World Hepatitis Day: 28th July 2017

New Delhi, July 27 2017: World Hepatitis Day is a chance to propel all efforts towards implementing WHO’s first global health sector strategy on viral hepatitis. This strategy consists of four steps: Preventing Hepatitis, Getting Tested, Demanding treatments and making injections safe. The collaborative outcome of these four steps forms the theme for this year’s Hepatitis day, ‘Eliminate Hepatitis.’

Dr Gourdas Choudhuri, Director & HOD, Gastroenterology & Hepatobiliary Sciences, Fortis Memorial Research Institute, Gurgaon gives us a complete overview of Hepatitis – Types, Common Symptoms, Causes and Transmission, Prevention as it’s essential to know the disease to prevent it.

Types of Hepatitis:

There are five types of Hepatitis viruses – A, B, C, D and E.
Hepatitis B and C are dangerous as they can produce chronic liver disease.
Hepatitis A and E spread through contaminated water or food, often produce more dramatic symptoms such as jaundice but last for short durations.
Hepatitis D is an incomplete virus and causes infection only along with Hepatitis B.

Common Symptoms of Hepatitis:

Jaundice (yellow eyes and skin, dark urine)
Loss of appetite accompanied with nausea
Fever
Diarrhoea
Fatigue
Web of swollen blood vessels in the skin
Itching
Pain on the right side of the belly, under the rib cage
Clay-coloured stool
Sore muscles

Causes and Transmission:

Close contact with a person who is infected with the virus
Sharing food or drinks with someone who is infected
Eating contaminated food
Sexual contact with the infected person
Faecal-oral route due to faecal contamination of drinking water
Ingestion of undercooked meat or meat products derived from infected animals
Transfusion of infected blood products
Transmission from a pregnant woman to her foetus
I/V Drug abuse and Tattoos

Who is at the risk of chronic disease?

The chronic nature of the disease depends upon the age at which a person is infected by the disease. Children less than 6 years of age who become infected with the hepatitis B virus are the most likely to develop chronic infections; 80–90% of infants infected during the first year of life develop chronic infections and 30–50% of children infected before the age of 6 years develop chronic infections. Less than 5% of otherwise healthy persons who are infected as adults will develop chronic infection and 20–30% of adults who are chronically infected will develop cirrhosis and or liver cancer.

Treatment:

Acute hepatitis due to any virus is usually self-limiting and requires good diet, bed rest and only symptomatic treatment. Only acute liver failure in acute viral hepatitis requires urgent hospitalization and intensive treatment and maybe liver transplant too. Chronic hepatitis B and C can be treated with antiviral drugs (oral and injectable). HCV is curable now and HBV is controllable with medication. Vaccine is available for HAV and HBV only.

Prevention:

Maintaining quality standards for public water supplies
Establishing proper disposal systems for human faeces
Maintaining hygienic practices such as hand-washing with safe water, particularly before handling food
Avoiding consumption of water and/or ice of unknown purity
Immunization
Safe transfusion of Blood
Safe Injection safety
Testing of donated blood for hepatitis B and C
Promotion of correct and consistent use of condoms.

Who should be vaccinated?

All children and adolescents younger than 18 years-old and not previously vaccinated should receive the vaccine if they live in countries where there is low or intermediate endemicity.

People who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations; people interned in prisons

People who inject drugs
People with multiple sexual partners
Healthcare workers and others who may be exposed to blood and blood products through their work
Travellers who have not completed their hepatitis B vaccination series, who should be offered the vaccine before leaving for endemic areas.

Hepatitis is a paramount global health problem that requires an extensive and immediate response. Very few of those infected, accessed testing and treatment, especially in low- and middle-income countries. According to WHO, viral hepatitis caused 1.34 million deaths in 2015 comparable with TB deaths and exceeding deaths from HIV. In India every 12^th person is either HBV or HCV positive and most people who need treatment have not been treated, largely due to a lack of awareness, and access to hepatitis diagnosis and treatment. Over 90% of people with hepatitis C can be completely cured of the virus within 3-6 months. Appropriate treatment of hepatitis B and C can prevent the development of the major life-threatening complications of chronic liver disease – cirrhosis and liver cancer.