Reminder: Any change of address, phone number or postal code, please let your phone contact (in Victoria) or your chapter secretary know ASAP
HeCSC Victoria Tel. (250) 388-4311 hepcvic@pacificcoast.net
NEW VANCOUVER SUPPORT GROUP MEETING
Darlene Morrow and Darlene Nicolaas will be hosting a monthly support group meeting in the afternoon from 1-3 pm. The first meeting will be in September. The meetings will take place at the CDC Building on 12th at Ash Street (next to City Square Shopping Mall). The room number and day will be confirmed in August. Please call Darlene Nicolaas (djnicol@ibm.net ) at 685-3813 or Darlene Morrow (hepcbc@home.com ) at 987-7378 for more info.
Local efforts are underway to form a Hepatitis C Support Group for Saint John, New Brunswick. Meetings are held at 7 PM on the 3rd Thursday of every month at the Community Health Centre - (506) 632-5537 - located at 116 Coburg St., Saint John, New Brunswick E2L 3K1. Contact: Audrey Knight, kknight@nbnet.nb.ca
The downtown Eastside Hep C Support Group will be meeting on Wednesdays, 7:30-9:30 PM, at Carnegie Centre, 401 Main St. in Vancouver, BC—yes, the notorious corner of Main and Hastings, so come on down and visit us. Actually we have some wonderful spots down here. We are not far from Aun Yat Sen gardens, Gastown, and the 2nd largest Chinatown in North America. Our community centre is one of 2400 that Andrew Carnegie built in North America, and we have one. It is a beautiful old building, and we have a lot of programs, including low cost lunches, several support groups: diabetic, AIDS, drug and alcohol, seniors program, plus tai chi, a pool room, library, TV room, theatre, the best staff (most of them) and me !!! :-)
Carolyn
HEP C SUPPORT GROUP
CARNEGIE CENTRE 401
Has HeCSC Victoria helped you? Now’s your chance to return the favour!
We are planning a rummage sale to help raise funds for HeCSC Victoria, and we need volunteers desperately. It will be held during HepFest, on Saturday, July 17th, at the same time as our speakers, so ideally, we need volunteers to man the tables and sell the items who are not especially interested in hearing the speakers. Do you have family members or friends who would be willing to do this? Please call the office and leave a message: 388-4311.
We also need:
Donated items, cardboard boxes, and plastic bags. To drop off items, please call Jean Day at 370-1587, effective immediately. To arrange for pickup of items on July 9th and 10th, please call the office at 388-4311.
Strong people with cars or trucks to pick up donated items on July 9th and 10th. Call the office, please.
Clothes racks. Contact the office.
People to price the items on July 14th. We're having a little Pricing Party. Please call Jean Day at 370-1587 to find out about the time.
Strong people with cars or trucks to transport items to the sale early on July 17th. Contact the office, please.
People to set up the tables and display the items. Contact the office.
People to clean up afterwards, and strong people with cars or trucks to deal with any unsold items. Please contact the office.
People to put up signs along the street before the sale. Contact the office.
People to take signs down after the sale. Contact the office, please.
Echinacea, if used for more than eight consecutive weeks, could cause liver toxicity and should not be used with drugs such as anabolic steroids, amiodarone and methotrexate which are toxic to the liver as the affect may be additive.
Feverfew, garlic, ginger, ginseng, and ginkgo biloba all affect bleeding time and should not be taken by patients using warfarin or by patients that have decreased platelet counts.
St. John’s Wort should not be taken with monoamine oxidase inhibitors or selective serotonin reuptake inhibitors like Prozac and Paxil until more information is available.
Licorice, plantain, hawthorn and ginseng may interfere with digoxin therapy and valerian root should not be taken when barbiturates are used because it could cause an increase in the barbituate effects.
Evening primrose oil and borage are contraindicated in patients taking anticonvulsants (e.g., clonazepam).
Immunostimulants such as echinacea and zinc should not be given with immuno suppressants such as corticosteroids (like prednisone) and cyclosporine and are contraindicated in patients suffering from rheumatoid arthritis, systemic lupus erythematosus and autoimmune hepatitis.
Source: Hans Larsen is a health sciences researcher living in Victoria, British Columbia from Alive Magazine March 1999 with some changes by D. Morrow
By Natalie Rock BSN, RN.,
Hepatology Clinical Research Nurse
UBC Department of Medicine, Vancouver Hospital and Health Sciences Center
HEPATITIS C IN CHILDREN
The commonest reasons children receive blood transfusions are for bone marrow transplantation and in the management of other malignancies. A significant number of these children survive their primary disease and may thus be at risk also for hepatitis C.
The extent, course, and management of chronic hepatitis C in children has not been well described, although many studies are currently underway. It is still somewhat controversial as to the progression of chronic hepatitis C in children, although there is less controversy over the efficacy of management. A summary of present knowledge follows below.
INCIDENCE
There have been a few look-back studies to determine the incidence of chronic hepatitis C in transfused children, one of the largest being done in Canada by Dr. Eva Roberts. The incidence of hepatitis C among children is not dissimilar from adults, with seropositivity being from 1.4 to 3.2% of the population. As well, like adults, 80-90% of children exposed to hepatitis C will become chronic carriers.
NATURAL HISTORY
There is some controversy as to the course of chronic hepatitis C in children. There have been a number of European studies that suggest the disease is mild and that progression to clinical liver disease is uncommon. A number of points are important, however; many of these studies only followed the patients for less than ten years, and these patients were diagnosed with hepatitis C after 1990. There are differing reports as to the number with enzyme elevation and the degree of enzyme elevation, but it seems that enzymes are less significantly elevated in children than in adults. It is important to note, however, that none of the above studies included liver biopsies and follow-up was completely clinical. There have been a few studies that have included liver biopsies. These studies have shown that the type of liver pathology seen in children is the same as in adults, and that there is progression to fibrosis and cirrhosis. Although the follow-up in these studies was generally less than 10 years, it is suggested that the course of chronic hepatitis C may be longer in children with a greater tendency for remission and exacerbation. It is thus possible that if followed long enough the occurrence of cirrhosis may be the same as in adults, but this had not been demonstrated clearly in any study.
Many studies of chronic hepatitis C in children have not included liver biopsies. A recent paper, (Guido 1998), has suggested that biopsies are helpful and should be considered. Liver biopsies in children are relatively safe, although actual risk figures are not well-documented.
TREATMENT
There was initially some hesitancy in treating children with chronic hepatitis C, but more and more papers are reporting results. Children do seem to tolerate interferon well, and side effects are short lasting. The response rate to interferon in children is encouraging with reported responses from four centres ranging from 33 to 56%. A response has generally been considered as normalisation of enzymes and a negative HCV RNA, and a sustained response rate was generally obtained. One study did include liver biopsies which confirmed the absence of HCV RNA in the liver tissues of those responding, as well as improvement in the Knodell score (fibrosis). Similar to adults, those children with lower serum HCV RNA levels had the best response to therapy, and also similar to studies in adults, genotype 1b was the commonest genotype.
There have been no reported studies of combination interferon and ribavirin therapy in children.