Some of you have asked me in conservation why I haven't been contributing to the last 3 newsletters. Its been a busy few weeks and a lot has changed since the spring; both on the HepC issue, and for me personally. Although I've never felt better in my adult life, I've been experiencing "the burn-out factor" and feel that I've taken on too many tasks to maintain indefinitely. I always enjoyed sharing my thoughts and feelings with all of you and I've met many of you over the years and hope to meet many more in the future.

It has been quite an odyssey, going from complete ignorance of what I had inside of me to end-stage liver disease in one weekend and having to go from what was already a desperate situation to having a liver transplant 2 years later. The psychological implications are mind-boggling, to say the least, and the changes I've put myself through are definitely book material.(It is said that there is a book in everyone).

As I've said before, one door closes and another one opens. You just have to find it and recognize it .Well, the door that opened I'm still walking through and in some ways I feel like Dorothy when she arrived in Oz—you know, the "Wow Factor."

I remember thinking to myself there should be a support group for people with Hep C (exact thoughts) about 3 months after my initial bleed. Little did I realize that there are many more of you out there in the boat, so to speak.

In October ‘94 we had our first local meeting (nationally the first meeting was held in June ‘94), and the rest, as they say, is history.

My own personal growth since that time has corresponded with all of yours and we are all in this together. It pains me to no end to see the divisiveness that seems to inevitably creep into any organization over time and I, for one, think it ultimately requires more energy to be divisive than it does to simply agree to disagree and let us not forget that we are all mere volunteers and are donating our time and energy freely because we believe in our cause (whew!).

So, it is with great regret (and a rather long-winded declaration) that I have to say that I will be stepping down as chairman and from the day-to-day activities of the local Victoria chapter. However, I will stay on as a consultant and advisor. My last function will be Joey's arrival on Friday (which will have come and gone by the time you read this). I will still be contributing to the newsletter on a regular basis, and we are having a fund-raising dance on Oct. 28 at the Esquimalt Legion with RUKUS, a great 50s/60s rock ‘n roll band. In all honesty, I could never truly leave this organization.

I will stay on as national VP as long as I'm able to, and if I have to step down, I would hope to continue as a resource.

Does it really look like I'm stepping down? Yes! Most definitely. I have a new chapter in my life to write.

More on that later.

David Smith

Grading and staging the liver biopsy is also useful in evaluating the long-term efficacy of treatment. Post treatment liver biopsies are compared to pre-treatment biopsies to assess the degree of histological response. The grade of inflammation, stage of fibrosis and cirrhosis are compared. A positive outcome of treatment would be the lack of progression in the grade and stage of the biopsy post treatment.

Assessing the pathological changes is also important because some studies have suggested that the liver enzymes may not correlate well with histology, and improvement in histology may occur even though enzymes do not normalise. Histological improvement may also occur even though the virus is still present in the blood as determined by PCR. Nevertheless, there is a general correlation between the degree of histological improvement, liver enzymes, and viral load. Recent studies have also suggested that interferon treatment improves liver histology and that it is important to assess the response by follow-up liver biopsy.

Few studies have been done assessing liver histology on patients with normal enzymes, but it has been suggested that as many as 30% of these people may show evidence of chronic active hepatitis with at least grade 1 or 2 inflammation. A recent paper has also suggested that there may be indirect evidence of active inflammation by the demonstration of abnormal, and enlarged lymph nodes adjacent to the liver as seen by ultrasound.

Given the above information there are many factors that are taken into account when assessing a person who has been diagnosed with hepatitis C. This assessment requires not only the determination of hepatitis C antibodies, but also liver enzymes, hepatitis C RNA by PCR, possibly the determination of genotypes, ruling out of other liver diseases, and pathology determined by liver biopsy.

When an herbal tea bag is steeped in hot water, it is actually a type of herbal extract known as an infusion. Teas often are better sources of bioavailable compounds than the powdered herb, but are relatively weak in action compared to tinctures, fluid extracts, and solid extracts.

Tinctures are typically made using an alcohol and water mixture as the solvent. The herb is soaked in the solvent for a specified amount of time, depending on the herb. The solution is then pressed out, yielding the tincture.

