June 2001/July 2001
Killing the Host to Stop the Virus?
Alternative Strategies to Combat Hepatitis C
By William Triplett
Many Vietnam veterans have only begun to learn that they may be
prey to a slow, silent killer Ė hepatitis C. Health experts
estimate that some 3 million Americans have this potentially fatal
virus, which attacks the liver and for a while has been the
number-one cause of liver transplants in the United States. But
Vietnam veterans Ė particularly combat vets, because of the way
the disease is spread Ė are far more likely to be infected than
the general population.
The hepatitis C virus (HCV) is blood-borne, and Vietnam combat
vets were subjected to an extraordinary amount of blood exposure,
usually through transfusion. HCV was isolated and identified only
within the last 12 years; the blood supply during the war was not
screened for it.
But a veteran didnít necessarily have to be wounded and
transfused to contract HCV. "My worst case was a man who had
the unpleasant job of sending dead men home from the war,"
says Dr. Bennet Cecil, an HCV specialist in Louisville, Ky.
"He was the one who had to put them in body bags, and he got
hepatitis C from that. He later got cirrhosis and died from liver
cancer not long ago."
Not everyone who has HCV dies from it. Indeed, statistics
compiled by the Centers for Disease Control show that fewer than
three percent of infected people do. About 80 percent of sufferers
experience only mild symptoms for a long time because HCV usually
takes 20-to-30 years to do serious damage. Those infected in
mid-life or later will likely never experience problems and will
die of something unrelated to HCV. But the majority of infected
Vietnam veterans were exposed more than 30 years ago. For them,
the clock is ticking.
The Department of Veterans Affairs, while aware of the threat
posed by HCV to the Vietnam generation, has been slow to respond.
"The VA has talked the talk but largely has not walked the
walk," says Dr. Cecil, who works two days every week at the
Louisville VA Medical Center. "A lot of veterans are having
difficulty getting treatment. We have people coming from other [VAMCs]
because the doctors there wonít treat them."
Part of the reason has been that the standard treatment for HCV
is expensive and ostensibly beyond the VAís budget. Yet,
although Congress recently allotted funds to the VA specifically
for HCV treatment, most VAMCs continue to treat relatively few HCV-infected
Complicating matters further is the fact that the standard
treatment works for relatively few people taking it, and for some
genotypes, not at all. Alternative treatments exist, but because
the U.S. Food and Drug Administration doesnít recognize them,
the VA will neither use them nor pay for veterans to use them.
Veterans are left hoping that medical science will develop
something more effective before HCV starts destroying one of their
bodyís most important organs, or they can seek alternative
treatment on their own.
The first thing to do is to get tested. This requires
specifically asking for an HCV test, which is available through
the VA health care system. Veterans can call their nearest VAMC or
health clinic for more information or go online to www.va.gov/hepatitisc.
For detailed information and background on HCV, call the CDCís
hotline at 1-888-4-HEP-CDC.
The VA recommends testing for veterans who meet any of the
you are a Vietnam-era veteran
you had a blood transfusion before 1992
you have injected drugs (past or present)
your skin or mucous membranes have been exposed to another
you have had multiple sexual partners
you were on hemodialysis
you had tattoos or repeated body piercings
you have a history of using cocaine
you have unexplained liver disease
you have unexplained/abnormal ALT levels
you have a history of drinking alcohol excessively
The VA is not alone in recommending that veterans be tested. In
a recent interview with Health Talk Interactive, Dr. Adrian
DiBisceglie, medical director of the American Liver Foundation and
professor of internal medicine at St. Louis University, said,
"We are interested in encouraging veterans to be tested,
particularly veterans of the Vietnam era as it turns out hepatitis
C is very common among this group."
If the test, which looks for the presence of HCV antibodies in
the blood, is positive, veterans should then undergo an HCV-RNA
test, which minutely measures the level of the virus, or
"viral load," in the system. A veteran with a viral load
of less than 50 is considered to be uninfected, even with a
positive HCV antibody test.
