Viral hepatitis is the most common cause of chronic liver disease worldwide. In fact, the two most common forms, hepatitis B (HBV) or hepatitis C (HCV), infect over 500 million people around the world – compared to 31 million with HIV. Chronic HBV is the most common cause of viral hepatitis followed by HCV. These two viruses are responsible for up to 2 million deaths a year. Therefore, it makes sense to call attention to this important global issue and this is why July 28 is World Hepatitis Day.
The liver is the largest gland in the body, weighing about 3 pounds. Its many functions include processing nutrients, managing glucose and fats, storing vitamin A, detoxification, producing bile, and making the majority of the necessary proteins for the body. HBV and HCV can cause chronic inflammation (injury) in the liver. Over years of infection, this injury leads to liver scarring (fibrosis) and ultimately cirrhosis. Cirrhosis eventually leads to liver failure and death. The viruses can also increase the risk of developing a liver cancer called hepatocellular carcinoma.
Although both viruses have known risk factors for transmission, some people may not know where or when they were infected. Those with risk factors or abnormal liver enzymes should get tested. The Centers for Disease Control has specific guidelines for testing and these can be found at http://www.cdc.gov/hepatitis/index.htm. HBV is most often transmitted at birth, through blood exposure (transfusions, intravenous drug use) or sexual contact. The most common risk factors for transmission of HCV are intravenous drug use, blood exposure (transfusions before 1992, tattoos, needle sticks), and healthcare exposure such as dialysis in the past. Infection at birth or through sexual contact is much less common with HCV than HBV. People born between 1945 and 1965 are at greatest risk of having exposure to HCV. Neither virus is transmitted through casual contact such as kissing, hugging, coughing, sneezing, breastfeeding, or sharing eating utensils or drinking glasses.
Research over the years has led to multiple treatment options for these viruses. HBV cannot be cured, but antiviral treatments are effective in suppressing the virus and reducing the risk of developing cirrhosis or hepatocellular cancer. New treatments are now available for HCV infection and can cure up to 98-99% of those infected.
Generally, your primary care physician will refer you to a hepatologist (liver specialist) or gastroenterologist to see whether treatment would be helpful and which treatment would be best. The advances in treatment for these viruses has been truly amazing and gives hope to the millions of chronically infected people in the world.
If you have questions about HCV or HBV, contact the Swedish Liver Center here.
