[00:00:01] Speaker A: You COVID-19.
[00:01:02] Speaker B: And good evening. Thank you for joining Disability in Progress, where we bring you insights into ideas about and discussions on disability topics. My name is Sam, I'm the host of this show. Thanks so much for tuning in. Charlene Doll is my research person. Hi Charlene.
[00:01:16] Speaker C: Good evening everyone.
[00:01:18] Speaker B: And this week we are speaking with Dr. Jose DeBess and he is an associate professor at the University of Minnesota Medical School and he's a gastroentologist ontology hepatology specialist with Hennepin Healthcare. He also specializes with caring for patients with liver disease, particularly those for viral hepatitis and liver cancer. Tonight he'll be speaking about hepatitis and who gets it and what it is and the vaccines and how it pertains to you. So good evening Dr. Debes good evening, how are you? Thank you so much for joining me.
[00:02:06] Speaker A: Thank you for inviting ah also thank.
[00:02:10] Speaker B: You for your PR person for helping set you up with us, so we appreciate that.
So I want to start out a little bit about how you decided to get into this field.
[00:02:24] Speaker A: That is a long question. No, I'm fascinated by the field of liver diseases and it's particularly viral hepatitis and liver cancer mainly because it's a global problem, so it happens all over the world. And also I'm fascinated by the connection of an inflammation or an infectious disease that eventually can lead to a cancer. So I thought one could tackle and do research in multiple aspects affecting one particular organ, such as the liver, which it is by default quite an important organ in the body.
[00:02:58] Speaker B: Yes. Excellent. Well, thank you so much again for joining us. Give us a definition of what hepatitis is.
[00:03:08] Speaker A: So strictly speaking, hepatitis is an inflammation of the liver. So basically there are multiple causes and we can talk about that later, but it is when the liver gets inflamed and it can cause a lot of problems in the body. That's the strict definition of hepatitis.
[00:03:27] Speaker B: How many types of hepatitis are there and what are the most common ones?
[00:03:32] Speaker A: Yeah, so the type of hepatitis, we could divide them independent, how it affects a person and what affects the liver. The first one I'm talking about, it could be acute hepatitis or you could also have chronic hepatitis. So acute hepatitis you have the problem for a limited period of time and for chronic hepatitis you have the problem for the rest of your life.
So that's the first part. The second part is what is causing the hepatitis. And I think most people, when they think about hepatitis, they think about viruses and infections, which are the most common causes among those viruses. It can get rather confusing, but we have multiple letters, so we have hepatitis ABCD and E, so there's many letters in there.
Now, there are other kinds of hepatitis. One of them that we're seeing a lot lately is what is called alcohol related hepatitis, which is related as the word says, to the consumption of alcohol.
[00:04:37] Speaker B: Right.
[00:04:38] Speaker A: Another type of hepatitis that is frequent also is autoimmune hepatitis, which is almost like an immune response from your body towards the liver. And I would say, generally speaking, those are the most common causes and I would say the most common ones are the viral ones. And we're seeing more and more lately the alcohol related hepatitis.
[00:05:05] Speaker B: So I'd like to dive into the viral ones. But first I do want to touch on that because you mentioned alcohol related hepatitis.
Why lately?
[00:05:14] Speaker A: That is a great question. So because of the pandemic and one thing that we have known so alcohol related hepatitis is not new, we've seen it for many years. It tends to affect middle aged people, women in particular can get affected and people sometimes are not aware of this disease. So there's a common understanding that if you drink large quantities of alcohol for a prolonged period of time, you can get cirrhosis of the liver. What people sometimes don't know is that there is this other disease or entity called alcoholic hepatitis which is very acute and it actually carries a very high mortality. So people that get alcoholic hepatitis have around a 40% to 50% mortality at six months. So it's very deadly. And we've been seeing this for a long time. However, during the pandemic period with the COVID-19 pandemic, obviously a lot more people were staying at home and I think a lot more people were drinking more. So we started seeing more alcohol related hepatitis, particularly in younger people and actually in women. So this is something that has become more problematic and more frequent because of the pandemic in the last couple of years.
