PREVENTION OF HEPATITIS AND LIVER DISEASE
People living with liver disease must address two separate issues regarding prevention. The first concerns preventing the spread of a potentially infectious liver disease—namely viral hepatitis—to others. Fortunately, the hepatitis A and B vaccinations are available and are an effective means of preventing a person from becoming infected with these types of viral hepatitis. The second issue concerns the importance of preventing additional liver diseases in people already living with liver disease. People with chronic liver disease often experience a severe if not life-threatening course of disease when infected with acute hepatitis A. And some people who have had a liver transplant are at risk for developing hepatitis B, which could lead to dysfunction of the transplanted liver, fulminant hepatitis, and/or cirrhosis. It is of utmost importance that all people with chronic liver disease receive the immunizations for hepatitis A and B. Please refer to “Vaccinations” for a discussion of the importance of vaccination, both for people living with or in close contact with someone who has viral hepatitis and for all people with chronic liver disease of any type. This section discusses some general preventative strategies which all people with liver disease, their loved ones, and their friends should be aware.
Even though some liver diseases are impossible to prevent, there are many strategies that people can adopt to protect their livers and to maximize their health. All people—especially women—should consume alcohol only in moderation. People with liver disease should eliminate alcohol from their lives altogether. People with a family history of hemochromatosis or primary biliary cirrhosis should have blood work regularly performed to test for these liver diseases. If either disease is found to be present, treatment should be started as soon as possible. For the best results to be achieved, treatment should begin during the earliest stages of the disease before any symptoms develop. As a general rule, all people should attempt to maintain a normal weight and to keep their diets low in saturated fats. This can reduce the likelihood of developing nonalcoholic fatty liver disease (although other factors may have a role in the development of this disease). As much as possible, all hepatotoxic medications should be avoided. Cigarette smoking should be terminated, as it has been linked to the development of liver cancer and may enhance the hepatotoxicity of some medications.
The hepatitis A virus can be killed by boiling infected foods for three minutes and by disinfecting surfaces infected with the virus with bleach. It is best to avoid eating raw or partially cooked mollusks (clams, oysters, mussels, and scallops), as these fish often live in HAV-contaminated rivers and seas. When traveling to areas of the world known to have a high incidence of hepatitis A, it is especially important to eat well-cooked foods and to drink only bottled water. Sanitizing diaper-changing tables is also important, as hepatitis A-infected infants are typically a silent source for the spread of hepatitis A infection. Meticulous hand washing is of a great importance after using the bathroom, before eating a meal, and when preparing food for others.
Not engaging in unprotected sex will greatly reduce the likelihood of infection with HBV. While the risk of sexual transmission of HCV is rare, protected sex is recommended if a person engages in anal sex, has multiple sexual partners, has frequent prostate infections, has open cuts or sores on the genitalia, or is menstruating. People with hepatitis B or C should avoid sharing anything that may contain even the tiniest amount of their blood, including toothbrushes, razors, and nail clippers.
In order to further reduce the likelihood of spreading hepatitis B and C, people who are using injection drugs should never share needles with others or inject themselves with a used needle. A drop of blood so minuscule that it cannot be detected by the human eye may contain hundreds or even thousands of hepatitis B and/or C particles. Even meticulous cleaning may not totally eradicate the virus from a needle. If a person needs unused needles but cannot obtain them, she should seek out a needle exchange program. Alternatively, needle use can be limited to auto-destruct syringes. These needles are non-reusable. They are designed to self-destruct after one use so that they cannot be reused or shared with others. Of course, the best advice for a person who continues to actively use illicit drugs is to discontinue this activity immediately and seek help at a drug rehabilitation center. Also, anyone who intends to get a tattoo or have a body part pierced should make sure that they deal only with establishments that are clean and that adhere to meticulous sterilization practices.
Finally, while the risk of transmission of hepatitis B and C through a blood transfusion is extraordinarily low, if a person will be undergoing surgery and may need a blood transfusion, she may wish to donate her own blood or to select a specific person (usually a relative) to donate blood to her. These are known, respectively, as autologous blood and directed blood donation. If this route of blood donation is desired, it should, if possible, be planned out well in advance of surgery.
All contents of this article are Copyright © Melissa Palmer, MD
Melissa Palmer, MD is the author of " Dr. Melissa Palmer's Guide of Hepatitis and Liver Disease". (Published 2004. Penguin Putnam).
Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. Prior to 2012, she maintained perhaps the largest medical practice devoted to liver disease in the United States. Dr. Palmer is Clinical Professor of Medicine at New York University Medical Center. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City.
Dr. Palmer is Board Certified in Gastroenterology and in Internal Medicine.
She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.
She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis. Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis.
Dr. Palmer has performed numerous clinical trials on various experimental medications for the treatment of hepatitis.
Dr. Palmer is currently available for lecturing, investor and hedge-fund consultations, consultations to industry, and media interviews and appearances-- including television. For such matters, she can be contacted through hepatitismedia@gmail.com.
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