To Your Health

What usually happens with chronic hepatitis C infection, and can anything be done nutritionally to improve the outcome?

Q. My mother contracted hepatitis C, apparently from a blood transfusion in the 1980s, but is just now beginning to experience serious symptoms. What usually happens with chronic hepatitis C infection and can anything be done nutritionally to improve the outcome?

A. Hepatitis C is an inflammation of the liver caused by infection with the hepatitis C virus. HCV is carried by approximately 4 million Americans, making it the most common blood-borne infection in the U.S. Since 1992, blood banks have rigorously screened blood donors for HCV, but there are still about 35,000 new cases per year because of risky behavior such as recreational drug use.

Chronic hepatitis C often progresses imperceptibly over a period of 10-to-20 years, until it begins to damage the liver. Once cirrhosis of the liver develops, the most feared outcome is the 20% to 30% chance that liver cancer will develop. However, there is good news on the horizon.

In the July 21, 2004 issue of the Journal of the American Medical Association researchers at Osaka City University reported the accidental observation that supplements of vitamin K protect against the progression of liver cirrhosis to liver cancer. The study group was small, only 40 women, with 21 getting vitamin K in the form of vitamin K2 and 19 getting a placebo. In the placebo group, over a period of two years, nine women developed liver cancer compared to two in the vitamin K2 supplemented group. The study was intended to examine the role of vitamin K2 in the prevention of osteoporosis in women with viral liver cirrhosis when it was observed that it also reduced the occurrence of liver cancer. The study also fulfilled its original intent, demonstrating quite conclusively that vitamin K2 prevents osteoporosis in these women. This is an example of research that starts out to ask one question and then, serendipitously, produces results of another sort that are no less exciting and important.

The study above used vitamin K2 supplements of 45 milligrams per day, but there are two other sources of vitamin K. Vitamin K1 or "phylloquinone" is found in plants, notably kale, cabbage, spinach, and such. It is converted to vitamin K2 or "menaquinone" by the friendly bacteria in our intestinal tract. Third is the synthetic vitamin K3 or "menadione," which is not generally recommended since it can be toxic in high doses while K1 and K2 appear to be much safer. However, an individual on Coumadin, a common prescription blood thinner, should consult with his or her doctor before using any vitamin K supplement since it can interfere with Coumadin's function.

Vitamin K deficiency can occur at any age, but because breast milk is low in vitamin K and they do not have a lot of intestinal bacteria to produce it, infants are at higher risk than adults. Vitamin K deficiency is assumed to be uncommon in adults due to the intake of a wide variety of vegetables, adequate gut flora to produce vitamin K, and our ability to recycle and conserve the body's supply. This assumption may need to be questioned in view of the widespread osteoporosis we now see. Certainly the millions of Americans suffering from hepatitis C have reason to add a harmless food supplement to their other efforts to conquer this affliction.

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