Frontline Hepatitis C Risk Assessment Form

Call with questions: 360-805-1700 or Toll free at: 1-866-hep-gogo (437-4646). Call if you want to be mailed info and are not in touch with a computer. Please be tested and get involved in this work. HCV is an epidemic and affects 4 times more than the HIV virus in the USA. We also work with those who are Co-infected with HIV.

Currently or in the past have you:

· Been exposed to improperly sterilized (not autoclaved) equipment while having a tattoo, dental work, beauty shop procedures or body piercing? _____________
· Snorted cocaine or other drugs with a shared straw or rolled paper? __________
· Injected IV drugs even one time? -------
· Shared a toothbrush, razor or any item, which may contain infected blood? __________
· Been in the military? ____________
· Had multiple sex partners? ___________
· Been in Prison? _____________

Has your work ever put you in contact with blood, blood products, or needles? Such as:

· Health Care: Doctors, Nurses, Dentists or Dental workers, Oral Surgeons, Hospital Cleaning Services
· Institution Workers: Nursing Home/Elderly Care, Psychiatric Hospitals, Substance Abuse and Treatment Centers or Hospice
· Science Laboratories
· Clinical Laboratories
· Tattooists
· Beauticians or Barbers
· Emergency Services, Firefighters, Police Officers or Paramedics
· Prison Services: Corrections Officers, Prison Janitorial staff and cleaning persons
· Armed Forces: Army, Navy, Air Force, Reserves, Coast Guard
· Currently, or in the past, have you experienced any of the following?
· Blood transfusion before 1992?
· Elevated liver enzymes test (ALT)
· Any surgery, including dentistry or Cesarean birthing, where blood or blood product were administered
· Hemodialysis (treatment with a kidney machine
· Chronic fatigue/tiredness for which your doctor was unable to find an explanation
· Diagnosis of HIV-positive
· Diagnosis of hepatitis B or C (non a or B)

If so you qualify as high risk for Hepatitis C and are in need of testing, we have free anonymous testing kits available if you want to be screened for Hepatitis C. Call us please.

Sign the sign-up sheet here if that is easier for you and we will contact you soon. Thanks.


Frontline Hepatitis Awareness, educating in the PNW for 5 years, hosting rallies and musical events through our "Dancing With the Dragon" Productions events in WA. We use donations to help many patients with HCV. Frontline is a 501C(3) Charitable Organization dedicated to raising awareness through education and outreach. We have received honors from the City and County for our efforts. We hope to eradicate the STIGMA so folks will be more willing to admit to at least themselves it is OK to have this virus, it is not OK to let it destroy your body without empowering ourselves and making lifestyle changes if necessary to be able to go through treatment to rid our bodies of this Dragon we call the Hepatitis C Virus. We all deserve to be healthy. It is not easy to know we will have to make changes; some of us have done the necessary changing to be able to receive treatment and of those who are and have been willing 25 to 40% are today virus free. There is hope!
Sandra Tara Balduf
Frontline Hepatitis Awareness
701 West Elizabeth #54
Monroe, WA 98272
http://frontline-hepatitis-awareness.com
Help Line 1-866-hep-gogo (437-4646)
hepbegone@yahoo.com

The Liver: -Master Organ for Optimal Nutrition

The liver is the master organ for creating optimal nutrition for all the 50 trillion cells in your body. The liver is the body's largest organ, weighing three to five pounds in adults.  It uses 12 - 20% of the body's total energy, and it must generate this energy to it's own cells.  The liver routinely performs over 500 known functions to regulate your cell's metabolism.  It is the "alchemical wizard" of the body, transforming toxin into harmless chemicals for excretion, and digestively absorbed nutrients into the proper biochemical forms your cells can use to function.  Yet the liver is probably the organ most assaulted by toxic modern lifestyles, full of pollution, stress, junk foods, drugs, etc.