A viral load of more than 50 should then trigger a test to
determine the genotype of the virus. This is critical, for the
virus has six known genotypes, and generally only those people
infected with genotype-2 or -3 tend to respond to the standard
medical treatment. Whatever the genotype, however, infected
veterans should then have a complete assessment of their health
performed because the standard treatment is toxic and can
seriously harm those who might also be suffering from other health
For example, if an HCV patient also has heart disease, the HCV
treatment can precipitate a heart attack. These patients should
always have stress tests performed before undergoing HCV
Currently, HCV treatment consists of a combination therapy Ė
interferon injections and ribavirin pills. Interferon is a protein
that the human immune system uses to fight off infections.
Of the two, interferon has the more deleterious side
effects. It can cause body aches, fatigue, sleep problems,
irritability, and feelings of deep depression possibly leading to
suicide. Moreover, according to the web site www.holisticcancersolutions.com
"An important side effect of interferon is worsening of liver
disease with treatment, which can be severe and even fatal."
Ribavirin can damage red blood cells, and if enough are
damaged, anemia can result. Anemia in an HCV patient with heart
disease can lead to a heart attack.
More troubling than the side effects, however, is the
relatively narrow profile of patients who respond to interferon
and ribavirin. The majority are less than 45 years old, have only
minimal fibrosis present in the liver, are for the most part
female, and have either genotype-2 or -3. Most HCV cases in the
U.S. are genotype-1A or -1B, the strains of HCV least likely to
respond to standard treatment.
Nevertheless, Dr. Cecil argues that Vietnam veterans Ė only a
handful of whom might respond to treatment, given the above
parameters Ė should still be tested and seek treatment, if
necessary. "There are so many exceptions to the rules that I
donít think people should use them to decide whether or not to
be treated," he says. "Iíve got patients who are
genotype-2 who do not respond, and they should. Iíve got other
patients who are genotype-1, the genotype that usually doesnít
respond, [and their viral loads] go to undetectable in a
Dr. Cecil does acknowledge, though, that HCV patients on
interferon and ribavirin should see significant results within 30
days. "If youíre not going down in your viral level by more
than 90 percent every month, youíre not going to succeed."
At that point the patient should either increase dosage Ė and
possibly the toxicity of the side effects Ė or quit the therapy.
There are alternatives to the standard therapy, and VVA
strongly recommends that HCV-infected veterans consider all of
them before entering any kind of treatment. VVA also recommends
that veterans carefully consider where they go for treatment.
While the Veterans Administration has been reliably providing HCV
antibody testing, there have been reports, and not just from Dr.
Cecil, of the VA health system failing to do much of anything
In a recent letter to a VVA service representative, William F.
Feeley, director of the VA Western New York Healthcare System,
wrote that "evaluation ofÖ genotypes and quantification ofÖ
viral loadsÖ are excellent indicators of who will respond to
treatment. I understand these expensive tests may have been denied
to some veterans at other facilities."
Above all else, VVA believes veterans should be aware of as
wide a range as possible of what is currently available regarding
treatment of hepatitis C. What follows are the personal stories of
some HCV patients who have tried the standard as well as
alternative treatments. Also included is testimony from an
acupuncturist who treats HCV patients.
Ramona L. Jones is a certified nutritional consultant, who, in
response to her own hepatitis C, developed a cookbook for people
with a diseased liver. One VA Medical Center has adopted her
recommended diet. The book is available by calling her at
I was diagnosed in 1992, after feeling really bad for about six
years. During that time, Iíd gone to different doctors, and they
all told me it was in my head. Some said I was depressed and put
me on Prozac. I continued to have symptoms until finally I found a
doctor, a general practitioner in San Antonio, who diagnosed
hepatitis C. They think I got if from blood transfusions when I
had open-heart surgery. Eighteen transfusions, all donated by GIs.
