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One week ago, World Hepatitis Day (WHD) was observed on July 28, 2019, with the theme, “Invest in Eliminating Hepatitis.” World Hepatitis Day is an annual event that targets raising awareness about hepatitis. The World Health Organisation (WHO) urged all countries and partners to promote the theme. According to WHO, viral hepatitis B and C affect an estimated 325 million people worldwide and cause over 1 million deaths a year, with deaths reported to be on the increase.
Recently, although there is an increased level of awareness on hepatitis, many still have conflicting views about the disease. However, hepatitis is preventable and treatable. Hepatitis may be described as an inflammation of the liver. There are various causes of hepatitis which include certain drugs, exposure to toxins, alcohol, infections and autoimmune conditions. However, viral infections are the commonest cause of hepatitis in the world. For better understanding, a brief description of the liver is necessary. The liver is a large organ that is located on the right side of the belly. Normally, the liver cannot be felt because it is protected by the rib cage.
The functions of the liver includes: filtering blood coming from the digestive tract before it is released to the rest of the body; detoxifying chemicals and breaking down drugs used by an individual; storing glycogen, vitamins and minerals; production and excretion of bile; excretion of bilirubin, cholesterol, hormones and drugs amongst other functions.
Viral hepatitis is an inflammatory condition of the liver caused by viral infections. There are about five types of viral hepatitis, which include hepatitis A, B, C, D and E, classified according to the type of virus causing the infection. Overall, hepatitis A causes immediate symptoms and is usually short term (acute) while hepatitis B and C have the potential of causing chronic diseases like liver cirrhosis or cancer of the liver. Hepatitis E can lead to more serious outcomes in pregnant women.
Hepatitis A: This condition is caused by hepatitis A virus (HAV) and transmission is usually through consuming contaminated food or water. Hepatitis A virus is present in the faeces of infected persons and is usually found in areas with poor sanitation.
Hepatitis B: This is caused by hepatitis B virus (HBV) and transmission occurs through contact with infectious body fluids. Examples include blood, semen, amongst others. Hence practices such as illicit drug use (injections), unsafe sexual behaviours, sharing of sharp objects can increase the chances of a person to be infected with the virus. Hepatitis B can also be transmitted from an infected mother to the baby during delivery, transfusion of infected blood and blood products, accidental needle stick injuries among healthcare workers.
Hepatitis C: This is caused by hepatitis C virus (HCV) and its mode of transmission is similar to that of hepatitis B virus. Hepatitis C virus like HBV can cause chronic liver disease.
Hepatitis D: Also called “delta hepatitis,” it is an infection of the liver caused by hepatitis D virus. Hepatitis D only occurs in people who are infected with HBV (hepatitis B virus) as hepatitis D virus requires HBV to multiply.
Hepatitis E:- This is a water-borne disease caused by the hepatitis E virus. It is usually transmitted through consumption of contaminated food or water, especially in areas with poor sanitary conditions and can cause outbreaks.
As previously mentioned, other causes of non-infectious hepatitis include:
1. Excessive alcohol consumption: The condition is commonly referred to as alcoholic hepatitis. When injury on the liver from alcohol is sustained, there can be permanent damage that may result in long term (chronic) liver disease.
2. Autoimmune hepatitis and other autoimmune conditions, such as Grave’s disease, systemic lupus erythematous (SLE), amongst others.
3. Illicit use of drugs, exposure to toxins and chemicals.
The symptoms of hepatitis vary with the cause of the disease. For instance, hepatitis B and C may not cause any symptoms until the function of the liver is severely affected while some common possible symptoms and signs of acute hepatitis (Hepatitis A) include fatigue (extreme tiredness/lack of energy), flu-like symptoms (body aches, fever, chills, loss of appetite, headache), dark urine, unexplained weight loss, jaundice (yellow skin and eyes), diarrhoea and vomiting, amongst others. The diagnosis of hepatitis includes a thorough history taking and physical examination by a medical practitioner. It also includes laboratory investigations like liver function tests, viral infection screening, imaging studies like abdominal ultrasound, magnetic resonance imaging and others. It should be noted that investigations should be carried out on medical practitioner’s request/recommendation for proper guidance.
The treatment options depend on the cause and stage of the disease when detected. Early diagnosis and prompt treatment improves outcome, hence the need for routine medical check-up and early presentation to the health facility when symptoms are noticed. Management of acute symptoms like vomiting and diarrhoea should start from the home to prevent dehydration and its consequences. Antiviral medication for treatment of some viral infections and should be used as prescribed by the doctor.
Hepatitis can be prevented by maintaining good hygiene (ensure use of safe, potable water, washing raw fruits and vegetables properly), practicing safe sexual behaviours, screening blood and blood products before transfusion, avoiding the excessive alcohol, sharing of sharp objects like razors, needles, amongst others and vaccination. Vaccination is an important way of preventing viral hepatitis. The vaccine is recommended for anyone who has never been infected and is at risk for getting viral hepatitis, for example, healthcare workers and infants. Government can also provide support by implementing interventions to prevent the disease like vaccination of high risk individuals.
Health question of the week:
Our bodies are our gardens, our wills are our gardeners – William Shakespeare
