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Tag: liver

  • Hepatitis B vaccine Q&A: Why do babies need the shot?

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    The people at highest risk for contracting hepatitis B include health care workers, IV drug users and people having sex.

    So why do babies get vaccinated for hepatitis B as soon as they are born? It’s a fair question, and health care providers have compelling answers. 

    Hepatitis B is a virus that can do serious, sometimes fatal, liver damage. Although groups that are more exposed to swapping bodily fluids are at greater risk, anyone can get infected.

    Getting infected with hepatitis B as a baby is extra dangerous. Infected infants have a 90% chance of developing the disease’s more dangerous chronic form. And a quarter of those babies will go on to die prematurely from the disease when they become adults, according to the American Academy of Pediatrics. 

    When the vaccine was invented in the 1980s, doctors initially vaccinated only the highest risk individuals. Cases didn’t meaningfully decline. 

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    In 1991, the Centers for Disease Control and Prevention began recommending vaccinations for everyone at birth. 

    The protocol produced results: New infections dropped significantly, especially among children and adolescents.

    “Now it’s a very uncommon disease in young children because of that vaccine,” Dr. Paul Offit, Children’s Hospital of Philadelphia pediatrician and infectious disease expert, said. “It was a remarkable, remarkable achievement.”

    Today, infants get their first dose within 24 hours of birth and receive two to three more doses by the time they are 6 months old. 

    But the CDC’s independent vaccine panel is scheduled to reevaluate the vaccine schedule at its Sept. 18 meeting. KFF Health News reported that the panel is expected to vote on whether to delay the vaccine until children are 4. 

    Here’s what you should know about hepatitis B and what is behind the CDC’s longstanding “at birth” hepatitis B vaccine recommendation.

    What is hepatitis B? 

    The hepatitis B virus attacks the liver. Some people become very sick upon initial infection. Others have only mild symptoms or none at all. Acute cases can resolve on their own, but sometimes they develop into chronic infections. 

    Long-lasting infections can be asymptomatic, and dangerous. They develop more slowly and symptoms may not show up until much later in life, sometimes decades after the first exposure. 

    “It’s a stealth infection,” said Dr. William Schaffner, Vanderbilt University School of Medicine professor and infectious disease expert. “After you get over the acute infection, you can have this smoldering infection and be contagious to others and feel perfectly normal.”

    Untreated, chronic hepatitis B infections can cause cirrhosis and death. It is also one of the leading causes of liver cancer. Patients can seek treatments to reduce the virus’ worst effects. But there is no cure. 

    The CDC estimates about 640,000 adults have chronic hepatitis B, but because of its asymptomatic nature, about half of people with the virus do not know they are infected and contagious.

    Who gets hepatitis B and how? 

    Anyone can get it. 

    Hepatitis B is transmitted through bodily fluids like blood, semen and vaginal fluids. It is usually transmitted through sexual activity, direct contact with blood, or from mother to child during delivery due to contact with bodily fluids.

    Because hepatitis B is an especially tough virus, it can live outside the body on surfaces for up to seven days. Even a small amount can be infectious.

    That means that although you can get it through sexual contact or health care work, mundane contact can also result in transmission. Small amounts of dried blood on innocuous household items like nail clippers, razors or toothbrushes could be enough.

    Many hepatitis B patients are never sure how they contracted it.

    “Those environmental routes of transmission of hepatitis B undoubtedly play a small but notable role,” Schaffner said. 

    Because so many people are unaware they are infected, preventing transmission was much more difficult — until the vaccine. 

    How do babies get hepatitis B?

    The fact that so many infected people have no idea they have it makes it nearly impossible to guarantee a child will never come into contact with a hepatitis B-positive individual.

    Babies can get infected from their mothers during childbirth. Testing for hepatitis B during pregnancy is recommended, and patients who receive regular prenatal care are highly likely to be tested at some point. But not all expecting mothers receive regular medical care. In some cases, those at highest risk for contracting hepatitis B are also less likely to access prenatal care, Schaffner said.

    The vaccine works well to prevent infection in babies born to mothers with hepatitis B. 

    But even if a mom tests negative, the child’s risk of contracting hepatitis is not zero. The reasons are varied: The test produces some false negatives. Pregnant patients can contract hepatitis B after being tested. Children may become infected simply by being in contact with the world at large.

    Offit said that prior to the vaccine being recommended for all infants, around half of children under 10 were infected from their mother during birth. The other half contracted it somewhere else. 

    How does the vaccine work and has it been effective at reducing cases? 

    The hepatitis B vaccine was first introduced in 1981; the version in use today was put in place in 1986. 

    It uses proteins from the surface of the hepatitis B virus to provoke an immune response that gives the body a defense against future infection. It is not a live virus, and the vaccine can’t infect someone with hepatitis B. 

    Doctors expect the vaccine may provide lifelong protection, but they are still monitoring results of the 39-year-old vaccine.

    Prior to the vaccine, around 200,000 to 300,000 people were infected with hepatitis B each year, including approximately 20,000 children, older CDC reports show. 

