HEART / LIVER
Liver Blood Tests
Fatty liver (Fatty Liver)
Heart disease induced by drugs
Liver disease (Liver)
Liver disease is a term for a set of conditions, diseases and infections that affect the cells, tissues, structure and function of the liver.
The liver is an important organ located in the upper right abdominal quadrant. He is responsible for:
Filtering the blood
Makes bile, a substance that aids digestion of fat
Processing and binding fat in carriers (proteins), including cholesterol. Combined fat and protein called lipoproteins (Chylomicron, VLDL, LDL, HDL), store sugar and help the body to transport and conserve energy.
Make important proteins, like most involved in blood clotting
Metabolize many drugs such as barbiturates, sedatives, and amphetamines
Store iron, copper, vitamins A and D, and some of the vitamin B
Make important proteins such as albumin that regulate fluid pengakutan in the blood and kidneys
Help break down and recycle red blood cells
If the liver becomes inflamed or infected, then the ability to perform these functions become weakened. Liver diseases and infections are caused by a condition that varies including viral infections, bacterial attack, and chemical or physical changes in the body. The most common cause of liver damage is malnutrition (malnutrition), especially those that occur with alcohol addiction.
The symptoms of liver disease may be acute, occurring suddenly, or chronic, developing slowly over a long period of time. Chronic liver disease is much more common than acute. Figures from chronic liver disease than men are two times higher than women.Liver disease can range from mild to severe depending on the type of disease present.
Signs and Symptoms of Disease
Symptoms partly depend on the type and heart disease’s reach.In many cases, there may be no symptoms. The signs and symptoms that are common to a number of different types of liver disease include:
Jaundice or yellowish skin
Urine is brown like tea
Loss of appetite
Loss or abnormal increase in body weight
The color of the stool (feces) of pale
Abdominal pain (stomach) on the upper right abdomen
Unwell (malaise) or a vague sick feeling
Varices (enlarged veins)
Hypoglycemia (low blood sugar)
Decreased libido (decreased sex drive)
A rare severe form of liver infection called acute fulminant hepatitis, causing liver failure. Symptoms of liver failure include:
Aplastic anemia, a condition in which bone marrow (bone marrow) can not make blood cells
Ascites, the accumulation of fluid in the abdomen
Edema or swelling under the skin
Encephalopathy, disorders that affect brain functions
An enlarged liver and tenderness (pain)
Changes in mental status or level of consciousness
Prone to bleeding
Causes and Risk of Disease
Liver disease can be caused by factors that vary. The causes include:
Defects or congenital heart abnormalities present at birth
Metabolic abnormalities or damage in the process of basic body
Viral infections or bacterial
Alcohol or poisoning by toxins
Terentu medications that are toxic to the liver
Trauma or injury
Liver diseases are most likely to occur in children include:
Alagille’s syndrome, a condition where the bile ducts narrow and deteriorate, especially in the first year of life
Alpha 1 – antitrypsin deficiency, a genetic liver disease in children that can lead to hepatitis and liver cirrhosis
Biliary atresia, a condition of which the bile duct extending from the liver to the small intestine is too small cross section or there is absolutely no
Galactosemia, an inherited disease where the body can not tolerate certain sugars in milk. These sugars can expand, causing serious damage to the liver and other organs of the body.
Hemorrhagic telangiectasia, a condition where blood vessels are thin to allow easy and frequent bleeding from the skin and gastrointestinal tract
Chronic active hepatitis, an inflammation of the liver which causes sores that leave scars and impaired liver function
Liver cancer, which can be derived from cancer in other body parts that had spread to the liver
Neonatal hepatitis, the hepatitis in newborns that occurred in the first few months of birth
Reye’s syndrome, a condition that is causing the expansion of fat in the liver. In some cases this condition is associated with aspirin use, particularly those associated with chickenpox, influenza or other diseases with fever
Thalassemia, a group of inherited anemia, or low red blood count
Tyrosinemia, a disorder that causes serious problems with the liver metabolism
Wilson’s disease, an inherited condition (offspring) is causing the expansion of the mineral copper in the liver
Liver diseases are likely to occur in adults include:
Gallstones, which may clog the bile duct
Hemochromatosis, a condition that causes the body to absorb and store too much iron. Accumulation of iron causes damage to the liver and other organs
Hepatitis, an inflammation and infection of the liver caused by one of several viruses
Cystic disease of the liver, causing injuries and mass-fluid-filled mass in the liver
Porphyria, a condition that causes malfunctions in how the body uses porphyrins. Porphyrins is very important in the manufacture of hemoglobin in red blood cells to carry oxygen throughout the body
Primary sclerosing cholangitis, a condition that causes narrowing of the bile ducts of the liver due to inflammation and scarring
Sarcoidosis, a disease that causes an expansion of the wounds in the liver and other organs of the body
Cirrhosis, a serious condition that causes tissues and cells of the liver is replaced by scar tissue
Type I glycogen storage disease, which causes problems in controlling blood sugar when one is fasting
Liver disease associated with alcohol include:
Fatty liver disease that causes liver enlargement
Some but not all liver diseases can be prevented. For example, hepatitis A and hepatitis B is preventable by vaccination.