In the US 40,000 deaths a year are due to liver disease.  Yet most people will never suffer from hepatitis, cirrhosis, or jaundice, the "classic" liver diseases.  Toxic modern lifestyles may however promote "sub clinical" liver dysfunction. And, as this review will make clear, no matter how good your diet and digestion, if your liver does not perform its many jobs properly, your cells can still be grossly malnourished.  Optimal nutrition is a function, not just of what we eat and digest, but of how well the liver bio-transforms incoming food nutrients into forms that the bloodstream can transport to all the body's cells, and that the cells can use to perform their metabolic functions.

Key Liver Functions

1. The liver converts the thyroid hormone thyroxine (T4) into its more active form tri-iodothyronine (T3).  Thyroid hormones act as the body's thermostat, regulating the rate at which virtually all biochemical reactions occur in the body. Inadequate conversion of T4 to T3 by the liver may lead energy-depleting hypothyroidism, leading to chronic fatigue, weight gain, poor memory and a host of other problems.

2. The liver creates Glucose Tolerance Factor (GFT) from chromium, niacin and possibly glutathione.  GFT is needed for the hormone insulin to properly regulate blood-sugar levels.  Due to its critical role in facilitating amino acid entry into muscle cells, GFT empowered insulin is also a necessary co-factor for Growth Hormone to be effective in promoting muscle growth in response to athletic training programs.

3. The liver manufactures bile salts.  These are used to emulsify fats and fat soluble vitamins (A,D,E, and K) for proper digestive absorption. The liver also removes some fat-soluble toxins from the body by first dissolving them in bile salts, then dumping the bile and toxin mixture into the intestine for eventual fecal excretion.

4. The liver activates B vitamins into their biologically active coenzyme forms. B1 must be made into thiamin pyrophosphate, B2 into flavine adenine dinucleotide, B3 into nicotinadenine dinucleotide, etc. The plant vitamin A precursor beta carotene must be turned into real vitamin A.  Other nutrients, such as iron and copper, must be changed by the liver into their appropriate bloodstream transport or storage forms, such as ferritin or ceruloplasmin.  Virtually every nutrient, whether it be vitamin, mineral, amino acid, must be biotransformed into its proper biochemical form in which the nutrient may be stored, transported or used in cellular metabolism. If the liver does not properly activate nutrients into their bioactive forms, then even the most well-absorbed, high potency, broad spectrum supplement will be useless at best and possibly even mildly toxic.

The forms in which nutrients are found in supplements and foods are NOT the final, active biochemical forms used by the cells.  And even if you do get the active coenzyme form of a nutrient from a food or supplement, it will usually be broken down during digestion.  So there's no getting around the critical role of the liver in bio-activating the nutrients we get from foods or supplements.

5. The liver stores various nutrients, especially A, D, B12 and iron for release as needed.

6. The liver manufactures carnitine from lysine and other nutrients. Carnitine is the only known bionutrient, which can "escort" fats into the mitochondria, where the fats may be "burned" to generate ATP bio-energy. The mitochondria are microscopic "power plants" found in each of the body's 50 trillion cells - as many as 1000 per cell!  These mitochondria generate 90% of the ATP bio-energy that powers every aspect of our life at the cellular level.The heart muscle "burns" fats to make ATP almost exclusively, and is extremely sensitive to cellular carnitine deficits. The muscles of well trained endurance athletes will "burn" fats to supply up to 70% of their fuel needs.  Carnitine is also necessary to get  branched-chain amino acids (BCAA's) into the mitochondria.  BCAA's, supplied either from breaking down existing muscle tissue or supplements, are known to provide a major portion of muscle cell fuel needs during prolonged, intense athletic  training or performance.

7. The liver converts lactic acid from a toxic waste to an important storage fuel. Lactic acid is produced when glucose (sugar) is metabolized through the glycolytic energy production cycle, and may irritate nerves and muscles if it accumulates  to excessive levels. However, a healthy liver will extract lactic acid dumped into the bloodstream by hard-working muscles and convert it into the important reserve endurance fuel glycogen.

8. The liver serves as the main glucose buffer, preventing high or low extremes of blood sugar.  It is the key regulator of blood sugar between meals, due to its manufacture, storage and release of glycogen. Glycogen is the starch form of glucose in which the body can store a half days sugar supply.  When the blood sugar is low, a healthy liver converts stored glycogen into glucose, releasing it into the bloodstream to raise blood sugar levels.  When blood sugar is to high, the healthy liver will remove much of it, converting the excess into stored glycogen or fat.