    Since hepatitis B vaccines began being universally administered to babies, overall cases are down to around 14,000 annually. The change is especially dramatic among young people. In 2022, the CDC reported 252 new chronic hepatitis B infections among people up to age 19, or 0.4 out of every 100,000 kids. 

    Dr. James Campbell, a University of Maryland pediatric infectious disease doctor, said the low rate is directly related to the recommended hepatitis B vaccine schedule: “Because we’ve been vaccinating nearly the entire population since 1991 those people are now 30 something years old.” New infections are largely among older Americans. 

    All the doctors we spoke with, the CDC and the American Academy of Pediatrics describe the vaccine as safe and effective. 

    But why not delay the vaccine until a child is a little older?

    When it comes to hepatitis B, that first year of life is critical.

    Whereas the Department of Health and Human Services reports that 90% of infants who become infected go on to develop a chronic hepatitis B infection, that rate is 2% to 6% for adults. And with research showing that 25% of infected infants die prematurely from the disease, public health officials have long held that early delivery is crucial. 

    “Think about it,” Campbell said. “We used to have 18,000 or 20,000 kids a year being born with this, a quarter of them going on to have liver cancer. We now have almost none.”

    Delaying administration by even a few months increases a baby’s risk should they come into contact with the virus, Offit said. And Schaffner said delaying a vaccine can easily lead to never getting it: An unvaccinated child can become an unprotected adolescent or young adult with sexual partners, “and boom, then they get infected,” he said.  

    What are the hepatitis B vaccine’s safety risks?

    The most common side effects are mild and short term including pain or soreness where the shot is given, headache, fatigue or fever, according to the CDC. Very rarely, some people have a severe allergic reaction to the shot called anaphylaxis, which can be treated. 

    The vaccine contains small amounts of aluminium, an additive used to enhance the body’s immune response. Although large amounts of aluminum can be harmful, the vaccine contains less aluminum than infants get from their natural surroundings. 

    According to the Children’s Hospital of Philadelphia, babies get about 4.4mg of aluminum from vaccines in their first six months; they get around 7mg from breastmilk and around 38 mg from formula in the same time. 

    I heard that the risk of a baby dying from hepatitis B is 1 in 7 million. Is that wrong?

    Health and Human Services Secretary Robert F. Kennedy used that statistic during recent Senate testimony. “That means you need to give 7 million hepatitis B vaccines to prevent one death,” he said.

    The vaccine is not administered to prevent babies from dying as babies. It aims to prevent them from developing the more harmful chronic hepatitis B, which can be fatal when they get older. It also prevents severe illness. 

    Kennedy’s statistic for babies who will eventually die from hepatitis B is still missing a lot of context.  

    It’s based on a 2020 research paper that tried to quantify how many people would have died of hepatitis B in 2014 had there never been mass vaccination. 

    The study estimated that 1,740 children ages 10 or younger would have contracted a deadly case of hepatitis B in a single year, 2014. 

    But to make his “1 in 7 million” calculation, Kennedy left out 99% of those deadly cases — any considered to be due to “elevated risk” of exposure, including among children born to infected mothers, children living with infected individuals, or those in communities with large numbers of infected people. 

    Since many people do not know they are infected, it can be hard to know if you are at elevated risk or reside in a community with infected individuals. 

    Vaccines given at birth “protect not only infants and children in their infancy and childhood, but throughout their lives,” Schaffner said. “It’s a larger series of issues that we’re trying to address. We’re trying to protect not only babies, but the transmission of the virus to the next generation.”

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  • New program in Virginia aims to increase the number of living donor transplants – WTOP News

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    A new program just launched in Virginia is aiming to increase the number of living donors that can help patients get the transplants they need sooner.

    Living donor first — that’s the slogan of a new transplant program in Virginia.

    When someone needs a kidney or liver transplant, they could wait years before they get a call, if they even get one at all. A new program just launched in Virginia is aiming to increase the number of living donors that can help patients get the transplants they need sooner.

    “It’s putting the concept of living donor right up front, so that when patients come in, it’s in the forefront of their mind,” said Dr. Shawn Pelletier, director of the transplant service line and chief of the Division of Transplant Surgery at U.Va. Health.

    He said their new program, “Living Donor First,” aims to educate patients and the public about the option of living donors and the benefits to patients.

    They have new signs and pamphlets to inform patients of their options, and they have people ready to assist anyone needing any direction about the process on finding a living donor.

    For kidney patients, living donors are “almost always the best option. The potential recipient doesn’t have to wait on the list for a deceased donor, that might take four to seven years,” he said.

    And for liver transplant patients?

    “You have to wait till you’re the sickest person on the list, and that’s obviously not the best strategy to plan a big operation,” he said.

    He said anyone — family, friends and strangers — can be living donors.

    “You don’t even necessarily have to be compatible or the same blood type,” he said. “We really want everyone thinking of, you know, the potential of being a living donor, and the fact that by doing this, you are literally saving someone’s life.”

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    © 2025 WTOP. All Rights Reserved. This website is not intended for users located within the European Economic Area.

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    Valerie Bonk

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  • WTF Fun Fact 13725 – Liver Response to Food

    WTF Fun Fact 13725 – Liver Response to Food

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    A recent study has unveiled a fascinating liver response triggered by the mere sight and smell of food, showcasing the body’s intricate connection between sensory input and metabolic processes.

