milk 1/2 cup cornflakes 1/2 cup sugar 2 tsp  frozen yogurt 1/2 cup saltine crackers 6   This Sample Diet Provides the Following Calories 1343 Fat 35 gm Protein 52 gm Sodium 2639 mg Carbohydrates 206 gm Potassium 1411 mg Step 3 Food Groups Group Recommend Avoid Milk & milk products skim milk, products made with skim milk, low-fat yogurt, low-fat cheeses whole milk products, creams (sour, light, heavy, whipping), half & half Soups fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed vegetables soups made with cream, whole milk, or broths containing fat Fruits fruit juices, canned fruits without skins (applesauce, peaches, pears) all fresh & dried fruits, canned fruits with skins (apricots, cherries, plums, blueberries, fruit cocktail, oranges, grapefruit, pineapple, persimmons) Meat & meat substitutes eggs, peanut butter (2 Tbsp/day), poultry, fish, lean ground beef fibrous meats (steaks, roasts, chops), dried beans, peas, lentils Fats & oils any type of fat, but only in small amounts none Breads & grains breads & cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackers oatmeal; whole grain rice, cereal, bread Vegetables vegetable juices (tomato V-8), well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summers quash, strained tomato sauce, yams) all raw vegetables; cooked vegetables with skins: beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini Sweets & desserts* hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves Beverages Gatorade*, soft drinks* (sipped slowly throughout the day), coffee, tea, water (note: non-caloric beverages should be limited if patient cannot maintain adequate caloric intake) all others, except allowed juices *Concentrated sweets Sample Menu Step 3 Breakfast Lunch Dinner skim milk 1/2 cup cream of wheat 1/2 cup sugar 2 tsp orange juice 1/2 cup white toast 1 slice margarine 1 tsp jelly 1 Tbsp   tuna fish 2 oz low-fat mayonnaise 2 Tbsp white bread 2 slices canned peaches 1/2 cup Gatorade 1.2 cup baked chicken 2 oz white rice 1/2 cup cooked beets 1/2 cup dinner roll 1 skim milk 1/2 cup margarine 2 tsp  Morning Snack Afternoon Snack Evening Snack low-fat yogurt 1/2 cup Sprite 1/2 cup   chocolate pudding 1/2 cup gingerale 1/2 cup  ice milk 1/2 cup pretzels 2   This Sample Diet Provides the Following Calories 1822 Fat 42 gm Protein 75 gm Sodium 2234 mg Carbohydrates 286 gm Potassium 2467 mg

Prebiotics in your diet or in a supplement naturally restore digestive balance and health.  Learn more . . .  

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Team Larry walks again

Just about 2 weeks left before Team Larry the Livers 2nd annual Donate Life walk in Fullerton. Make sure you join us if you can!!

Click **HERE** to register to walk with us or to donate funds to Donate Life California. 

Over 109,000 men, women, and children are waiting for life saving transplants. You can be some ones hero.

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Celebrities with HCV

Thank you to HCV New Drug Research for this: ...I must admit that I love how Keith Richards was cured. :)

Several public figures suffer from hepatitis C and some have died. Celebrities with hepatitis C, according to news reports: 

• Gregg Allman Rock musician and founding member of The Allman Brothers Band

• Pamela Anderson: She is perhaps the best-known hepatitis C patient, if only because the former Baywatch star has such a flair for publicity. Her revelation last year that she had the disease prompted innumerable news stories.

• Keith Richards–Guitarist/singer/songwriter/producer and founding member of the Rolling Stones. He claims that due to the strength of his immune system he beat hepatitis C by leaving his body to deal with it

• Ray Benson–Front man of the Austin Western swing band Asleep at the Wheel. Benson chose to treat his hepatitis C with Eastern medicine.

• Steven Tyler–Musician and songwriter in the rock band Aerosmith. In September 2006, he announced that he had been diagnosed three years previous and had just completed eleven months of treatment with interferon.

• Natalie Cole–Singer and daughter of Nat King Cole. She was diagnosed in mid-2008 during a routine examination.

• Willy DeVille One of the founders of the band Mink DeVille and a pioneer in punk rock. He was diagnosed with hepatitis C in February 2009 and was found to have pancreatic cancer during the course of his treatment

• Anthony Kiedis–American vocalist/lyricist of the rock band Red Hot Chili Peppers. He contracted Hepatitis C from regular intravenous drug use in the early 1990s and claims he was cured of the Hep C virus by Ozone therapy

• Naomi Judd: The former nurse and country singer has been one of the best-known hep C celebrities. She retired from the Judds, the duo with daughter Wynonna, in 1991. But she has since undergone treatment and become more active.