[00:06:40] Speaker B: Wow. So higher in women because they have smaller bodies, smaller liver, smaller what?
[00:06:47] Speaker A: That is a great question and I don't think we know the answer. People are doing research to see whether it has to do with estrogen, has to do with the body mass index.
But there are studies looking at people at similar weights, men, female, and they still females get more, I mean, yeah, they get more frequent alcohol related hepatitis. One thing we see sometimes frequently is that a couple, for example, the male and the female, they're both drinking quite a bit at home, the male doesn't have anything, and then the female acquires alcoholic hepatitis or alcohol related hepatitis.
[00:07:22] Speaker B: Wow.
I find it interesting that you point to the pandemic as the probable cause of this higher instance of alcoholic hepatitis because surely we've been through harder things or hard things before, but it seems like the pandemic just pushed people over the edge.
[00:07:47] Speaker A: Absolutely, we've been through hard things before, but I think the pandemic has been extremely hard. But also remember the pandemic kept a lot of people at home. Right. And people sometimes get bored at home and when they get bored, they drink.
That is a problem. But there are many studies showing that right now, particularly in women, and it's quite a scurry, may I say.
[00:08:13] Speaker B: I guess they should come in my life. I've got plenty of things for them to do.
[00:08:18] Speaker A: I think you should.
[00:08:20] Speaker B: So I do want to break a little bit of this down and can we start with the hepatitis A?
[00:08:32] Speaker A: Yeah, absolutely.
[00:08:34] Speaker B: And discuss what causes it, what are the symptoms?
[00:08:38] Speaker A: Yeah, absolutely. So hepatitis A actually is quite common. It is one of the acute hepatitis, as I was referring to, not a chronic one.
Again, it's a virus, it's called hepatitis A virus. And basically it is transmitted, as disgusting as it might sound, from feces to humans, basically. So sometimes there can be outbreaks of alcoholic, of hepatitis A in restaurants where for one reason or another there has been a connection between somebody, not necessarily the feces, but somebody maybe wash their hands. Exactly. And wash their hands very well. Exactly.
And the person has to be actively infected at the time and then they pass on the virus to the food and then people acquire it.
[00:09:31] Speaker B: Scary.
[00:09:31] Speaker A: And part of the problem is that a lot of times it doesn't give any symptoms. So the person that is transmitting the hepatitis A has no idea that he or she is doing that.
As most hepatitis, the viral hepatitis symptoms are quite similar. So again, I would say the majority of people don't have any symptoms, but the people that do, they will sometimes get jaundice, so their skin will become yellow, they can have pain in the upper right portion of the abdomen. They also can have some diarrhea as well.
And interestingly, because of the physiology or some of the liver enzymes, they might have this combination of having very dark urine and very pale stools that is something that is typical from hepatitis. Again, all hepatitis, but we see it very commonly with hepatitis A.
If I might expand again, it's very frequent, it is not really very deadly unless it occurs in older people or in people that are immunosuppressed. And it usually lasts for a few weeks and then patients recover.
In this country, we don't see it that often because there is vaccination for it, but it's seen relatively often in other countries of the world.
[00:11:01] Speaker B: Okay, so you went off on vaccine, I'd like to cover that. So talk about the vaccine.
Should everyone get this vaccine? How do you know if you should get it? How often do you get it?
[00:11:16] Speaker A: Yes, so hepatitis A is a one time vaccine, actually, that most children will get. Now children, they all get it. I think unless you're immunosuppressed or you have any other disease in the liver, there is no really recommendation to get hepatitis A vaccine for an adult. For an adult, yeah.
[00:11:38] Speaker B: But what if you get it?
[00:11:39] Speaker A: Well, so if you get it, the majority of people will get the symptoms and they will get better. So that's why nobody's against it. So if somebody wants to get the vaccine, it is completely appropriate. But it is not strictly recommended, again, unless you have a disease of the liver, because if you have a problem in the liver and all of a sudden you get another acute hepatitis that might tip your liver to having issues, right?
