Any chronic liver disease can eventually lead to cirrhosis. Hepatitis C, fatty liver disease and alcohol abuse are the most common causes of cirrhosis of the liver in the U.S., other causes include:
Although less likely, other causes of cirrhosis include prolonged exposure to environmental toxins, or parasitic infections.
Medication such as Tylenol, Pain Killer and Anti-inflammatory Drugs do NOT cause cirrhosis, BUT can lead to acute liver failure which is a serious liver damage that happens within a few days.
Not necessarily. It is unknown why some people get cirrhosis and others don’t, although they may have the same disease. This depends on the severity of the disease, duration of the disease, and the presence of other liver conditions. For example, hepatitis C patients who drink alcohol will get cirrhosis faster than other hepatitis C patients who do not drink alcohol. Overall, individuals who have two risk factors for liver such as obesity and hepatitis C, or hepatitis C and alcohol use, develop cirrhosis faster.
It is unknown how long it requires to develop cirrhosis. It depends on many factors as well as the severity of the disease. A patient who has two liver conditions will get cirrhosis faster than a patient who has one liver condition.
Although there is no cure for cirrhosis of the liver, there are treatments available that can stop or delay its progress, minimize the damage to liver cells, and reduce complications.
Medications may be given to control the symptoms of cirrhosis. Edema (fluid retention) and ascites (fluid in the abdomen) are treated, in part, by reducing salt in the diet. Drugs called diuretics are used to remove excess fluid and to prevent edema from recurring. Diet and drug therapies can help improve the altered mental function that cirrhosis can cause. Laxatives such as lactulose may be given to help absorb toxins and speed their removal from the intestines.
Liver transplantation may be needed for some people with signs and symptoms of liver failure or worsening cirrhosis
Patients with cirrhosis need to follow a certain diet in order to prevent major complications that can lead to serious consequences. While we encourage patients to eat a general diet with high calorie content, the only restriction needed is “Salt.” Patients with cirrhosis needs to follow a “2g sodium diet.” There is NO reason to restrict eating meat or other poultry food. As a matter of fact, patients with cirrhosis tend to lose muscle mass quickly and therefore need a high protein intake every day to prevent excessive loss in their body muscle. This brochure addresses the 2-gram sodium diet and illustrates which food has high and low sodium content. Please read it and discuss it with your liver doctor or dietary specialist.
Please visit our FAQ page on the recommended Low Salt Diet.
It is a virus that gets into the blood and causes inflammation and damage to the liver, and in some cases other organs.
Hepatitis C mainly transmitted by blood and rarely by sexual contact. You are at risk if you have one of the following:
Yes, but the risk of transmission from sexual contact is believed to be low (<3%). The risk increases for those who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV. If your sexual partner has hepatitis C, you should be tested and if you are negative then your chance of getting the virus is almost zero, and there is no clinical reason to use protection if you are in a monogamous relationship.
Yes, but this does not occur very often. If the Hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member. Sharing a razor or toothbrush is NOT recommended if you live with a hepatitis C person.
If symptoms occur, the average time is 6–7 weeks after exposure, but this can range from 2 weeks to 6 months. These symptoms may include one of the following:
However, many people infected with the Hepatitis C virus do not develop symptoms.
Yes, the majority of patients with hepatitis C do not have any symptoms and find out about the disease only when it is far advanced and caused either cancer or scarred liver. Persons with no symptoms, he or she can still spread the virus to others.
Yes, many people who are infected with the Hepatitis C virus do not know they are infected because they do not look or feel sick.
Most people with chronic Hepatitis C do not have any symptoms. However, if a person has been infected for many years, his or her liver may be damaged. In many cases, there are no symptoms of the disease until liver problems have developed. In persons without symptoms, Hepatitis C is often detected during routine blood tests to measure liver function and liver enzyme (protein produced by the liver) level.
Chronic Hepatitis C is a serious disease and in many cases is a DEADLY disease if left untreated. It can result in long-term health problems, including liver damage, liver failure, liver cancer, or even death. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. Approximately 15,000 people die every year from Hepatitis C related liver disease.
These can range from chronic liver disease to liver cancer and death. Between 20%-30% of patients will live with hepatitis C and have no liver damage. Almost 70% of patients will develop either chronic hepatitis C, cirrhosis or liver cancer.
Cirrhosis is a stage 4 scarring in the liver. It is a very serious disease and will lead to liver cancer, death, or liver transplantation.
Typically, a person will first get a screening test that will show whether he or she has developed antibodies to the Hepatitis C virus. (An antibody is a substance found in the blood that the body produces in response to a virus.) This is called Hepatitis C antibody test. Having a positive antibody test means that a person was exposed to the virus at some time in his or her life. If the antibody test is positive, then the next test will be hepatitis C viral load or HCV RNA. It means measuring how much virus exists in the blood. If it is positive, or detected at any range, then the person has chronic hepatitis C and needs evaluation for treatment.
There are six types of hepatitis C called genotypes. The most common one in the United States is genotype 1. It is very important to know the genotype because it helps determine what kind of treatment the person needs.
Yes, many treatments are available now that are very effective, cause less side effects, and can cure the virus in more than 90% of all cases.
First you need to have your primary doctor determine that you have hepatitis C, then have him/her refer you to a local gastroenterologist or liver specialist who is treating hepatitis C. You can also refer yourself if you don’t have primary care physician. If you live in Southern California or Nevada you can contact us and we will help get you referred to a hepatitis C specialist. A liver specialist or gastroenterologist may run certain blood test and ultrasound of the liver before considering the treatment.
