Q&A with Dr. Danilewitz: Treating Hepatitis C in Philadelphia
Could you be living with hepatitis C?
Dr. Mervyn Danilewitz, a gastroenterologist who runs the Liver Clinic at Mercy Philadelphia, is raising awareness about hepatitis C, a disease he says has turned into a “silent epidemic” in Philadelphia, and one that particularly affects minorities, especially older black men.
Q: To get started, what exactly is hepatitis C?
Hepatitis C is a virus that infects the liver primarily. This virus is transmitted from an infected person via blood into the next person, but it can also spread via unclean needles. Once inside you, the virus starts causing liver damage. But it can remain undetected for up to 30 years before developing into cirrhosis, which is hardening of the liver, and can lead to liver cancer and liver failure. Hepatitis C is the number one reason for a liver transplant.
Q: Why is hepatitis C so dangerous?
It's referred to as a silent epidemic because most people who have hepatitis C aren’t even aware of it. They often don’t have symptoms until the disease is advanced, and much liver damage has already been done. But by that stage the treatment might not be as effective. They could have some tiredness, but we all have a little tiredness at the end of the day.
Q: Are you seeing hepatitis C in certain populations?
The silent epidemic refers to baby boomers who were born between 1945 and 1965. That's the predominant group. Keep in mind that the virus wasn’t discovered until 1989. A lot of patients got it from IV drug use, and the heyday of that was the 1960s and 1970s.
There are also patients who have had blood transfusions before 1989 who may have gotten the virus. It’s a blood-driven disease. Tattoos are another concern—needles may not be sterilized. Health care workers can be at risk as well following a needle stick.
Q: Why is liver health so important?
You cannot live without your liver. It gets rid of toxins. It produces essential things the body needs, like proteins and certain hormones. The liver also responsible for producing clotting factors in your blood that prevent bleeding.
Q: Why did you open the Liver Clinic in Philadelphia?
There is such a high prevalence of hepatitis C in West Philadelphia and we wanted to help people that Mercy Philadelphia Hospital serves. There was a great need for treating the community, and we are right in that community.
Q: Should you get a test if you are asymptomatic?
Yes. Anyone who is a baby boomer and who has a history of IV drug use—even if it was only once—or anyone else in a high-risk group, such as having tattoos or a history of cocaine use, should be tested.
Q: What are the latest advances in hepatitis C treatment?
The latest advancement is the new medication that will be coming out within the next six months. At the moment patients have to go into therapy for six months, sometimes a year. But now with the second generation of direct anti-viral agents, they will be on the medications for just three months. Also, instead of a 70 percent eradication rate, there will be a 90 percent eradication rate. And in the next year there’s going to be even better treatment.
Q: What’s the best part of your job?
Seeing the look of appreciation from patients who are cured of the virus. It’s so gratifying. Today that happens with 70 percent of the patients; soon it will be 90 percent and hopefully one day it will be 100 percent.