    Food Cues and Rapid Liver Response

    Have you ever wondered what happens inside your body when you’re hungry and suddenly see or smell delicious food? Researchers from the Max Planck Institute for Metabolism Research have discovered a fascinating process in mice that begins in the brain and reaches the liver in just minutes. Their study, recently published in Science, could have significant implications for understanding and treating type 2 diabetes.

    When hungry mice were exposed to the sight and smell of food without eating it, their liver cells underwent rapid changes. The mitochondria, crucial for metabolism and energy production, adapted quickly to prepare for sugar metabolism. This reaction was triggered by the activation of specific nerve cells in the brain known as POMC neurons.

    The Science Behind the Sensory Influence

    The researchers focused on how the liver’s mitochondria changed upon just seeing and smelling food. This process involves a specific phosphorylation—a chemical modification important for regulating protein activity—within the mitochondria. Phosphorylation appeared to increase the liver’s sensitivity to insulin, an essential hormone for controlling blood sugar levels.

    Sinika Henschke, the study’s lead author, explains the significance of these findings. “We already knew that our bodies prepare for food intake by producing saliva and digestive acids,” says Henschke. “But now, we’ve seen how the liver, too, prepares rapidly through changes in the mitochondria.”

    The study further reveals a direct link between sensory perception of food and insulin sensitivity adjustments in the body. Jens Brüning, head of the study and director at the Max Planck Institute, emphasizes the importance of this discovery. “Our study shows how closely connected sensory experiences of food are to adaptive processes in the mitochondria and insulin sensitivity. This understanding is crucial, particularly because insulin sensitivity often diminishes in type 2 diabetes.”

    Implications for Diabetes Treatment

    These insights into the liver’s immediate response to food cues through brain signaling open new avenues for treating type 2 diabetes. By harnessing the body’s natural response mechanisms, researchers hope to develop methods to enhance insulin sensitivity and manage diabetes more effectively. Therefore, understanding these rapid adaptive processes in the liver can help in designing interventions that mimic or enhance the body’s natural responses to food stimuli, potentially offering a novel approach to diabetes care.

    In conclusion, this groundbreaking research not only deepens our understanding of the body’s interconnected systems but also offers hope for new treatments that could one day benefit millions of people with diabetes. As we continue to uncover the complex relationships between our senses, the brain, and metabolic processes, the potential for innovative therapeutic strategies expands, potentially transforming how we manage and treat metabolic diseases.

    — WTF fun facts

    Source: Food in sight? The liver is ready! — ScienceDaily

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    WTF

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  • Organs from Cannabis Consumers Don’t Pose Risks of Infection | High Times

    Organs from Cannabis Consumers Don’t Pose Risks of Infection | High Times

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    A study published in the American Journal of Transplantation recently shows that organs that come from donors with a history of recent cannabis use don’t show signs of infection or significant risk.

    The study was conducted by a handful of researchers from University of California, San Francisco, University of Pennsylvania, and Temple University, and funded by National Institutes of Health, the Centers for Disease Control and Prevention (CDC), and Transplant Foundation Innovative Research Grant Program. Researchers examined information from three specific transplant centers located in Philadelphia, Pennsylvania, between transplants that were conducted by the Gift of Life Program between January 1, 2015-June 30, 2016.

    According to the CDC, organ transplant patients take anti-rejection medicine that lowers their body’s immune system response, which helps their bodies accept the new organ. That same medicine can sometimes lead to mild or life-threatening infections, which can develop days, weeks, months, or even years after transplant surgery occurs.

    The authors explained that cannabis leaves sometimes contain harmful bacteria or fungi, and inhaled cannabis has also been found in relation to infections in transplant patients. This study addressed the question regarding if cannabis consumer’s organs are harmful to patients on the organ receiving end. “The goal of our study is to better characterize the infection risks that marijuana use among deceased organ donors may pose to [solid organ transplants] recipients,” the authors wrote.

    The authors explained the importance of their findings amidst the rising percentage of people consuming cannabis regularly. “It is likely that a growing proportion of deceased organ donors have a history of marijuana use, as well, though this metric has not been specifically reported,” authors said.

    The study examined donors with cannabis use within the last 12 months prior to the study, as well as donors with no recent cannabis use history. “Despite concern that donor exposure to marijuana increases the risk of fungal infection in recipients, our study found that a donor history of marijuana use did not increase (1) the likelihood of donor culture positivity (including respiratory cultures), or (2) the risk of early recipient bacterial or fungal infection, graft failure, or death posttransplant,” the study stated. “Even when evaluating only lung recipients, there remained no association between donor marijuana use and the risk of posttransplant infection.”

    The researchers explored a variety of data from the three transplant facilities, such as donors who experienced bacterial or fungal infections, or if the transplant failed and led to death in the patient. Overall, organs from consumers with recent cannabis use posed little threat to the patients. “Among donors with a history of recent marijuana use, 79 (89%) had at least 1 positive culture, compared to 264 (87%) among those with no history of marijuana use,” researchers wrote. “On donor respiratory cultures, 76 (85%) donors with a history of recent marijuana use and 250 (82%) donors with no history of recent marijuana use had bacterial or fungal growth on respiratory cultures. On both unadjusted analyses and multivariable analyses, there was no association between recent donor marijuana use and donor culture positivity.”

