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 The Princess Grace Hospital
Dedicated to Caring.... |
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The Princess Grace Hospital Hepatitis
Diagnostic & Treatment Services
The Princess Grace Hospital offers the first rapid, comperhensive diagnostic evaluation treatment programme in the British private sector for chronic hepatitis. It is designed to diagnose assess and decide the correct course of treatment for the individual with suspected chronic hepatitis within a week, reducing anxiety and uncertainty and allowing rapid action to reverse the disease wherever possible.
What is Chronic Hepatitis and how is it acquired?
Chronic Hepatitis is long term inflammation of the liver usually caused by one of 2 viruses, hepatitis B or C, both these viruses are of low infectivity requiring direct blood to blood contact for their transmission. Worldwide the commonest route of spread is across the placenta from an infected mother to her baby, but they can also be transmitted by blood transfusion, hypodermic needles and sexual intercourse.
Rates of infection in the general population vary between countries from 0.5% to 20% tending to be higher in Eastern countries.
What are the Consequences?
Millions of people world-wide are infected with these viruses, once a chronic infection has arisen it results in gradual impairment of liver function, although this is rarely symptomatic in the early stages, if left untreated eventual destruction of liver cells in chronic active hepatitis, cirrhosis and liver failure. Rarely even cancer of the liver may develop. In general about one third of those chronically infected go on to get chronic inflammation and about one third of those will develop serious consequences after 10-12 years.
Fortunately since it commonly takes 10-20 years for serious consequences to arise, the recent development of effective antiviral drugs such as interferon and ribavirin, mean that the inflammation can be reversed and if cought early enough the virus can even be eradicated before severe damage is caused.
How can it be diagnosed?
First blood tests are necessary to determine whether there is true chronic infection or whether the patient has simply been exposed to the virus and developed an effective immunity without inflammation of the liver. DNA technology now allows us to detect virus in the blood directly and assess the amount of virus. If virusis present and biochemical liver function tests are abnormal it is likely that there is inflammation of the liver and it is necessary to proceed to biopsy the liver to assess the degree of inflammation, the extent of any reactive fibrosis, (which leads to cirrhosis) and enable selection of the correct treatment.
Do all patients need treatment?
Patients who have been exposed to the virus but do not have active inflammation of the liver do not need treatment. The only way to tell is by blood tests. Patients who have true infection with significant inflammation of the liver need to be treated. If the disease has been present for many years (10-20) the disease may be too advanced for any benefit to be derived from direct antiviral treatment, in these patients measures to minimise the effects of the infection will be advised, and the treatments available for established liver disease will be discussed. Fortunately many patients seek treatment soon after infection is suspected and are able to benefit from antiviral treatment.
What is the treatment for chronic hepatitis?
Depending on the findings at liver biopsy it may be possible to reverse the inflammation and eradicate the virus using agents such as interferon. These can be supplied from the clinic. The test results are available within a week and their significance for the treatment and prognosis is explained in detail by medical and nursing staff who are recognized experts in the field. the treatment programme is tailored to the individual so that patients living abroad can have their drugs supplied together with instructions on administration and response monitoring which can be done locally .
Treatment commonly consists of a course of antiviral treatment lasting from 6-8 months with assessments by regular blood tests and where necessary repeat liver biopsy.
General advice concerning viral transmission, avoidance of alcohol, drugs likely to be toxic to rhe liver and diet will also be given. A written summary of the findings and treatment will be given for reference. Clinic personnel will always be available for advice by phone or fax.
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