But because it's mainly symptomatic and doesn't really, bluntly speaking, doesn't really kill many people, it is not strictly recommended for all adults.
[00:12:16] Speaker B: Okay, so let's move on hepatitis B, because that's another real common one, isn't it?
[00:12:23] Speaker A: That is a real common one, honestly speaking, the one that is deep, I dare to say, is the most common and the most scary because it's so broadly distributed around the world.
It is one of the most common, if not the most common cause of liver disease worldwide. And it is the most common cause of cancer of the liver worldwide. So that one is a really scary one.
[00:12:50] Speaker B: And so what are the symptoms?
[00:12:52] Speaker A: So this is a problem with hepatitis B. The majority of people that get exposed to hepatitis B don't express any symptoms. So it's a silent disease. When people get the acute form of hepatitis, it's similar to aid, you get yellowing in the skin and diarrhea and pain in the abdomen. But I dare to say that over 90% of the people will not get any symptoms.
And then this is one of the ones that can become chronic, right, that once you acquire it, you live with it for life. And sadly, there are really almost no symptoms. So by the time you start getting symptoms is when your liver is cirrhotic or you are in trouble.
Sorry.
[00:13:40] Speaker B: So how does one get the hepatitis B?
[00:13:43] Speaker A: So hepatitis B, and I say this because people might be more familiar with this, is the routes of transmission are very similar to HIV. So there are three main routes. One, it is mother to child, so a pregnant mother can transmit it to the son or the daughter. The other one is via blood. So if somebody gets transfused blood with hepatitis B or sometimes people that use intravenous drugs with contaminating needles, they can acquire hepatitis B and then through intercourse. So sexual intercourse can also transmit hepatitis B.
The one thing I would like to add, because it is quite unique to hepatitis B and is a relatively interesting fact, is that if you are a baby or a child below three or five years old and you get exposed to the virus, you have 90% to 95% chances of being infected chronically with the virus. However, if you're an adult, so you say you are 2030 years old and you get exposed to the virus, you only have 5% chances of being infected chronically. So the age at which you are exposed has a huge impact in whether you develop or not chronic disease.
[00:15:06] Speaker B: And do we know why?
[00:15:08] Speaker A: The immune system. So the thought is that the immune system in children is not properly developed so the virus can sneak in while in adults the immune system will kick it out.
[00:15:19] Speaker B: Okay, so hepatitis B is a very common to get liver cancer from mean.
[00:15:27] Speaker A: Just to be clear, doesn't mean that if you have a hepatitis B you will have liver cancer. But it is so common that it is the most common cause of liver cancer in the world. In the US. It's a little bit different, but worldwide it is the most common cause of liver cancer. Yes.
[00:15:43] Speaker B: So how does that affect you if you get liver cancer? Is there treatment?
[00:15:47] Speaker A: There are treatments for liver cancer. A lot of it depends how early you catch it. So if you treat the cancer early on, a tumor is three to 5 can remove it via surgery. You can literally speak it, burn it with radiation or with certain drugs. You can also get a liver transplantation. However, if it's advanced, we still can treat it, but it is a lot more difficult to treat.
The other problem that liver cancer has is that it mainly occurs over 90% of liver cancers will occur in people that have liver disease, whether it be hepatitis B or cirrhosis from another cause. So even if you remove the cancer, you are still at risk for another cancer because you have the disease ongoing.
[00:16:44] Speaker B: Because, I mean, what I've learned is the liver is so it's one of the best organs that you can literally cut out part of your liver and it will grow back.
[00:16:53] Speaker A: You are absolutely right. It is a phenomenal organ. You can kill up to 90% of your liver and it will still work.
But sadly, when you get it affected with cirrhosis, it starts to fail once you pass a 90% threshold.
[00:17:10] Speaker B: Wow. Okay, so on to the next one.
[00:17:14] Speaker A: Hepatitis C. Hepatitis C. So hepatitis C.
It's a very unique disease. I would say it is also a virus.
