As the world commemorated Hepatitis Day on July 28 2020 with the theme being Hepatitis-free future, we engaged Star Hospital medical officer Doctor Khalid Abdi-Aziz on what this disease is, how it is transmitted but also how it can be treated.
According to Abdi-Aziz, Hepatitis is a disease affecting the Liver (a part of the body that mainly filters blood coming from the digestive tract, before passing it to the rest of the body. It also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines). Hepatitis is an inflammation or rather swelling of the liver.
Abdi-Aziz says that the condition can be self-limiting or can progress to fibrosis, cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world however other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can as well cause hepatitis.
There are 5 main hepatitis viruses, referred to as:
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis D
- Hepatitis E
These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.
Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.
Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.
Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.
Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.
Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.
Treatment depends on the type of hepatitis. Viral hepatitis may be treated with antiviral medication.
Hepatitis A – Treatment consists of preventative measures and self care
The condition clears up on its own in one or two months. Rest and adequate hydration can help.
Hepatitis B – Treatment depends on severity
The condition often clears up on its own. Chronic cases require medication and possibly a liver transplant.
Hepatitis C – Treatment consists of HCV antivirals
Hepatitis C is treated with antiviral medication. In some people, newer medicines can eradicate the virus.
Hepatitis D – Treatment consists of self care
There are few treatments specifically for hepatitis D, although different regimes may be tried. Management also focuses on supportive care.
Hepatitis E – Treatment consists of self care and fluids
Hepatitis E usually resolves on its own within four to six weeks. Treatment focuses on supportive care, rehydration and rest.
Alcoholic hepatitis – Treatment consists of self care
Treatment involves hydration, nutritional care and stopping alcohol use. Steroid drugs can help reduce liver inflammation.
Autoimmune hepatitis – Treatment consists of steroids
When treated early, it can often be controlled with drugs that suppress the immune system. In rare cases, a liver transplant may be required.