“Hepatitis Can’t Wait”
World Hepatitis Day is observed each year on 28 July, to raise awareness of viral hepatitis, an inflammation of the liver that causes severe liver disease and hepatocellular cancer. This year’s theme is “Hepatitis Can’t Wait”. With a person dying every 30 seconds from a hepatitis- related illness, even in the current COVID-19 crisis, we can’t wait to act on viral hepatitis. There are five main strains of the hepatitis virus: A, B, C, D and E. Together, hepatitis B and C are the most common, resulting in 1.1 million deaths and 3 million new infections per year.
Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage the liver, affecting how well the liver functions.
Hepatitis can be an acute (short-term) infection or a chronic (long-term) infection. Some types of hepatitis cause only acute infections; other types can cause both acute and chronic infections.
CAUSES OF HEPATITIS
There are different types of hepatitis, with different causes:
* Viral hepatitis is the most common type. It is caused by one of several viruses – hepatitis viruses A, B, C, D, and E. In most countries, A, B, and C are the most common.
* Alcoholic hepatitis is caused by heavy alcohol use
* Toxic hepatitis can be caused by certain poisons, chemicals, medicines, or supplements
* Autoimmune hepatitis is a chronic type in which the body’s immune system attacks the liver. The cause is not known, but genetics and the environment may play a role.
THE 5 TYPES OF VIRAL HEPATITIS
Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally-transmitted hepatitis.
Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute, but can be particularly dangerous in pregnant women.
* Hepatitis A
Hepatitis A is caused by an infection with the hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by consuming food or water contaminated by faeces from a person infected with hepatitis A.
* Hepatitis B
Hepatitis B is transmitted through contact with infectious body fluids such as blood, vaginal secretions, or semen containing the hepatitis B virus (HBV). Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase the risk of getting hepatitis B.
It’s estimated by the CDC that 1.2 million people in the United States and 350 million people worldwide live with this chronic disease.
* Hepatitis C
Hepatitis C comes from the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact.
HCV is among the most common bloodborne viral infections in many parts of the world; however, it is undiagnosed.
* Hepatitis D
Also called delta hepatitis, hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through direct contact with infected blood.
Hepatitis D is a rare form of hepatitis; it occurs only in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B.
* Hepatitis E
Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation, and typically results from ingesting faecal matter that has contaminated the water supply. Cases of hepatitis E have been reported in the Middle East, Asia, Central America, and Africa, according to the CDC.
CAUSES OF
NON-INFECTIOUS HEPATITIS
* Alcohol and other toxins
Excessive alcohol consumption can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of the liver. Over time, it can cause permanent damage and lead to liver failure and cirrhosis, a thickening and scarring of the liver.
Other toxic causes of hepatitis include overuse or overdose of medications, and exposure to poisons.
AUTOIMMUNE SYSTEM RESPONSE
In some cases, the immune system mistakes the liver for a harmful object, and begins to attack it. It causes ongoing inflammation, which can range from mild to severe, often hindering liver function. It’s three times more common in women than in men.
TRANSMISSION OF HEPATITIS
Hepatitis A and hepatitis E usually spread through contact with food, or water that was contaminated with an infected person’s stool. Persons can also get hepatitis E by eating undercooked pork, deer, or shellfish.
Hepatitis B, hepatitis C, and hepatitis D spread through contact with the blood of someone who has the disease. Hepatitis B and D may also spread through contact with other body fluids. This can happen in many ways, such as sharing drug needles, or having unprotected sex.
RISKS OF HEPATITIS
The risks are different for the different types of hepatitis. For example, with most of the viral types, the risk is higher if you have unprotected sex. People who drink a lot over long periods of time are at risk of contracting alcoholic hepatitis.
SYMPTOMS OF HEPATITIS
Some people with hepatitis do not have symptoms, and do not know they are infected. Symptoms may include
* Fever
* Fatigue
* Loss of appetite
* Nausea and/or vomiting
* Abdominal pain
* Dark urine
* Clay-coloured bowel movements
* Joint pain
* Jaundice, yellowing of the skin and eyes
In an acute infection, the symptoms can start at any time between 2 weeks and 6 months after exposure to the infection. In the case of chronic infection, persons may not have symptoms until many years later.
DIAGNOSIS
To diagnose hepatitis, the health care provider
* Will ask about the symptoms and medical history
* Will do a physical exam
* Will likely do blood tests, including tests for viral hepatitis
* Might do imaging tests such as an ultrasound, CT scan, or MRI
* May need to do a liver biopsy, to get a clear diagnosis and check for liver damage
TREATMENT
Treatment for hepatitis depends on which type a person has, and whether it is acute or chronic. Acute viral hepatitis often goes away on its own. To feel better, people may just need to rest and get enough fluids. But, in some cases, it may be more serious, and even need treatment in a hospital.
There are different medicines to treat the different chronic types of hepatitis. Possible other treatments may include surgery and other medical procedures. People who have alcoholic hepatitis need to stop drinking. If the chronic hepatitis leads to liver failure or liver cancer, a liver transplant is needed.
COMPLICATIONS OF HEPATITIS
Chronic hepatitis can lead to complications such as cirrhosis (scarring of the liver), liver failure, and liver cancer. Early diagnosis and treatment of chronic hepatitis may prevent these complications.
PREVENTION
There are different ways to prevent or lower the risk of hepatitis, depending on the type of hepatitis. For example, not drinking too much alcohol can prevent alcoholic hepatitis. There are vaccines to prevent hepatitis A and B. Autoimmune hepatitis cannot be prevented.
World Hepatitis Day is a day for the world’s hepatitis community to unite and make our voices heard. It’s a day to celebrate the progress we have made, and to meet the current challenges. It’s also an opportunity for us to increase awareness and encourage a real political change to jointly facilitate prevention, diagnosis and treatment. WHD is a great opportunity for us to raise awareness of the importance of knowing the hepatitis status, and to spread the word about treatment.
