Most people at some point in their life will find themselves at risk of contracting a highly infectious disease that affects hundreds of millions of people, killing close to 1.4 million per year – yet many remain unaware of the threat!
The 28th of July is World Hepatitis Day, which is observed every year to raise global awareness of this infectious disease.
The latest World Health Organisation (WHO) data reveals that an estimated 325 million people worldwide are living with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. It reckons that 6.1% of the population of Africa are infected with HBV – that’s 60 million people – one of the highest infection rates in the world. The WHO Global hepatitis report 2017 indicates that most of these people lack access to life-saving testing and treatment. Many are unaware that they have hepatitis. As a result, millions of people are at risk of a slow progression to chronic liver disease, cancer, and death.
The Independent Community Pharmacy Association (ICPA) offers the following advice on what Hepatitis is, who is at risk and how to protect yourself from this prevalent disease.
What is hepatitis?
Hepatitis is an inflammatory disease of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis, or liver cancer. The most common cause of hepatitis is due to infection by one of the hepatitis viruses but it can be caused by other infections, medications, alcohol, toxic substances and certain autoimmune diseases.
The liver is located in the right upper area of your abdomen and 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
What are the different hepatitis viruses?
There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. Types B and C lead to chronic disease and are the most common cause of liver cirrhosis and cancer.
How is it caused/spread?
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur through contact with infected body fluids.
What are the symptoms of hepatitis?
Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
Hepatitis A virus (HAV) is present in the faeces of infected people and is most often transmitted through the consumption of water or food contaminated with faecal matter. Certain sexual practices can also spread HAV. In many cases these infections are mild and most people make a full recovery and are then immune from further HAV infections. However, HAV infections can also be severe and life threatening. The good news is that safe and effective vaccines are available to prevent HAV.
Hepatitis B virus (HBV) is transmitted through exposure to infected blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from an infected family member to an infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through the sharing of needles by intravenous drug abusers. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. As with hepatitis A, safe and effective vaccines are available to prevent HBV.
Hepatitis C virus (HCV) is mostly transmitted through exposure to infected blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through drug use that involves needles. Sexual transmission is also possible, but is much less common.
Hepatitis D virus (HDV) infections occur only in those who are infected with hepatitis B. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.
Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed.
Treatment and protection from hepatitis
Treatment options vary depending on which type of hepatitis you have. You can prevent some forms of hepatitis through immunizations and lifestyle precautions.
Jackie Maimin, CEO of ICPA, says that people can protect themselves from hepatitis by doing the following:
- Avoid contact with blood and body fluids by wearing gloves when touching or cleaning up other people’s blood, vomit or other body fluids;
- Don’t share razors, toothbrushes, pierced earrings, or other personal items with anyone;
- Use condoms if you have multiple sexual partners, or when having sex with an infected person;
- Don’t share chewing gum;
- Make certain any needles or other sharp implements for drugs, ear piercing, manicuring or tattooing are properly sterilized;
- Be careful about the water you drink when travelling abroad.
“Vaccination against Hepatitis B forms part of the Expanded Programme of Immunisation for infants and has very effectively lowered the rate of new infections in children. All children should receive the 3 recommended doses of hepatitis B vaccine. If you are planning to travel to a country with poor sanitation we recommend that you protect yourself against Hepatitis A by getting vaccinated as soon as you start planning the trip,” says Maimin. “Hepatitis A vaccination consists of 2 injections spaced 6 months apart.”
“Safe and effective vaccines against most of the different types of hepatitis are available and you can visit your local pharmacy to ask for advice and guidance if you think you may be at risk,” advise the ICPA.