Hepatitis C, Chronic

Publication Title: 
Gastroenterology Nursing: The Official Journal of the Society of Gastroenterology Nurses and Associates

The use of mind-body medicine by patients with chronic hepatitis C has not been reported. The prevalence and reasons for using mind-body medicine and prayer among a cohort of patients with chronic hepatitis C are described. Use of mind-body medicine and prayer was investigated as a component of a larger exploratory, descriptive study of the use of complementary and alternative medicine by patients with hepatitis C attending a tertiary healthcare facility in the United States.

Author(s): 
Richmond, Jacqueline A.
Bailey, Donald E.
McHutchison, John G.
Muir, Andrew J.
Publication Title: 
Complementary Therapies in Clinical Practice

BACKGROUND: The use of complementary and alternative medicine (CAM) is expanding globally. However, prevalence of its use by patients with chronic hepatitis C (CHC) remains unclear. METHODS: An exploratory, descriptive study was conducted using a questionnaire and interview to describe the use of CAM by patients with CHC attending a liver clinic in the United States. RESULTS: Eighty percent (n = 120) had used CAM in the last 12 months, most often prayer for health reasons (63%), multivitamins (56%) and herbal medicine (25%).

Author(s): 
Richmond, Jacqueline A.
Bailey, Donald E.
Patel, Keyur
Jezsik, Janet A.
Muir, Andrew
Lin, Jr-Rung
Chow, Shein-Chung
Uzarski, Diane
McHutchison, John G.
Publication Title: 
Medical Care

OBJECTIVES: We sought to assess health values of patients coinfected with HIV/hepatitis C (HCV) and compare them with those of patients singly infected with HIV or HCV and to characterize and assess the relationship of clinical and nonhealth-related factors with health values. SUBJECTS: We studied a total of 203 subjects infected with HIV, HCV, or both.

Author(s): 
Mrus, Joseph M.
Sherman, Kenneth E.
Leonard, Anthony C.
Sherman, Susan N.
Mandell, Karen L.
Tsevat, Joel
Publication Title: 
Journal of Clinical Pharmacology

Silymarin, derived from the milk thistle plant Silybum marianum, is widely used for self-treatment of liver diseases, including hepatitis C virus (HCV), and its antiviral activity has been demonstrated in vitro and in HCV patients administered an intravenous formulation of the major silymarin flavonolignans, silybin A and silybin B. The safety and dose-exposure relationships of higher than customary oral doses of silymarin and its acute effects on serum HCV RNA were evaluated in noncirrhotic HCV patients.

Author(s): 
Hawke, Roy L.
Schrieber, Sarah J.
Soule, Tedi A.
Wen, Zhiming
Smith, Philip C.
Reddy, K. Rajender
Wahed, Abdus S.
Belle, Steven H.
Afdhal, Nezam H.
Navarro, Victor J.
Berman, Josh
Liu, Qi-Ying
Doo, Edward
Fried, Michael W.
SyNCH Trial Group
Publication Title: 
Journal of Hepatology

BACKGROUND & AIMS: To evaluate the prevalence and risk factors for low bone mineral density (BMD) in persons co-infected with HIV and Hepatitis C. METHODS: HIV/HCV co-infected study participants (n=179) were recruited into a prospective cohort and underwent dual-energy X-ray absorptiometry (DXA) within 1 year of a liver biopsy. Fibrosis staging was evaluated according to the METAVIR system. Osteoporosis was defined as a T-score ≤-2.5.

Author(s): 
El-Maouche, Diala
Mehta, Shruti H.
Sutcliffe, Catherine
Higgins, Yvonne
Torbenson, Michael S.
Moore, Richard D.
Thomas, David L.
Sulkowski, Mark S.
Brown, Todd T.
Publication Title: 
Drug Metabolism and Disposition: The Biological Fate of Chemicals

Silymarin, derived from the milk thistle plant Silybum marianum and widely used for self-treatment of liver diseases, is composed of six major flavonolignans including silybin A and silybin B, which are the predominant flavonolignans quantified in human plasma. The single- and multiple-dose pharmacokinetics of silymarin flavonolignans were examined in patients with nonalcoholic fatty liver disease (NAFLD) or hepatitis C virus (HCV) to determine whether the disposition of silymarin and therefore its potential efficacy vary among liver disease populations.