The GP said I was terminal and he couldnít help me, so I told
him he was terminal. He said he would send me to a specialist and
said the only treatment he knew of at the time was interferon. So
I did a little research about interferon before going to the
specialist, and after that I decided I did not want to take the
Itís a poison. Itís like chemotherapy in that it kills the
good with the bad. I couldnít see putting myself through that. Iíd
already been through enough, and I couldnít find anybody it had
really helped. There were also a lot of long-term side effects,
some of them permanent, so I just couldnít see subjecting myself
to further damage and being sicker than I already was.
So thatís how I got started into vitamins and herbs. I
started studying them and found a couple doctors in San Antonio
who are into natural alternatives, and one of them worked with me
for two years, teaching me everything he knew.
I started treating myself, and within four months I had my
liver enzymes in a normal range. I felt fine and could function a
lot better. And Iíve been doing that ever since. I do still have
hepatitis C but as far as they know, itís dormant.
I was never tested for genotype, and it didnít matter to me
since it wasnít going to change my [decision to use alternative
treatment]. But I did have a [liver] biopsy recently. I was having
my gall bladder removed, and the doctor did a liver biopsy without
me knowing it. The biopsy showed no damage to the liver, and in
fact, the fatty infiltrations that had been there five years ago
were now gone and that the hepatitis was there but it was not
The first thing about treating yourself is proper diet. You can
take all the herbs and vitamins you want, but if you donít
follow proper diet youíre going in circles. Your goal is to take
all the stress off the liver that you can, and if you eat improper
foods you continue to stress the liver. Low fat, high fiber, and
as much as possible organic foods. Foods that are not hard to
digest. You need to keep the immune system boosted. The vital
organs all work in conjunction with each other: If oneís
stressed, theyíre all stressed. So you have to pay attention to
the whole body.
I was in Vietnam in 1969 in a naval security group on a swift
boat doing electronic intercepts, and we got caught in a
crossfire. A bullet hit the radio receiver and some shrapnel flew
off, and I got a little piece of it in my leg. But the guy next to
me had a major arterial wound and bled all over me. Because of
that, the corpsman thought we were both seriously injured. I guess
the corpsman had only been in-country 48 hours because he panicked
and just stuck IV needles in both of us. When he started cleaning
me off, he found that I wasnít seriously wounded, and he pulled
the IV. I think thatís maybe when I caught it, because I had my
transplant in 1997, and if you count back the years Ė 28 Ė
thatís about the right amount of time for hep C to do its
I was diagnosed in 1983. I thought at the time I had some kind
of infection because I was feeling weak and tired and felt like I
had a flu. I went to see a doctor, who said I didnít have the
flu but something called hepatitis non-A, non-B. Hepatitis C was
not identified until 1989.
They didnít do anything for me at the time because there was
nothing they could do except watch it. I changed doctors, and in
1991, I was put on one of the first trials of a new version of
interferon. But I had a virulogic breakthrough in three months of
a six-month protocol, meaning the virus had broken through the
treatment and [the viral load] was climbing. So the doctor said no
sense keeping me on interferon, and took me off it.
He had actually put me on Prednisone for three weeks. That
probably contributed to the [breakthrough] because Prednisone is
now contraindicated for use in people with hepatitis C. I also
have genotype 1-A. The absolute worst is 1-B in terms of not
responding to interferon, but 1-A is almost the same as 1-B as far
as results go.
So I thought, well, gee, if this disease is progressing, well,
my first diagnosis had shown mild fibrosis of the liver, the
second had shown bridging fibrosis, which is the next stage up.
Obviously the disease was progressing, so I asked if I was a
candidate for a transplant. I was told no because of my
substance-abuse history. The fact is this was five years after I
had stopped using.
So I didnít do anything until three years later when I
noticed I was gaining weight even though I was eating a low-fat
diet and trying to exercise. My legs were filling up with fluid
and my gut was getting big. I saw another doctor, and he said I
had pronounced cirrhosis, about 80 percent sclerotic liver. They
said it was too late for interferon to do anything for me, so theyíd
just monitor me.