    However, it’s important to note that the data that researchers reviewed was collected well after transplants occurred, and relied on next-of-kin to help measure a patient’s cannabis use. This was described as an “imperfect measure” of data collection.

    “In conclusion, our study demonstrates that donors with a history of recent marijuana use are not more likely to have positive donor cultures, and their recipients are not more likely to develop a bacterial or fungal infection, graft failure, or death in the early posttransplant period (in the context of current management),” the study concluded. “These results suggest that organs from donors with a history of recent marijuana use do not pose significant novel infectious risks to recipients in the early posttransplant period.”

    Currently, medical cannabis patients often experience discrimination when seeking out health care, but specifically encounter restrictions when it comes to organ transplants, according to a report published by the Petrie-Flom Center at Harvard Law School last October. “Many transplant centers prevent cannabis users from receiving solid organ transplantation due to concerns regarding interactions between cannabis and immunosuppressant drugs used for transplants, treatment non-adherence, fungal infections, and neuropsychiatric effects,” the report stated. As a result, medical cannabis patients are often ineligible for transplant.

    The review adds that larger-scale studies are needed in order to determine if medical cannabis consumption “…should not be an absolute contraindication to solid organ transplantation.” Furthermore, some research shows evidence of medical cannabis helping to prevent transplant rejection in some patients.

    Last year, another study found that cannabis use isn’t a risk for liver transplant patients. Researchers found no correlation between cannabis and non-cannabis users, stating that there was “no statistically significant associations between marijuana use with post-transplant bacterial or fungal infections, medication non-compliance, or continued substance use.”

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    Nicole Potter

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  • Experts ID Likely Cause of Mysterious Hepatitis Outbreak in Kids

    Experts ID Likely Cause of Mysterious Hepatitis Outbreak in Kids

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    April 4, 2023 – Researchers have found that co-infection by multiple common viruses may have caused a mysterious hepatitis outbreak in kids worldwide. 

    Since October 2021, these hepatitis cases in young children affected more than 1,000 kids in 35 countries. Although most children survived, of about 350 patients identified in the United States until May 2022, 22 required a liver transplant and 13 died.

    Most of these children were under 6 years old. 

    Not only are these hepatitis cases acute and severe, but what’s causing them is a mystery. They don’t fit into the common categories of liver inflammation, known as hepatitis A through E. 

    Now, researchers have zeroed in on a possible culprit. They identified a strain of virus, called adeno-associated virus type 2 (AAV2), as the central player in the outbreak. And if they are correct, AAV2 is not acting alone. 

    In fact, this virus is not strong enough to cause these severe cases without help. Instead, affected children must have at least one other “helper” virus at the same time, such as a human adenovirus (which can cause symptoms similar to the common cold or flu, according to the CDC), Epstein-Barr virus, and/or human herpesvirus 6. 

    The new study was published online March 30 in the journal Nature. 

    Pointing to the Pandemic

    The researchers say there is no evidence linking the illnesses to the virus that causes COVID-19, but the pandemic may still be a factor in these infections. Because many children were not exposed to the viruses linked to the hepatitis cases during lockdowns and social isolation, as they normally would be, they did not build up immunity to them.  

    “So it is possible once restrictions were lifted, they were suddenly exposed over a short period of time to multiple viruses,” said senior study author Charles Chiu, MD, PhD, a laboratory medicine and infectious disease specialist at the University of California San Francisco School of Medicine. 

    This setup and lack of a strong immune system to deal with these specific viruses “would have increased their risk of developing severe disease.”

    William Balistreri, MD, a pediatric hepatitis specialist who was not affiliated with the study, agreed this was possible. 

    This has been a popular theory, especially in view of the timing of the bulk of cases, peaking during the height of the COVID-19 pandemic and associated isolation procedures,” said Balistreri, who is also a professor of pediatrics and director emeritus of the Pediatric Liver Care Center at Cincinnati Children’s Hospital Medical Center. 

    What to Watch for in Kids

    As for his take-home message for parents and health care providers, “the keys are awareness and reassurance,” Balistreri said. 

    Vigilance also is warranted, he said, if a child has symptoms that often come right before hepatitis, including respiratory symptoms, nausea, vomiting, diarrhea, and belly pain. Also, If jaundice or yellowing of the eyes from jaundice, called scleral icterus, develops, then hepatitis should be suspected. 

    “Reassurance is based on the good news that most children with acute hepatitis get better. If a case arises, it is good practice to keep the child well-hydrated, offer a normal diet, and avoid medications that may be cleared by the liver,” Balistreri said, noting that COVID vaccination is “strongly suggested.”

    Working to Solve the Mystery

    Chiu and colleagues were not completely in the dark at first. They knew from previous research that adenoviruses might be involved. So they used genomic sequencing and other advanced technologies to look for the virus in 27 blood, stool, and other samples from 16 children with this severe hepatitis. They also wanted to know what other viruses might be present. 

