HEALTH AND WELLNESS
in men, women and children. However, some people have no known risk factors.
"It's very common for a person with early-stage NASH to be unaware their liver health is slowly declining because they may not feel sick or look unwell," said Dr. Zobair Younossi. "Typically, we see people experience symptoms when fibrosis turns to cirrhosis but that can vary. This is why early-stage detection and intervention is so crucial."
Tony Villiotti's Story
Tony Villiotti was seeing his general practitioner every six months for routine diabetes care. "At one appointment after some blood work, he told me that my liver enzymes were elevated, and that I had a fatty liver. He didn't make a big deal of it, so I didn't think much of it," said Villiotti. In 2014, nine years later, he asked Villiotti to have an ultrasound done in addition to normal blood work. "At the next appointment, he told me I had NASH, and I also might have cirrhosis. I was shocked. First, I had never heard of NASH, and second, I always thought cirrhosis was a disease associated with alcohol."
In 2017, on St. Patrick's Day, Villiotti visited his doctor, and she revealed he had liver cancer. "I went nine years between my fatty liver diagnosis and my cirrhosis diagnosis - nine years. That was 18 doctor's visits. I'm no physician, but I know the cirrhosis didn't occur between my 17th and 18th visit. It happened over time, but I was not aware of it. My experience has been, in some cases, that the patient needs to initiate those discussions. If you're aware of it early,
you can take action early, and hopefully stop the progression."
Early Detection
Despite affecting millions of Americans, early detection of patients at increased risk of disease progression in NASH can be challenging. The current standard for assessing liver fibrosis is a liver biopsy which involves an in-hospital procedure where a needle is inserted into the liver to collect a sample. Although the first known liver biopsy was performed more than 100 years ago, patients still are subjected to this invasive procedure and can face extreme discomfort and pain.
NASH Symptoms:
* Unexplained weight loss
* Decreased appetite
* Abdominal pain or discomfort
* Feel weak or lethargic
* Exhaustion
* Nausea and vomiting
"Early and accurate identification of patients at risk of progressing to cirrhosis and liver-related events (LREs) is crucial in helping the patient prevent additional inflammation and liver decline," said Dr. Chuck Cooper, Chief Medical Officer, Siemens Healthcare Diagnostics, Siemens Healthineers. "Over the last decade, non-invasive methods have made great strides. These tests will undoubtedly make detection easier for the patient and help shape how we evaluate indications for biopsy in the future."[1]
Recently, a simple, effective blood test to assess the likelihood of progression of advanced liver fibrosis to cirrhosis and liver-related clinical events in patients with NASH became available in the U.S.