• Dusty Hill: The band ZZ Top stopped touring in 2000 because the bassist had hepatitis C. The band began touring again in 2002.

• Evel Knievel: The motorcycle daredevil had a liver transplant more than two years ago and later said doctors could find no trace of the virus in his blood.

• Chuck Negron: He's the former lead singer on such Three Dog Night classics as "Joy to the World."

• Larry Hagman: The television actor required a liver transplant in 1995.

• Phil Lesh: One of the founding members of the Grateful Dead, the bass player received a liver transplant several years ago.

• "Superstar" Billy Graham: The former WWF wrestling champion got a liver transplant last year. He thought he contracted the virus by being bled on during wrestling matches years ago.

• David Crosby: The rock star with a fabled history of drug abuse is touring again after receiving a liver transplant in 1995.

• Freddy Fender: The singer of such '70s hits as "Wasted Days and Wasted Nights" suffers from several health problems, including hepatitis C.

• Jack Kevorkian: The retired pathologist, now serving a prison term for killing a man who had Lou Gehrig's disease, has hepatitis C, his lawyer says.

• Laurie Bembenek: The former Playboy bunny, whose conviction in a Milwaukee murder and later escape are chronicled in the book Run, Bambi, Run, is free now but suffers from hepatitis C.

• Rolf Benirschke: The former star kicker for the San Diego Chargers got the virus from a transfusion two decades ago. He has used his sports status to raise awareness about the disease.

• Linda Lovelace: The star of the 1972 porn film "Deep Throat" contracted the virus from a transfusion and had a liver transplant in 1987. She died in 2002 at age 53 after a car crash.

• Willie Dixon: The legendary bluesman was diagnosed with hepatitis C shortly before his death in 1992. He contracted the virus from transfusions in 1987.

• Alejandro Escovedo–Musician specializing in roots rock/alternative country, diagnosed in April 2003.

• Mickey Mantle: The baseball great is thought to have contracted hepatitis C during a transfusion for a knee operation. He died of liver cancer in 1995.

• Stormie Jones: The 13-year-old died in 1990 six years after becoming the first person in the world to receive heart and liver transplants in a single operation. Hepatitis C damaged that liver, though, and before she died she received a second liver and treatment for the virus.

• Ken Kesey: The author of One Flew Over the Cuckoo's Nest, who died of liver cancer in 2001, suffered from hepatitis C.

• James Earl Ray: The confessed assassin of Martin Luther King Jr. died in 1998 of liver disease after being infected with hepatitis C, probably in a 1981 blood transfusion he received after a prison stabbing.

• Allen Ginsberg: The poet laureate of the Beat Generation died in 1997 after battling hepatitis C for many years. He had terminal liver cancer.

• Lance Loud: The free-spirited son on public television's "An American Family" in 1971, he died in 2001 of liver failure caused by hepatitis C and HIV.

• Frank Reynolds: Experts speculated at the time that the newsman's death in 1983 was hastened by the virus later known as hepatitis C, which he may have contracted through a transfusion.

• Benito Mussolini: Did Il Duce, the World War II Italian dictator, have the disease? A new biography speculates that his chronic health problems -- stomach pain, fatigue and depression -- stemmed from an ulcer and a mild case of hepatitis C.

• Chet Helms Music producer who helped create the vibrant San Francisco rock music scene in the 1960s. He was undergoing interferon treatment for hepatitis C when he suffered a stroke

• Phil Lesh Founding member and bass guitarist of the rock band Grateful Dead. He was diagnosed with hepatitis C in 1992 and received a liver transplant in 1998.

• David Marks Early member of The Beach Boys, who believes that he contracted the disease through drug use. He campaigns to raise awareness, supporting the UK National Health Service's "FaCe It" campaign.

• Tawn Mastrey Disc jockey who was the voice of 1980s heavy-metal scene in Los Angeles. She contracted hepatitis C when she was a child.

• Kenny Neal New Orleans blues and swamp blues guitar player. He took a year off from performing while receiving treatment and returned to the Monterey Blues Festival in 2007.

• Chuck Negron Vocalist and founding member of Three Dog Night. He contracted hepatitis C due to "the long-lasting effects of drug use and alcoholism".

