The other side of antiviral treatment: With great expectation comes great disappointment

Over the years, people have used interferon as the primary treatment for chronic hepatitis. Direct-acting antiviral drugs (DDAs) launched in recent years can control the replication of hepatitis virus. Although the prices of these drugs are very high, they are more effective than interferon. [1] Overwhelming introduction to these new medications has given patients high hopes and expectation.

The genotype of the virus, the extent of liver damage, and the way patients use the medication all have an impact on the effectiveness of the drug. [2] While the virus can be successfully eradicated in some patients, there are also cases of failure. We can easily find messages from patients who failed DDA treatment on the Internet. For those who had high hopes and expectation for the drugs but eventually failed the treatment, the disappointment is enormous.

“I’m depressed now - more than I ever was before I heard there was such a great treatment on the market.” - smmace. [3]

What should patients who failed to eradicate the virus after receiving various antiviral treatment do now? How can they control the disease? This is a very fundamental, important and urgent issue for all hepatitis patients, including hepatitis B/C patients, patients who are not suitable to undergo medication treatment, patients who had to stop treatment due to side effects, patients who had no response to treatment, and patients who relapsed after a successful treatment and so on. 

To control the disease, patients must first understand that the amount of virus in the body does not directly relate to the extent of liver damage. The book Addressing Viral Hepatitis in People With Substance Use Disorders stated that ‘The extent of liver damage does not correlate with measures of HBV DNA or HCV RNA. A low viral load does not mean a person has little liver damage, nor does a high viral load necessarily indicate more severe infection or more advanced disease.’ [4] The viral load test can only be used as a reference as to whether antiviral treatment is working. 

In fact, studies have already proven that many hepatitis carriers contain a large amount of hepatitis virus in their body, yet their liver function (ALT level) remains normal. It is also suggested that hepatitis C treatment is not required unless the liver becomes inflamed. [5] We can use ‘bees’ as an example: When stung by dozens of bees, some people may require immediate hospitalization, the situation might even be life threatening. However, some others can have their body covered in millions of bees without being injured. The reason for this is that bees were not born to sting. Therefore, killing the bees, i.e. the virus, is not a must for liver patients, as long as they do not cause any harm. Once liver patients understand this, the answer to controlling the disease becomes quite obvious - protecting liver health does not necessarily require the elimination of the virus.

However, if patients are constantly under attack from the bees, and at the same time ‘insecticides’ or killing the bees is not an option, then what should they do? The answer is simple, they just need a ‘protective suit’ to protect the body against the attack by the bees. The situation is the same with protecting the liver. Why is the hepatitis virus so scary? Because it can cause liver inflammation, and chronic inflammation of the liver can lead to liver fibrosis, cirrhosis, or liver cancer, which are the main reasons for liver transplant and surgery. [6] Thus, an effective ‘protective suit’ should be something that can anti-inflammatory and help to control inflammation in the liver. Liver damage can be greatly reduced as long as there is no inflammation in the liver. This can also help the liver to recover and function better.

Take YHK as an example: it is a highly effective ‘protective suit’. Studies have shown that after using it for 10 to 30 days, the ALT level of hepatitis patients are normalized, effectively stopping inflammation in the liver. [7][8][9] For chronic hepatitis patients, both ‘insecticide’ and  ‘protective suit’ are beneficial tools, if patients are unable to find an effective ‘insecticide’, or feel that the effect of the ‘insecticide’ is not ideal, it is probably better to seek an effective ‘protective suit’. This is a safer and more secure option for the patients’ health compared to sitting there waiting for a new ‘insecticide’ to emerge.