The Center for Liver Disease and Cancer Care at St. Joseph's Medical Center
Multidisciplinary Treatment and
Surgical Care
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American Association for the Study of Liver Disease HCV Guidelines

Need Hepatic Elastography for Hepatitis C treatment authorization?
Hepatic Elastography now available at St Joseph's Outpatient Radiology
1135 Broad St, Clifton New Jersey
Call 973-569-6300 for information and an appointment

The number of people with complications from chronic liver disease, particularly chronic viral hepatitis C and B, will increase 2-3 fold by the years 2015-2020. The main complications are liver failure and liver cancer. Currently there are about 4,000,000 people with chronic hepatitis C and 2,000,000 people with chronic hepatitis B in the United States who can benefit from treatment. In New Jersey there are over 135,000 people with hepatitis C and 65,000 people with hepatitis B. This puts overwhelming and unachievable demands on the need for liver transplantation and will cause the number of people diagnosed with liver cancer to double over the next 10-15 years. This does not include cirrhosis as a result of fatty liver disease and steatohepatitis due to obesity. By 2025 fatty liver disease will be the leading cause of cirrhosis and liver failure in the United States. By that time there will be at least 2,500,000 people in the United States with cirrhosis.

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The majority of people with hepatitis C and B virus infection, were exposed during the 1970-1990's. Currently there are about 5,000,000-6,000,000 people with active infection in the United States. As a result by 2020 large numbers of these people will have been infected for 20-30 years. Of people with chronic hepatitis C and/or B infection over many years, 20%-25% will develop cirrhosis. These people are at high risk for liver cancer and liver failure. Due to epidemic levels of obesity, 3 out of 10 people in the United State (100,000,000 people) have "Non-Alcoholic Fatty Liver Disease" or NAFLD. NAFLD causes inflammation in the liver, or "Steatohepatitis" in 5% of people with NAFLD. Of people with "Steatohepatitis", up to 30% will develop cirrhosis. These people are also at risk for liver cancer and failure.

The United States still remains a beacon of hope for immigrants. As such, as thousands of people arrive each year, so do endemic rates of hepatitis B and C infection.

Over the next 10-15 years the number of patients with liver failure and cancer with continue to increase rapidly (black line), while the number of transplantable livers will stay relatively unchanged (red line). This will cause the number of people dying from liver disease to dramatically increase. Liver failure and cancer from "Non-Alcoholic Fatty Liver Disease" or NAFLD will be the leading cause for need of a liver transplant by 2020-2025.

The Center for Liver Disease and Cancer Care at St. Joseph's Medical Center is dedicated to advocacy, education, prevention,
multi-disciplinary treatment, advanced surgery, advanced interventional radiology, clinical trials and scientific development of better therapies. As the health burden of liver disease continues to grow, we not only need to find better treatment for liver disease, but advocate lifestyles that promote good health and prevent chronic liver damage.

There are now over 60,000 people in New Jersey with cirrhosis. For each person recieving a liver transplant, there are 500-1000 people with cirrhosis. These people are at continued risk for liver cancer and liver failure. As the number of organ donors remain mostly unchanged, the rapidly growing number of people with liver failure will result in more patients dying while awaiting liver transplant. As the distribution of donor livers has been prioritized to those patients with a MELD score greater than 35, a large void has been created for patients with a MELD less than 25. The largely affects patients with early liver cancer, poorly controlled ascites and poorly controlled encephalopathy. Live donor liver transplant is a viable option for these patients, who are still clearly in need of a liver transplant.

Early diagnosis and treatment of chronic viral hepatitis can eradicate infection and reduce the risk of liver failure and liver cancer. Currently the average cost of a liver transplant is $285,000 to $315,000. Although liver transplant is life saving, there is a great need to improve early diagnosis and treatment to more effectively deal with this epidemic. Unfortunately 70-80 percent of people with hepatitis C or B are not diagnosed. Recently major advances have been made in anti-viral treatment for hepatitis C. Now, up to 90% of patients treated are able to eradicate their virus. Now is the time to find infected patients with hepatitis C and get them into treatment.

Similarly, 70-80 percent of patients diagnosed with liver cancer are not curable, and will die within 5 years of diagnosis. The biggest barrier to improving survival is most people are diagnosed too late. There is a great need to identify people who may benefit from routine liver cancer screening.

Please contact me if I can assist you with any project to combat liver disease in your area.

Andrew N. de la Torre MD, FACS
Founder of Comprehensive Liver Care of New Jersey

or call us at 973-754-2315

New Jersey Physicians Working Hard to Treat New Jersey Residents