• Gary S. Paxton Bakersfield country and gospel music artist. He contracted hepatitis C through several blood transfusions and almost died from the disease in 1990.

• Curtis Salgado Blues, R&B, and soul singer-songwriter-musician. Developed cirrhosis and liver cancer because of hepatitis C. Six benefit concerts were held in 2006 to raise money for his medical bills

• Tony Scalzo Rock musician and songwriter, best known as a founding member of the band Fastball.

• Uncle John Turner Blues musician and one of the founders of the blues-rock style of drumming

• Randy Turner Lead singer for the seminal hardcore punk band Big Boys.

• Christopher Lawford Nephew of John F. Kennedy, best known for his role as Charlie Brent on the soap opera All My Children in the early 1990s. He was diagnosed with hepatitis C in 2001

• Natasha Lyonne Best known for her roles in the first two American Pie films

•Anita Pallenberg –Italian-born model, actress and fashion designer. Also known as the great influence on the development and presentation of the Rolling Stones from the late 1960s and through the 1970s

• Ken Watanabe Japanese actor best known for his role in The Last Samurai. He contracted hepatitis C from a blood transfusion when he was receiving treatment for acute myeloid leukemia

• Stanley Fafara Child actor who played "Whitey" on Leave it to Beaver. He contracted hepatitis C from intravenous drug use

http://en.wikipedia.org/wiki/List_of_people_with_hepatitis_C

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Percutaneous transhepatic biliary drainage (PTBD)

Ricki's new liver is having bile duct issues, which is more common in LDLT (living donor liver transplant) Statistics show about 10% of transplant patients that receive cadaver livers have biliary problems, but the number jumps to about 35% for LDLT patients. Since the drain has been placed, my bilirubin has dropped from the low 20's to 7 (normal is under 2) I am less itchy and already much less jaundiced. Since this drain is placed between the ribs and through the diaphragm it starts off pretty painful but after a while, just becomes uncomfortably bearable. Since stents had been unsuccessfully placed previously, this is my last option before surgery. I know for many of us liver patients, feeling a little sick is a daily feeling for us, but if you notice anything "un-normal" (I started feeling like I did just before my transplant) get yourself checked out... Following is more information on the PTBD.

Percutaneous transhepatic biliary drainage (PTBD) is a procedure that is done to open a blocked bile duct. Your bile duct is like a network of pipes that go from your liver to your gallbladder, pancreas, and small intestine (bowel). Your liver is an organ that makes fluid called bile, which is stored in your gallbladder and helps you digest food. Digestion is the process of the body breaking down food that is eaten. When bile reaches your small intestine, it helps break down the fat in your food. The pancreas is an organ that helps you digest food.

With PTBD, your body may digest food more easily. Abdominal pain and jaundice (yellowing of your skin and the whites of your eyes), may decrease. PTBD can help you get the nutrition that you need to feel better and be healthier.

  

Why may I need percutaneous transhepatic biliary drainage?

You may need PTBD if your bile duct is blocked. A disease called cholangitis causes swelling, which blocks your bile duct. Abnormal growths and small bile stones may block your bile duct. Trauma (an accident) or a scar from a past surgery also increase the risk of getting a blocked bile duct. Ask your caregiver to explain how your bile duct may have become blocked.

What tests may I need before or during percutaneous transhepatic biliary drainage?

Tests such as fluoroscopy, magnetic resonance imaging (MRI), and computed tomography (CT) may be needed before and during your procedure. These tests take pictures of your body organs and areas. Dye may be used to help caregivers see the pictures. Tell caregivers if you are allergic to dyes, iodine or seafood, as you may also be allergic to the dye used for these tests.

What happens during percutaneous transhepatic biliary drainage?

Your caregiver will put a needle through the right side of your abdomen and into your liver. A wire will be pushed through the needle into your liver. Your caregiver will use the wire to break up stones blocking your bile duct. Your caregiver will put a tube over the needle and then remove the needle and wire. A small part of the tube will come through your skin to the outside of your body. If the tube is capped closed, bile will drain into your intestines. If the tube is left open, bile will drain into a bag that is attached to the end of the tube outside of your body. You may need to have a PTBD tube for a short time, or it may be long-lasting.

What are the risks of percutaneous transhepatic biliary drainage?

