Do you like your liver? Protect him from hepatitis with new treatments and tests

Hepatitis C (HCV) is a common but fully curable disease, but it is the leading cause of liver cancer if left untreated. According to the most recent data available, HCV causes more deaths in the United States than all 60 other reportable infectious diseases combined, excluding COVID-19. While HCV was once thought to primarily affect baby boomers – those born between 1945 and 1965 – cases have risen steadily across all adult age groups. Thus, the Centers for Disease Control (CDC) now recommends HCV testing for anyone 18 and older, as well as anyone who is pregnant.

Fortunately, testing is quick and easy, and if you test positive, there are new drugs to treat and even cure HCV, as well as vaccines and treatments for hepatitis B and A.

What you need to know about hepatitis C, B and A

Hepatitis is an inflammation of the liver caused by one of five known viruses, HCV and hepatitis B (HBV) being the most concerning. HCV and HBV are the main causes of liver cancer, cirrhosis and liver transplantation. More than half of people infected with HCV and HBV have no idea they have the virus because they have virtually no symptoms until years or even decades after infection. The number of HCV-related deaths increased each year from 2010 to 2013, but has been declining since 2014, thanks to CDC efforts to increase testing and treatment.

Hepatitis A (HAV) – generally a less common foodborne illness in the United States – is not chronic, can be alleviated with supportive treatment, and can be prevented with the combination hepatitis A vaccine and B. The vaccine is recommended for babies 6-11 months old traveling outside the United States, all children 2-18 years old, and all adults who want protection against the virus, especially patients with chronic liver disease or HIV.

Say yes to testing and know your risk factors

Tests that lead to earlier treatment of hepatitis are essential to avoid the devastating health consequences of long-term chronic infection with HCV and HBV. For most patients, hepatitis is diagnosed based on routine blood tests.

HCV is transmitted through the exchange of bodily fluids, and the most common risk factor in the United States is a history of intravenous drug use. But even sharing a razor, nail clipper or toothbrush with someone who has HCV can pass it on. And although HCV is not transmitted through kissing, coughing or sneezing, you can catch it through unprotected sex.

Regular HCV screening is recommended for certain at-risk populations, depending on medical history and vocation, while those who live in areas where the prevalence of HCV infection is less than 0.1% may not have need to be tested at all. Ask your healthcare provider if any of these situations apply to you.

Three out of four people living with chronic HCV are baby boomers. While the CDC now recommends HCV testing for everyone 18 and older, as well as anyone who is pregnant, some older patients may have been exposed through blood transfusions in the 1970s and 1980s, before the community doctor knows about the virus. Although there is no vaccine to prevent HCV, it is curable.

Fortunately, there is a vaccine for HBV, which is also transmitted through the exchange of blood and other bodily fluids. The HBV vaccine is automatically given to most newborns in the United States, and pregnant women are routinely screened for HBV because it can be passed from mother to child in the womb. If you were born in Asia, Southeast Asia, or Africa, where HBV is more common, you are most at risk and should get tested.

Chronic hepatitis has few symptoms until liver damage occurs

Signs of advanced liver damage can be subtle: fatigue, weakness, and mild memory loss (or a general feeling of “helplessness”). As the liver becomes more scarred and damaged by inflammation, patients may experience overt confusion, an enlarged abdomen potentially filled with fluid, and yellowing of the skin and eyes called jaundice, all of which may indicate a cirrhosis, liver cancer or the need for a transplant.

A new generation of treatments successfully manages and cures hepatitis

HCV drugs are now available to effectively cure the infection. Unlike the old injected drugs, which had nasty side effects, these new drugs come in pill form, are very well tolerated, and have cure rates of over 95%.

Although hepatitis B is not easily cured, there are drugs that effectively suppress the virus. Patients with HBV usually continue to take this medication for the rest of their lives.

Patients should also be aware that although liver damage caused by hepatitis is similar to that caused by alcohol, it is not the result of drinking alcohol. However, patients with any liver disease are advised to stop consuming alcohol. Treatment reduces inflammation and prevents further scarring, but the liver may never fully return to normal, so it’s important to avoid toxins that could further damage it.

Montefiore Einstein: A Leader in the Prevention, Diagnosis and Treatment of Liver Disease

Montefiore Einstein pledged to help find the millions of missing people who don’t realize they are infected. Hepatitis testing can save your life. If you have any of the risk factors for HCV or HBV listed above, please contact your primary care physician or any medical system where you receive care to request testing. For patients diagnosed with hepatitis, the Montefiore Einstein test Complete Liver Program offers individualized treatment for all stages of the disease. Patients with advanced liver disease or cancer can benefit from the multiple therapeutic trials underway at Montefiore Einstein, as well as the evaluation of liver transplants.

Catching hepatitis early means less liver damage and a healthier life ahead. To arrange your hepatitis screening with a Montefiore Einstein primary care physician, call 1-800-636-6683. To learn more about Montefiore Einstein’s treatments for liver disease, please visit the Complete Montefiore Einstein Liver Program website.

Alvin Htut, MD, is a hepatologist transplantologist and assistant professor of medicine (hepatology) at Montefiore Einstein.
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