Yesterday, the world observed World Hepatitis Day under the theme ‘Find the missing millions’. The event aimed to raise global awareness about viral hepatitis, a group of infectious diseases known as viral Hepatitis A (HAV), B (HBV), C (HCV), D (HDV) and E (HEV). According to the World Health Organization (WHO), HBV and HCV are the most common ones. In fact, WHO cautions that 325 million people worldwide are living with the two infections. Organisations, such as the Centers for Disease Control and Prevention (CDC) and the World Hepatitis Alliance (WHA), work closely with the WHO to address the disease in all its forms.
Viral hepatitis is an inflammation of the liver and is mostly a self-limiting condition, meaning that the immune system can clear the infection without medicine. However, a large number of people with HBV and HCV develop chronic disease, a condition which has become the second major killer of infectious disease globally, after tuberculosis. The signs and symptoms of all five types of viral hepatitis are quite similar, but a large number of infected people initially do not exhibit any symptoms. This results in unawareness of infection in the infected person. Where symptoms are present, it may include fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured stools, joint pain and jaundice (yellowing of skin and the whites of the eyes). Even where there is a strong suspicion of infection, the final diagnosis for each of the five types can only be confirmed through specific blood tests.
The modes of transmission for HAV and HEV are very similar, and happen via the faecal-oral route, generally via contaminated water. Pregnant women are especially at risk of developing complications from HEV, hence they may require hospitalisation. For HBV and HCV, transmission is blood-borne, and mostly spreads from mother-to-child at birth, through needle stick injury, tattooing, body piercing and exposure to infected blood and body fluids, certain sexual practices such as men who have sex with men, sharing of needles by injectable drug-users, and although rare, the transfusion of unscreened blood and blood products. As for HDV, it requires a host already infected with HBV, hence infection occurs as a super-infection with HBV. Simply put: you cannot get HDV without having HBV.
As alluded earlier, new hepatitis infections do not always require treatment, as the immune response usually clear the infection, but chronic infection necessitates treatment. Some patients develop scarring of the liver (cirrhosis), cancer, liver failure and eventually death. Specific antiviral medicines cure most infections, and treatment is usually between 3 and 6 months, depending on the condition of the liver.
Viral hepatitis in all its forms is preventable, hence, awareness of and education on the disease is key. The available WHO endorsed vaccines are only for HAV and HBV. Hepatitis vaccination is embedded in the routine childhood immunization schedule, as children below the age of 5 years are especially at risk. To prevent HAV and HEV, clean and safe water, sanitation, and basic hygiene is key. For HBV and HCV, the safe handling of sharp objects and waste, harm-reduction services to injectable drug users, testing of donated blood, training and vaccination of health personnel, hand hygiene and promotion of correct and consistent use of condoms are key.
We urge our readers to please report to the nearest health facility if you suspect you or someone close to you may be infected with viral hepatitis. You may be just one of the missing millions. Let us all become hepatitis combatants, and in so-doing close the gap.
*Karin Husselmann is the CEO and Founder of B-Healthi Coaching and Training CC. She writes on public health and lifestyle issues, offer support with smoking cessation and assist corporate clients with general health and wellness of their employees.