    And for comparison, they searched for the same viruses in a group of 113 children without this severe hepatitis of unknown origin.

    Strengthening their findings were two other studies that were done at different institutions and published in the same journal at the same time. One was a genomic study confirming the presence of AAV2 and other suspected viruses, and the other was a genomic and laboratory study further supporting the results.

    Of the 16 affected children studied by Chiu and colleagues, the average age was 3. About half were boys. These children were diagnosed with severe hepatitis starting when it was first detected on Oct. 1, 2021, until May 22, 2022. 

    Key Findings

    Of the three studies published in Nature, using different diagnostic tools, there was a consistent presence of the adeno-associated virus type 2 in all or almost all of children, while the “helper” viruses of varying types were also discovered.

    Also striking in the studies: what was not found. Of 113 children in one comparison group, among those with diagnoses other than the mystery ailments — including stomach flu, hepatitis of known origin, and those admitted to a hospital for liver failure — AAV2 was much less common. 

    There was also hardly any evidence of the “helper” viruses. 

    “I am quite confident that we have identified the key viruses” because they used  comprehensive genetic sequencing “to look for potential infections from any virus or non-viral pathogen,” Chu said.

    Moving Forward

    The next steps in the research could go beyond identifying presence of these viruses and figuring out which one – or ones – are adding the most to the acute pediatric hepatitis. 

    There was also a study in the United Kingdom that identified a specific genetic factor linked to the condition, and Chiu and colleagues might look into that further. 

    They also said they might study other things linked to the COVID pandemic, including if and how long COVID fits into this and resurgence of other viruses, such as respiratory syncytial virus (RSV) and the flu.

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  • Fast-Food Fans May Face Liver Damage

    Fast-Food Fans May Face Liver Damage

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    Jan. 13, 2023 – A new study that shows the harm to the liver of eating fast food might provide people with motivation to eat less of it in the new year. 

    The study found that eating at least 20% of total daily calories from fast food can increase the risk of nonalcoholic fatty liver disease, a potentially life-threatening condition where fat builds up in the liver. The disease can lead to cirrhosis and its complications, including liver failure and liver cancer. 

    People with obesity or diabetes are more vulnerable to the harmful effects of fast food on the liver, although the general population is not immune to the harm. 

    “My hope is that this study encourages people to seek out more nutritious, healthy food options,” says lead investigator Ani Kardashian, MD, with Keck Medicine at the University of Southern California.  

    “At a policy level, public health efforts are needed to improve access to affordable, healthy, and nutritious food options across the U.S. This is especially important as more people have turned to fast foods during the pandemic and as the price of food as risen dramatically over the past year due to food inflation,” she says. 

    The researchers analyzed data on diet and fatty liver measurements for nearly 4,000 adults.

     Nearly 30% of them got 20% or more of their total daily calories from fast food, such as burgers, fries, pizza, and the like. 

    They found that people with obesity or diabetes who take in one-fifth or more of their daily calories from fast food had severely high levels of fat in their liver, compared with those who eat less or no fast food.

    The general population had moderate increases in liver fat when one-fifth or more of their diet was made up of fast food. 

    The findings are particularly “alarming” given the increase in fast-food consumption over the past 50 years, regardless of socioeconomic status, Kardashian says. 

    “If people eat one meal a day at a fast-food restaurant, they may think they aren’t doing harm. However, if that one meal equals at least one-fifth of their daily calories, they are putting their livers at risk,” she says. 

    For people who have limited options and need to eat fast food, “there are healthy choices at most restaurants; you just need to be smart about reading labels, watching calories, and ordering the healthier options,” says Nancy Reau, MD, with Rush University Medical Center in Chicago,  who wasn’t involved in the study.

    Lisa Ganjhu, DO, with NYU Langone Health in New York City, agrees. 

    “I am a firm believer that fast food can cause fatty liver. It goes hand in hand, and I counsel and coach my patients on healthy diet and exercise, and I’ve been pretty successful,” she says. 

    “If my patient is eating at McDonald’s a lot, I basically walk through the menu with them and help them find something healthy. When patients see the benefits of cutting out fat and reducing carbohydrate, they are more apt to continue,.”

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  • Taming the Emotions That Come With Hepatitis C

    Taming the Emotions That Come With Hepatitis C

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    You have hepatitis C, a disease caused by a virus that’s contagious and attacks the liver. Maybe you know how you got it. Maybe you don’t.

    Whatever the case, the virus could be just part of the problem. Now that the doctor has told you that you have hep C, get ready to battle a range of head-spinning emotions that often can be as difficult to deal with as the virus itself.

    There are ways to calm your nerves and ease your mind.

    What You’re Facing

    Fear and anxiety: Most people with hepatitis C don’t have any symptoms. Even if you’ve had it for years, you may not have the fever, fatigue, nausea, vomiting, and other things that some folks with the virus have.

    Still, doctors will tell you that hepatitis C is a serious disease that can cause lasting damage to the liver, including cancer and a scarring of the liver (cirrhosis). Hepatitis C is, in a word, scary.

    “I think fear is probably the first thing: ‘What does it mean?’ ” says Lucinda K. Porter, RN, author of two books about her experience with hep C.

