You may have seen television commercials advising all baby boomers to get tested for hepatitis. If you’ve heard about hepatitis, you may have associated hepatitis with injection drug use. However, the population of individuals with hepatitis is changing.
What exactly is hepatitis, and how might it affect you?
The word hepatitis literally means inflammation of the liver. There are multiple causes of hepatitis. Hepatitis is classified as either non-infectious or infectious. Non-infectious hepatitis occurs when the liver is damaged as a result of alcohol, medicines, obesity, genetic disorders or autoimmune disease. Infectious hepatitis follows infection by a virus. There are several different strains of the hepatitis virus, labeled Hepatitis A, B, C, D and E. There are two forms of hepatitis most common in the U.S., and most likely to affect the general population.
Hepatitis C is the most common form of infectious hepatitis. The Centers for Disease Control (CDC) estimates that approximately 3.5 million Americans have hepatitis C, and up to 85% of these people are unaware they have the infection. Because individuals infected with hepatitis C often have either no symptoms or very mild symptoms, the infection goes undetected for years. Over time, the infection slowly damages liver cells. Damaged liver cells die and scar tissue develops. This scarring of liver tissue is called cirrhosis. Ultimately, if all of the liver stops functioning, even the non-scarred sections, liver failure results.
New guidelines issued by the CDC recommend testing for Hepatitis C, because of the damage an undetected infection causes over time. The recently issued recommendation advises all baby boomers born between 1945 and 1965 to get tested. This group is 5x more likely to have HCV because they may have received blood transfusions prior to the introduction of screening for HIV and hepatitis, may have a history of injection drug use, may have had unprotected sex, unsterile piercing or tattoos, or exposure to infected blood through needle sticks or direct contact. Even if you think you haven’t been exposed to hepatitis, it is suggested that you have the simple blood test to confirm you are virus free.
Non-Alcoholic Steatohepatic Hepatitis (NASH)
Another form of hepatitis that is growing in incidence is called nonalcoholic steatohepatic hepatitis (NASH). This form of hepatitis is noninfectious and develops as a result of fatty liver disease. Risk factors for fatty liver disease include obesity, diabetes, and metabolic syndrome. Non-alcoholic fatty liver is diagnosed when more than 10% of the liver is fat. Over time, the excess fat causes the liver to swell and become inflamed, and NASH is diagnosed. As with infectious hepatitis, inflammation ultimately leads to scarring (cirrhosis) and liver damage. There are typically no symptoms from fatty liver until inflammation occurs. At that point, individuals may experience poor appetite, weight loss or abdominal pain.
Fatty liver can be diagnosed with a physical exam, blood test evaluating liver enzymes, and ultrasound. There are currently no drug treatments for fatty liver or NASH. However, because the liver can repair itself, the damage is reversible with lifestyle changes. Patients with fatty liver are advised to lose weight, monitor cholesterol, manage blood sugar, exercise, and limit alcohol. Fatty liver can also be prevented with these same lifestyle choices.
Our physicians are board certified in hepatology (the study of the liver) as well as gastroenterology. If you have been diagnosed with hepatitis, or have questions about the disease, we are here to assist you.