Friday, October 19, 2007

CAM for HCV: case



One of the health professionals (HP) at Herzl comes to me asking that I meet with one of her patients (a young man) who has Hepatitis C and is resisting interferon. The HP tells me her patient is interested in complementary and alternative therapies (CAM). Although she would prefer that he accept the recommended treatment she is open to discussing alternatives with him. She hopes the young man's specialist will be open to exploring CAM treatments.


When the young man meets with me I mention to him that since he is not sure about interferon a decision aide might help him decide. He hesitates but is amenable once I explain that the aid will not force him to decide one way or another but will rather give him a structure for clearing his thoughts. While we talk he shows me a link to a resource he has already accessed on the subject. It turns out to be a good resource,, that has HONcode accreditation which is at present undergoing annual review.

I give the patient some information I had prepared ahead of time: information about HCV and CAM on the Public Health Agency of Canada website and about interferon from MedlinePlus, a decision aid from the Ottawa Health Research Institute, and a research report from the National Centre for Complementary and Alternative Medicine, as well as some fact sheets from the HCV Advocate website.

The patient is very happy with what I have printed for him. In addition he would like to find some information about the use of vitamine C as a therapy, having heard that it can cure HCV completely. We look together and find a few references to vitamin C and HCV but I am not able to find anything definitive or evidence-based, although something is mentioned on Hepatitis Central that might be worth showing to his specialist. We discuss some criteria to use in order to judge whether a website can be trusted including: who maintains the site? who wrote the article? when was it updated? is the information cited?


It remains to be seen whether the patient will decide to accept the interferon treatment or whether his specialist will be amenable to exploring CAM therapies.

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