In 1996, I went into the hospital for a bacteriological
infection, and a doctor came in and said he thought it was time I
get listed for a transplant. So I went to Johns Hopkins hospital
[in Baltimore] and was screened and listed that December, then was
transplanted in June 1997.
Even with the transplant, I still have hepatitis C. I just had
a biopsy a few weeks ago, and I have mild fibrosis and a
pronounced inflammation, so itís already attacking my new liver.
In 1999, I went on a sort of combination of various forms of
interferon. It was to be for six months, but again in three months
I had another virulogical breakthrough. Iím hoping that the way
of the future is to get away from interferon.
What Iím doing now is I watch my diet, I try to exercise as
much as possible. I do fast-walking, and I try to get a lot of
rest. On those days I feel real fatigued I just take a nap. My
health right now is that Iím functioning. Iím not end-stage at
Nat Slayton is a Vietnam-era veteran who followed the advice
and treatment VA doctors gave him. He is now sorry he did.
For about 15 years or so I'd been experiencing different types
of rashes. They could appear as welts, as if someone had beat me
with a whip. Or they could appear as scabs or redness on my face.
The only thing that ever worked for me was a huge dose of
Benadryl. Sometimes I would be given Benadryl shots, which would
knock me out completely for eight or ten hours.
I was complaining to a doctor at Bethesda Naval Hospital that
this had been going on for a long time, and in 1998 he ran some
tests. When they came back he said, "You have hepatitis C,
and that's causing the skin rashes." During my service I had
two incidents where I had blood transfusions. One was an
automobile accident, and the other was a gunshot wound. Could have
been either one of those where I caught hepatitis C.
Anyway, the Bethesda Naval doctor said the military wasn't
treating hepatitis C at that time, so I scheduled an appointment
with my VA doctor. I said I wanted to be tested for hepatitis C,
and he asked why. I said because I'd been tested and had come up
positive, and I need to be tested again. The VA tested me and I
came up positive. Next they did a liver biopsy. And then they said
they had a treatment for me. I said, "great."
They scheduled me for the liver clinic. I met with a doctor
there who told me that since I was also being seen at the time by
a mental-health specialist, I needed to get clearance from him
before starting the treatment. Because sometimes the treatment -
interferon - can cause severe depression. I got cleared for
treatment and so started taking it.
At the time I was attending University of Maryland and was
maintaining a 3.875 grade point average. I was kicking butt. I
wasn't sure if it was the medication or maybe the stress of my
life at the time - I was looking for a job and had family problems
and other health problems - but suddenly I developed a serious,
My doctor was asking me if I was having problems from the
treatment, and I said, "Yes, the depression." So the
dosage was cut in half. I didn't know then that genotype had
anything to do with response to treatment. Anyway, this was about
a month into it, and I was still feeling bad, even worse. Some
days I could not get out of bed. My joints ached, I started
sleeping in a separate room because I couldn't stand my wife
touching me, it was terrible.
I stayed with the treatment, though, because sometimes my body
takes a long time to react to medication and I felt that in the
long term, this was going to be beneficial. My doctor agreed, so I
went back up to the normal dosage. This was about two months into
About the third month of treatment I met a nurse there, and she
asked me how was I doing. I told her I was having all kinds of
problems. She told me that normally these problems go away after
about six weeks. I said my problems were escalating. She asked me
what genotype I was. I said, "Genotype? What's that?"
She said your genotype determines whether this program is going
to work for you or not. I asked my doctor for my genotype. She
said it's in a separate database that she couldn't get to. She did
say she'd have it by the next time I came in. I came back in two
weeks and asked her about my genotype again. She gave me a
So I talked again with the nurse who first told me about it. I
don't know how she did it, but she later told me I was 1-B. I
asked what that meant. She said it was the least receptive to the
medication I was on. I said, "What do you mean, least
receptive? I was told the success rate was 30-40 percent."
