Natalie Rock, RN, BSN -Hepatology Clinical Research Nurse, Dept. of Medicine U.B.C., Vancouver Hospital Div. Gastroenterology

Dear Natalie,

Question 1: Have you found any alternative therapies that support or are good for HCV?

Patients are commonly trying alternative therapies for the treatment and management of hepatitis C such as Milk Thistle, Shark Cartilage, Echinacea, Dandelion, Vitamin Regimes, etc. In assessing over 500 patients in our clinic, many of whom are taking various alternative therapies, there is no apparent difference in the clinical course (enzyme level, viral levels) of those taking alternative therapy versus those who are not. However this is not to say that there is no benefit from some alternative therapies. patients have reported that taking certain herbal preparations have helped in the alleviation of symptoms of HCV and therefore alternative therapies are not discouraged. Certainly there is much needed research to be done in this area.

A healthy lifestyle is important in the body's ability to deal with chronic disease. Thus, the maintenance of good nutrition through a well balanced diet, and appropriate rest and exercise are very important. Other therapies such as massage therapy, therapeutic touch, acupuncture, etc. may help patients cope with and deal with the symptoms of the disease.

Question Two: Are there any preliminary results in from the INF/Ribavirin trials?

The preliminary results of the INF/Ribavirin trials are encouraging. In a small Italian study (Brillianti, Oct/96), seven out of eight "relapsers" (previously treated with Interferon but did not have a sustained response) who were treated for six months responded to combination therapy and after a three year follow-up had a sustained response (normal ALT, and negative HCV RNA) On the other hand, only one out of seven "non-responders" (previously treated with Interferon but did not have a sustained reduction in their ALT or HCV RNA), achieved a sustained response after a three year follow-up. Presently, a combination INF/Ribavirin study is under way at the Vancouver Hospital with 48 relapsers and 29 non responders currently enrolled. An initial assessment suggests very encouraging results, but only a few patients have completed the twelve month treatment course and results are still being analyzed. This study is part of a world wide multicenter study which incorporates a large number of patients so that meaningful results will be available over the next year. The success of this combination therapy, however, will need to be determined not only at the end of therapy, but also one, three, and five years after completion of therapy.

HepC BC