Hepatitis B Q&A With a Liver Specialist — Plus a Turkey Meatball Recipe Your Liver Will Love

Credit: Adobe Stock/TheWaterMeloonProjec

In this special feature, Anthony Junsung Choi, M.D., transplant hepatologist at New York-Presbyterian, answers common patient questions about hepatitis B, from understanding the difference between acute and chronic infection to lifestyle tips for protecting your liver. To help you take action at home, we’re also sharing a liver-friendly recipe from the American Liver Foundation (ALF): Skillet Turkey Meatballs With Lemon Brown Rice, originally published on its recipe page. Packed with lean protein, whole grains and fresh herbs, this dish is as good for your health as it is for your taste buds.

Skillet Turkey Meatballs With Lemon Brown Rice

Ingredients:

• 2 slices whole wheat sandwich bread, torn into 1-inch pieces
• 1 ¼ pounds ground turkey
• 6 scallions, white and green parts separated and sliced thin
• 1 large egg
• 3 tablespoons chopped fresh parsley
• 1 tablespoon grated lemon zest plus 2 tablespoons juice
• 2 tablespoons olive oil
• 1 1/2 cups brown (or wild) rice
• 1/2 cup water
• 3 garlic cloves, minced
• 3 ¼ cups low-sodium chicken broth
• 1 ounce Parmesan cheese, grated (1/2 cup)
• Salt-free seasoning

Instructions:

1. Make breadcrumbs and place them in a large bowl. Combine with turkey, 2 tablespoons of scallion greens, egg, 2 tablespoons of parsley, 1 1/2 teaspoons of lemon zest and 1/2 teaspoon of salt-free seasoning. Shape the mixture into 20 portions and roll into meatballs. Arrange them on a plate and refrigerate for 15 minutes.
2. In a skillet, add olive oil and heat until oil is warm (reduce heat before placing meatballs). Place meatballs in the skillet, turning occasionally, until they are browned on all sides. Once meatballs are browned, remove meatballs from skillet and transfer to a separate dish. Drain fat from the pan and return to heat.
3. Once drained, return to heat and add water and rice. Cook rice for about 5 minutes, making sure you stir while cooking.
4. Add scallions, garlic and 1/2 teaspoon of salt-free seasoning. Allow to simmer for about 2 minutes, then add broth, lemon juice and remaining lemon zest.
5. Bring the skillet to a boil and add meatballs. Cover and reduce to low, continuing to cook until rice is soft and meatballs are cooked through. Add a light sprinkle of Parmesan if desired and remove from heat. Serve and enjoy!

What exactly is hepatitis B, and how does it affect the liver?

Anthony Junsung Choi, M.D.: Hepatitis B is an infection caused by the hepatitis B virus (HBV). The Centers for Disease Control and Prevention (CDC) estimates about 640,000 adults in the U.S. are infected chronically with HBV, and it is usually transmitted via an exchange of body fluids. HBV causes damage to the liver, which if left unchecked can lead to cirrhosis, liver cancer and liver failure.

What’s the difference between acute and chronic hepatitis B?

AJC: Acute hepatitis B occurs within the first 6 months after initial exposure to HBV. Patients may have no symptoms or may have a series of symptoms including malaise, fatigue and jaundice, and may need hospitalization. For most adults infected with acute hepatitis B, it is a self-limited disease that doesn’t require specific HBV treatment. However, about 5% of adults remain infected beyond the six months after exposure, which is then considered chronic HBV. Unfortunately, infants and children infected with HBV have a higher chance of developing chronic HBV.

Is there a cure for hepatitis B?

AJC: While acute hepatitis B can resolve on its own, once it has transitioned to chronic HBV, it is often considered a lifelong infection. Currently, medicines exist to treat HBV in order to keep the virus under control and protect one’s liver, but there is no cure to completely rid one’s body of HBV. Efficacious vaccines exist to prevent being infected by HBV, and already infected patients can take medicines to prevent HBV transmission to others.

What lifestyle changes can help protect a patient’s liver if they have hepatitis B?

AJC: Besides taking one’s HBV medications (if prescribed), it is important to try to avoid any other injury or stress to the liver. Most commonly, this means minimizing alcohol use and incorporating lifestyle modifications to prevent metabolic dysfunction associated steatotic liver disease.

Are there any promising new treatments being studied for hepatitis B?

AJC: There are several compounds in development for HBV, including those that target different parts of the virus and others that utilize the body’s immune system. While we remain optimistic, research and clinical trials remain ongoing. The last HBV medicine in the U.S. was approved in 2016.

What role can patients play in research or clinical trials?

AJC: If interested, patients should ask their doctors if there are any clinical trials they can participate in for HBV.

Is there anything else you would like to add?

AJC: The CDC recommends all adults be screened for HBV at least once in their lifetime. As HBV is preventable, it is extremely important to be vaccinated, and the CDC recommends all infants, children and adults up to age 60 to get the HBV vaccine.