She said that was for other genotypes. "The success rate for
your genotype is less than 10 percent." She also said my
records showed I'd been originally diagnosed with hepatitis back
in 1988! I'd gone to the VA for something, they'd taken a blood
test, and it had come back positive. They'd never told me.
I was four months into the program. My GPA had plummeted to
2.5. My wife had threatened to leave me. My daughter didn't want
me to come around. And now I was finding all this out.
During my last visit with the VA, they told me they were going
to put in an application for me at National Institutes for Health,
where they have a hepatitis C program using a different drug.
There's a possibility I wouldn't be accepted because of my
genotype, and because my condition is not severe enough, even
though my doctor at Bethesda had told me that my viral load was a
I'm in no treatment at the moment. I still don't know if I've
been accepted into the NIH program. My VA doctor also told me that
hepatitis C is "historical," meaning that if it did not
get worse in the past, it won't in the future. I said, "How
can you say that? Once you get a disease, if it goes untreated,
it's probably going to get worse, right?" She told me not to
I wish I could say something positive about the VA doctors. All
of them appeared caring. My feeling now is that was a masquerade.
I once thought they were acting in my best interest, but I don't
believe so now.
Diana Donaldson maintains her own web site -- http://alternativehopeforhepc.com
-- and has transformed her suffering from hepatitis C into
passionate advocacy for alternative treatment. She also sells an
alternative treatment package. Her toll-free number is
I was diagnosed three years ago, genotype 1-A. Most of us in
the United States are 1-A or 1-B. When I'd heard that 1-A and 1-B
are both very unresponsive to the standard treatment, the
combination of interferon and ribavirin, I didn't want to do it.
For a lot of people taking the combo, their immune system gets
worse. They'll get thyroid problems, worse mental fog problems,
and it can lower your platelets, which clot your blood. Some new
data I understand is linking autoimmune disease now with the combo
For me, my treatment consists of building up my immune system
and creating an environment where the virus can't duplicate.
My package basically builds up the immune system and helps with
energy levels because it helps you detox your liver. My enzymes
were elevated before but on this program they've been totally
normal for two years. There are a few doctors who are trained in
both arenas of standard medicine and alternative treatments. For
genotype-2 or -3, they'll recommend the combo treatment, but for
those of us who are 1-A or -B, they say let's wait for something
better medically to come along, but in the meantime let's clean up
your diet, drink more water, and let's get you on herbs and
supplements and anti-oxidants.
I started aggressively taking a powerful anti-oxidant called
Micohydrin and other natural supplements. I also drink lots more
water. Distilled water is best, but I switch back and forth during
the week from regular bottled water to distilled. Cutting out most
sugars has been important. Sugar can be hard for a challenged
liver to process, as are red meats, fried foods and junk food and
processed foods in general.
I started little by little eating more and more raw organic
vegetables and fruits. I found, too, that natural, water-soluble
vitamins are the best, and after research I believe in the quality
of the supplements I'm taking. I understand now that certain
minerals, herbs, and vitamins can be toxic so I read all labels.
At the NIH Conference for Complementary and Alternative Medicine
for Liver Disease that I attended last fall I was frightened to
learn both iron and man-made vitamin A can be toxic, possibly
[advancing] scar tissue if fibrosis or cirrhosis are already
I feel that day by day my liver and system are detoxing and my
blood cells are getting the essential nutrients they need to
create new and healthy blood cells and tissue. The liver is one of
the organs that will regenerate, and nutritional products will
support that. My skin is looking healthier, I have lots more
energy, no more headaches, less aches and pains, and I'm feeling
much better overall. My liver function tests have been normal now
for some time including the enzyme levels.
Linda Miyoshi trained as a nurse but is now a practicing
acupuncturist who treats people with hepatitis C.
In Chinese medicine, by that I mean acupuncture and herbal
treatments, itís not about killing the hepatitis C virus. It's
about strengthening the body to be able to function well and not
be debilitated by the virus. With acupuncture and Chinese herbs,
we are able to normalize liver functions, which can be measured by
Western blood tests, and mitigate the symptoms of hep C, so the
person is able to live out his life.
