With the sixth highest population in the world, Pakistan is a developing country that is severely impacted by Hepatitis. According to WHO, 150,000 individuals in Pakistan succumb to the disease every year, making public education about it urgently necessary. Therefore, following are key facts to remember on World Hepatitis day:
What is Hepatitis?
It is an inflammatory disorder of the liver, one of the most vital organs of the body. Its healthy function is critically necessary for survival, and is severely compromised in this condition. Hepatitis can harm the liver to the point where it develops scarring even cancer, and ultimately leads to death.
What are its root causes?
The most common causes of the condition are infections of Hepatitis viruses A, B, C, D and E which lead to viral hepatitis. In addition, alcohol/drug toxicity and certain autoimmune disorders contribute significantly to its prevalence.
How is the virus transmitted?
Viral hepatitis is of 5 distinct types according to the agent causing it and consequently, each type gets transmitted in different ways.
- Hepatitis A:
It is primarily transmitted by the fecal-oral route, but inadequately treated water and close physical contact with an infected person are also to be blamed for its spread. It is a self limiting disease with only supportive therapy given through the disease period.
- Hepatitis B:
It is a potentially life-threatening type that can be transmitted from an infected mother to a child (at the time of delivery/perinatal transmission) or by exposure to infected body fluids (such as saliva, vaginal and seminal fluids) including blood (by any type of needle stick injury).
- Hepatitis C:
It spreads through transfusion of unscreened blood/blood products, using of poorly sterilized medical equipment, and re-using needles. Infection with this type of Virus is usually chronic and damages the liver over months and years destroying the structure and function of the organ.
- Hepatitis D:
A very significant component in its occurrence is the presence of hepatitis B virus in the body; hence needle stick injuries are typically the cause of hepatitis B and D co-infection.
- Hepatitis E:
Its spread is essentially linked to poor hygiene. It also spreads via the faeco- oral route like Hepatitis A. Usually through contaminated drinking water. Infection with this type of virus is also usually self limiting with only supportive therapy given through the disease.
What are its symptoms?
Even though Hepatitis is of multiple different types, yet symptoms are quite similar overall.
An infected person usually presents to the hospital with complaints of:
- Abdominal discomfort
- Dark colored urine
- Loss of appetite which eventually leads to anorexia.
How is it diagnosed?
Clinically, similarities in signs and symptoms make it challenging to differentiate one form of viral hepatitis from another. However, several laboratory techniques, such as RT-PCR, RNA assays and testing blood for antibodies against a particular virus, are beneficial in this regard. Additionally, tests might reveal a person’s hepatitis immunity or the length of their infection.
Is hepatitis treatable?
Yes, the treatment depends upon the severity and type of infection. A mild infection only requires antiviral and symptomatic therapy, whilst a fulminant infection may potentially necessitate a liver transplant. Furthermore, dosage and duration of the therapy vary depending upon presence of any other health conditions, and it is advised to avoid certain medications (acetaminophen) and alcohol during the treatment.
- Hepatitis A and E:
Symptomatic therapy is sufficient for these infections because they resolve on their own.
- Hepatitis B:
It is advised to administer oral antiviral medications (including interferon alpha-2b and lamivudine).
- Hepatitis C:
The medications used to treat chronic hepatitis C (pegylated interferon alpha-2a and 2b) are different from those used to treat acute forms of the infection (interferon alpha-2b).
- Hepatitis D:
Pegylated interferon-alpha is used to treat its infection and it is crucial to maintain the therapy for 48 weeks regardless of patient’s response.
How can we prevent hepatitis?
In recent years, cases of hepatitis have been surging, especially in developing nations; therefore, it is crucial to take the right prophylactic steps on a personal and organizational basis. Several preventative measures include:
- The availability of clean drinking water
- Proper sewage disposal
- Blood screening
- Good personal hygiene
- Proper cleaning of wounds
- Avoid re-using needles.
Availability of vaccines
Vaccines are available only against hepatitis A and B viruses, which can be administered as a combination as well. Separately, Hepatitis B vaccine can be given within the first 24 hours of life while first dose of hepatitis A vaccine is typically given between the ages of 12 to 23 months.
Considering the high rates of illness and morbidity, especially in pregnant women and infants, it has become essential to take rapid action for the control of hepatitis.
Hepatitis – Basil Saleem, SMDC Literary Society