Hepatitis and Liver Diseases
What are some symptoms of liver disease?
Each patient's liver disease can develop differently. Some symptoms of deteriorating liver function are fatigue, forgetfulness or mental confusion, loss of consciousness (coma), sleep reversal (inability to sleep at night, but wanting to sleep all day), ascites (fluid in the abdomen), spontaneous bacterial peritonitis (infection of the ascetic fluid), edema (swelling of the legs), bleeding gums, vomiting of blood, bleeding from rectum or passing black stools (from internal bleeding), itching of the skin, enlarged breasts in males, jaundice or "liver spots" (spider angiomata and petechiae).
What is hepatitis?
Hepatitis literally means inflammation of the liver, and refers to a group of conditions that may be caused by one of many viruses. Hepatitis can be inherited, acquired or brought on by excessive alcohol consumption. The most well known forms of hepatitis are hepatitis B and hepatitis C.
What is hepatitis B?
Hepatitis B is caused by the hepatitis B virus (HBV) and can be transmitted through blood contact. Chronic hepatitis B can lead to cirrhosis (deterioration of the liver where scar tissue replaces healthy tissue and impedes blood-flow through the liver) and also liver cancer.
How is hepatitis B treated?
The hepatitis B virus (HBV) is treated with antiviral or immunomodulatory therapy. Currently approved therapies include standard interferon, lamivudine, adefovir, and entecavir. In 2011, the vast majority of people with hepatitis B can be cleared of the virus with medications.
What is hepatitis C?
Hepatitis C is caused by the hepatitis C virus (HCV) and can be transmitted through blood contact. Because of the lack of symptoms during early stages, hepatitis C is usually not diagnosed until its damage is well advanced.
How is hepatitis C treated?
Treatment for the hepatitis C virus (HCV) has typically been treated with interferon and Ribavirin. This year two new therapies with improved effectiveness have been approved for the treatment of Hepatitis C, boceprevir and telaprevir. These new drugs are used in conjunction with interferon and ribavirin.
How is hepatitis diagnosed?
Although the treatment for hepatitis B and hepatitis C is different, they are both diagnosed through blood tests.
What is cirrhosis?
Cirrhosis is the scarring of the liver over a period of time, which in turn impedes blood flow in the liver. Cirrhosis is usually caused by chronic hepatitis or excessive alcohol consumption.
What is hepatocellular carcinoma (HCC)?
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and usually occurs as a result of damage to the liver from chronic hepatitis or cirrhosis.
Can hepatocellular carcinoma (HCC) be treated?
There are four types of treatments for HCC. They are liver transplantation, surgical resection, chemoembolization or ablation, and chemotherapy through the vein. Liver transplantation has the highest cure rate but requires lifelong immunosuppression and requires being on a list for a liver transplant. Liver resection has a high cure rate and can often be performed laparoscopically but still requires major surgery. Chemoembolization or ablation can control tumors for months and is minimally invasive and requires a short hospital stay. Nexavar is the first approved chemotherapy for advanced HCC and improves survival.
How is liver cancer diagnosed?
Blood tests may lead a physician to suspect liver cancer, which can then be diagnosed by CT, MRI, or ultrasound with contrast. Cholangiocarcinoma must be diagnosed with special endoscopic and contrast imaging techniques to explore the bile ducts.
What is radiofrequency ablation (RFA)?
Radiofrequency ablation (RFA) directs thermal energy into the tumor. RFA is an option for tumors less than 5cm. The procedure can often be conducted on an outpatient basis with a minimal access approach utilizing ultrasound to guide the ablation probe.
What is transcatheter arterial chemoembolization (TACE)?
Transcatheter arterial chemoembolization (TACE) involves shutting off blood flow from the hepatic artery to the tumor in combination with delivery of a chemotherapeutic agent to the tumor. The effectiveness of TACE depends upon the size and extent of the HCC.