9. The liver can make glucose from dietary or body-derived amino acids. This process called gluconeogenesis or "the making of new glucose", ensures adequate brain and muscle carbohydrate fuel supplies even when the diet provides little or no carbohydrates.  The liver produces as much as 20-25% of the blood sugar and endurance athlete's muscles might burn during intense training or competition by converting the amino alanine (released from muscle tissue) into glucose.

10. The liver is the chief regulator of protein metabolism.  It converts different amino acids into each other as needed.  The liver also synthesizes creatine from the aminos glycerine, arginine, and methionine.  If not for the super high energy biochemical creatine phosphate, sprint-type athletics would be biologically impossible.

11. The liver produces cholesterol and packages it into different forms for blood transport-HDL, LDL, VLDL.  Essential fatty acids, such as linoleic acid, GLA, EPA, and DHA, must also be properly packaged by the liver into appropriate lipoprotein forms (VLDL) to allow transport through the blood to the 50 trillion cells using the fatty acids.

12. The liver is the main poison-detoxifying organ in the body.  It must break down virtually everything toxic to the body- from metabolic wastes, to insecticide residues, drugs and alcohol industrial and food processing chemicals, etc.  Failure of this liver function will usually cause death in twelve to twenty-four hours.  The liver uses a relatively small number of enzyme systems - called " Mixed  Function Oxidases" - to detoxify the 10.000 or more chemicals polluting modern food, air, and water.  Ironically, in metabolizing some toxic chemicals through its standard limited repertoire of detoxifying processes, the liver may inadvertently convert a toxic substance into an even more damaging toxin!

13. The liver must dispose of ammonia, and extremely toxic by-product mal protein metabolism.  The amino acids arginine and orthinine are used by the liver to control ammonia levels.  Ammonia can cause brain irritation and even death, at surprisingly low levels.

14. The liver is the main organ for breaking down hormones after they have served their messenger function to their target cells.  For example, if the liver does not break down insulin quickly enough, hypoglycemia results as the still circulating insulin continues to lower blood sugar.  If the liver does not metabolize estrogen properly, PMS will result.  Failure to dispose of adrenalin (the "fight" or” flight" hormone) after it has outlived its usefulness may lead to chronic irritability and temper explosions.

This brief review, which has not even touched on other key liver functions, such as immune functions and blood clotting protein manufacture, should make clear the central role of the liver in promoting optimal cellular nutrition.

A brief survey of mild liver dysfunction symptoms sounds like a description of "normal" modern life.  These might include chronic fatigue and feeling tired after meals.  Depression, mood instability, and irrational anger and temper flare-ups may be liver related.  PMS symptoms, including breast soreness and sensitivity, depression, hypoglycemia and irritability, may be liver related. Morton Biskind, M.D., published several articles in endocrinology journals in the early 1940's linking PMS to a B-vitamin and protein deficient liver's difficulty in de-activating estrogen.  Nausea, dietary fat intolerance, foul smelling gas, swollen belly, loss of appetite, constipation and diarrhea are some of the digestive toxic-liver symptoms. Aching joints and muscles, sore feet, psoriasis, and slow wound healing are common dysfunction symptoms.  Headaches (especially behind the eyes,) insomnia, difficulty awakening, poor memory, and difficulty concentrating are possible brain liver symptoms.

Who Is At Risk for Subclinical Dysfunction?

1. People routinely consuming large amounts of overheated, hydrogenated, "junk food" fats-- for example, French fries, fried chicken, doughnuts, chips, etc. These heated "junk foods" are a major source of liver-toxic lipid peroxides (rancid fats) and trans-fatty acids (abnormal structure fats).  Lipid peroxides are powerfully immune suppressive, and damage liver cell membranes.  Trans-fatty acids suppress production of PGE1, a major liver-protecting anti-inflammatory prostaglandin.