This one is mainly transmitted via blood so transfusions or contaminated needles.
The reason I say it's interesting is because in the United States and in Europe for many years, hepatitis C was the most common cause of cirrhosis and liver cancer. Because it was so common.
It can express a few more symptoms and hepatitis B when it's chronic because it can affect other parts of the body. So it can give you kidney problems, it can give you skin problems, it can actually it's related to depression as well. So it has a few more symptoms of hepatitis B.
And one of the reasons are you okay if I speak of the treatment of hepatitis C? And that's the part that is fascinating because for years the only treatment that we had for hepatitis C was something called interferon, which is an immune treatment. And basically we would tell patients to inject a drug in their skin once a week for a year and only 50% of the patients will respond to the treatment or not. And the treatment had horrible side effects and many side effects. And in 2015, basically there was a big change, one of the biggest changes in the history of medicine, I dare to say, because the scientific community developed drugs that directly targeted the hepatitis C virus.
So now a patient can take oral medications. So one pill a day for anywhere between two and three months and you can actually cure the disease in more than, I dare to say right now, 99% of cases.
[00:19:20] Speaker B: Wow.
[00:19:21] Speaker A: So from being a disease that was almost uncurable before, very difficult to cure with a very difficult treatment now, I would say it's very easy to cure with a very easy treatment that almost has no side effects.
[00:19:34] Speaker B: That's really amazing. Can we talk about vaccines for B or C?
[00:19:40] Speaker A: Yeah. So for hepatitis B we have a vaccine. We have had it for many, many years, since 1996.
The who organization implemented worldwide vaccination in 2001. So everybody born after 2001 should be and should have been vaccinated for hepatitis B. It is a fairly effective vaccine. So we used to have another vaccine before there were three shots that you would give to a child at times zero, then one month and six months and the efficacy was about 90% to 93%.
Right now we have a new vaccine over the last few years, which is only two shots. And the figures is better. It's 98, 99%, so it's much better.
Now, for hepatitis C, we don't have a vaccine.
There is not a lot of people working in a vaccine right now.
And I think the fact that we have better treatments, it's going to lead to less people doing research on this. One aspect that is interesting and my team has been working on that, is that people with hepatitis C respond less to hepatitis B vaccine. So one thing we're trying to do now is that people that are treated for hepatitis C to get revaccinated for hepatitis B if they haven't responded to the vaccine before.
[00:21:16] Speaker B: So something I read, everything on the net's.
[00:21:20] Speaker A: Right, right, sorry.
[00:21:22] Speaker B: Something I read on hepatitis C said that associated deaths were highest in 2020 for American Indians and native and non Hispanic black people. Is that true? And why is that?
[00:21:40] Speaker A: That is sadly correct.
There is a variety of reasons for that. I dare to say that one of them is economical, meaning that sometimes native Americans and people of black color or Hispanics, they have less resources to seek medical care on time and to actually maybe obtain medical care at the same degree that other people can do that. So that is one problem. The other problem that we have is that the US. Is pretty sad, but it's one of the few countries in the resource rich world that is seeing a higher peak now of hepatitis C and that is because of the drug epidemic. So there's a lot of intravenous drug use. So we're seeing a comeback of hepatitis C and sadly, a lot of the populations that suffer the most from the intravenous drug epidemic are Native Americans, people of black color and then Hispanics as well.
[00:22:44] Speaker B: Gotcha.
Dr. Debes, I wonder so you were talking about see how it's gotten so much higher, but I want to step back and I saw that screening for hepatitis A was not recommended unless you are showing symptoms and I'm curious to know why that is.
[00:23:07] Speaker A: Yeah, it's basically because of the mortality, right? So hepatitis A doesn't carry high mortality or actually high morbidity, if you might. People get sick but there's no treatment so you basically have to stay at home and then you come out of it basically.
So it's one of the few viral hepatitis that we don't recommend screening just because it doesn't really impact I mean, if you have it, it's not fun, but it doesn't really impact mortality or doesn't keep people away from work too long or almost anything unless you are working in the restaurant business or something like that.
