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The liver is the largest internal organ in the body, responsible for more than 500 essential tasks. Among other key functions, it filters blood traveling from heart as well as the stomach and intestines. It converts nutrients from food into substances the body can use, metabolizes drug treatments and breaks down toxic substances, making sure they are released from the body. In addition to all this, the liver secretes chemicals that are used by other parts of the body to regulate everything from controlling the metabolism to helping blood clot to seal a cut.
Maintaining a healthy liver is crucially important for overall health and wellbeing. In recognition of Liver Health Month, which occurs annually in March, learn more about one of the most common threats to liver health: viral hepatitis.
Hepatitis B and C are two of the most common threats to liver health. Viral hepatitis affects more than 350 million people worldwide and causes approximately 700,000 deaths every year – more than HIV, tuberculosis or malaria. Hepatitis B and C infections cause progressive damage to the liver, leading to the development of scar tissue – called cirrhosis – that prevents the liver from performing its functions. Once someone has cirrhosis, they are at risk of liver failure and liver cancer.
Worryingly for such a pressing health concern, many people with hepatitis B and C are not even aware that they have been infected. The liver is an incredibly resilient organ, and this resiliency can be its downfall. That is because, thanks to the organ’s resiliency, symptoms often don’t appear until the liver is already at an advanced stage of decline. That means individuals can have diseases like hepatitis B or C causing damage to their liver for years or even decades without knowing anything is wrong.
Testing and treatment
One of the most important things that you can do to look after your liver is also one of the easiest: getting tested for viral hepatitis. Hepatitis B and C are diagnosed with simple blood tests. Hepatitis B can be prevented with vaccination, which is administered in Ontario for adolescents and at birth for babies with family members with hepatitis B. Those who have not been vaccinated and children whose mother has a hepatitis B infection are at higher risk of contracting the virus. Hepatitis B is primarily spread from mother to child and through unprotected sex, whereas hepatitis C is most often contracted through blood to blood contact – injection drug use, improperly sterilized medical equipment or body piercing tools, or having received a blood transfusion prior to 1992.
With a simple blood test, hepatitis B and C can be detected long before symptoms appear. Earlier diagnosis allows for treatment to prevent future complications and – in the case of hepatitis C – cure of the disease.
In 2015, researchers discovered that a simple drug regimen – one pill, taken daily for three months – can cure hepatitis C. Dr. Jordan Feld, Research Director, Toronto Centre for Liver Disease, R. Phelan Chair in Translational Liver Research and Co-Director of the Schwartz Reisman Liver Research Centre led the multinational study, which showed that 99 per cent of participants were cured in just twelve weeks.
With hepatitis B vaccination and hepatitis C cure, the World Health Organization has set a goal to eliminate viral hepatitis as a public health threat by 2030. Canada has signed on to meet this ambitious target. However, a lot of work will be required over the next decade to identify those living with viral hepatitis, get them linked to care and treatment and ensure that prevention tools are strengthened to avoid new infections.
Dr. Feld and his colleagues at the Viral Hepatitis Care Network (VIRCAN) are helping to lead the charge towards elimination. Their research has shown that point-of-care testing for hepatitis can be done in as little as 5 minutes, rather than the standard 40 minutes, with 100 per cent accuracy. This makes hepatitis C screening more accessible for everyone, but is particularly helpful for people who face additional barriers in accessing care, including people who are homeless. This new standard is being adopted in countries around the world, helping turn the tides in the global fight against this disease. VIRCAN is also training doctors and nurses in primary care, to diagnose and treat hepatitis infections to help build the capacity needed to achieve the ambitious elimination targets.
1 in 4 Canadians may be affected by liver disease
Source: Canadian Liver Foundation
Look after your liver health – get tested
Testing is even more important now. Due to COVID-19, viral hepatitis testing rates have plummeted, with UHN’s Viral Hepatitis Care Network (VIRCAN) reporting a staggering 79 per cent drop in screening in the first months of the pandemic, and rates have not fully recovered. It is estimated that an additional 72,000 deaths from hepatitis C will occur by 2030 in people who were not diagnosed because of the impact the pandemic had on screening efforts.
This Liver Health Month, take a simple step to protect the health of this vital organ. Talk to your healthcare practitioner to learn more about getting tested for hepatitis B and C or go to HCV411.ca to find hepatitis C screening services near you.