    “If you don’t know anything about hepatitis C, and you go on the Internet — which a lot of people seem to go to before they go to their physicians — you might see a full variety of outcomes, including death. Or see that this is an infectious disease and get the fear you might infect someone else. That’s a huge fear.”

    The fears keep coming:

    • Is it going to be debilitating?
    • Can you infect someone else?
    • Will you be able to work?
    • How are you going to pay for your treatment?
    • How are you going to take care of your family?
    • How are you going to pay the mortgage?

    “Once you learn more, you find out that hep C doesn’t work like that,” says Porter, who works as a hepatitis C advocate, writing for hepmag.com and hcvadvocate.org. “If you find out about it in an early stage and get some good, solid information, you find out that those fears don’t usually get realized.”

    Remember: In many cases, the medicines that your doctor prescribes can pretty much wipe the virus out of your body.

    “There is nothing to be afraid of. No matter how you got the infection, now we have a group of different, good therapies that can get rid of this infection,” says Victor Machicao, MD, a gastroenterologist with McGovern Medical School at UTHealth-Houston.

    “I usually tell [people] there’s a good chance that, you start taking the treatments, you’re going to start feeling better, and by the time that we complete the therapy, you’re going to feel almost like a new person.”

    Embarrassment and shame: Hepatitis C gets spread through exposure to an infected person’s blood. That’s the only way. Often, that’s how intravenous drug users, sharing needles, spread the virus. Sometimes, it gets passed down through high-risk sex. Before 1992, when blood wasn’t screened for hepatitis C in the U.S., it often was passed along through transfusions and organ transplants, too.

    Some of those activities — drug use and high-risk sex, especially — are what many people associate with hepatitis C. That thinking creates a stigma that makes people who have the disease not want to tell others about it.

    “So many of [the people I treat] are those baby boomers who did have a brief period of experimentation with drug use. Or maybe they did use drugs for a year or two of their adolescence. But now, that’s like 30 years ago,” says Andrew Muir, MD, a hepatologist who is chief of the Division of Gastroenterology at Duke Clinical Research Institute in Durham, NC.

    “Often, they’re not married to somebody that they knew back then … it’s embarrassing, then you’re worried about what that person is going to think of you, and then when you realize that there may be a chance that you’ve passed on the virus through sex. … All these things are spiraling around in their heads.”

    Guilt: “There’s a lot of guilt, especially in someone who has a remote history of IV drug use, or got a tattoo at an unregulated parlor, or had a high-risk sexual encounter,” says Nancy Reau, MD, section chief of hepatology at Rush University Medical Center in Chicago.

    People feel guilty about the possibility that they’ve infected others unknowingly. They feel guilty about putting loved ones in a situation that is often financially and emotionally costly. Sometimes, it can be too much for a person to handle.

    Regret: People with the disease often beat themselves up for not making better choices when they contracted the virus.

    “At that point, I tell every single one of my [folks] that there’s not a single one of us that wouldn’t go back and change a decision that we’ve made,” Reau says. “To some extent, looking back isn’t going to help us. We have to look forward.”

    Anger: “Anger is not an uncommon one. Anger is one of those emotions that make us feel like we’re empowered,” says Porter, who got hepatitis C in 1988 through a blood transfusion.

    For some, it comes from the fact that they had nothing to do with what gave them the virus.

    “I didn’t react with anger because in my case, that blood transfusion saved my life. But other people … can feel quite angry, and they feel quite victimized by that. I find [this] one is probably the hardest to address. Sometimes I just acknowledge that they feel angry.”

    Depression: The virus, the symptoms that may accompany it, all the emotions — it can be difficult to handle.

    Muir says a common scenario, in his experience, is a drug user who addresses the problem of addiction, goes in for treatment, and just as things start looking better, finds out they have hepatitis C.

    “I find a lot of them are really down on themselves: ‘I’m a bad person, I did this, I’m being punished for it.’ We really need to try to change the way they feel about that,” Muir says.

    “I was a mess. I felt dirty. I was hard on myself,” says Stella Armstrong, a Las Vegas office manager who got the virus through drug use. Armstrong is now virus-free and is a hepatitis C advocate and member of the National Patient Advisory Committee for the American Liver Foundation. “I had to seek counseling. I had to see a psychiatrist. I was taking depression and anxiety medicine.”

    How to Get Help

    Talk to your medical team. Meet with your doctor and anyone else you might need (a hepatologist or pharmacist, for example). Get a plan. Follow treatment.

    “You start there. Always,” Porter says.

    Don’t underestimate the power of feeling physically better. It’s good for your mind, too.

    Once again, the virus can disappear in many of those who have hepatitis C.

    “People are surprised. They ask you, ‘Doctor, did you mean ‘cure’?” Machicao says. “They come to the office and say, ‘Doctor, that means I don’t have the infection anymore?’ I tell them, ‘For practical purposes, you’re cured.’ They are in total disbelief. It is amazing.”

    “The success of being cured of hepatitis C is really powerful,” says Muir.

    If you feel depression or anxiety, the National Institute of Mental Health suggests that you talk to your primary doctor or go to a psychologist or psychiatrist. Depression is a real illness and, even in the most severe cases, it’s treatable with medication or other means.