Other ways to reduce heart disease risk of infection include:
Practice good hygiene, like washing hands after using the toilet or changing diapers
Avoid drinking or using tap water when traveling abroad
Avoid taking drugs, especially the use of shared syringes
Having safe sex
Avoiding the use of shared medical equipment such as personal shaver or nail clippers
Avoid toxic materials and excessive alcohol consumption
Use the bat-like drugs are recommended
Use caution on chemical products industry
Eat a well balanced diet according to the instructions of the food pyramid
Get an injection of immune globulin after exposure to hepatitis A
Diagnosis of Diseases
The doctor can determine whether symptoms, medical history and physical test match with liver disease. Hepatomegaly, an enlarged heart and harden and other signs of liver disease can be found on the tests conducted.
Many further tests can also be used to support the diagnosis.These include blood tests, such as:
Abdominal CT scan or abdominal MRI, which presents more information about the structure and function of the liver
ERCP, or endoscopic retrograde cholangiopancreatography. A small tube called an endoscope used to view various structures in and around the liver
Ultrasound examination, to see the size of abdominal organs (stomach) and the presence of mass
Examination of abdominal X-rays
Calculation of full blood, which looks at the type and number of blood cells in the body
Liver scans with radiotagged substances to show structural changes in the liver
Upper GI studies, which can detect abnormalities in the esophagus caused by liver disease
Liver function tests, is a blood test that checks liver enzymes are highly variable and side products
In some cases, the only way to definitively diagnose the presence of a certain liver disease is liver biopsy. This procedure involves taking a bit of liver tissue for examination under a microscope.Liver biopsy may be done several times to see the progress of the disease and its response to treatment.
Long-Term Effects Diseases
Long-term effects depend on the presence of the type of heart disease. For example, chronic hepatitis can lead to:
Diseases in other parts of the body, such as kidney damage or low blood counts
Cirrhosis of the liver
The effects of other long-term can include:
Encephalopathy, is the deterioration of brain function that may progress to coma
Gastrointestinal bleeding (gastrointestinal bleeding). These include bleeding esophageal varices, which is an abnormal enlargement of veins in the esophagus and / or within the abdomen
Peptic ulcers, which erode the lining of the abdomen / stomach
At the risk of Others
Some highly contagious liver disease and suggest the risk to others. For example, some forms of hapatitis is highly contagious through sexual contact or contaminated food and beverages.Other liver diseases such as biliary atresia is not contagious.
Treatment for heart disease include:
Rest in bed
Drink plenty of water to prevent dehydration
Avoid drugs that do not need
Eat a balanced diet for liver disease
Drink anti-nausea medication if needed
Further treatment depends on the type and extent of disease. For example, treating hapatitis B, hepatitis C and hepatitis D may involve the use of drugs such as anti-viral drugs (antiviral) alpha interferon. Other medications used to treat hepatitis may include ribavirin, lamivudine, steroids, and antibiotics.
Acute fulminant hepatitis can cause life-threatening liver failure.This requires a hospital stay and care for bleeding disorder, encephalopathy, and nutritional problems.
Biliary atresia may be treated with a procedure called a Kasai surgery, a procedure in which surgeons replaced part of the bile ducts with infant intestine.
Hemochromatosis treated by removing 0.5 liters of blood once or twice a week for several months to a year, depending on the severity of his condition. This will effectively spend the excess iron.
