Every year 28th July is celebrated as World Hepatitis Day by WHO. Today, by means of this blog, we will try to understand the nature of Hepatitis and measures to prevent it.
What is Hepatitis? “Hepat” means liver and “itis” means swelling. Hence, it means swelling of the liver. Overall the focus of World Hepatitis Day is towards hepatitis caused by viruses—Viral Hepatitis.
Viral hepatitis B and C affect 325 million people worldwide causing 1.4 million deaths/year. It is the second major killer infectious disease after tuberculosis, and nine times more people are infected with hepatitis than HIV. Hepatitis is preventable, treatable, and in the case of hepatitis C, curable. However, over 80% of people living with hepatitis are lacking prevention, testing, and treatment services.
In India, Hepatitis A and Hepatitis E are transmitted due to infected water or food. Usually, these infections are self-limiting but can cause life-threatening infections in a few cases. Especially in pregnant women infected with Hepatitis E is very dangerous, hence needs particular attention.
Hepatitis B and C are transmitted in a different manner. When the already infected mother gives birth to a child, the chances of transmission are very high, this means of transmission is known as vertical transmission. On the other hand, by means of unprotected intercourse, infected syringes, infected blood products can also lead to viral spread from one person to another which is known as horizontal transmission. A person with intravenous drug abuse, HIV infections, a person on hemo-existing Liver disease usually dialysis, and those requiring frequent blood products (thalassemia, haemophilia) are especially at high risk of acquiring the infection.
In India, as per the latest estimates, 40 million people are chronically infected with hepatitis B and 6 to 12 million people are chronically infected with hepatitis C.
On one hand, Hepatitis A and E cause illness for a short duration. In the absence of pre-existing liver disease usually, the infection gets cleared without causing permanent damage. In some cases where the disease is very severe, life-threatening hepatitis can happen which may need ICU care and liver transplantation.
Hepatitis B and C, on the other hand, tend to last for prolonged duration and can cause chronic illnesses. The spectrum of diseases includes chronic hepatitis, cirrhosis of the liver, and liver cancer (Hepatocellular carcinoma). This virus remains calm in body and only a few symptoms appear till permanent damage to liver-cirrhosis sets in. Once cirrhosis develops multiple symptoms like fatigue, jaundice, swelling in the body, reduced consciousness and vomiting of blood appear on the surface. Therefore, it is essential for us to pick up the infection early and treat it before the development of cirrhosis and liver cancer.
Very efficient treatment is available for Hepatitis B and C. Oral medicines for Hepatitis B is effective in suppressing the virus and keeping the viral load lower down to reduce liver damage. Recent achievements in the treatment of Hepatitis C have made it the only curable virus. Oral medications for 3 to 6 months clear the virus for the body in almost all cases. A simple card base blood test is sufficient enough to find out the presence of B and C viruses and hence can prevent major morbidities.
Symptoms of hepatitis
Chronic and infectious forms of hepatitis, such as hepatitis B and C don’t exhibit any symptoms in the beginning and unless the damage affects the functioning of the liver.
In the case of acute hepatitis, the following signs and symptoms can appear quickly.
- Fatigue
- Dark urine
- Flu-like symptoms
- Pale stool
- Abdominal pain
- Unexplained weight loss
- Loss of appetite
Hepatitis treatment procedures
Treatment procedures for hepatitis can vary depending on the type of condition you have and whether it is acute or chronic.
- Hepatitis A – If you’re wondering if hepatitis A is permanent, it is not. Hepatitis A is short-term and doesn’t need any treatment. However, bed rest may be recommended in cases of extreme discomfort. Hepatitis A can be prevented by vaccines. Children aged between 12 and 18 months are given a series of two vaccines to prevent the condition.
- Hepatitis B – Chronic hepatitis B is treated with antiviral medications. The treatment for hepatitis B continues for several months or years, and hence, can be expensive. Moreover, regular medical evaluations and monitoring are necessary to check if the virus is responding to treatments. A series of three vaccinations for hepatitis B is recommended for all new-borns over the first six months of childhood.
- Hepatitis C – Both acute and chronic forms of hepatitis C need antiviral medications. So, hepatitis C is curable or treatable. People with chronic hepatitis C need a combination of antiviral drug therapies. In case, chronic hepatitis results in liver cirrhosis, such patients may be candidates for a liver transplant.
- Hepatitis D – Presently, there are no antiviral medications for the treatment of hepatitis D. A study conducted in 2013 used alpha interferon to treat hepatitis D, but it showed improvement in only about 25-30 percent of people. However, one way of preventing hepatitis D is by getting vaccinations for hepatitis B as hepatitis D cannot develop without an infection with hepatitis B.
- Hepatitis E – The infection in hepatitis E is acute, and no medical therapies exist for its treatment. It typically resolves on its own. It is recommended to get rest, stay hydrated, get enough nutrients, and avoid alcohol.
Prevention of hepatitis
1. Avoid consuming impure food and water. Especially from the places where hygienic measures are not taken in preparing the food.
2. Say a big “No” to unprotected sex and intravenous drug abuse.
3. Community-based periodic checking of Hepatitis B and C can help to pick the cases early and gives the opportunity to treat them at an early stage.
4. All pregnant women should be checked for Hepatitis B and C.
5. Vaccines are available for Hepatitis B. Those who are at high risk of acquiring infections like health care workers and close kins of Hepatitis B patients must be offered vaccination.
The theme for the 2019 World Hepatitis Day is “invest in eliminating hepatitis”. Let us all invest our precious time and spread this knowledge in the community for awareness of Hepatitis, which will help in building a healthy community, healthy city, healthy country, and healthy future.
Dr.Vatsal Mehta | Medical Gastroenterologist and Hepatologist | Narayana Multispeciality Hospital, Ahmedabad