the same way that prescribed medicines do, and sales via the Internet make them easily available to all.There is then the uncertainty of what is really in the preparations, if they contain the right plant at all or the wrong part of it, and then whether or not they have been stored correctly, or if they have been contaminated with other liver-damaging agents or microorganisms.Advice for physiciansDILI from prescription and nonprescription medicines is an important but rare event in the westernized world, Dr. Robert Fontana of the University of Michigan in Ann Arbor said in an interview. However, because it can bring about very bad and unpredictable liver injury, it is of great importance for hepatologists and general family physicians alike.In the United States and I think worldwide, the frequency in use of [herbal treatments] is increasing and as we start to see registry data I think we will start to see more and more cases [of hepatoxicity], Dr. Fontana said.Dr. Fontana is part of the National Institutes of Healthfunded Drug-Induced Liver Injury Network (DILIN), a multicenter, prospective registry looking at the etiologies, risk factors, and outcomes of DILI in the United States (Drug Saf. 2009;32:55-68). Data from the registry show the prevalence of herbal and dietary supplements is around 9% (n = 300) in confirmed DILI cases.Patients need to tell their doctors what they are taking, he advised, adding that, as physicians, we all need to be aware and maybe ask more questions of our patients.The LiverTox website produced by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Library of Medicine is a valuable online and freely available resource for determining if a medication, herbal, or other supplement is known to cause liver problems. This is going to have a new chapter on herbal medicines, Dr. Fontana said, and is worth using in daily practice to help advise patients on the prescription or CAM they might be talking.Dr. Larrey and Dr. Fontana had no disclosures relevant to their comments.New Chinese herbal medicine inhibits HCV activityA compound named SBEL1 after the laboratory in which it was discovered has multiple effects on the hepatitis C virus (HCV) life cycle, according to data from a late-breaking poster presented at the meeting.Researchers from the Systems Biology of Epithelia Laboratory at the National Taiwan University, Taipei, screened six herbal medicines and found that one of these SBEL1 inhibited HCV activity by about 90% in infected cells.Cheng-Wei Lin and Ming-Jiun Yu pretreated liver cells with the herbal extract and then infected these cells with HCV. Compared with control cells, SBEL1-treated cells contained 23% less viral protein. This suggested that SBEL1 prevented HCV from entering the pretreated cells.Their findings also suggested that SBEL1 reduced internal-ribosome entry sitemediated translation, a process vital for viral protein production, and might also have interfered with the RNA replication process.SBEL1 has demonstrated significant inhibition of HCV at multiple stages of the viral life cycle, Dr. Markus Peck-Radosavljevic, the secretary-general of the European Association for the Study of the Liver, said in a press release issued by the Society.Dr.