Mar 25, 2014

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Kim: Hepatitis C virus is a liver disease that has become the forefront of health care attention and resources. The CDC has mandated that patients or baby boomers who were born from 1945-1965 should all get a single hepatitis C virus test because the preponderance of hepatitis C in that population of the United States is upwards of eight-fold or ten-fold larger just by virtue of the fact that those baby boomers were subjected to behaviors that were high risk. This mandate was brought up by the CDC in April this year. Our primary care providers are supposed to enact that mandate by testing our baby boomers once. And so this is a good time to talk about hepatitis C.
In addition, hepatitis C is a disease which research is developing huge gains in terms of managing in and so over the next few months we will see two new drugs, anti-viral drugs specifically designed to treat hepatitis C, and this is a huge difference in terms of hep C strategies that we didn't have.

Interviewer: So is it a lifestyle disease 100%? Meaning it was behaviors that caused it, meaning like needles and drug use. How does it get transferred, first of all? It transferred by a blood.

Kim: Yeah, the hepatitis C is a bloodborne pathogen. It's a virus, and once it resides, it gets access to your blood with a certain concentration and it will preferentially reside in the liver. And so hence the hepatitis portion of the virus name.

Interviewer: So hepatitis C, what are the symptoms? If I have hepatitis C am I going to notice anything?

Kim: The symptoms of hepatitis C upon first contraction may be general feelings of illness, almost like viral-type, flu-type symptoms. People do describe an upper abdominal pain on the right side, and that's likely due to the swelling that occurs when the hepatitis infects the liver. These are not necessarily common but these are things that would make you aware that something is going on. I think most people who, unless they were attune to the fact that they may have been exposed to blood, they wouldn't think too much of those types of symptoms.

Interviewer: All right. So the whole message here, there again, as a health care provider you're trying just to let people know, "You need to have this test." Is that accurate?

Kim: Absolutely. Knowing about this condition is the best way to treat it.

Interviewer: Is time of the essence in detecting hepatitis C?

Kim: Time is always important in any chronic diseases, and certainly chronic liver disease is another disease that would benefit from early detection because there are ways to decrease the end effects of hepatitis C in particular.

Interviewer: And one of the reasons somebody should be concerned about this is because-very startling statistic-85% of primary liver cancer is due to end-stage liver disease which could be caused by something like hepatitis C.

Kim: Cancer in general is a process where injury to tissues-and the liver is simply a tissue-results in the body creating unregulated growth in tumors. So hepatocellular cancer and also to a smaller degree bile duct cancer are cancers that are developed specifically in the liver in the setting of injury or cirrhosis.
If you were to contract hepatitis C on day zero about ten to fifteen years from then you will, unless you're treated, you will develop scarring of the liver or cirrhosis. From there on, we know that 85% of people over the course of 12 years will develop cancer in the liver. If detected early there are many therapies available to patients. However, if detected late, your options are far less.

Interviewer: Any final thoughts?

Kim: I think the end goal for centers like ours is to manage organ disease at all of its spectrum. So if we can in any way contribute to the early management or detection of liver disease then we're doing a service to the community. What we would like to try to avoid is folks who may be able to avoid the more rigorous and intense treatments of advanced organ failure such as cirrhosis, such as liver failure, because those are much more costly both socially to the patient and also financially to the community. If we can avoid that point that would be the ultimate goal.

Interviewer: So the old adage, an ounce of prevention is worth a pound of cure.

Kim: Absolutely.

Interviewer: Really does apply.

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