[00:23:46] Speaker B: I was going to say but if you do have it, then you don't know.
[00:23:49] Speaker A: Correct. So if you don't have it, you don't know. But a lot of people have been vaccinated as children in this country.
The majority we don't see it's not a public health problem basically, I wonder.
[00:24:02] Speaker B: Because we have more and more people coming in from other countries. I mean, that's been for a little while if you guys might change your tune on whether people should be tested or not or maybe you just push the vaccines more.
[00:24:16] Speaker A: No, but it's interesting that you mentioned that because that actually makes it better because the hepatitis A is very common in other countries.
Don't quote me on this, but I think it's about 80% to 90% of the populations of other countries have had it at some point. So the majority of people that immigrate here from resource limited countries, they already had the disease, they have had it. So they cannot transmit it anymore because they're immune. So it actually goes the other way.
It is interesting what you say because I was fascinated by that point for a while. So the only time we see outbreaks are usually in countries or regions that have enough people without it, that enough people can get it. But if you go to areas where a lot of people get it as children, you don't see outbreaks anymore because everybody's immune to it.
[00:25:10] Speaker B: Once you get it, you can't correct.
[00:25:13] Speaker A: You cannot get it again.
[00:25:15] Speaker B: It's almost like chickenpox sort of correct.
[00:25:18] Speaker A: No, it is. I mean, once you get it, you don't get it again.
[00:25:20] Speaker B: So is it worth to be screened for hepatitis B or C?
[00:25:25] Speaker A: Absolutely.
And the reasons for that there are many reasons. One of them is that we have treatment for both of them. They're different, but we can offer treatment for both of them. Second reason is that they're both chronic. And as I said, they don't usually don't give symptoms. So unless you screen for them, unless you look for it, you're not going to find it.
And those are the main reasons. So the CDC initially was recommending screening for certain populations, and right now, really, they're recommending that every adult is screened for hep B and hep C. So.
[00:26:04] Speaker B: When might one get that screening? If you don't usually go in for something?
[00:26:09] Speaker A: Yeah, usually if you go to a primary doctor, they will offer you the screening for hepatitis C and hepatitis B. And if you don't, I think it's a great idea to ask your doctor to do that because if you have it, you can get treated. If you don't have it and you're not immune, you can get vaccinated for B.
[00:26:27] Speaker B: So are the screenings different for hep B and hep C? How are those screenings?
[00:26:34] Speaker A: Yeah, so there are two different tests. Of course. For hepatitis B, you look at something that is called the hepatitis B surface antigen, and that is a marker that is present in people that have hepatitis B chronically. So if you get tested for that, in a very simple test, you can even do a point of cursor a finger prick. And the hepatitis C, we do something called a hepatitis C antibody, also a very simple test. Now both of them, if you are positive, it leads to other testing because, for example, for hepatitis C, if you have a positive antibody, that means you've been exposed to hepatitis C. Doesn't mean you are necessarily infected. So if your antibody is positive, then your physician will order what we call a viral load. So to measure the amount of virus in your body to see if you've been chronically infected or not.
[00:27:34] Speaker B: So you're a research guy as well, and you told me you spend quite a bit of your time in research, actually. What's happening in the research area for hepatitis right now?
[00:27:46] Speaker A: There's a lot going on.
So, yeah, I spend about 70% of my time in the research area and I think a lot of the work is focused on hepatitis B and C. Right now, there is a lot of people working on hepatitis D and E as well, and they are slightly different for hepatitis B.
There is a big push right now to try to get a cure. So hepatitis B, if you get treated, you get a treatment for life. So you take a pill every day of your life. It can be for 510 years or it can be forever. But with the excitement of the hepatitis C treatment that is curative, a lot of researchers and companies are trying to see if we can find a cure for hepatitis P. We are a little bit further away from that, I think that we like. But that's where the push is right now.
For hepatitis C. We have a cure right now, and I would say most of the research is being done at a public health level in understanding how to prevent transmission of the disease and how to screen for people with the disease.