2. Coffee Drinkers.  Carcinogenic hydrocarbons are produced during roasting, and dark roasts are the worst offenders.  Also, coffee is grown entirely outside the U.S. and is often therefore sprayed with high levels of pesticides that are not even allowed to be used inside the U.S. Only a tiny fraction of coffee imported is checked for even some of the pesticides it is commonly sprayed with.

3. Regular Alcohol Users.  The liver converts alcohol into toxic acetaldehyde during its alcohol detoxification process.  Acetaldehyde inhibits PGE1 production, is a powerful free radical inducer, and is largely responsible for the liver, brain, heart, kidney, skin and blood vessels lining damage associated with chronic alcoholism.

4. Smokers.  While many people are aware of smoking's negative effect on the lungs, less consideration is usually given to its effects on the liver. Tobacco and marijuana smoke are rich airborne stews of toxic benzpyrene, polycyclic aromatic hydrocarbons, cyanide, acetaldehyde, tars, acrolein, etc.  Since these get into the bloodstream through the lungs, the liver must detoxify them.  And virtually all the constituents of smoke are known to be at least mildly liver damaging.

5. People regularly driving on crowded, exhaust-filled roads and highways. Auto and diesel exhaust contain dozens of liver damaging poisons the liver is forced to detoxify including lead, sulfur, and nitrogen oxides, acetaldehyde, cadmium, peroxyacetylnitrile, and more.

6. Women using Birth-Control pills. In some cases, even as little as two or three weeks of use have been documented to ruin the ability of the liver to detoxify naturally produced estrogen. The livers of women on B vitamin/protein deficient diets may have difficulty metabolizing estrogen to non-toxic estriol, leaving it instead in the form of liver  toxic estradiol. Estradiol is the form associated with hyper emotional states including explosive temper and obsessive-compulsive tendencies.

7. Candida Patients. Candida yeast ferments dietary sugars into liver-toxic acetaldehyde in the process of turning sugar into energy. Candida also seems to increase gut and urinary levels of ammonia, another liver toxin.

8. Arthritis, rheumatism, and other chronic pain sufferers who routinely exposed to higher than normal levels of pesticides.  Pesticides such as DDT, Aldrin, chlordane, lindane, 2,4,5T dioxin, and toxaphene can cause chronic liver damage, even at body levels measured in parts per billion, and tend to accumulate in body fat over a lifetime.

9. Farm Workers, produce handlers, and pest control workers are routinely exposed to higher than normal levels of pesticides.  Pesticides such as DDT, Aldrin, chlordane, lindane, 2,4,5T dioxin, and toxaphene can cause chronic liver damage, even at body levels measured in parts per billion, and tend to accumulate in body fat over time.

10. Industrial and service workers routinely exposed to heavy metals (lead, cadmium, mercury), radioactive chemicals, hydrocarbon solvents such as sulfuric acid and mixes like piranha, TCE, paint sprays and beauty parlor chemicals.

11. Gas Station workers and Auto Mechanics.  Gasoline, diesel fuel, motor oil, degreasing agents etc. are all liver toxic and may be absorbed through the skin or by inhaling them. 12. Those on long term prescription drug therapy. Dilantin, phenobarbitol, Nizoral etc. are some of the many potentially liver toxic drugs.  Those regularly abusing drugs illegal and legal are at risk.

13. Athletes using anabolic-synthetic variations of male hormone testosterone. Serious liver damage is a medically recognized major side effect of chronic steroid abuse.

 Therapy That Protects the Liver
 

Fortunately modern nutritional science has discovered many nutritional measures to promote optimal liver function and detoxification, even in the presence of unavoidable toxins.  A major liver-protecting nutrient is vitamin E. E is generally recognized as the major lipid fat-soluble antioxidant in human tissue. As a free radical/antioxidant expert Stephen Levine has noted, toxic xenobiotic (foreign to the body) chemicals that may damage the liver during detoxification fall into four main classes: Toxins that are themselves radicals or contain free radicals. Toxins that are very reactive, and though not free radicals themselves, cause radicals to be formed in target molecules, e.g. ozone. Toxins that can spontaneously yield free radicals in the body, e.g. brain chemicals such as 1-dopa. Toxins that are metabolically converted to radicals derivatives in the body, e.g. carbon Tetrachloride, acids and other solvents, etc.
As early as 1973,   N.R. Diluzio published studies demonstrating that many liver toxic compounds caused their damage through creation of lipid peroxides (rancid fats) in liver cells, and that this damage could be offset by supplementary vitamin E.  Fatty infiltration, in which streaks of fatty material interpenetrate the liver's structure, is a common feature in alcoholism and in various liver diseases.
Note:
-------
Liver  =  Body's largest internal organ.
Skin   =  Body's largest organ (some say)