Vitamin and mineral supplements are given to prevent complications of primary biliary cirrhosis. These include vitamin A, vitamin D, vitamin E, vitamin K, and calcium. Cholestyramine may also be given to relieve itching.
To treat Wilson’s disease, doctors can prescribe drugs trientine or penicillamine. If these drugs can not be tolerated by the patient, then he may be required to take medication zinc acetate.
Side Effects of Treatment
Side effects will depend on ynag treatments used for liver disease. Antibiotics can cause stomach upset or allergic reactions. Side effects of interferon include flu-like illness, with fever and body aches.
A liver transplant can cause many complications, including liver failure or refusal of a new one. After liver transplantation, someone needs to take strong anti-rejection drugs for life.Because these drugs contrary to the normal functioning immune system, they increase a person’s risk for infections and certain types of cancer.
What Happens After Treatment
What happens after treatment will depend on the type of heart disease and response to treatment. For example, a person with hepatitis A usually does not need medication after his illness was cured. They can return to normal life style when the symptoms of the disease has disappeared, although they still have a little jaundice (yellow skin).
Someone with hepatitis B, hepatitis C or hepatitis D needs to be monitored for side effects and its benefits during and after treatment with interferon. Treatment with alpha interferon may be repeated if the disease recurred. A person who has received a liver transplant will be checked for other diseases as well as his new liver function.
Monitoring the disease will depend on the type of disease. Liver function tests may be performed during the period of the visit to the doctor, to monitor the disease and see her work. A new symptom or the worsening should be reported to the doctor.Status of the liver may require repeated liver biopsy. Decisions for further treatment or liver transplantation are often made on the basis of these tests.
Liver Blood Tests
An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood.Under normal circumstances, these enzymes in the liver cells. But when the liver is injured, these enzymes are spilled out into the bloodstream.
Among the most sensitive and widely used of these liver enzymes are the aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes normally contained within liver cells. If the liver is injured, the liver cells spill the enzymes into the blood, raising the enzyme levels in the blood and marked liver damage.
Definition of the aminotransferases
Aminotransferases catalyze chemical reactions in cells in which an amino group is transferred from a donor molecule to a recipient molecule. Hence, the name “aminotransferases”.
Adakalaya medical terminology can be confusing, as the case of these enzymes. Another name for aminotransferase is transaminase. The enzyme aspartate aminotransferase (AST) also known as serum glutamic oxaloacetic transaminase (SGOT) and alanine aminotransferase (ALT) also known as serum glutamic pyruvic transaminase (SGPT). To simplify it, AST = SGOT and ALT = SGPT.
In Normal, Where the existence of the aminotransferases?
AST (SGOT) is normally found in a variety of tissues including liver, heart, muscle, kidney, and brain. He is released into serum when any one of these damaged tissues. For example, levels in the serum rises with heart attacks and with muscle abnormalities.He is therefore not a highly specific indicator of liver injury.
ALT (SGPT), opposite to him, normally found largely in the liver.This is not to say that it is located exclusively in the liver but that he was there where he is most concentrated. He was released into the bloodstream as a result of liver injury. He therefore serve as a fairly specific indicator of the state (status) of the liver.
Normal levels? From AST and ALT
The normal range of values for AST (SGOT) is from 5 to 40 units per liter of serum (the liquid part of blood).
The normal range of values for ALT (SGPT) is from 7 to 56 units per liter of serum.
The Meaning Of the increase of AST and ALT
AST (SGOT) and ALT (SGPT) are sensitive indicators of liver damage of the types of different diseases. However, it must be emphasized that the levels of liver enzymes are higher than normal should not be automatically equated with liver disease.They may or they did not mean the heart problems. Interpretation (interpretation) of the levels of AST and ALT rise depends on the entire clinical picture and so it is best done by doctors experienced in evaluating liver disease.
Appropriate levels of these enzymes do not correlate well with the extent of liver damage or prognosis. Thus, the levels of AST (SGOT) and ALT (SGPT) is appropriate can not be used to determine the degree of liver damage or predicting the future.For example, patients with acute hepatitis A virus may develop a level of AST and ALT-tingat very high (sometimes in the range of thousands of units / liter). However kebnyakan patients with acute viral hepatitis A recover fully without residual liver disease. For an opposite example, patients with chronic hepatitis C infection typically have only a small increase of the levels of AST and ALT them. Some of these patients may have chronic liver disease that develops silently as chronic hepatitis and cirrhosis.
