Much has been written about the resilient and dependable liver, an organ that functions efficiently and uncomplainingly as it fulfills over 500 tasks daily. So reliable is the liver that, if damaged, it can repair and regenerate itself by up to an astonishing 90 percent!
“It is like your independent middle child that can take care of itself,” quips Makati Medical Center (MakatiMed) Gastroenterology and Hepatology Specialist Angelo B. Lozada, MD. “The liver does not need a lot of maintenance.”
Still, like the middle child, the liver has its limits. Although one of the liver’s main jobs is processing the alcohol we drink, consuming too much produces toxins that damage liver cells, which lead to inflammation, scarring (fibrosis or cirrhosis), and a high risk of liver cancer. Cirrhosis and liver cancer are also the consequences of fatty liver disease, a condition that develops from excessive amounts of alcohol, a sedentary lifestyle, and a diet loaded with sugar, sodium, and fat.
Turmeric, green tea extract, vitamin A, and other supplements touted as “healthy” and “all-natural” can damage the liver when taken in high amounts as can overdoing certain drugs, from over-the-counter pain relievers (acetaminophen, ibuprofen, naproxen) to prescription medication for cholesterol, the heart, antibiotics, antivirals, and steroids.
You can also contract viral hepatitis, “the infection of the liver that is caused by a virus,” says Dr. Lozada. “There are many types of viruses that may infect the liver, but the common ones are viral hepatitis A, B, and C.” Each is diagnosed through specific blood tests, though elevated liver enzymes—your SGPT and SGOT—should tell you that something’s off.
All three share similar symptoms: jaundice or the yellowing of the skin and eyes, fatigue, low-grade fever, and pain on the right side of the lower rib. Left untreated, hepatitis B and C could progress to cirrhosis, liver cancer, and liver failure.
Dr. Lozada, immediate past president of the Hepatology Society of the Philippines, is a tireless advocate of liver health, not just every January, which is Liver Cancer and Viral Hepatitis Awareness and Prevention Month, but every opportunity he gets. Because these infections may not present telltale signs till weeks, months, even decades later—or at all—a person could inadvertently expose others, who, in turn, infect more.
“They are just walking around amongst us,” he says. “And mind you, there is a lot of them and they do not have symptoms.”
The MakatiMed doctor runs through the ABCs of hepatitis A, B, and C—from how you get them to their treatments and ways to prevent infection and recurrence.
Hepatitis A: Acute, self-limiting infection
Food or water contaminated with the virus is how hepatitis A is usually transmitted. “The technical term is a fecal-to-oral route,” says Dr. Lozada. “A person who is infected with hepatitis A has the virus in the stool that he sheds.” Unhygienic practices can pass even the tiniest particles of infected stool to common objects, food, and drink.
Sexual contact and the sharing of needles with an infected person are other modes of transmission.
Two (2) doses of the hepatitis A vaccine (administered six (6) months apart) protect you from the virus, but if you had already been infected, expect to be treated with supportive measures—medications for your fever, fluids to hydrate, and such. Much like the flu, hepatitis A requires minimal intervention. “It is a self-limiting virus. It should eventually go away,” says Dr. Lozada. Thereafter, you will develop an immunity from the virus.
Prevent its spread by observing proper hand hygiene and food safety practices—cook food thoroughly, wash fruits and vegetables before consuming them raw, and avoid food and drink from unsanitary sources.
Hepatitis B: Endemic to the Philippines
Frequent salons or barbershops? Be careful about contracting hepatitis B. Shared razors, nippers, and nail cutters may carry the blood of an infected individual, “and if they are used on a person who has a break in their skin, it can pass on the virus,” Dr. Lozada points out.
Also transmitted through bodily fluids during sexual intercourse, and from a pregnant mother to her newborn at childbirth, hepatitis B can resolve itself in less than six months—or it can be chronic and remain in your system for life. Symptoms tend to be subtle to non-existent, which is why hepatitis B is endemic to the Philippines: Many have it but not know it. “If you have 100 million Filipinos, there is an estimated 17 million Filipinos with hepatitis B—and a great majority do not even know they have the infection,” says Dr. Lozada.
A stealthy virus makes hepatitis B challenging to treat. “The virus integrates itself into the host’s DNA, so it escapes eradication,” the doctor explains. “Hepatitis B hides inside your liver, the cells of your liver, and inside the DNA of your liver cells.”
Various sectors can benefit from a three-dose vaccine (the first two given two months apart, followed by a booster shot in six months) that prevents hepatitis B: babies within the first 24 hours of birth, children and adolescents, healthcare workers, people who live with someone with hepatitis B, and males who are intimate with men. You can also prevent infection by going to salons, barbershops, and tattoo parlors that routinely sanitize their tools, and using a condom during sex.
Hepatitis C: No vaccine, but there is a cure
A little less than 1% of the Philippines’ population has hepatitis C, says Dr. Lozada, but that does not mean you can let your guard down. Antivirals designed specifically to cure hepatitis C are available, and the latest ones boast a 98% efficacy rate.
“But there is a caveat,” he says. “You can be reinfected if you are exposed to the risk factors.”
Again, the blood of an infected individual is how hepatitis C’s virus is spread. This makes drug users who share needles, commercial sex workers, healthcare workers exposed to those with hepatitis C, patients who undergo hemodialysis, and males who have unprotected sex with male partners at high risk for infection.
While it can be acute like hepatitis A, it can also be chronic like hepatitis B, and would not reveal symptoms till years later, when some damage has already been done to the liver. Doing away with illegal drugs, engaging in protected sex, undergoing dialysis from professional health facilities, and getting tested for hepatitis C if you belong to the vulnerable sector can prevent infection and reinfection.
If you suspect you may have been exposed to any of the viruses, are exhibiting symptoms related to liver disease, or simply want a baseline on your liver health, commemorate Liver Cancer and Viral Hepatitis Awareness and Prevention Month this January by making an appointment with your doctor.
Assures Dr. Lozada, “We have a range of gastroenterologists as well as hepatologists at the Makati Medical Center who can help you with your liver concerns.”
Article based on Healthline with MakatiMed hosted by Nicole Jacinto guesting of Angelo B. Lozada, MD last January 22, 2024.
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