Written and researched by Captain Kevin Donnelly who passed away from the Hepatitis C virus. 

HRF Trek and association for support with Frontline Hepatitis

Experience Earth and the Hepatitis Research Foundation (HRF) would like to announce their first annual Trek For Life. In March of 2003, 70 people will embark on 5-day trek through the rainforest in Costa Rica to raise funds for the Hepatitis Research Foundation and simultaneously have an enlightening, life changing experience. Space is still available for individuals who have the desire to make a difference. Each participant will raise $4,800 for the cause and to take part in this expedition.

The goal is to raise a quarter of a million dollars for HRF, and at the same time, to leave a lasting impression on participants, so when they return to their communities they will continue to battle for good causes, and that is priceless! A Trek For Life will provide an opportunity for participants to bond with each other as they tackle the challenging and beautiful terrain. It is a 50-mile hike spread over 5 days; teamwork will bring people together on an extraordinary level. " When you put average people in an exotic environment like this, it is really a great way to bring out their human kindness. It is amazing to watch people change from day to day as they open up emotionally and challenge their physical limits, all for a great cause!" says event director, Sean Morits. " One day someone may help you carry your pack if you're tired, or offer you water, and that means so much when you are in the middle of the rainforest!"

The Hepatitis Research Foundation was established in 1998 to contribute to the prevention and cure of hepatitis infections worldwide by increasing the pool of funds available for a focused approach to development of a vaccine and immunotherapy. The foundation was created because federal funding for HCV research was grossly inadequate, and new developments in immunology have created exciting opportunities for prevention and cure of this important and devastating infection.

Ø Approximately 400 million persons worldwide are chronically infected with HCV, about 5 million of these are in the U.S. This includes 10% of Africa's population and a staggering 25% of Egypt's population. About 20% of these may die of cirrhosis or liver cancer, now the world's most common cancer.

Ø HCV is becoming a leading cause of death among those with HIV/AIDS

Ø Current NIH funding for HCV research is inadequate when considering the obvious public health importance of this infection. This is largely due to the present emphasis on HIV research. For fiscal year 2002, about $2.5 billion will be expended on HIV research; only $89 million was allocated to HCV research.

Hepatitis C was most recently in the news when actress Pamela Anderson ( of Baywatch) was diagnosed. She is not alone, Grateful Dead bassist Phil Lesh has been battling the disease and helping to raise awareness since 1998. Musician David Crosby is also an advocate and victim of HCV. More importantly it affects our mothers, fathers, sister, brothers, friends and family. HRF will continue to research hepatitis, and work to decrease the numbers of victims suffering.

A Trek For Life will bring people across the Osa Peninsula, home of one of the world's last pacific rainforests. Each night a base camp will be set up as participants arrive in their groups of 10 from the day's hike. The rainforest is filled with plants and animals that will amaze you! There is so much to learn about this place and how it is important to the world we live in. The evenings will be filled with speakers about the rainforest and hepatitis to give participants an experience they will never forget.

If you are of average fitness, any age, and would like to participate in A Trek For Life contact Sean Moritz of Experience Earth, or Lisa Fishler of HRF. You will be supplied with a kit to help get you started with your fundraising, as well as detailed information about the event.

