Hepatitis B & C

Liver-supportive diet: eliminate alcohol completely (accelerates liver damage, even small amounts harmful), low saturated fat (reduce liver fat), moderate protein (0.8-1.2g/kg—adequate for healing but not excessive if advanced cirrhosis), high antioxidant foods (colorful vegetables, berries, green tea, turmeric), cruciferous vegetables (support liver detoxification—broccoli, cauliflower, Brussels sprouts), beets (support bile flow), artichokes (liver protective), leafy greens, sulfur-rich foods (garlic, onions), adequate fiber (supports detoxification, gut health), omega-3 foods (fatty fish, walnuts, flax), organic foods (reduce toxin load on liver), bone broth (amino acids for healing), Avoid: alcohol (absolutely), processed foods, trans fats, excessive fructose (worsens fatty liver), iron supplements unless deficient (excess iron worsens liver damage in hepatitis C—monitor ferritin, consider phlebotomy if elevated >300), hepatotoxic herbs (kava, comfrey, pennyroyal, chaparral), acetaminophen/Tylenol (liver toxic—max 2g/day, less if cirrhosis, avoid if possible), aflatoxin exposure (mold toxin in peanuts, corn—potent liver carcinogen, buy fresh nuts/grains, avoid moldy foods), If overweight: weight loss (fatty liver worsens hepatitis—even 5-10% weight loss improves liver), Mediterranean diet effective, Adequate hydration, If cirrhosis: low sodium diet (prevent ascites), adequate calories and protein (prevent malnutrition—common in cirrhosis), branched-chain amino acids (if hepatic encephalopathy).

Avoid alcohol completely (even small amounts accelerate liver damage, increase cirrhosis and cancer risk), avoid hepatotoxic substances: IV drugs (Hep C reinfection risk, HIV co-infection), acetaminophen/Tylenol (liver toxic—max 2g/day, less if cirrhosis), anabolic steroids (liver toxic), kava, comfrey (hepatotoxic herbs), Weight management (obesity worsens liver disease—fatty liver accelerates fibrosis), exercise regularly (reduces liver fat, improves insulin sensitivity), Prevent transmission: Hepatitis B (get sexual partners vaccinated, use condoms, don't share toothbrushes/razors, cover wounds, notify healthcare providers), Hepatitis C (don't share needles, toothbrushes, razors, nail clippers, avoid tattoos/piercings unless sterile equipment, sexual transmission rare in monogamous relationships but use condoms with multiple partners), Get vaccinated: Hepatitis A (if not immune—co-infection with Hep A can be severe), Hepatitis B (if HCV+ and not immune), Monitor regularly: viral load, liver function tests, alpha-fetoprotein (AFP—screen for liver cancer if cirrhosis, every 6 months), ultrasound liver (if cirrhosis—screen for cancer every 6 months), Treatment: Hepatitis C: DAAs (direct-acting antivirals) curative 95%+ (sofosbuvir, ledipasvir, velpatasvir, others—combination regimens, 8-12 weeks treatment, minimal side effects, expensive but often covered by insurance or patient assistance programs, TREAT—life-changing, prevents cirrhosis and cancer), Hepatitis B: not curable but suppressible—antivirals (tenofovir, entecavir—first-line, suppress virus, prevent progression, lifelong treatment usually, minimal side effects, interferon rarely used now—significant side effects), not everyone needs treatment (low viral load, normal liver function—monitor), treat if high viral load, elevated liver enzymes, significant fibrosis, Manage complications: cirrhosis (low sodium diet, diuretics for ascites, lactulose for encephalopathy, beta-blockers for varices, transplant evaluation if decompensated), liver cancer (surveillance, treatment options—resection, transplant, ablation, TACE, systemic therapy), Avoid: NSAIDs if cirrhosis (bleeding risk from varices, kidney damage), sedatives/opioids if hepatic encephalopathy (worsen confusion), Support groups: living with chronic hepatitis challenging (stigma, fatigue, worry about progression—support groups, therapy helpful).