What is hepatitis?
Hepatitis is the inflammation of the liver and is usually caused by a virus. The viruses causing hepatitis are hepatitis A, B, C, D and E. There are, however, some cases where hepatitis is not caused by these viruses and is called non A-E hepatitis.
The World Health Organisation has set July 28 as World Hepatitis Day to promote awareness and prevention of this group of infectious diseases affecting hundreds of millions of people worldwide. Hepatitis causes acute and chronic liver disease which kills close to 1.5 million every year mostly from hepatitis B and C. These deaths and illness may be prevented by educating the communities on hygiene and safe practices.
Effects of hepatitis
Hepatitis viruses affect the liver, an important organ in the body playing a major role in metabolism. The liver produces bile which is essential in digestion, filters toxins from the body, excretes bilirubin, cholesterol, hormones and drugs as well as metabolises carbohydrates, fats and proteins. It also synthesises clotting factors, plasma proteins and stores glycogen, vitamins and minerals, among other functions.
Chronic hepatitis which is usually due to hepatitis B or C puts one at risk of chronic liver disease, scarring of the liver (cirrhosis) and in some cases cancer of the liver. Severe or chronic infections may give rise to liver failure.
How do I get hepatitis?
Hepatitis A is spread through the oral-faecal route. The virus is found in the faeces of an infected person. So poor hygiene can help spread the virus, e.g. handling food with unwashed hands, drinking contaminated water, eating uncooked shellfish and raw vegetables contaminated by sewage.
Hepatitis E is spread almost in the same way as hepatitis A. Hepatitis E is however mostly water-borne occurring in areas with poor sanitation.
Hepatitis B is transmitted mostly through puncture wounds or contact with infectious body fluids, e.g. blood, saliva or semen. Transmission of hepatitis B is more common in intravenous drug abusers sharing needles and tattooing with unsterilized utensils. Sexual contact with an infected person, sharing toothbrushes or razors or direct contact with bleeding wounds places one at high risk of contracting hepatitis B. Medical personnel carry an extra risk through accidental needle pricks.
Hepatitis C is transmitted in a similar way as hepatitis B through direct contact with infected bodily fluids.
Hepatitis D referred to as ‘delta hepatitis’ is a rare form of hepatitis usually causing serious liver disease. It occurs in conjunction with hepatitis B.
How do I know if it’s hepatitis?
Hepatitis B and C may cause chronic hepatitis which may have no symptoms at all in the beginning until liver damage occurs. Hepatitis may be slow in showing symptoms, taking up to four weeks, two months or three months in hepatitis A, C or B respectively.
Acute hepatitis may cause among other things, fatigue flu-like illness, dark urine and pale coloured stools. One may have yellow eyes (jaundice), loss of appetite, fever and joint pains.
When you suspect hepatitis visit your doctor who will examine you and may do some blood tests like liver function tests, a hepatitis screen and may do an ultrasound scan of the liver.
How can I prevent hepatitis?
The good news is that hepatitis A and B may be prevented through vaccination. Vaccination is included in children’s immunisation schedule. It may also be given in outbreaks and to people working in risk environments or travellers to high prevalence countries.
Avoid sharing drug needles, razors, toothbrushes or touching spilled blood. Make use of protective clothing and practise safe sex with condoms.
Hepatitis A and E can be prevented through good sanitation, clean water and basic hygiene such as washing of hands after toilet use and before handling food. Avoid contaminated food always and eat adequately cooked food.
What is the treatment?
Hepatitis A usually resolves without treatment. Bed rest and symptomatic (e.g. diarrhoea and vomiting) treatment may be recommended in more severe cases.
Chronic hepatitis B may be treated with anti-viral medication after an assessment by the doctor and requires regular monitoring and evaluation.
Always visit your doctor when in doubt.
• Dr Emmanuel Tom is a general medical practitioner at Wanaheda Medical Centre. He may be contacted on mobile: +264 811 476 330; or at etom@wanmedcentre.com.