The only way to cure or to protect oneself from a viral infection is to be born with a strong immune system or be vaccinated prior to infection, respectively. A vaccine simply increases the immune systems arsenal against future foreign invaders by allowing the body to produce antibodies against viral antigens prior to infection, rather than having the body go through a rigorous process to produce antibodies at the initial time of infection (Figure 1).
We learned earlier in this presentation that within the first six weeks of infection, one may experience jaundice, which is the yellowish staining of the skin. Jaundice is caused by an increase in blood plasma bilirubin, which is a chemical derivative of biliverdin – a chemical breakdown component of hemoglobin. Bilirubin is naturally yellow in colour, whereas biliverdin is naturally green. Increased levels of bilirubin in the blood suggests that red blood cells have been damaged and have released free hemoglobin into the bloodstream. Usually when the virus first enters the bloodstream, phagocytes such as macrophages take up the virus and release potent chemical agents to destroy the pathogen. These chemicals have an effect on neighboring cells, including red blood cells. Since blood and lymph pass through the liver, kupffer cells (specialized liver macrophages) and natural killer cells of the immune system are actively destroying free-hepatitis B virus flowing in the bloodstream and viral-infected cell, respectively, and subsequently damaging red blood cells.
Currently on the market, we hear of many natural Hepatitis B cures. Let’s look at a few and discuss their impact on the body.
Milk thistle: This herb is known to increase liver cell metabolism. This means that all the cellular processes that occur in the liver cell on a regular basis are up-regulated when taking this supplement. For example, if the liver cell is required to make a certain protein, this herb will increase the efficiency of that process by increasing the speed of production. This does not necessarily mean it will increase the responsiveness of one’s immune system and cure infected cells; however, it can help the liver in certain conditions.
Liv52: The combination of herbs found in this supplement is said to contain potent antioxidant properties. Its marketers claim that it can neutralize all kinds of toxins and poisons from food, water, air, and medication. However, does it stop the hepatitis B virus from replicating? The simple answer is No. Remember, the human body produces its own antioxidants and we obtain antioxidants, similar to the ones found in this supplement, on a regular basis through our diet.
Phyllanthus amarus: This is by-far the most promising natural cure for chronic hepatitis B. According to many studies, this plant is said to have curative properties by suppressing transcription of the hepatitis B virus messenger RNA (mRNA) (Click here for more details on the study). It does this by inhibiting the hepatitis B virus enhancer I activity. This means that when the infected cell wants to replicate and spread, the cell needs proteins called enhancer-binding proteins to bind to the DNA and allow the DNA to be copied (Figure 2). In other words, these protein-enhancers “enhance” the viral replication process. Remember, if a cell is going to replicate, both cells – the new one and the old one – need a copy of DNA. Phyllanthus amarus down-regulates the hepatitis B virus mRNA transcription (the production of viral proteins) by a specific mechanism involving interactions between the hepatitis B virus enhancer I and transcription factors (Figure 2). Said differently, this natural chemical compound blocks the binding of viral protein enhancers with transcription factors, and as a result, prevents the production of the hepatitis B virus proteins. Compared to most FDA approved hepatitis B treatments such as Entecavir, this herb is relatively inexpensive. However, more research is required since scientists still do not know whether the herb’s active ingredient may interfere with regular, uninfected cells in the body.
Moreover, if you are taking FDA approved medicine based on the science of interrupting DNA replication, such as entecavir or adefovir dipivoxil, you should not expect to be cured after your next blood test. However, these drugs are very effective at halting the spread of the virus in the liver and should generally help the recipient live a long, normal life. The only drawback is that these drugs must be taken daily and that the virus, depending on its strength and strain, could eventually find other ways to replicate and resist the medicine. Since these drugs are nucleotide-based, one could also experience an increase in uric acid production (a by-product of nucleotide metabolism), resulting in the production of sodium urate – the main cause of renal stones. Over a long period of time, a buildup of sodium urate destructs the kidneys, preventing them from effectively filtering out the blood. This is why the kidneys are constantly monitored when a person takes these drugs. Overall, since the positives heavily outweigh the negatives (i.e. liver cancer versus possible kidney stones production), as long as you can afford these drugs, you should have nothing to worry about.
References
(1) Hauser S., Pardi D., & Poterucha J. (2005). Mayo Clinic Gastroenterology and Hepatology Board Review. CRC Press.
(2) WHO Hepatitis B Fact sheet N. 204. Accessed on: October 23, 2008. http://who.int/mediacentre/factsheets/fs204/en/print.html.
(3) Travelers’ health: Yellow Book. (2008). US Department of Health and Human Services, CDC. Accessed on: November 02, 2008. http://wwwn.cdc.gov/travel/yellowbookch4-HepB.aspx
(4) Adachi Y., Fujita N., Horiike S., Ishida S., Kohara M., Konishi M., Tanaka H., Watanabe S. (2006). Morphology of hepatitis C and hepatitis B virus particles as detected by immunogold electron microscopy. Medical Molecular Morphology, 39:63–71.
(5) Büchen-Osmond C. (2006). Hepadnaviridae:The Universal Virus Database. ICTVdB Management. Accessed on: November 02, 2008. http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/
(6) Lemon S., Thomas H., & Zuckerman A. (2005). Viral Hepatitis. Blackwell Publishing.
(7) Baraclude (Entecavir). (2007). Bristol-Myers Squibb Company. U.S. Food and Drug Administration. Accessed on: October 04, 2008. www.fda.gov/medwatch/safety/2007/Baraclude_PI_jul2407.pdf
(8) Yao G. (2007). Entecavir is a potent anti-HBV drug superior to lamivudine: experience from clinical trials in China. Journal of Antimicrobial Chemotherapy, 60:201–205.
(9) Baldick C., Colonno R., Eggers B., Kapur A., Langley D., Levine S., Rose R., Tenney D., & Walsh A. (2007). Inhibition of Hepatitis B Virus Polymerase by Entecavir. Journal of Virology, 81(8):3992-4001.
(10) Seeger C., & Zoulim F. (1994). Reverse transcription in hepatitis B virus is primed by a tyrosine residue of the polymerase. Journal of Virology , 68(1):6-13.
(11) Anderson K., Bailey C., Chloe L., Detorio M., Domaoal R., McMahon M, Obikhod A., Rapp K., Schinazi R., Siliciano F., Tirado-Rives J. (2007). Pre-steady-state Kinetic Studies Establish Entecavir 5′-triphosphate as a Substrate for Hiv-1 Reverse Transcriptase. Journal of Biological Chemistry, 283(9):5452-5459.