[00:29:00] Speaker B: So you mentioned hepatitis D and E. We don't really hear much about those. What are they?
[00:29:07] Speaker A: Yeah, so there are also two viral hepatitis so there are two viruses that can cause viral hepatitis V has had a bit of a resurgence, I think, in the last few years. Hepatitis B is also very interesting because the virus depends on the hepatitis B virus in order to replicate, so to grow in your body. So only people that have hepatitis B can get hepatitis D.
Does it turn.
[00:29:39] Speaker B: Into that or is it that you.
[00:29:42] Speaker A: Also have you also have it. So there are two different viruses and you can get them both at the same time, or you can have hepatitis B and then acquire later hepatitis D, but you can't get D if you don't have B. And it's very confusing for patients because it's two viruses, similar letters. And we do know that patients that have hepatitis D in addition to B, they have a much worse prognosis. It's a very bad disease, actually.
And the reason I'm talking about a bit of a resurgence on this is historically only certain groups from certain countries in the world have been known to have hepatitis D and now we are finding it in other places. So there is a bit of a push to look for hepatitis D or Delta on everybody that is infected with hepatitis B. I see.
[00:30:40] Speaker B: But you wouldn't know if you had hepatitis B unless you were screened.
[00:30:44] Speaker A: Correct.
[00:30:45] Speaker B: Catch 22, indeed, yes. Okay, so you mentioned that A, B and C are kind of the most common ones here in the US. What happens outside the US?
[00:31:00] Speaker A: Yes, outside of the US. Is interesting. B is very common, way more common than here. And actually, I dare to say that here, a large amount of people that have hepatitis B are from outside of this country, mainly from Asian or African origin. Outside of here, hepatitis B is queen or king, if you might. I mean, it is the most common one in terms of the chronic viral hepatitis.
Also, hepatitis E is very common. The problem is that hepatitis E is acute. It's like A, right, it's very similar, actually. You also acquire via fishes, basically no washing your hands, but it basically induces acute hepatitis sprouts or outbreaks, and then people get better.
Hepatitis E also is interesting because it has been related to deadly hepatitis in pregnant women, and we don't understand exactly why, but if pregnant women get hepatitis E, they can have a pretty rough go, actually, it's pretty dangerous. But the majority of these cases come from basically a couple of countries like Pakistan or India. So definitely B and E are very common outside of the United States. Interesting, the hepatitis C is not that common outside of here. I mean, outside of the rich world. It's very common in Europe as well, outside talking blood transfusion. Correct. And it's interesting in some countries, if you go to Africa, for example, specific countries like Egypt, egypt has one of the highest rates of hepatitis C in the planet. It's almost 10% of the population has it.
[00:32:48] Speaker B: And why is that?
[00:32:50] Speaker A: Fascinating question. So I think it was in the 60s, egypt was having sixty s and seventy s, a very large outbreak of a disease called cystosomiasis. It's a parasite that can affect the liver as well. So the government, advised actually by who and other entities, underwent a campaign or promoted a campaign to give a treatment for everybody. And this treatment was with intravenous drugs. But they didn't do a great care in cleaning the needles. They reused needle, glass, syringes and reusable needles, which was relatively standard at the time, to be honest. But they ended up transmitting hepatitis C to a barbaric number of the population. So they have one of the highest rates in the world. Luckily, they've been very successful in implementing hepatitis C treatment after the new cures. So they are actively fighting that quite successfully, may I say.
[00:33:57] Speaker B: Does it matter when you get I mean, I'm sure it does.
For instance, if you have hepatitis C, let's say you didn't show symptoms, I don't know how long it takes for that to progress.
Or hepatitis B even. Yeah, let's say you waited two years and then you got screened and you said, oops, guess what? You have hepatitis B. Can you still get the vaccine or can you still get treatment for that?
[00:34:25] Speaker A: Yeah, great question. So if you have hepatitis B, let's talk different about B and C. If you have hepatitis B and you're positive similar to CDO, it takes years to affect your body. I mean, this varies dramatically from person to person, but we're talking about 20 years, 30 years with the disease in order to see some problems.
