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World Hepatitis Day 2019
Author: Sr. Erika Botha
Published: 30/07/2019

​World Hepatitis Day 2019 takes place on July 28th. This date was chosen because it is the birthday of Nobel-prize winning scientist Dr Baruch Blumberg, who discovered hepatitis B virus (HBV) and developed a diagnostic test and vaccine for the virus. The day is a celebration of the progress that has been made in viral hepatitis elimination and a chance for the general public, the affected community, medical professionals and policy makers to come together to call for the elimination of this disease.

In 2016, every country in the world signed up to eliminate viral hepatitis by 2030, currently only 12 countries are on track to do this. Viral hepatitis kills more than 1.34 million people each year, more than HIV/AIDs or Malaria yet there is a cure for hepatitis C and a vaccine and effective treatment for hepatitis B. The 4,000 deaths each day caused by viral hepatitis are preventable. Currently 290 million people live with viral hepatitis completely unaware, one of the key reasons for this is a lack of awareness about the disease.

 

What is hepatitis?

Hepatitis refers to an inflammatory condition of the liver. It's commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

Your liver is located in the right upper area of your abdomen. It performs many critical functions that affect metabolism throughout your body, including:

  • bile production, which is essential to digestion
  • filtering of toxins from your body
  • excretion of bilirubin (a product of broken-down red blood cells), cholesterol, hormones, and drugs
  • breakdown of carbohydrates, fats, and proteins
  • activation of enzymes, which are specialized proteins essential to body functions
  • storage of glycogen (a form of sugar), minerals, and vitamins (A, D, E, and K)
  • synthesis of blood proteins, such as albumin
  • synthesis of clotting factors

 

The 5 types of viral hepatitis

Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis.

Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

Hepatitis A

 

Hepatitis A is most commonly transmitted by consuming food or water contaminated by faeces from a person infected with hepatitis A.

Hepatitis B

 

Hepatitis B is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus (HBV). Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase your risk of getting hepatitis B.

Hepatitis C

 

Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact.

Hepatitis D

 

Also called delta hepatitis, hepatitis D is a serious liver disease contracted through direct contact with infected blood. Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can't multiply without the presence of hepatitis B.

Hepatitis E

 

Hepatitis E is a waterborne disease mainly found in areas with poor sanitation and typically results from ingesting faecal matter that contaminates the water supply.

 

Causes of non-infectious hepatitis

Alcohol and other toxins

Excessive alcohol consumption can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of your liver. Over time, it can cause permanent damage and lead to liver failure and cirrhosis, a thickening and scarring of the liver.

Other toxic causes of hepatitis include overuse or overdose of medications and exposure to poisons.

Autoimmune system response

In some cases, the immune system mistakes the liver as a harmful object and begins to attack it. It causes ongoing inflammation that can range from mild to severe, often hindering liver function. It's three times more common in women than in men.

Common symptoms of hepatitis

If you have infectious forms of hepatitis that are chronic, like hepatitis B and C, you may not have symptoms in the beginning. Symptoms may not occur until the damage affects liver function.

Signs and symptoms of acute hepatitis appear quickly. They include:

  • fatigue
  • flu-like symptoms
  • dark urine
  • pale stool
  • abdominal pain
  • loss of appetite
  • unexplained weight loss
  • yellow skin and eyes, which may be signs of jaundice

Chronic hepatitis develops slowly, so these signs and symptoms may be too subtle to notice.​

How hepatitis is diagnosed

History and physical exam

To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or non-infectious hepatitis.

During a physical examination, your doctor may press down gently on your abdomen to see if there's pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.

Liver function tests

Liver function tests use blood samples to determine how efficiently your liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if you don't show any signs on a physical exam of liver disease. High liver enzyme levels may indicate that your liver is stressed, damaged, or not functioning properly.

Other blood tests

If your liver function tests are abnormal, your doctor will likely order other blood tests to detect the source of the problem. These tests can check for the viruses that cause hepatitis. They can also be used to check for antibodies that are common in conditions like autoimmune hepatitis.

Ultrasound

An abdominal ultrasound uses ultrasound waves to create an image of the organs within your abdomen. This test allows your doctor to take a close at your liver and nearby organs. It can reveal:

  • fluid in your abdomen
  • liver damage or enlargement
  • liver tumors
  • abnormalities of your gallbladder

Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of your abnormal liver function.

Liver biopsy

A liver biopsy is an invasive procedure that involves your doctor taking a sample of tissue from your liver. It can be done through your skin with a needle and doesn't require surgery. Typically, an ultrasound is used to guide your doctor when taking the biopsy sample.

This test allows your doctor to determine how infection or inflammation has affected your liver. It can also be used to sample any areas in your liver that appear abnormal.

 

How hepatitis is treated

Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic. The treatment options range from bed rest and hydration, to vaccinations and antiviral treatments. Immune-suppressing drugs are used to treat autoimmune hepatitis.

 

Tips to prevent hepatitis

Hygiene

Practicing good hygiene is one key method to avoid contracting hepatitis A and E. If you're traveling to a developing country, you should avoid:

  • local water
  • ice
  • raw or undercooked shellfish and oysters
  • raw fruit and vegetables

Hepatitis B, C, and D contracted through contaminated blood can be prevented by:

  • not sharing drug needles
  • not sharing razors
  • not using someone else's toothbrush
  • not touching spilled blood

Hepatitis B and C can also be contracted through sexual intercourse and intimate sexual contact. Practicing safe sex by using condoms and dental dams can help decrease the risk of infection.

 

For more information about hepatitis and management, contact us at Campus Health Services (021 808 3496) and make an appointment with a doctor, or pop in and see a nurse.