Get Ahead of Hepatitis C

Get Ahead of Hepatitis C

Curing hepatitis C — a virus that attacks the liver — is possible. Screening is vital for identifying the disease early when damage can be reversed and before the organ has paid a heavy price.

Hepatitis C is contagious and spreads through contact with the blood of an infected individual. About one in five cases of hepatitis C infection is cleared naturally by the body; however, the remaining cases develop into chronic hepatitis C. Chronic hepatitis C infection causes inflammation in the liver that can lead to scarring and even organ failure if left untreated.

“Often, there aren’t symptoms with hepatitis C,” said Jenny Harkins, manager of the Hepatitis C Clinic and GI Motility Clinic at Jewish Hospital, part of KentuckyOne Health. “Individuals who have the virus may not realize it for decades. Then, one day, a routine laboratory exam will show elevated liver enzymes. The best way to know if you’ve been exposed is to test the virus directly using an antibody test, because not everyone will have elevated liver enzymes.”

By the time symptoms appear, hepatitis C may have already reached an advanced stage.

 

A Big Burden for Kentucky

 

The ability of hepatitis C to exist in the body for years without detection makes estimating the disease’s prevalence difficult for public health officials. One thing is clear: The virus is a major concern in Kentucky, where the rate of new infections is twice the national average, according to the Centers for Disease Control and Prevention. Two groups seem to be most vulnerable to hepatitis C: younger adults and baby boomers.

From 2008 to 2015, no state had a higher rate of new hepatitis C infections than Kentucky, according to the Kentucky Department for Public Health’s State Health Assessment Report, 2017 Update. In 2015, individuals 25–34 years old accounted for the largest proportion of new infections — 40 percent. The high rate of hepatitis C infection in Kentucky is closely related to the Commonwealth’s opioid epidemic, as sharing needles to inject heroin and painkillers increases individuals’ risk for contracting the virus.

For baby boomers, many cases of hepatitis C are likely traceable to health care services they received decades ago rather than to present-day substance abuse, according to Harkins.

“Baby boomers appear to be most at risk for having hepatitis C without knowing it,” Harkins said. “We think many of their infections occurred as a result of medical and dental procedures they had 30 to 40 years ago, when sanitation and sterilization protocols were less strict than they are today.

“Back then, it was common for providers to use the same equipment with multiple patients,” she continued. “Hepatitis C can be difficult to kill without proper sanitation procedures. Nowadays, medical equipment is either single-use or is sterilized after every patient encounter using a high-heat, high-pressure machine called an autoclave, which prevents infection.”

 

The Power of Screening

 

The CDC recommends individuals born between 1945 and 1965 get tested for hepatitis C, which providers can do using blood tests; the most common is the hepatitis C antibody test. Many patients diagnosed with the virus have reason to hope. An average of 12 weeks of oral medication therapy is enough to clear hepatitis C from the body, according to Harkins.

“Some think there is only one medication to treat hepatitis C, when in fact, there are 12 approved by the Food and Drug Administration,” Harkins said. “Treatment is typically easy. Since 2013, we’ve had effective, gentle medications that patients take for 8 to 12 weeks, sometimes up to 24 weeks, and they have cure rates as high as 100 percent in some cases. If you know you have hepatitis C, we can treat it, but you won’t know you have the virus unless you get screened.”

 

Your Destination for Treatment

 

If you have been diagnosed but aren’t receiving treatment, the Hepatitis C Clinic at Jewish Hospital, part of KentuckyOne Health, can help. The Hepatitis C Clinic offers liver assessments and antiviral therapy.

“We want to ensure everyone has access to treatment for hepatitis C and, ultimately, cure them,” said Harkins. “Getting rid of the virus doesn’t just benefit the liver. It also reduces patients’ chances of developing other issues, such as insulin resistance, kidney disease and overall all-cause mortality.”

KentuckyOne Health also plans to open a Hepatitis C Clinic in Lexington at Saint Joseph East, part of KentuckyOne Health, in the future.

To schedule an appointment at the Hepatitis C Clinic at Jewish Hospital, call 844.258.6211. A referral from your primary care physician may be required.

Testing for hepatitis C requires only a simple finger stick similar to checking your blood sugar.

This article originally appeared in the 2017 Summer edition of One Health magazine. For more health and wellness stories, sign up for your free subscription today.

Herbal Supplements and Your Liver

Herbal Supplements and Your Liver

Herbal Supplements and Your Liver

While alcohol use can harm the liver — the organ that cleanses blood and fights infection — so can overusing certain herbal supplements and medications.

Typically, herbal supplements do not cause problems when used, especially if the person taking them isn’t on prescription medication. However, there are cases in which supplements do not mix well with medications and can lead to liver damage.

When listing your current medications for a medical provider or pharmacist, make sure you mention any herbal supplements you take. This helps your doctor avoid possible toxic interactions, said June Yong, MD, board-certified gastroenterologist and internal medicine provider with KentuckyOne Health Gastroenterology Associates.

“Herbal supplements can change the way your body metabolizes medications,” Dr. Yong said. “When this occurs, the medication may stay longer in the body than intended and build up a higher concentration of the drug. Both are dangerous to your health.”

Signs that herbal supplements are interacting negatively with medications in ways that could potentially harm your liver include:

  • Yellowing eyes or fingertips
  • Insomnia
  • Muscle aches
  • Dark yellow urine

“Extreme confusion is a sign of liver failure,” Dr. Yong said. “If you or a family member notice confusion coupled with debilitating fatigue, go immediately to the emergency room for care.”

 

Teaming Up for Liver Care

 

Patients with symptoms of liver failure undergo liver function tests to confirm or rule out this diagnosis. Those with elevated numbers can be referred to the liver transplant program at Jewish Hospital, part of KentuckyOne Health, and placed on appropriate medications. During this time, patients are given intravenous fluids and monitored carefully for appropriate oxygenation levels and normal bowel movements, since constipation can result in toxin buildup.

“If the liver doesn’t recover, we determine next steps, including candidacy for liver transplantation,” said Laura Smart, MD, transplant hepatologist and medical director for the liver transplant program at Jewish Hospital.

Talk with your primary care physician about the use of herbal supplements.

 

When Transplant Is Needed

 

An established program for almost two decades now, the Liver Transplant Program at Jewish Hospital, part of KentuckyOne Health, was the first of its kind in the Commonwealth of Kentucky.

“This robust program connects 50 patients per year with lifesaving liver transplants as soon as they become available, sometimes in as few as two days,” said Dr. Smart.

This article originally appeared in the 2017 Summer edition of One Health magazine. Receive more health and wellness news and information by signing up for your free subscription to One Health.