A liver biopsy, obtaining small sample of the liver for testing by needle, is rarely needed these days to determine the eligibility for treatment. It helps estimate how much damage you have in the liver and / or if you have another liver disease that also damaging your liver. However, you need to discuss it further with your doctor. Another alternative to liver biopsy – but may not replace it – are Fibroscan and FibroSure blood tests. Discuss if you are eligible for one of these two tests with your doctor.
Hepatitis C treatment in the past was very long, had a lot of side effects, and was not very effective. It used to consist mainly of pegylated interferon, ribavirin and boceprevir and telaprevir.
Starting in 2014, multiple new hepatitis C treatments became available in the market. The new treatment is oral pills called Direct Acting Agents (DAAs) with or without pegylated interferon. It is expected that interferon will not be used as part of hepatitis C treatment starting November 2014. The treatment now, and in the future, consists of a combination of two or three pills that are taken every day for 8-12 weeks.
Sofosubuvir, simeprevir, ledipsevir and daclatasvir are all pills that are either already available in the market or it will be available by November 2014. Many other new medications will be available in 2015. These pills work by attacking the virus in different ways, which helps get rid of hepatitis and prevents it from occurring again after finishing the treatment. Your doctor will discuss with you the advantage of every combination, and which one is most suited for your case. Please contact us if you have any questions about any of the new hepatitis C treatments.
Very likely yes, the new treatment offers a greater-than 90% chance of cure from hepatitis C.
Anybody who has hepatitis C should be evaluated and get treated using the new treatment. There is no reason for anybody to live with this virus since the new treatment became available and offers a high response rate and few side effects.
It is NOT recommended for you to drink alcohol f you have hepatitis C. Alcohol drinking can lead to more and severe liver damage in person with hepatitis C. You can drink in moderation or socially if you received hepatitis C treatment and got cured from the virus. It is NOT recommended for you to drink any alcohol while you are receiving hepatitis C treatment.
Chronic hepatitis B (CHB) is an inflammation of the liver caused by certain virus that lives in blood. This virus is different type from other viruses that cause hepatitis. The disease can be easily prevented by vaccination or other measures that will be discussed below. Adult patients can effectively clear the virus without treatment. If the virus stay in the system more than 6 months then it will be called Chronic Hepatitis B and if it last less than six months then will be called acute hepatitis B. The disease is very common in certain areas in the world such as Southeast Asia, Africa and parts of the Middle East.
The most important step in prevention is getting vaccination as soon as possible. When all the vaccination shots are taken, the vaccine can offer 100% protection. If you did not receive hepatitis B vaccination during childhood then it is NOT too late to get the vaccination. Your doctor can help you obtain the vaccination. The second step is avoiding unprotected sex with, or sharing a needle with, an infected person.
Acute hepatitis B occurs right after exposure and person usually have many symptoms such as yellow color of the skin, nausea, and vomiting and abdominal pain. Some patients may not experience any symptoms. Liver function tests in this stage are usually elevated. 80% of adult patients will overcome this infection and will be cured and develop the immunity to it. Patients with acute hepatitis usually do not require treatment unless they have signs of liver failure such as altered level of consciousness.
Chronic hepatitis B usually means the person has the infection for more than six months and did not cure it. The majority of these patients have no symptoms. Treatment in this stage is required if the patient meets certain criteria or shows a sign of inflamed liver or elevated liver enzymes. Your liver specialist or doctor will explain the treatment criteria for you in details.
You will most probably have NO symptoms and in some cases patients may experience one or all of the following symptoms:
If you have any of the above risk factors you should ask your doctor to check you for hepatitis B.
Your doctor will check hepatitis B surface antigen in blood. If it is positive then the next step is checking viral load. If both are positive then you will be diagnosed with chronic hepatitis B.
You should see your doctor immediately and discuss the precautions that you need to follow.
If you received the vaccination and immunized to the disease, you are protected and you don’t need to do anything. If you did not receive vaccination then your doctor should immediately check you for the disease and give you vaccination.
If your sex partner diagnosed with hepatitis B and you are vaccinated and developed the immunity, you don’t need to worry about contracting the disease. If you are not vaccinated and your partner just diagnosed with hepatitis B, you should see your doctor immediately to be checked and use protection (condom) until your doctor tell you otherwise.
It means person has hepatitis B surface antigen but no viral load. Usually the person in this condition doe not needs treatment.
Hepatitis B can cause one or all of the following:
If you have hepatitis B, talk to your doctor about treatment as early as possible. You will need ultrasound of the liver EVERY SIX months to screen for liver cancer.
Your doctor will refer you for liver transplantation if you have cirrhosis with signs of liver failure such as ascites (fluid in the abdomen), confusion or bleeding from esophageal varices. Your doctor also will refer you for liver transplantation if you develop liver cancer.
According to the guidelines from American Association for the Study of Liver Disease, one of these two medications can be used: Baraclude (entecavir) or Viread (tenofovir). Usually you will need one of these medications but in certain cases when the virus does not respond to one, your doctor may add the second one.
No. The current treatment does not cure hepatitis B but it will keep it dormant and prevent further damage in your liver and decrease the chance of liver cancer. We are hoping the new treatment that is in development now will offer cure but this is not expected to happen before 2018.