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The Alphabet of Liver Viruses

Raymond O. West, M.D., M.P.H.

Have you ever wondered why we call it the liver – as in "liver and onions" – but when it gets infected we call it "hepatitis?" Here’s why: the old-time Latin name for liver is "hepar." And inflammations (as may be caused by a virus) changes it to hepatitis. The alphabet soup of virus infections leads to hepatitis A, B, C, D, E and even more. For now, let’s be content to examine the "C" variety – a real troublemaker.

Sometime hepatitis C is called "post-transfusion hepatitis." Appropriately so, because in most cases the virus slips quietly into the liver cells through transfused blood. But that’s only part of the story. Hepatitis C virus (HCV) passes from one human to another by way of dirty needles, body piercing, and tattooing. Even through sexual transmission. But all in all, most cases are passed through tainted blood. Maybe that’s why people who refuse to take or give blood can say with a vapid smile, "See, we told you so."

Hepatitis C is a sleeper and a sneaker. About 65 percent of those infected don’t even know that they are infected. At least at first. Here’s how it plays out – while 20 percent of new cases get better on their own, 80 percent become chronic. Many of these deteriorate into cirrhosis, and a significant remnant of these develops cancer.

Is it all as bad as it sounds? Don’t we have some means of killing that virus, healing that liver?

Well, one thing about this liver is this – it regenerates itself. Millions of new cells spring up to replace the damaged ones. The brain and kidneys can’t do that. Nor can the lungs or the heart. When it comes to self-repair, the liver is king. That’s a plus when it comes to treatment and cure. Since many viruses can be destroyed handily, the experts are quick to inform us that 60 percent of victims can be cured. That means normal liver function and normal life expectancy. For now, that’s pretty good, and maybe better is yet to come. For instance, we have the interferons, a variety of them. And thanks in part to the research prompted by AIDS, we have virus killers. One is named ribaviron. Combining these two – interferon and riboviron – assures us of many cures. That’s a great duo, and better drugs are on the way.

Let’s look at it again. Hepatitis C is one of several varieties of hepatitis caused by viruses. It is passed from one to another (humans and chimpanzees only) by blood, infected with the virus. Blood transfusions have been the major villain, but in Western nations, this problem has been mostly solved. In third-world countries, we have a long way to go in blood safety. Body piercing and tattoos will ever risk a hazard. Treatment is effective and better regimens are in the works. We’re getting to know our ABCs.