• You may be allergic to the dye used for tests that are done before or during the procedure, and have an allergic reaction. Your gallbladder, bile duct, or blood vessels may be damaged. You may lose too much blood and need a blood transfusion. After the procedure, there may be swelling or bleeding around the tube, and it may be painful. The skin around the tube may get infected. The tube may move out of place or get blocked. Your gallbladder may become swollen or infected. You could get a blood clot in a blood vessel in your liver. You could get a lung infection, or your lungs could fill with blood or air, making it hard for you to breathe.
  
• If you do not have percutaneous transhepatic biliary drainage, you may not have enough bile in your intestines to digest food. Because of this, your body may not get the nutrition it needs. Bilirubin may build up in your liver and bile duct. You may get jaundice, causing your eyes and skin to turn yellow. Your gallbladder may burst. With or without PTBD, you may die from infection. Call your caregiver with questions about your condition, the PTBD procedure, or your care.

How do I care for the tube after percutaneous transhepatic biliary drainage?

Ask your caregiver how to care for your tube and the skin around it. If bile is draining out of your body into a bag, you will need to make sure there is bile in the bag. Ask caregivers how much bile should be in the bag and what color it should be. You will need to make sure the PTBD tube is not blocked. Ask caregivers when to flush (clear out) the inside of the tube, and to show you how to flush it.

When should I call my caregiver?

Call your caregiver if:

• You cannot make it to your procedure or your appointments.
  
• Your skin or the whites of your eyes look more yellow than usual.
  
• You have a fever (increased body temperature).
  
• You are nauseated (feeling sick to your stomach) or you are vomiting (throwing up).
  
• Your stool (bowel movements) have changed color, and are very dark or very light.

When should I seek immediate help?

Seek care immediately or call 911 after surgery if:

• There is little or no drainage from the tube into the bag.
  
• You have severe (very bad) pain in your abdomen, or your abdomen feels hard or is swollen.
  
• You are coughing or throwing up blood.
  
• You are dizzy, or you feel too weak to stand up.
  
• You have new trouble breathing.
  
• Your tube falls out.
  
• Your stools look red, or you see blood when you go to the bathroom.

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


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Antiviral Cocktail Better than Single Drug for Children with Hepatitis C

 MEDIA CONTACT: Ekaterina Pesheva

EMAIL: epeshev1@jhmi.edu
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November 10, 2010

-Combo therapy better than single drug at wiping out the virus

Children with hepatitis C fare decidedly better with a supercharged combination of two antiviral drugs than with the usual and standard single-drug regimen, according to research led by investigators at the Johns Hopkins Children Center.
“Our findings indicate that when it comes to getting rid of the hepatitis C virus, the combination therapy seriously outperforms the single-drug therapy and its effects appear to endure well after stopping the treatment,” says lead investigator Kathleen Schwarz, M.D., a gastroenterologist and director of the Pediatric Liver Center at Hopkins Children’s.
The results of the study, published online in the journal Gastroenterology, indicate that the combination is more than twice as effective in eliminating the liver-ravaging viral infection as the single-drug approach. Unlike its more stubborn cousin hepatitis B, the hepatitis C virus can be eradicated from the body with antiviral medications, stopping its harmful activity, a key factor in preventing liver damage.
HEAR Kathleen Schwarz discuss Hepatitis C treatment with Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine:
The research, which involved 112 children, ages 5 to 17 years, treated at 11 U.S. hospitals, is believed to be the first large-scale, head-to-head comparison of the dual vs. single-drug approach in pediatric patients. The findings are particularly important, the scientists say, because treatment protocols in children with hepatitis C have not been studied well.
Of the 112 children, 57 received standard medication — weekly injections with long-acting pegylated interferon, or PEG interferon — plus a placebo, while 55 got a combination of PEG interferon injections and daily pills containing the antiviral drug ribavirin (RV). After the year-long treatment, patients treated with the PEG-ribavirin cocktail cleared the infection at a rate two and a half times greater than children receiving PEG interferon injections alone (53 vs. 21 percent). Viral clearance occurs when a child’s blood is free of viral traces at the end of the treatment, and sustained viral clearance, or full eradication, occurs when the blood remains clear for at least six months after stopping treatment. Full viral eradication is the hallmark of effective therapy and was where the greatest differences between the two approaches emerged. Children on the combination therapy were less likely to relapse after stopping treatment — 17 percent of them did — than children on the single-drug regimen (45 percent). In all, 41 of the 112 patients achieved complete viral eradication, and all of them continued to do well without medication at the one- and two-year check-ups. The researchers will continue to monitor these children for five years after stopping therapy.
Twenty-eight of the children receiving the PEG-placebo combination who didn’t respond to treatment after six months were offered treatment with the PEG-ribavirin combination. Nearly half of them (13) responded well and had undetectable viral loads at the end of a six-month treatment, and 11 of the 13 remained clear of infection six months after stopping the treatment. Children who responded well to standard PEG therapy continued on the same treatment.
The investigators note that because past research has shown ribavirin’s harmful effects on the fetus, it should be avoided or used cautiously during pregnancy.
The blood-borne hepatitis C virus is a leading cause of liver cancer, second only to hepatitis B, and a top reason for liver transplantation. An estimated 132,000 U.S. children are infected with the hepatitis C virus, and nearly 42,300 of them have a chronic infection, the researchers say. 
Other Johns Hopkins investigators on the study: Alexandra Valsamakis, M.D.
Other institutions involved in the research include the University of Florida College of Medicine; Seattle Children’s Hospital; Indiana University School of Medicine; Children’s Hospital of Philadelphia; Children’s Hospital Boston; University of California San Francisco; Children’s National Medical Center, Washington, D.C., Cincinnati Children’s Hospital; University of Colorado; and Columbia University Medical Center.  
The study was funded by the National Institutes of Health and the Food and Drug Administration.  Manufacturer Hoffman-La Roche supplied the medications for the study and funded the lab costs and the data coordination for the study.
Conflict-of-interest disclosure: Schwarz receives research support from Roche, Bristol Myers, Squibb, Gilead and consulting fees from Novartis. Valsamakis receives research support from Roche. The terms of these arrangements are being managed by The Johns Hopkins University in accordance with its conflict-of-interest policies.