Disease-Heart Disease Causes Abnormal aminotransferase levels?
The levels of AST and ALT are found with the highest abnormalities that cause many deaths from liver cells (extensive hepatic necrosis). It occurs in conditions such as A or B virus hapatitis chronic liver damage that clearly posed by toxins as from an overdose (overdose) of acetaminophen (brand name Tylenol), and the collapse of the old circulatory system (shock) when hearts deprived of / deprived of fresh blood that carries oxygen and nutrients. The levels of serum AST and ALT in these situations can include anywhere from ten times the normal upper limits to the thousands of units / liter.
The increase in liver enzymes from mild to moderate is not unusual. They are often discovered unexpectedly on screening tests routine blood in individuals who are otherwise healthy. The levels of AST and ALT in such cases is usually present between the two times the upper normal limits and a few hundred units / liter.
The most common cause of elevations of mild to moderate liver enzymes is fatty liver (fatty liver). In America, the cause of fatty liver is the most frequent abuse of alcohol. Other causes of fatty liver include diabetes mellitus and obesity (obesity). Chronic Hepatitis C also is becoming an important cause of liver enzyme elevations are mild to moderate.
Medications That Set Off Abnormal aminotransferase levels?
A group of drugs can cause liver enzyme levels are abnormal.Examples include:
Pain-relieving medications such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), neproxen (Narosyn), diclofenac (Voltaren), and phenybutazone (Butazolidine).
Drug-drug anti-epileptic drugs such as phenytoin (Dilantin), valproic acid, carbamazepine (Tegretol), and phenobarbital.
Antibiotics such as tetracyclines, sulfonamides, isoniazid (INH), sulfamethoxazole, trimethoprim, nitrofurantoin, etc..
Cholesterol-lowering medications such as “statins” (Mevacor, Pravachol, Lipitor, etc.) and niacin.
Cardiovascular medications such as amiodarone (Cordarone), hydralazine, quinidine, etc..
Drug-drug anti-depression of the tricyclic type.
With liver enzyme abnormalities caused by drugs, enzymes usually return to normal for weeks or months after stopping the drugs.
What are the causes of Not More Common From Abnormal aminotransferase levels
The causes are less common than abnormal liver enzymes in America, including chronic hepatitis B, hemachromatosis, Wilson’s disease, deficiency of alpha-1-antitrypsin deficiency, celiac sprue, Crohn’s disease, ulcerative colitis, and autoimmune hepatitis. Although not as common as hepatitis C, hepatitis B can cause chronic liver disease with abnormal liver enzymes continuously.
Hemachromatosis is a disorder of genetic (inherited) in which there is an excessive absorption of food iron that leads to the accumulation of iron in the liver with liver inflammation and scarring that result.
Wilson disease is an inherited disorder with excessive copper accumulation in various tissues including the liver and brain.Copper in the liver can lead to chronic liver inflammation, where the copper in the brain can cause psychiatric disturbances and motor.
Deficiency Alpha-1-antitrypsin deficiency is an inherited disorder where deficiency of a glycoprotein (carbohydrate-protein complex) called alpha-1-antitrypsin leads to chronic lung disease (emphysema) and in liver disease.
Autoimmune hepatitis from liver injury induced by antibodies and the body’s own defense system attacks the liver.
Celiac sprue is a disease of the small intestine where a patient has an allergy to gluten (the sticky adhesive substance) and develop gas, bloating, diarrhea, and in cases of advanced malnutrition. Patients with celiac sprue can also develop the levels of ALT and AST abnormal light.
Crohn’s disease and ulcerative colitis are inflammatory diseases with a chronic intestines. In these patients liver inflammation (hepatitis) or bile ducts (primary sclerosing cholangitis) may also occur, causing the liver tests are abnormal.
Rarely, abnormal liver enzymes may be a sign of liver cancer.Cancers that arise from cells called hepatocellularcarcinoma liver or hepatoma. The spread of the cancers to the liver from other organs (such as colon, pancreas, stomach, etc.) is called metastatic malignancies (metastatic dangerous diseases).