    Get educated. Find trusted sites online. Ask your doctor questions. Know what the virus is all about. Separate fact from fiction.

    “Education is how we start breaking down the stereotypes. How we find out we don’t need to be afraid anymore,” Porter says. “It can release the chains of anger.”

    Find some support. It can help to talk with other people who have been through what you have. Your doctor can point you toward online groups filled with people who are going through the same process. In some places, you can meet with people in person. Social services through government agencies or hospitals can help, too.

    “When you start to see other people who have a history of drug use, that regret and shame starts to diminish. ‘OK. I’m not a bad person. I can deal with this,’ ” Porter says.

    “I’ve always been open and have discussed my addiction with drugs. I think it’s the best thing. We only stay as sick as our secrets,” Armstrong says. “It was better for me to share my story. It’s still the same thing. It’s still hepatitis C, and we have to get through it.”

    Lean on family, friends, clergy, whomever it takes. Whether it’s someone else who has been through hepatitis C, or a spouse, a parent, a sibling, or your best friend — even if it’s a complete stranger — sometimes you just need a shoulder or a sympathetic ear. Search them out. Use them.

    “No matter how much positive you can hear about it, you still have to go home, you still have to be at a point by yourself, thinking these bad thoughts and you’re worried and you’re scared and you’re scared of the unknown,” Armstrong says. “Those are the times you have to call somebody and talk to them.”

    Take care of yourself. Once you get your medical plan in place, once you have your support in line, once you’re educated and know what you’re facing, taking a little “me” time is in order.

    “Having a chronic illness is hard,” Reau says. “Start by looking at the things you can change easily.”

    Eat well. Exercise. Get your sleep. Some people like to meditate. Nap if you need to nap. Make sure you’re around people you like. Enjoy a good book or a movie. All these can help you deal with the stress and emotions of hepatitis C.

    “Even at my lowest point and when I was feeling really sick, you just gotta keep moving. You have no other choice,” Armstrong says. “You have to keep moving forward and treating yourself well.”

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  • Taming the Emotions That Come With Hepatitis C

    Taming the Emotions That Come With Hepatitis C

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    You have hepatitis C, a disease caused by a virus that’s contagious and attacks the liver. Maybe you know how you got it. Maybe you don’t.

    Whatever the case, the virus could be just part of the problem. Now that the doctor has told you that you have hep C, get ready to battle a range of head-spinning emotions that often can be as difficult to deal with as the virus itself.

    There are ways to calm your nerves and ease your mind.

    What You’re Facing

    Fear and anxiety: Most people with hepatitis C don’t have any symptoms. Even if you’ve had it for years, you may not have the fever, fatigue, nausea, vomiting, and other things that some folks with the virus have.

    Still, doctors will tell you that hepatitis C is a serious disease that can cause lasting damage to the liver, including cancer and a scarring of the liver (cirrhosis). Hepatitis C is, in a word, scary.

    “I think fear is probably the first thing: ‘What does it mean?’ ” says Lucinda K. Porter, RN, author of two books about her experience with hep C.

    “If you don’t know anything about hepatitis C, and you go on the Internet — which a lot of people seem to go to before they go to their physicians — you might see a full variety of outcomes, including death. Or see that this is an infectious disease and get the fear you might infect someone else. That’s a huge fear.”

    The fears keep coming:

    • Is it going to be debilitating?
    • Can you infect someone else?
    • Will you be able to work?
    • How are you going to pay for your treatment?
    • How are you going to take care of your family?
    • How are you going to pay the mortgage?

    “Once you learn more, you find out that hep C doesn’t work like that,” says Porter, who works as a hepatitis C advocate, writing for hepmag.com and hcvadvocate.org. “If you find out about it in an early stage and get some good, solid information, you find out that those fears don’t usually get realized.”

    Remember: In many cases, the medicines that your doctor prescribes can pretty much wipe the virus out of your body.

    “There is nothing to be afraid of. No matter how you got the infection, now we have a group of different, good therapies that can get rid of this infection,” says Victor Machicao, MD, a gastroenterologist with McGovern Medical School at UTHealth-Houston.

    “I usually tell [people] there’s a good chance that, you start taking the treatments, you’re going to start feeling better, and by the time that we complete the therapy, you’re going to feel almost like a new person.”

    Embarrassment and shame: Hepatitis C gets spread through exposure to an infected person’s blood. That’s the only way. Often, that’s how intravenous drug users, sharing needles, spread the virus. Sometimes, it gets passed down through high-risk sex. Before 1992, when blood wasn’t screened for hepatitis C in the U.S., it often was passed along through transfusions and organ transplants, too.

    Some of those activities — drug use and high-risk sex, especially — are what many people associate with hepatitis C. That thinking creates a stigma that makes people who have the disease not want to tell others about it.

    “So many of [the people I treat] are those baby boomers who did have a brief period of experimentation with drug use. Or maybe they did use drugs for a year or two of their adolescence. But now, that’s like 30 years ago,” says Andrew Muir, MD, a hepatologist who is chief of the Division of Gastroenterology at Duke Clinical Research Institute in Durham, NC.