Related Information:

Pediatric Liver Center
Managing Childhood Liver Disease
New Recommendations Issued for Children with Chronic Hepatitis B Infections

Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children’s is consistently ranked among the top children's hospitals in the nation. Hopkins Children’s is Maryland's largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. Hopkins Children's will celebrate its 100th anniversary and move to a new home in 2012. For more information, please visit www.hopkinschildrens.org

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Possible Trial for Telaprevir Post Transplant for Hep C Patients

Vertex and Tibotec also plan to conduct several additional clinical trials of telaprevir in 2011 that aim to expand the future patient population for telaprevir-based regimens.

Phase 2 Post-Transplant Study: Vertex recently completed a drug-drug interaction study of telaprevir with immunosuppressive agents commonly used following a liver transplant. Based on results from this study, Vertex and Tibotec plan to initiate in 2011 a Phase 2 study of telaprevir-based regimens in people with recurrent hepatitis C following a liver transplant.

Additional Trials of Telaprevir to Advance Leadership Position in Hepatitis C

Vertex and Tibotec also plan to conduct several additional clinical trials of telaprevir in 2011 that aim to expand the future patient population for telaprevir-based regimens.

These trials include:Phase 3 HCV/Human Immunodeficiency Virus Co-Infection Trial: Vertex recently completed enrollment in a Phase 2 clinical trial of telaprevir-based regimens in people who are infected with genotype 1 hepatitis C virus and the human immunodeficiency virus (HIV), also known as HCV-HIV co-infection. If positive, results from this trial could support the planned initiation of a Phase 3 study of telaprevir-based regimens in people co-infected with HCV and HIV in 2011.

The Phase 3 trial will be designed to generate data that, if positive, could support the submission of a supplemental NDA for this population.

Phase 2 Short-Duration Treatment Study: Also in 2011, Vertex and Tibotec plan to initiate a clinical trial to evaluate the role of telaprevir as part of hepatitis C treatment regimens involving less than six total months of therapy.

One part of the trial may evaluate a telaprevir-based treatment regimen as short as 12 total weeks in duration for certain subsets of patients.

Phase 2 Post-Transplant Study: Vertex recently completed a drug-drug interaction study of telaprevir with immunosuppressive agents commonly used following a liver transplant. Based on results from this study, Vertex and Tibotec plan to initiate in 2011 a Phase 2 study of telaprevir-based regimens in people with recurrent hepatitis C following a liver transplant

See Full Press Release (at HCV New Drug Research)

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DID YOU KNOW...

1 in 4 Americans has a fatty liver that
can lead to cirrhosis (scarring) of the liver

Check your numbers:

Further testing is needed if your
ALT liver enzyme levels are OVER
30 IU/L for men
19 IU/L for Women

A simple blood test can help you
take better care of your liver.

A HEALTHY LIVER IS UP TO YOU


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