Evaluating Healthy People For The Light To Moderate increase of aminotransferase levels?
Evaluation of healthy patients with abnormal liver enzymes need to be made individually. A doctor may request a blood test data from the old records for comparison. If old records are not available, the doctor may repeat blood tests in the weeks to months to see whether these abnormalities remain valid. The doctor will look for risk factors for hepatitis B and C including sexual exposures, history of blood transfusions, injectable drug use, and exposure in the work on blood products. A family history of liver disease may increase the likelihood of diseases that are inherited / derived as hemachromatosis, Wilson’s disease, or lack of alpha-1-antitrypsin.
The pattern of liver enzyme abnormalities can provide useful clues on the cause of liver disease. For example, most of patients with alcoholic liver disease have enzyme levels that are not as high as the levels reached with acute viral hepatitis and AST ALT tended to be above. Thus, in alcoholic liver disease, AST is usually under 300 units / liter where ALT is usually under 100 units / liter.
If alcohol or drugs are responsible for the abnormal liver-enzyme levels, stopping alcohol or drugs (only under physician supervision) should bring the enzyme levels to normal levels or near normal within weeks to months. If obesity is suspected as the cause of fatty liver, weight reduction of 5% to 10% should also bring the liver enzyme levels to the levels of normal or near normal.
If abnormal liver enzymes remain in effect despite abstinence from alcohol, weight reduction and cessation drugs are suspected of certain blood tests can be done to help diagnose diseases of the heart that can be treated. Blood can be tested for the presence of hepatitis viruses B and C and their antibodies are associated. Blood levels of iron, iron saturation, and ferritin (another measure of the amount of iron stored in the body) are usually elevated in patients with hemachromatosis. Blood levels of a compound called ceruloplasmin are usually decreased in patients with Wilson disease. Blood levels of certain antibodies (anti-nuclear antibody or ANA, anti-smooth muscle antibody, and anti-liver and kidney microsome antibody) increased in patients with autoimmune hepatitis.
Ultrasound and CAT scan of the abdomen is sometimes used to remove or eliminate tumors in the liver or other conditions such as gallstones or tumors that block the ducts that drain the liver.
Liver biopsy is a procedure where a needle is inserted through the skin over the right upper abdomen to obtain a thin strand of liver tissue for examination under a microscope. The procedure is often performed after the ultrasound study was to localize the liver. Not every person with abnormal liver enzymes needs a liver biopsy. The doctor will usually recommend this procedure if 1) the information obtained from liver biopsy will probably be useful in planning treatment, 2) the physician needs to know the extent and severity of inflammation / liver damage, or 3) to evaluate the effectiveness of treatment.
Liver biopsy is most useful in confirming a diagnosis of a condition that can be treated berpotesi. Liver diseases that have the potential to be treated include chronic hepatitis B and C, hemachromatosis, Wilson disease, autoimmune hepatitis, and the lack of alpha-1-antitrypsin.
Monitor aminotransferase levels?
What is usually most useful is the test of serial (consecutive) of AST (SGOT) and ALT (SGPT) through time to determine whether the level-level rise, remain steady, or fall. For example, patients who underwent treatment for chronic hepatitis C should be monitored with liver enzyme tests series. Those who respond to treatment will experience a decrease in liver enzyme levels to normal levels or normal medekati. Those who experienced recurrence of hepatitis C after completion of treatment will usually develop liver enzyme levels of abnormal return.
Enzymes-Enzymes Liver Other
In addition to AST and ALT, there are other enzymes including alkaline phosphatase, 5′-nucleotidase (“5 prime” nucleotidase), and gamma-glutamyltranspeptidase (GGT) are often tested for liver disease.
We have limited the consideration of these liver enzymes AST and ALT on because they are biochemically related to each other and, more importantly, they are two enzymes that are most beneficial.
Definition of Fatty Liver, NAFLD, NASH
Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH) and cirrhosis (irreversible, advanced scarring of the liver). All levels of NAFLD have jointly accumulation of fat (fatty infiltration) into liver cells (hepatocytes). In NASH, fat accumulation associated with varying degrees of inflammation (hepatitis) and scarring (fibrosis) of the liver.
