Vitamin K-2 prevents liver cancer in Hepatitis C patients
Subject: People living with Hepatitis C are at high risk for developing liver cancer. Vitamin K-2 lowers the risk.
People infected with Hepatitis C are more likely to develop liver cancer than other people. One recent study put their risk at 34.5 times that of uninfected people. It gets worse. If patients with hepatitis C also have liver cirrhosis, they are 118.5 times as likely to develop liver cancer. 
Vitamin K-2 may provide a means to reduce this risk. Last July, researchers in Osaka , Japan reported in JAMA that Vitamin K-2 reduces the risk of developing liver cancer by 90% in hepatitis patients. This was an accidental finding. The original goal of the study was to examine Vitamin K-2 as a way to prevent osteoporosis in women with viral liver cirrhosis. We've been sending out newsletters about this use of Vitamin K-2 for over a year now. The researchers also tracked how many women developed liver cancer during the study which ran from 1996-1998. Liver cancer was found in 2 of the 21 women given vitamin K2 and 9 of the 19 women in the control group. This would calculate to a risk of 0.20 for the vitamin K-2 versus the control group. The researchers analyzed their data and when all the other variables were factored in, they calculated an even greater benefit. They report that taking vitamin K-2 reduced the relative risk to 0.13 compared to the control group of patients not taking Vitamin K-2. Doses were comparable to those in other osteoporosis studies, 45 mg/day of vitamin K-2. 
Also in July, other Japanese researchers, these from Tokyo , published a very relevant paper in Hepatology. They studied the effects of vitamin K-2 in liver cancer cells in vitro and in vivo. They demonstrated that vitamin K-2 inhibits the growth and invasion of liver cancer cells through the activation of protein kinase A. In addition, administration of vitamin K-2 to mice inoculated with liver tumor cells reduced both tumor growth and body weight loss. 
By the way, the original Osaka study which questioned whether vitamin K-2 prevented osteoporosis in women with hepatitis C showed that it did, quite conclusively. Recall that the study went for two years. After the first year, the vitamin K-2 women had gained 0.1% in bone density. The control group though had lost 2.2%. By the second year the gap was wider; the Vitamin K-2 ladies had lost 0.5% of bone density since the study began. The controls without the vitamin K-2 supplementation had lost an average of 4.6%.  These numbers agree with other studies on Vitamin K-3. It appears to slow the loss of bone as followed by bone density measurements. Other studies report a large decrease in bone fractures with vitamin K-2 suggesting that it increases bone strength.
In the past we have suggested all hepatitis C patients take vitamin E daily to provide protection against the development of liver cancer. This remains a reasonable suggestion. A recent study suggests that this may provide some benefit but nowhere near the effect of vitamin K-2. In the vitamin E study published about a year ago, forty-four hepatitis C patients were treated with vitamin E over a five year period. Compared to a control group they had less liver cancer and lived longer. Yet the differences were slight and were not statistically significant.  What does this mean? It won't hurt to take Vitamin E and probably helps but the benefit isn't dramatic.
Selenium has also been researched as a way to decrease the risk of liver cancer in hepatitis C. A Taiwanese study showed an inverse correlation between serum selenium levels and development of liver cancer. That means the more selenium a person had floating in their blood, the less likely they were to develop liver cancer.  The protection was strongest in male smokers, a result consistent with other selenium studies.
The bottom line with is that if you have Hepatitis C you should be taking Vitamin K-2 at 45 mg/day. You should probably continue taking modest doses of Vitamin E. You should also take selenium, especially if you are male and smoke.
 Hepatology. 2001 Oct;34(4 Pt 1):714-8.
The risk of liver and bile duct cancer in patients with chronic viral hepatitis, alcoholism, or cirrhosis.
Kuper H, Ye W, Broome U, Romelsjo A, Mucci LA, Ekbom A, Adami HO, Trichopoulos D, Nyren O.
 JAMA. 2004 Jul 21;292(3):358-61.
Role of vitamin K2 in the development of hepatocellular carcinoma in women with viral cirrhosis of the liver.
Habu D, Shiomi S, Tamori A, Takeda T, Tanaka T, Kubo S, Nishiguchi S.
 Hepatology. 2004 Jul;40(1):243-51
Vitamin K2 inhibits the growth and invasiveness of hepatocellular carcinoma cells via protein kinase A activation.
Otsuka M, Kato N, Shao RX, Hoshida Y, Ijichi H, Koike Y, Taniguchi H, Moriyama M, Shiratori Y, Kawabe T, Omata M.
 Am J Gastroenterol. 2002 Apr;97(4):978-81.
Comment in: Am J Gastroenterol. 2002 Apr;97(4):786-8.
Vitamin K2 (menatetrenone) for bone loss in patients with cirrhosis of the liver.
Shiomi S, Nishiguchi S, Kubo S, Tamori A, Habu D, Takeda T, Ochi H.
 Int J Vitam Nutr Res. 2003 Nov;73(6):411-5
Pilot clinical trial of the use of alpha-tocopherol for the prevention of hepatocellular carcinoma in patients with liver cirrhosis.
Takagi H, Kakizaki S, Sohara N, Sato K, Tsukioka G, Tago Y, Konaka K, Kabeya K, Kaneko M, Takayama H, Hashimoto Y, Yamada T, Takahashi H, Shimojo H, Nagamine T, Mori M.
 Am J Epidemiol. 1999 Aug 15;150(4):367-74.
Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection.
Yu MW, Horng IS, Hsu KH, Chiang YC, Liaw YF, Chen CJ.