Even if a person has a liver transplant, he will still carry
the virus. Why not just take care of yourself with a much less
invasive, gentle technique that has been around for centuries.
Hepatitis and other liver health issues are endemic in China. That
is why Chinese have so much experience dealing with liver disease.
By treating each individual, not as a hep C patient, but looking
at how hep C has affected their whole being, we can bring the
person back to a better balance. Hep C affects more than just the
liver. It can affect the spleen and kidney and cause other
problems. With Chinese Medicine, even advanced disease may be able
to be reversed.
All this is taken into consideration when planning treatment.
There are protocols developed for Hep C treatment, using ear
acupuncture, regular acupuncture, and specific herbal formulas,
that help suppress the viral load, improve immune function, clear
jaundice, normalize liver enzyme levels, reverse fibrosis, and
improve cirrhosis. Fatigue is reduced, appetite is improved,
headaches are relieved, as is liver pain. Antiviral treatment is
not the top priority. The patientís quality of life and
stabilizing and optimizing organ function is more important in
These days, more and more people are turning to Chinese
medicine to help them with this disease.
Dave Myers has been battling hepatitis C for almost 30
years. He, too, runs a support group for HCV patients.
I was in the Navy, in board-and-search patrol. This was 1967
through '71. Part of what you do on board-and-search is they give
you a flak jacket, a .45, and a flashlight. You go below decks and
pull off the little guys in the black pajamas. I was exposed to
blood several times. I received cuts quite often below decks. I
was also in an automobile accident in 1969. I ended up with three
broken ribs and the other guy with me ended up on top of me with a
lacerated forehead bleeding all over me.
So there are any number of ways I could have contracted
hepatitis C. I was first diagnosed in 1973 with what they were
then calling hepatitis non-A, non-B. I was experiencing a lot of
nausea, my stool was almost white, and I was very fatigued often.
I'd gone to a private hospital, a regular civilian doctor, but he
couldn't really do anything for me because they really didn't know
much about the disease then. Nobody did.
The VA never called me in on anything. I was told, and I quote,
that I had "sub-acute chronic hepatitis," but that I was
not contagious. So I thought I was just okay, that I'd just be
monitored, and so I didn't take any interferon or anything because
there was no sense of urgency about it. I kept drinking and
partying and having a good time. It wasn't until 1991 that I found
out I have hepatitis C. And ever since I've tried to teach people
that you have to be your own advocate. If a doctor can't give you
answers, go to another doctor, but that's hard within the VA
I was never genotyped in the VA. But I finally got to the point
back in '73 that I hurt so bad that they decided to do a liver
biopsy on me. They said that my gall bladder would have to come
out eventually. Well, that didn't happen until 1995, and I had to
fight with them to do a second liver biopsy. Now, they don't like
to do biopsies, but without a liver biopsy, you're never really
going to know [how far hepatitis C has progressed]. But by then I
was too far gone. I had cirrhosis. I wasn't happy with the VA. I
figure they should have been a little better in following up on
I'm now 100 percent disabled. I'm divorced and unemployable, so
since I've basically got nothing, I've thought, why not go [back]
to the VA system? I went to my local VA clinic and they just loved
seeing me. "We're really glad you're here! We'll see you back
in 14 months!" Fourteen months? What are you talking about?
The woman there said they had a backup for that long. I said I
hadn't come in for a sprained wrist but a terminal disorder.
"Oh, you can drive down to the other clinic and wait
I am now about to go into in a program with an expert who works
at Georgetown University Hospital. This is a VA program, but I'm
doing it because of this expert. I trust him -- he doesn't work
for the VA. If he wasn't involved, I wouldn't be doing it. I'll be
taking what's called a maintenance dosage of interferon, a smaller
dosage, of what they normally dispense. I'm told this helps
reverse the fibrosis in the liver. I was finally genotyped: 1-A.
One of the bad boys. I'm told I have two years to live, so I've
got to do something.