For further information, or to register, please visit
http://www.heprf.org/Trek.htm

Thursday, October 31, 2002
Pegylated interferon and ribavirin coverage

Due to the budget crisis facing most Federal and States' drug assistance programs, and the high cost of treatment, coverage for pegylated interferon and ribavirin will be hard to come by. We provide some options for people who need to go on HCV treatment now but have no way to pay for the drugs themselves. This is a patchwork coverage at best, it is by no means universal. Following are some ways to make best use of what is available:

Medicaid - The federal insurance program for the poor and disabled is required to cover all FDA approved treatments. Currently, all 50 Medicaid programs cover Peg-Intron and ribavirin. Only 9 cover Pegasys so far. Check with your Medicaid for eligibility criterias.

ADAP - Currently, only seven ADAPs (AIDS Drug Assistance Programs) covers Peg-Intron and ribavirin for people co-infected with HIV and HCV. They are: California, Connecticut, Delaware, New Hampshire, New Jersey, Massachusetts, and Virginia. In addition, New York covers ribavirin but not Peg-Intron. For eligibility criterias, See the Access Project database at www.atdn.org/access/states/index.html. People who live in states where the ADAP does not cover HCV treatment can apply to the programs listed below.

Schering's "Commitment To Care" Program for Peg-Intron and Rebetol (ribavirin) - This program will help you identify ways to get the drugs paid for. If your private insurance does not cover the drugs, and you do not qualify for Medicaid, or your ADAP does not cover Peg-Intron and Rebetol, Schering will supply a full 48-week treatment of the drugs for free. Eligibility ranges between 200% to 300% of the Federal Poverty Level (Currently $17,720 and $26,580 annual income for an individual, respectively) ,depending on where you live. Call 1-800-521-7157 to enroll.

Everyone, regardless of the ability to pay, must still register with Schering's "Access Assurance Program" in order to get Peg-Intron. However, the previous supply shortage has now been resolved and there is no longer a waiting list to get the drug. Schering plans to phase this program out as soon as they are certain there will be no supply problems. The phone # for Access Assurance is 1-800-437-2608, or go to www.access-assurance.com.

Roche's "Pegassist" 12-week free sample program - Roche will be providing physicians with samples of Pegasys for the first 12 weeks of therapy. These samples will be provided at the request of a physician for the first 15,000 patients who apply prior to December 31, 2002. Pegasys is available by prescription with no registration requirements. Call 1-877-pegasys or go to www.Pegasys.com.

Cardiomyopathies

HCV RNAs were found in the hearts of patients with cardiomyopathies, and negative strands of HCV RNA were also detected in the hearts, suggesting that HCV replicates in myocardial tissues. PMID: 10078023

Detection of HCV-Specific Sequences in Chronic Myopathy with Hepatitis C. PMID: 10529547

The importance of (HCV) infection has been recently noted in patients with cardiomyopathies. PMID: 10078023

Hypertrophic Cardiomyopathy - HCM A high prevalence of HCV infection was found in patients with HCM, particularly of the apical variety, suggesting that HCV is an important causal agent in the pathogenesis of the disease. PMID: 10406581 Apical hypertrophic cardiomyopathy and hepatitis C virus infection. A high prevalence of HCV infection was found in patients with HCM, particularly of the apical variety, suggesting that HCV is an important causal agent in the pathogenesis of the disease. PMID: 10406581

Researched by Captain Kevin Donnelly before his passing in 2000.

Frontline has moved to Snohomish County and is forming a support group at Friendship House . For more information please call our number: 360-805-1700 We are considering a Weeknight or even Saturday so input is needed. Both Medical and Alternative routes of care will be topics of this meeting. We are working with the Food Bank to help them also feed the hungry. We Need volunteers to help us on this project.

Contact Information and Links to  services across America

To self Subscribe, write to:  
frontline-hepatitis-awareness-subscribe@Yahoogroups.com  This is our email information list and discussion site. We post daily abstracts and inter-act here.

http://clubs.yahoo.com/clubs/frontlinehepatitis2  Our Yahoo Club where we also post and hold discussions.  Anyone may post here and add abstracts or 'unload' in a supportive manner.  Beginning Sept.5th an online support group will meet here in the chat room at 6PM PST

http://frontline-hepatitis-awareness.com   Our website where you can find links and events as well as the online newsletters.  We list a national support groups listing here for folks and encourage anyone to send information to us to be shared.

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