Nonalchoholic term is used because NAFLD and NASH occur in individuals who do not consume excessive amounts of alcohol.However in many aspects, the histological picture of NAFLD (when we refer to the section of liver biopsy under the microscope) is similar to what can be seen on a liver disease caused by excessive alcohol consumption. Like what we see, however, the clinical realities in NAFLD and NASH are very different than in the diseased alcoholic liver disease (ALD).
The spectrum of NAFLD
The spectrum of NAFLD is estimated to begin and evolve from the simplest level are called simple fatty liver (steatosis). So beginning of fatty liver is an abnormality in the spectrum of NAFLD. Simple fatty liver is only about the accumulation of fat / fat in the liver cells without inflammation or scarring (scarring). Fat / fat is actually composed of a special type of fat (triglyceride) that accumulates in the small bag inside the liver cells. The accumulation of fat in liver cells is not the same as the fat cells (adipocytes) that constitute our body fat. Fatty liver is a harmless condition, which means he himself will not cause significant liver damage.
The following levels and degrees of severity in NAFLD spectrum is NASH. Luckily only a small proportion of patients with simple fatty liver that develops into NASH. As already mentioned, NASH involves the accumulation of fat in liver cells and liver inflammation. Inflamed cells that can destroy the liver cells (hepatocellular necrosis). In the term “steatohepatitis” and “steatonecrosis”, steato refers to fatty infiltration, hepatitis refers to inflammation in the liver, and necrosis refers to the liver cells are damaged. Strong evidence indicates that NASH, in contrast to simple fatty liver, is not a harmless condition. This means that NASH can ultimately lead to scarring of the liver (fibrosis) and then continued scarring that can not be returned kesemula (cirrhosis). Cirrhosis caused by NASH is the last level and the worst in the spectrum of NAFLD.
Remains much still unknown about NASH and NAFLD. For example, as discussed below, the progress of each different level of NAFLD is not well understood. Moreover, even liver specialists still do not agree on the precise microscopic definition of NASH.However, individuals who developed one of the three levels of NAFLD (fatty liver, NASH, or cirrhosis) share risk factors are common. Therefore, fatty liver and NASH are described in this article as part of the spectrum of NAFLD. Remember, the whole spectrum of NAFLD dirujukan by starting with a fatty liver, NASH progress to cirrhosis and end up with. NASH is the level of the spectrum that involves fat accumulation (steatosis), inflammation (hepatitis) and scarring (fibrosis) in the liver.
Other causes of fat accumulation in liver
Many other causes of fat accumulation in the liver other than NAFLD. However, NAFLD and NASH are considered as major fatty liver disease.
Hepatitis C Infection
Infection with hepatitis C virus (HCV) is also associated with the development of liver cancer. In fact, in Japan, hepatitis C virus is present in up to 75% of cases of liver cancer. As with hepatitis B virus, the majority of patients with hepatitis C virus with liver cancer have cirrhosis related to it. Liver cancer occurs approximately 8 to 10 years after development of cirrhosis in these patients with hepatitis C. Several prospective European studies report that the annual incidence of liver cancer in patients with hepatitis C virus who had cirrhosis ranged from 1.4 to 2.5% per year.
In patients with hepatitis C Cirus, risk factors for developing liver cancer include the presence of cirrhosis, older age, male gender, elevated baseline alpha-fetoprotein (a blood tumor marker), alcohol use, and infection with viral hepatitis B. Several studies suggest that early genotype 1b (a common genotype in the U.S.) hepatitis C virus may be a risk factor, but further studies currently do not support this finding.
The way the hepatitis C virus causes liver cancer is not well understood. Unlike hepatitis B virus, hepatitis C virus genetic material is inserted genetic material directly into the liver cells.Known, however, that cirrhosis from any cause is a risk factor for developing liver cancer. It has been argued, therefore, that the hepatitis C virus, which causes cirrhosis of the liver, is an indirect cause of liver cancer.
On the other hand, there are some individuals who are infected with chronic hepatitis C virus who suffer from liver cancer without cirrhosis. So, it has been suggested that the protein core (center) of the hepatitis C virus is a defendant in the development of liver cancer. Core protein itself (a part of the hepatitis C virus) is estimated to impede the natural process of cell death or interfere with the function of a gene (gene p53) tumor suppressor is normal. As a result of these actions is that the liver cells continue living and reproducing without control-normal control, which is what happens in cancer.