Fluid extracts are more concentrated than tinctures. Although they are most often made from hydroalcoholic mixtures, other solvents may be used. Commercial fluid extracts usually are made by distilling off some of the alcohol, typically by using methods that do not require elevated temperatures, such as vacuum distillation and counter-current filtration. However, some small manufacturers produce fluid extracts in a similar manner to tinctures via a "cold percolation" process.

A solid extract is produced by further concentration of the extract by the mechanisms described above for fluid extracts as well as by other techniques such as thin layer evaporation. The solvent is completely removed leaving a viscous extract (soft solid extract) or a dry solid extract depending upon the plant, portion of the plant or solvent used, or if a drying process was used. The dry solid extract, if not already in powdered form, can be ground into course granules or a fine powder.

The potencies or strengths of herbal extracts are generally expressed in two ways. If they contain known active principles, their strengths are commonly expressed in terms of the content of these active principles. Otherwise, the strength is expressed in terms of their concentration. For example, tinctures are typically made at a 1:5 concentration. This means one part of the herb (in grams) is soaked in five parts liquid (in milliliters of volume). This means that there is five times the amount of solvent (alcohol/water) in a tincture as there is herbal material.

A 4:1 concentration means that one part of the extract is equivalent to, or derived from, four parts of the crude herb. This is the typical concentration of a solid extract. One gram of a 4:1 extract is concentrated from four grams of crude herb. Since a tincture is typically a 1:10 or 1:5 concentration while a fluid extract is usually 1:1, a fluid extract is typically at least four times as potent and a solid extract 40 times as potent when compared to an equal amount of tincture.

Typically, one gram of a 4:1 solid extract is equivalent to 4 ml of a fluid extract (1/7^th of an ounce) and 40 ml of a tincture (almost 1 ½ ounces). Some solid extracts are concentrated as high as 100:1, meaning it would take nearly 100 grams of crude herb, or 100 ml of a fluid extract (approximately 3.5 ounces), or 1,000 ml of a tincture (almost 1 quart) to provide an equal amount of herbal material in 1 gram of a 100:1 extract.

In the past, the quality of the extract produced often was difficult to determine as many of the active principles of the herbs were unknown. However, recent advances in extraction processes, coupled with improved analytical methods, have reduced this problem of quality control. The concentration method of expressing the strength of an extract does not accurately measure potency since there may be great variation among manufacturing techniques and raw materials. By using a high quality herb (an herb high in active compounds), it is possible to have a more potent dried herb, tincture, or fluid extract compared to the solid extract that was made from a lower quality herb. Standardization is the solution to this problem.

Standardized extracts (also known as guaranteed potency extracts) refer to an extract guaranteed to contain a "standardized" level of active compounds. Stating the content of active compounds rather than the concentration ratio allows for more accurate dosages to be made.

The best scenario for determining the quality of an herb is the level of active components or key biological markers. Regardless of the form the herb is in, it should be analyzed to ensure that it contains these components at an acceptable standardized level. More accurate dosages can then be given. This form of standardization is generally accepted in Europe and is beginning to be used in the United States as well.

This form of standardization, i.e., stating the content of active constituents versus drug concentration ratio, allows for dosage to be based on active constituents. For example, in Europe Silybum marianum extracts dosage levels are based on their active constituent levels rather than drug ratio or total extract weight, e.g., 70 mg silymarin for Silybum marianum. This type of dosage recommendation provides the greatest degree of consistency and assurance of quality.

Although referred to in terms of active constituents, it must be kept in mind these are still crude extracts and not isolated constituents. For example, an Uva ursi extract standardized for its arbutin content, say 10%, still contains all of those synergistic factors which enhance the active ingredient’s (arbutin) function.

She is living with a rare blood disease, has survived a heart attack and several strokes, but now she may die from what saved her.

Cathie Norwick, an Oshawa resident, found out just a few months ago the units of blood which saved her life may now kill her because the blood was tainted with hepatitis C.

