The number of people dying from liver disease or liver cancer related to chronic viral hepatitis C and B and fatty liver, will increase 2-3 fold by 2020. Of patients with cirrhosis and liver cancer, less than 25% receive routine liver cancer screening. Currently there are over 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. As a result of obesity, there are also about 2,000,000 people with Non-Alcoholic-Steato-Hepatitis (NASH) in the United States. 25% of patients with hepatitis C, hepatitis B or NASH already have cirrhosis. Cirrhosis is the leading cause of liver cancer.

In New Jersey there are over 250,000 people with hepatitis C, hepatitis B or NASH. Unidentified and untreated, the number of people diagnosed with liver cancer may double over the next 10-15 years. By 2025 NASH related cirrhosis will be the leading cause of need for liver transplant in the United States. By that time, there will be at least 2,500,000 people in the United States with cirrhosis. Recent advances in HCV treatment now allow 9 out of 10 patients to successfully be cured of their infection. Treatment of NASH will depend on how we deal with the obesity epidemic.

Liver Disease and Cancer Care at CarePoint Health: Multidisciplinary Treatment and Surgical Care

Phone: 201-795-8596 or 201-420-7903, Fax: 201-418-7067

Bayonne, NJ
Jersey City, NJ
Kearny, NJ
Hoboken, NJ
Edgewater, NJ
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Support Senate bill No. 1279 requiring hospitals and health care professionals to offer hepatitis C testing to patients born between 1945 and 1965

If you were born outside the United States, check to see if you need to be tested for
hepatitis C or hepatitis B

Do you have a fatty liver or NASH?

The Program for Liver Disease and Cancer Care at CarePoint Health is dedicated to advocacy, education, prevention, multi-disciplinary treatment, advanced surgery, advanced interventional radiology, clinical trials and scientific development of better therapies. To reduce the health burden of liver disease, we need to find and treat those afflicted by liver disease, and advocate lifestyles that promote good health and prevent liver damage.

There are over 60,000 people in New Jersey with cirrhosis. For each person receiving a liver transplant, there are 500-1000 people with cirrhosis and continued risk for liver cancer or liver failure. This program actively works on public health projects to improve our understanding, early diagnosis and treatment of liver disease, and has been doing so for over a decade. Listed below are some of our projects. Though liver transplant is life saving, it is equally life saving and far more effective to find and fix liver disease early, long before need of a transplant.

de la Torre AN, Ahmad M, Fernandez I, Ayoub F, Korogosky M, Pichardo N, Green L, Montesdeoca A, McDowall P, Danko C.Electronic Health Record Year and Country of Birth Testing and Patient Navigation to Increase Diagnosis of Chronic Viral Hepatitis. Journal of Viral Hepatitis, 2019 (In Press)

de la Torre AN, Castaneda I, Ahmad M, Ekholy N, Tham N, Herrera IB, Beaty P, Malapero RJ, Ayoub F, Slim J, et al. Audio-computer-assisted survey interview and patient navigation to increase chronic viral hepatitis diagnosis and linkage to care in urban health clinics. J Viral Hepat. 2017 Dec;24(12):1184-1191. doi: 10.1111/jvh.12744. Epub 2017 Aug 2. PubMed PMID: 28636784.

de la Torre AN, Contractor S, Castaneda I, Cathcart CS, Razdan D, Klyde D, Kisza P, Gonzales SF, Salazar AM.
A Phase I trial using local regional treatment, nonlethal irradiation, intratumoral and systemic polyinosinic-polycytidylic acid polylysine carboxymethylcellulose to treat liver cancer: in search of the abscopal effect. J Hepatocell Carcinoma. 2017 Aug 7;4:111-121. doi: 10.2147/JHC.S136652. eCollection 2017. PubMed PMID: 28848723; PubMed Central PMCID: PMC5557908.

Ferrante JM, Winston DG, Chen PH, de la Torre AN.
Family physicians' knowledge and screening of chronic hepatitis and liver cancer. Fam Med. 2008 May;40(5):345-51. PubMed PMID: 18465284.

Muir AJ, Shiffman ML, Zaman A, Yoffe B, de la Torre A, Flamm S, Gordon SC, Marotta P, Vierling JM, Lopez-Talavera JC, Byrnes-Blake K, Fontana D, Freeman J, Gray T, Hausman D, Hunder NN, Lawitz E. Phase 1b study of pegylated interferon lambda 1 with or without ribavirin in patients with chronic genotype 1 hepatitis C virus infection. Hepatology. 2010 Sep;52(3):822-32. doi: 10.1002/hep.23743. PubMed PMID: 20564352.

The number of organ donors will remain mostly unchanged. Undiagnosed, the number of people with liver failure will grow, resulting in more patients dying while awaiting liver transplant. As the distribution of donor livers has been prioritized to patients with a MELD score greater than 35, a large void exists for patients with a MELD less than 25. This 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. 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.

Andrew N. de la Torre MD, FACS
Director Liver Disease Services, Hepatobiliary Surgery and Cancer Care
CarePoint Health