Omar Massoud.

Gulf Today, Staff Reporter

Infection with the hepatitis C virus is almost always curable, but given its impact on liver health, it is important to catch it early and to address any liver damage after the infection has been eliminated, says a hepatologist from global health system Cleveland Clinic ahead of World Hepatitis Day, observed on July 28.

Hepatitis refers to inflammation of the liver and viral hepatitis is caused by one of five strains of hepatitis viruses named from A to E. According to the World Health Organisation, an estimated 354 million people worldwide live with hepatitis B or C, both of which are blood-borne, and which together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths. While there is a vaccine to prevent hepatitis B, there is none for hepatitis C.

Dr. Omar Massoud, Chief of Hepatology at Cleveland Clinic, says, "The good news is that treatment for hepatitis C improved remarkably over the past decade. Direct-acting antiviral medications are highly effective in clearing the hepatitis C virus from the body in just two to three months. Studies have shown they have a 98% to 99% cure rate and are generally well tolerated by people who take them.”

Dr. Massoud points out, however, the challenge is that patients with hepatitis C often have no symptoms and therefore do not seek testing or treatment. "This is why it is important for everyone above the age of 18 to get tested for hepatitis C at least once, otherwise, by the time they develop symptoms and seek treatment for cirrhosis, it may be too late. Higher-risk individuals such as healthcare workers would need to be tested more often,” he adds.

In the same vein, says Dr. Massoud, it is important for patients to realise that the treatment journey does not end with the antiviral medication. "Further blood tests will need to be done after three months to confirm that the virus has been eliminated. More importantly, we must remember that while the capsules can eradicate the hepatitis C virus, they cannot reverse the liver damage that has already occurred.”

When assessing the severity of liver damage, Dr. Massoud explains that fibrosis, or scarring of the liver, can be classified from the least-serious stage one up to stage four, which is cirrhosis.

Stages one and two require the shortest follow-up period and the damage is reversible. These patients will usually be advised to adjust their lifestyles so as to avoid alcohol, eat healthily, exercise regularly and maintain a healthy weight. In stages three and four, however, the damage might not be reversible, and the patient could need lifelong monitoring to check for complications of liver disease, and will also need to adjust their healthy lifestyle choice.