If you get hepatitis B, you are almost always eligible for treatment, unless your disease is incredibly advanced. But you're always eligible for treatment. Not though, for vaccination. So once you have it, you cannot get vaccinated because you have it. However, your family can get vaccinated, so they don't get the disease, which is very important for hepatitis C is very similar. We don't have a vaccine, but you can pretty much always get treated. And to be honest, even when you get the disease at advanced stages, we recommend the treatment either for B or C, we still recommend treatment. So to try to decrease the progression of the liver disease.
[00:35:39] Speaker B: Okay, so if one is living or finds out they're sharing a house or a roommate, if they have a roommate that has hepatitis of some sort, what should they do? Should they be worried?
[00:35:52] Speaker A: I. Wouldn't say they should be worried. But what I recommend to my patients is that everybody that shares the house with them to get tested for hepatitis B and if they are negative, to get vaccinated to make sure they are vaccinated against hepatitis B. The reason is that we know that particularly children that live in households where somebody has hepatitis B, they have a higher chance of acquiring it and we still don't understand why. We think it's because of sharing, say, of razors, nail clippers, anything that could potentially have a little bit of blood there that you don't see that you're transmitting it right.
So we advise people living in households with people with hepatitis B to get tested if they are negative, to make sure that people are vaccinated. And I always tell my patients they shouldn't be scared of it. So I tell them if you have hepatitis B, you should use your own razor to shave. So you don't share with that with anybody else. You use your own nail clipper. If you cut yourself and you're bleeding, make sure you clean that with Bleach. Not in your body, but in the surface, in the plastic surface.
But I also tell them not to be scared. So particularly once the household people has been vaccinated, they can play with the chiller, they can kiss people, they can hug them, they can cook for them, so you can have a normal life. You just need to be a bit careful and make sure that those around you have been vaccinated for hepatitis B. Gotcha.
[00:37:31] Speaker B: Well, I have certainly picked your brain this hour, Charlene. I want to always give my research person a chance to ask any questions if I've missed anything.
[00:37:42] Speaker C: I have learned a lot and I can't think of anything that hasn't come to mind before.
I've been around a lot of people, I worked in the VA hospital, so we had a lot of people with hepatitis B and C and I'm glad to have this opportunity to hear what it really is and how different they are.
[00:38:09] Speaker A: Thank you.
[00:38:10] Speaker B: Yeah, I'm just thinking, I wonder if I feel like you hear hepatitis ABC a lot. Like I hear the different letters, but I don't really hear a lot about what they are and how to keep yourself safe. So I wonder what kind of campaigns are out to help people understand and know that.
[00:38:37] Speaker A: Yeah, that's a great question. For hepatitis A, I don't think we have any campaigns for B and C.
[00:38:45] Speaker B: Primarily B, I suppose.
[00:38:46] Speaker A: Yeah, primarily B. And I think there is a pretty simple message here, which is that in my opinion, people need to have an increase in awareness. So understand that the disease exists in order to a be tested for it and B sort of demystify it because there is a little bit of a stigma sometimes in certain populations associated to the disease.
One of the things this might not apply to here. But one of the things my team and I do, we work a lot in Africa and we try to go to rural areas and promote awareness of the disease. So we test people for hepatitis B. We let them know that the disease exists but we also let them know that there is a treatment and there is a vaccine and that there are things that they can do to decrease damage to their bodies if they have the disease.
So I think it's important to increase awareness so that people know that this disease exists and it's important also for people to know that there are treatments and that there are steps that you can take in your life to decrease the damage that these viruses can cause to your body and also protect others.
So this is really particularly for hepatitis B. I think an increase in awareness is critical.
Just to keep talking a little bit, we are trying to do some campaigns in refugee centers so people that are immigrants because it's a bit more common in there.
