Hepatology – Latest developments
The contribution to the field of hepatology of recent developments in the field of diagnostic and treatment methods for many diseases has been great.
The field of prevention has also now acquired a special position. However, to be more specific, we will highlight some of the most important developments, hoping that in the years to come we will develop further.
The most important development has been achieved in the treatment of hepatitis C, a chronic disease that leads to cirrhosis, liver failure in 10-20% of people infected with it and 2-6% per year to hepatocellular cancer. In recent years, its treatment has become easy and affordable with an effectiveness that exceeds 90%. This fact has led many European countries to policies of complete elimination of hepatitis C. Prevention policies have also been intensified.
Hepatitis B has been successfully treated with medications for years, so that its progression to chronic liver disease and cirrhosis has now been controlled. One aspect of this effort is the restriction of liver transplantation in patients with hepatitis B, which was the most common a few years ago. However, efforts to completely cure chronic hepatitis B continue intensively.
In chronic hepatitis D, another dangerous disease, there are new treatments that achieve very good results with greater ease than in the past.
Significant progress has also been achieved in the field of early diagnosis and treatment of hepatocellular carcinoma, a disease that affects approximately 12 men and 4 women per 100,000 population in Greece and occurs most commonly in people with liver cirrhosis or chronic hepatitis. Monitoring methods have been established, usually done every 6 months with modern imaging methods, and there are modern treatments, either excision or local treatment, that can achieve high rates of effectiveness.
The problem that probably concerns the majority of the population, as it can be discovered in 40-80% of people with obesity, diabetes or elevated cholesterol, is the appearance of fat in the liver, which is called fatty liver disease, and which is becoming a scourge of modern civilization mainly due to diet and lifestyle. In recent years, several methods of treating obesity have been developed, surgical and endoscopic, as well as important drugs, such as for example in diabetes mellitus, which combine very good effectiveness with fatty liver disease.
Alcoholic liver disease is also a major modern problem that leads to cirrhosis and is the first cause of liver transplants in many countries. Europe is first with an average alcohol consumption of 10.9 liters of pure alcohol per year. There has been a major campaign to inform and avoid chronic alcohol consumption by the European Union, mainly in population groups such as young people. Also, in many hospitals, detoxification and public information units have been created.
Other major liver problems such as chronic autoimmune hepatitis have also significantly evolved in their treatment. Primary biliary cholangitis and autoimmune hepatitis have acquired some additional treatments that help control difficult and resistant cases and also reduce important symptoms such as itching from bile stasis.
Cirrhosis is part of the progression of a chronic liver disease of any of the aforementioned causes and often, especially if the underlying cause is not treated, leads to liver failure. In these cases, the only treatment is liver transplantation. Nevertheless, there are modern treatments that treat the complications of cirrhosis and delay the progression of these patients. That is, the correct endoscopic and therapeutic treatment of bleeding, the timely treatment of infections and the encephalopathy it causes help many patients with cirrhosis to have a good quality of life.
Therefore, the effort of modern hepatology is based on research, information and communication with specialist doctors for the best treatment of patients with liver diseases. Modern approaches are best achieved with the good cooperation of various specialties, which in addition to the hepatologist are imagers, surgeons, oncologists, infectious disease specialists, psychologists, nutritionists, pathologists and general practitioners with the ultimate goal of the best use of methods for the benefit of the patient.
