Worldwide, 290 million people are living with viral hepatitis unaware (1). On World Hepatitis Day, 28 July, we call on people from across the world to take action and raise awareness. Nine in ten people living with viral hepatitis do not know they are infected (1).
Hepatitis refers to an inflammatory condition of the liver. Your liver is located in the right upper area of your abdomen. It performs many critical functions that affect metabolism throughout your body.
Hepatitis is commonly caused by a viral infection, but there are other possible causes. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drug, toxins and alcohol. Hepatitis A is always an acute, short-term disease, while hepatitis B, C and D are most likely to become ongoing and chronic.
Hepatitis A is caused by an infection with the hepatitis A virus. This type of hepatitis is most commonly transmitted by consuming food or water contaminated by faeces from a person infected with hepatitis A.
Non-immune South African adolescents and adults are at constant risk of becoming severely ill for several weeks and are even at risk of death. All non-immune South Africans should consider being vaccinated against hepatitis A.
Hepatitis A poses a considerable risk to travelers from countries of low endemicity to countries of medium to high endemicity. South Africa has a mix of high and low endemicity, and disease patterns are changing within the country. A large part of the population would have contracted mild or subclinical infection as babies or toddlers and are subsequently immune. Those who grew up in better socio-economic conditions with better food and water hygiene would, however, not have been exposed and consequently are not immune. This part of the population would not only be at risk when travelling to developing regions of the world but equally so if remaining in South Africa as non-immunes (3).
Hepatitis B is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus. It is far less common than hepatitis A in South Africa but still far more common than in most countries (2). The disease may infect babies at a young age, increasing the risk for chronic and potentially fatal disease in adulthood. Hepatitis B has been part of the South African Expanded Programme of Immunisation since 1995. Children born after 1995 should have been vaccinated and therefore we can expect to see a shift in the prevalence of clinical hepatitis B in years to come.
Hepatitis C comes from the hepatitis C virus. Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact. There is no vaccine.
Causes of noninfectious hepatitis:
- Alcohol and other toxins: excessive alcohol consumption can cause liver damage and inflammation.
- Autoimmune system response: in some cases, the immune system mistakes the liver as a harmful object and begins to attack it. It is three times more common in women than in men (2).
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 the liver function.
However, signs and symptoms of acute hepatitis appear quickly. They include:
- flu-like symptoms
- dark urine
- pale stool
- abdominal pain
- loss of appetite
- unexplained weight loss
- yellow skin and eyes, which may also 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 examination by your doctor.
- Tests such as liver function tests, blood tests, ultrasound and a liver biopsy.
Treatment for Hepatitis:
Hepatitis A usually does not require treatment because it is a short-term illness. Rest and adequate hydration can help. In rare cases, Hepatitis A can be severe and lead to liver failure; however, the Hepatitis A vaccine is available to prevent this infection. Most children begin the vaccination between ages 12 and 18 months. Vaccination for Hepatitis A is also available for adults and can be combined with the Hepatitis B vaccine.
Hepatitis B and C:
Chronic Hepatitis B is treated with antiviral medications but can be prevented with a vaccination. The CDC (Centers for Disease Control and Prevention) recommends Hepatitis B vaccinations for all newborns (2). The vaccine is also recommended for all healthcare and medical personnel. In addition, it is recommended for all lay first aid providers and contact sports participants.
Hepatitis C is treated with antiviral medication.
To reduce your risk of spreading or catching Hepatitis A virus:
- Always wash your hands thoroughly after using the restroom.
- Avoid unclean food and water.
The best way to prevent Hepatitis B is by getting vaccinated, use a condom during intercourse and do not share needles.
For more information about hepatitis or hepatitis vaccines, especially for those that are travelling, please contact Campus Health Service to speak to a doctor or sister. Stellenbosch Campus: 021 808 3494/6, Tygerberg Campus: 021 938 9590
3. Baker L, de Frey AF. A guide to the practice of travel medicine in the South African context. 3rd ed. SASTM Publications. 2017; 8:98.