Some of my colleagues at Hennepin County are also taking this step further, and they are going and screening homeless shelters because sometimes people in homeless shelters have increased risk and they try to screen them so we can link them to care and treat them, particularly for hepatitis C. So I think there's quite a bit that can be done. But I think it's important for people to be aware of the disease and be aware that it is silent and this is very important to understand.
I personally cannot think of any other disease like hepatitis B that is so silent until it's lethal.
To my knowledge, there's really almost no other disease that way.
[00:41:04] Speaker B: And I wonder, I think I feel like dare I say, if you're a Caucasian you get kind of an attitude well, that's not going to be me. It's always something else, somebody else. But I wonder it can hit you if you run in that circle or run in the promiscuous or other behaviors that cause that you too it doesn't matter what color you are.
[00:41:29] Speaker A: You can be absolutely I mean, if you look at percentages proportions, for sure it affects more people that are from outside of this country, and it affects more people that are engaged in certain behaviors, but it can affect anyone.
I can tell you that it's not uncommon that I see patients in the clinic that we have absolutely no idea how they got hepatitis B or C and we go through a whole history with them and we can't pinpoint it, but they got it.
[00:42:03] Speaker B: They didn't tell you? No.
[00:42:05] Speaker A: Yeah, I mean, some people don't tell, but at some point we do develop a rapport with the patients and when we develop a rapport, we explain to the patient it's in their best interest that we find out when they got it. So we know for how long they got it and sometimes they cannot pinpoint at it, to be honest. The other part that is important to mention as well, because I'm talking about people that are maybe not from this country, but also if you are a son or daughter of immigrants, particularly of Asian origin, it can be transmitted from mother to child. So sometimes these populations can also have a high incidence of hepatitis B without knowing that. But the bottom line is, I think, regardless of proportions, no one is a spare of this, I can guarantee you that.
[00:42:52] Speaker B: Well, I want to thank you for coming on. Is there anything more we should know? Is there anything that is special that's coming out, do you think, for the future of hepatitis?
[00:43:05] Speaker A: I think the hepatitis C treatment has been impressively special.
Again, I think we should be on the look for new treatments as well for hepatitis B. But I think the main message I like to say is that awareness is critical so that people know that these diseases exist, that they are silent, and that if you get diagnosed with it, there are things that we can do for you. I think that's a very important message. Absolutely. Yeah.
[00:43:35] Speaker B: Well, thank you so much, Dr. Debesque, for coming on. I really appreciate your time and you're educating everyone just like we try to do.
[00:43:44] Speaker A: No, thank you very much and thank you for this because this actually increases awareness dramatically. So as a member of the scientific community, I do thank you for that, both of you.
[00:43:54] Speaker B: Thank you. Good night.
[00:43:55] Speaker A: Thank you.
[00:43:56] Speaker B: And that was Dr. Jose DeBess and he was talking about hepatitis. Wow. Was that educational or what?
I learned so much. I always learned so much about this. I want to remind you that next week we will be having somebody on to talk about breast cancer. It is National Breast Cancer Month, right?
[00:44:15] Speaker C: It is.
[00:44:17] Speaker B: So we will be doing that and it is also the beginning of our pledge drive. And although it's not always people's favorite, we hope you'll show us the love and donate to us. This is kind of our way of making sure everything and the show keeps running and we can bring more guests on like Dr. Debes. So if you enjoyed this and enjoy this program, enjoy the people that we bring on. Please remember next week, start to show us the love and
[email protected].
[00:44:50] Speaker C: Don't forget to tell us where you're from and who you are. We want to know how far our listeners are coming from. And if anybody has any ideas about a show that you're wondering about, shoot us a line because there's so much stuff.
There's always stuff. Yeah, but we're up for suggestions.
Just shoot us a line at Disabilityandprogress. At me. Oh, wait.
[00:45:29] Speaker B: You're at
[email protected]?
[00:45:34] Speaker C: I stutter. Sorry.
[00:45:40] Speaker B: Yeah,
[email protected]. And let us know what you're doing, where you're from, and what you'd like to hear. We welcome suggestions on this show.
KPI.