Her views on the compensation package offered by the government are strong and she believes everybody who contracted the virus from bad blood should receive compensation.

"I wish the government would stop thinking about the money for a change and think about humanity," said Mrs. Norwick.

She believes families should also be compensated if the victim actually dies from hepatitis C.

Mrs. Norwick, 44, suffers from a rare blood disease that caused her to have a heart attack and several mini strokes. She started receiving blood in April, 1990 and the last unit of blood she received was in 1996. She could have contracted hepatitis C anytime between 1990 and 1996.

Mrs. Norwick gets "wonderful" support from family and friends and says "the hardest part is trying to survive it all-I'm not ready to die yet."

She knows the doctors and nurses are not at fault. "They take the blood on honour...they administer the blood to save lives and expect the blood is safe. This time, obviously, it wasn't." Now Mrs. Norwick's son, 16, is left wondering what will happen to him, if his mom dies.

Right now, Mrs. Norwick suffers from major migraines caused by blood clots which are caused by the original blood disease. She also suffers from chronic fatigue and memory loss that could be from the blood disease or from hepatitis C.

She doesn't know if she will be compensated by the government but, she is prepared to sue if she isn't. She feels bad for the people suffering from the virus who have young children.

Newspaper reports have suggested the Childhood Cancer Foundation-Candlelighters Canada is also urging the government to reconsider its decision and compensate all victims who contracted the virus through bad blood. The foundation supports all the victims but, in particular, their children.

Because the disease can take up to 20 years to surface, many anxious parents of young cancer victims now have that to fear as well, said Eleanor Pask, executive director for the Childhood Cancer Foundation-Candlelighters Canada.

"I hope the government does the right thing. They must know in their hearts what that is. Otherwise, hospitals and doctors will be held libel and that will be more expensive in the long run."

In March, the federal government and the provinces agreed the 22,000 Canadians who were infected with hepatitis C through tainted blood from Aug. 1, 1986 to June 30, 1990, would be compensated through a $1.1 billion fund

"Twenty per cent of the people with hepatitis C will die from it. It's like a game of 'Russian Roulette' as to who the 20 per cent will be," said Mrs. Norwick. Because of the other health problems she has suffered and is suffering from, she believes she may become one of the 20 per cent.

Ontario Premier Mike Harris and the premiers of Quebec and British Columbia are now demanding that the deal be reopened to compensate all victims of tainted blood.

We have continued to hear back from many of the drug companies doing investigational work into HCV (Vertex, Agouron, GlaxoWellcome, Chiron, Gilead and Ribogene). Unfortunately, they are all in the developmental stages at this time. That means they have yet to discover the protease inhibitors to do the work. However, they have all agreed to keep us on file and we will keep in touch with them. We are also working very hard right now on setting up some sort of Clinical Trials Registry for HCV. As this progresses we will keep you informed In keeping with the above, we have sent the drug companies an issue of the hepc.bull so that they can see the work that we are doing. And we will continue to research for more companies.

We are also working very hard right now on setting up some sort of Clinical Trials Registry for HCV. As this progresses we will keep you informed.

The first animal study, originating from a Cooperative Research and Development Agreement (CRADA) between Nabi and the Centers for Disease Control (CDC), was reported by Dr. K. Krawszynski of the Hepatitis Branch of the CDC. Dr. Krawszynski described preliminary results of multiple intravenous infusions of Nabi-Civacir administered over an 89-day period to a chimpanzee after experimental infection of the animal with HCV. Although HCV RNA levels and HCV antigen levels increased steadily in the control animal throughout the dosing period, the Civacir-treated animal became HCV antigen negative and HCV RNA negative and remained so after about 42 days of dosing.

Dosing of both control and Civacir-treated chimpanzees was ended on day 89, and the chimps continue to be followed to determine the long-range effects of the earlier treatment. These results from ongoing animal studies suggest that the elevated level of anti-HCV in serum maintained by multiple infusions of Nabi-Civacir may be associated with early termination of viremia and the possible elimination of HCV antigen from liver cells during experimental HCV infection.