Author(s): 
Schrieber, Sarah J.
Hawke, Roy L.
Wen, Zhiming
Smith, Philip C.
Reddy, K. Rajender
Wahed, Abdus S.
Belle, Steven H.
Afdhal, Nezam H.
Navarro, Victor J.
Meyers, Catherine M.
Doo, Edward
Fried, Michael W.
Publication Title: 
Clinical Trials (London, England)

BACKGROUND: Chronic hepatitis C is associated with significant morbidity and mortality as a consequence of progression to cirrhosis, hepatocellular carcinoma, and liver failure. Current treatment for chronic hepatitis C with pegylated interferon (IFN) and ribavirin is associated with suboptimal responses and numerous adverse effects. A number of botanical products have been used to treat hepatic disorders. Silymarin, extracted from the milk thistle plant, Silybum marianum (L) Gaertn.

Author(s): 
Reddy, K. Rajender
Belle, Steven H.
Fried, Michael W.
Afdhal, Nezam
Navarro, Victor J.
Hawke, Roy L.
Wahed, Abdus S.
Doo, Edward
Meyers, Catherine M.
SyNCH Study Group
Publication Title: 
JAMA

CONTEXT: The botanical product silymarin, an extract of milk thistle, is commonly used by patients to treat chronic liver disease, despite scant and conflicting evidence of its efficacy. OBJECTIVE: To determine the effect of silymarin on liver disease activity in patients with chronic hepatitis C virus (HCV) infection unsuccessfully treated with interferon-based therapy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, double-blind, placebo-controlled trial conducted at 4 medical centers in the United States.

Author(s): 
Fried, Michael W.
Navarro, Victor J.
Afdhal, Nezam
Belle, Steven H.
Wahed, Abdus S.
Hawke, Roy L.
Doo, Edward
Meyers, Catherine M.
Reddy, K. Rajender
Silymarin in NASH and C Hepatitis (SyNCH) Study Group
Publication Title: 
Hepatology (Baltimore, Md.)

Intravenous silibinin (SIL) is an approved therapeutic that has recently been applied to patients with chronic hepatitis C, successfully clearing hepatitis C virus (HCV) infection in some patients even in monotherapy. Previous studies suggested multiple antiviral mechanisms of SIL; however, the dominant mode of action has not been determined. We first analyzed the impact of SIL on replication of subgenomic replicons from different HCV genotypes in vitro and found a strong inhibition of RNA replication for genotype 1a and genotype 1b.

Author(s): 
Esser-Nobis, Katharina
Romero-Brey, Inés
Ganten, Tom M.
Gouttenoire, Jérôme
Harak, Christian
Klein, Rahel
Schemmer, Peter
Binder, Marco
Schnitzler, Paul
Moradpour, Darius
Bartenschlager, Ralf
Polyak, Stephen J.
Stremmel, Wolfgang
Penin, François
Eisenbach, Christoph
Lohmann, Volker
Publication Title: 
Journal of Viral Hepatitis

Silymarin displays anti-inflammatory effects on T lymphocytes in vitro. The immunomodulatory properties of oral silymarin in vivo in humans with chronic hepatitis C have not previously been characterized. We hypothesized that silymarin would suppress T-cell proliferation and pro-inflammatory cytokine production of virus- and non-virus-specific T cells while increasing anti-inflammatory IL-10 production in vivo.

Author(s): 
Adeyemo, O.
Doi, H.
Rajender Reddy, K.
Kaplan, D. E.

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