    “Often, they’re not married to somebody that they knew back then … it’s embarrassing, then you’re worried about what that person is going to think of you, and then when you realize that there may be a chance that you’ve passed on the virus through sex. … All these things are spiraling around in their heads.”

    Guilt: “There’s a lot of guilt, especially in someone who has a remote history of IV drug use, or got a tattoo at an unregulated parlor, or had a high-risk sexual encounter,” says Nancy Reau, MD, section chief of hepatology at Rush University Medical Center in Chicago.

    People feel guilty about the possibility that they’ve infected others unknowingly. They feel guilty about putting loved ones in a situation that is often financially and emotionally costly. Sometimes, it can be too much for a person to handle.

    Regret: People with the disease often beat themselves up for not making better choices when they contracted the virus.

    “At that point, I tell every single one of my [folks] that there’s not a single one of us that wouldn’t go back and change a decision that we’ve made,” Reau says. “To some extent, looking back isn’t going to help us. We have to look forward.”

    Anger: “Anger is not an uncommon one. Anger is one of those emotions that make us feel like we’re empowered,” says Porter, who got hepatitis C in 1988 through a blood transfusion.

    For some, it comes from the fact that they had nothing to do with what gave them the virus.

    “I didn’t react with anger because in my case, that blood transfusion saved my life. But other people … can feel quite angry, and they feel quite victimized by that. I find [this] one is probably the hardest to address. Sometimes I just acknowledge that they feel angry.”

    Depression: The virus, the symptoms that may accompany it, all the emotions — it can be difficult to handle.

    Muir says a common scenario, in his experience, is a drug user who addresses the problem of addiction, goes in for treatment, and just as things start looking better, finds out they have hepatitis C.

    “I find a lot of them are really down on themselves: ‘I’m a bad person, I did this, I’m being punished for it.’ We really need to try to change the way they feel about that,” Muir says.

    “I was a mess. I felt dirty. I was hard on myself,” says Stella Armstrong, a Las Vegas office manager who got the virus through drug use. Armstrong is now virus-free and is a hepatitis C advocate and member of the National Patient Advisory Committee for the American Liver Foundation. “I had to seek counseling. I had to see a psychiatrist. I was taking depression and anxiety medicine.”

    How to Get Help

    Talk to your medical team. Meet with your doctor and anyone else you might need (a hepatologist or pharmacist, for example). Get a plan. Follow treatment.

    “You start there. Always,” Porter says.

    Don’t underestimate the power of feeling physically better. It’s good for your mind, too.

    Once again, the virus can disappear in many of those who have hepatitis C.

    “People are surprised. They ask you, ‘Doctor, did you mean ‘cure’?” Machicao says. “They come to the office and say, ‘Doctor, that means I don’t have the infection anymore?’ I tell them, ‘For practical purposes, you’re cured.’ They are in total disbelief. It is amazing.”

    “The success of being cured of hepatitis C is really powerful,” says Muir.

    If you feel depression or anxiety, the National Institute of Mental Health suggests that you talk to your primary doctor or go to a psychologist or psychiatrist. Depression is a real illness and, even in the most severe cases, it’s treatable with medication or other means.

    Get educated. Find trusted sites online. Ask your doctor questions. Know what the virus is all about. Separate fact from fiction.

    “Education is how we start breaking down the stereotypes. How we find out we don’t need to be afraid anymore,” Porter says. “It can release the chains of anger.”

    Find some support. It can help to talk with other people who have been through what you have. Your doctor can point you toward online groups filled with people who are going through the same process. In some places, you can meet with people in person. Social services through government agencies or hospitals can help, too.

    “When you start to see other people who have a history of drug use, that regret and shame starts to diminish. ‘OK. I’m not a bad person. I can deal with this,’ ” Porter says.

    “I’ve always been open and have discussed my addiction with drugs. I think it’s the best thing. We only stay as sick as our secrets,” Armstrong says. “It was better for me to share my story. It’s still the same thing. It’s still hepatitis C, and we have to get through it.”

    Lean on family, friends, clergy, whomever it takes. Whether it’s someone else who has been through hepatitis C, or a spouse, a parent, a sibling, or your best friend — even if it’s a complete stranger — sometimes you just need a shoulder or a sympathetic ear. Search them out. Use them.

    “No matter how much positive you can hear about it, you still have to go home, you still have to be at a point by yourself, thinking these bad thoughts and you’re worried and you’re scared and you’re scared of the unknown,” Armstrong says. “Those are the times you have to call somebody and talk to them.”

    Take care of yourself. Once you get your medical plan in place, once you have your support in line, once you’re educated and know what you’re facing, taking a little “me” time is in order.

    “Having a chronic illness is hard,” Reau says. “Start by looking at the things you can change easily.”

    Eat well. Exercise. Get your sleep. Some people like to meditate. Nap if you need to nap. Make sure you’re around people you like. Enjoy a good book or a movie. All these can help you deal with the stress and emotions of hepatitis C.

    “Even at my lowest point and when I was feeling really sick, you just gotta keep moving. You have no other choice,” Armstrong says. “You have to keep moving forward and treating yourself well.”

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