In a separate investigational study also reported at the meeting, Dr. M.W. Yu of the Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, described the results of a study in which the HCV-neutralising capabilities of Nabi-Civacir was evaluated in chimpanzees. In this study, HCV was incubated in vitro with either Nabi-Civacir, or with albumin, or with standard intravenous immune globulin prior to its injection into chimpanzees. Both control animals developed evidence of HCV infection (HCV RNA and elevated ALT levels, and later anti-HCV) within 10 weeks, whereas the animal receiving HCV mixed with Nabi-Civacir has been followed for more than 1 year without evidence of infection. These results suggest that neutralising antibodies to HCV are present in Nabi-Civacir, which is prepared from virally-inactivated anti-HCV positive donor units, and that such a product might be useful in the future for the prophylaxis or possible treatment of HCV infections.

There were no adverse effects of Nabi-Civacir in either of the chimp studies and additional studies will evaluate the safety of the drug.

Three of the most common questions hepatitis C victims ask when they call our office are: "Do I need a lawyer to obtain compensation?", "How much are the legal fees?", and "How much will I have to pay if I don’t receive any compensation?"

While it is possible to pursue a claim for compensation without the help of a lawyer, victims are generally more successful and receive higher compensation, with legal assistance. Settlement agreements are usually complicated and often quite stringent about the documentation required to support a claim. Your lawyer will obtain copies of all the relevant hospital and medical records, order the needed physician reports, retrieve information from witnesses, and represent you in all dealings with the defendants.

Your lawyer will also act as your advocate in any settlement negotiations and can advise you on what constitutes fair and equitable compensation. Your lawyer will not agree to any settlement without your consent, and will advise you on whether you should accept the compensation package or pursue an individual lawsuit.

Klein, Lyons accepts hepatitis C tainted blood cases on a "contingency fee" basis. That means we are paid a percentage of any damages award you receive. We are not paid any legal fee until the client receives his or her compensation. When setting our fees, we take into consideration such factors as anticipated risk, cost and complexity of the case.

Our contingency fee for hepatitis C tainted blood cases is 33.33% of your settlement or damages award plus disbursements, GST and PST. If you decide not to pursue your claim, you will be required to reimburse us for out of pocket expenses but we will waive our legal fees. If you decide to change lawyers or act on your own behalf to pursue your claim, you will be asked to pay for the outstanding disbursements as well as a reasonable fee for our time.

We recognize the physical, emotional and financial hardship that this disease inflicts on its victims and their families. If we are unable to obtain compensation for a client, there will be no charge for legal fees or disbursements.

Camp Church and Associates

Sharon Matthews / Kim Graham

4th Floor, Randall Building

Vancouver, B.C. V6B 1Z5

1-(800) 689-2322

Grant Kovacs Norell

Bruce Lemer

Grosvenor Building

930-1040 West Georgia Street

Vancouver, BC, V6E 4H1

Phone: (604) 609-6699 Fax: (604) 609-6688

Before August 1, 1986

Klein Lyons

David A Klein

805 West Broadway, Suite 500

Vancouver, B.C. V5Z 1K1

(604)874-7171 or 1-(800) 468-4466

(604)874-7180 (FAX)

also:

Dempster, Dermody, Riley and Buntain

William Dermody

4 Hughson Street South, 2nd Floor

Hamilton, Ontario L8N 3Z1

(905) 572- 6688

The toll free number to get you in touch with the Hepatitis C Counsel is 1-(800)-229-LEAD (5323).

Pre 1986/post 1990

Mr. David Harvey

Goodman & Carr

200 King Street West

Suite 2300

Toronto, Ontario, M5H 3W5

Phone: (416) 595-2300

Fax: (416) 595-0527

TRACEBACK PROCEDURES:

The Canadian Red Cross Society

4750 Oak Street

Vancouver, BC, V6H 2N9

1-(888) 332-5663 (local 207)

This information is for anyone who has received blood transfusions in Canada, if they wish to find out if their donors were Hep C positive.

If you would like more information about class action/compensation, you can contact:

Tricia Plunkett Tel. (250) 479-5369

E-mail: plunket@islandnet.com