Advances in medicine are bringing hope to millions of hepatitis patients worldwide, according to hepatologist ahead of World Hepatitis Day (July 28)
 
  
27 July, 2022:   Infection with the hepatitis C virus is almost always curable, but given its impact on liver health, it is important to catch it early and to address any liver damage after the infection has been eliminated, says a hepatologist from global health system Cleveland Clinic ahead of World Hepatitis Day, observed on July 28. 

Hepatitis refers to inflammation of the liver and viral hepatitis is caused by one of five strains of hepatitis viruses named from A to E. According to the World Health Organization, an estimated 354 million people worldwide live with hepatitis B or C, both of which are blood-borne, and which together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths. While there is a vaccine to prevent hepatitis B, there is none for hepatitis C.  
Dr. Omar Massoud, Chief of Hepatology at Cleveland Clinic, says, “The good news is that treatment for hepatitis C improved remarkably over the past decade. Direct-acting antiviral medications are highly effective in clearing the hepatitis C virus from the body in just two to three months. Studies have shown they have a 98% to 99% cure rate and are generally well tolerated by people who take them.” 

Dr. Massoud points out, however, the challenge is that patients with hepatitis C often have no symptoms and therefore do not seek testing or treatment. “This is why it is important for everyone above the age of 18 to get tested for hepatitis C at least once, otherwise, by the time they develop symptoms and seek treatment for cirrhosis, it may be too late. Higher-risk individuals such as healthcare workers would need to be tested more often,” he adds.
In the same vein, says Dr. Massoud, it is important for patients to realize that the treatment journey does not end with the antiviral medication. “Further blood tests will need to be done after three months to confirm that the virus has been eliminated. More importantly, we must remember that while the capsules can eradicate the hepatitis C virus, they cannot reverse the liver damage that has already occurred.”

He explains that the longer the disease has remained undetected, the higher the likelihood of liver damage. “So, while a young person who had the infection for a year might not have any liver damage, someone who lived with the infection for decades might have developed serious liver disease,” he says.
When assessing the severity of liver damage, Dr. Massoud explains that fibrosis, or scarring of the liver, can be classified from the least-serious stage one up to stage four, which is cirrhosis. 

Stages one and two require the shortest follow-up period and the damage is reversible. These patients will usually be advised to adjust their lifestyles so as to avoid alcohol, eat healthily, exercise regularly and maintain a healthy weight. In stages three and four, however, the damage might not be reversible, and the patient could need lifelong monitoring to check for complications of liver disease, and will also need to adjust their healthy lifestyle choices. 
“Patients should know that a stage-four diagnosis is not the end of the world,” Dr. Massoud says. “Many people mistakenly believe that if they are diagnosed with cirrhosis, it means they will automatically need a liver transplant. This is not true as even with a stage-four diagnosis, the patient could still lead a normal life with a normal lifespan.”

Dr. Massoud adds that there is a small group of patients with hepatitis C who will be diagnosed with advanced or complicated cirrhosis, also known as end-stage liver disease, and who will need a liver transplant in addition to the hepatitis C treatment.

Commenting on World Hepatitis Day, Dr. Massoud concludes, “Overall, with vaccines and modern medications that prevent, treat or cure the various forms of hepatitis, there is much to be positive about this year. The awareness day is also a timely reminder for everyone to be tested for hepatitis C, as they will have the peace of mind in knowing they are not infected, or if they are, the opportunity to prevent or halt further liver damage,”.