Hepatitis is a term used to describe liver inflammation. It is usually caused by a viral infection or liver damage induced by heavy alcohol consumption. Hepatitis A, B, C, D, and E are the five recognized hepatitis viruses. Crowded environments and poor sanitation exacerbate the transmission of Hepatitis A and E, which are spread through contaminated food or water intake. Sexual contact or exposure to contaminated blood are common modes of infection for Hepatitis B, C, and D viruses. 

A person dies every 30 seconds from a hepatitis-related sickness, therefore, even amid the current COVID-19 crisis, we must take action against viral hepatitis. To raise awareness of the global burden of viral hepatitis and to influence real change, the theme for World Hepatitis Day 2021 is, “Hepatitis Can’t Wait”.

Symptoms of hepatitis:

Acute (short-term) hepatitis often has no symptoms. If symptoms do appear, they may include the following:

  • Pain in muscle and joints
  • High temperature
  • Feeling and being ill
  • Unusually tired all the time
  • Loss of appetite
  • Stomach pain
  • Dark urine
  • Pale, grey-colored stool
  • Itchy skin
  • Jaundice (yellowing of the eyes and skin)

Chronic (long-term) hepatitis may sometimes go undetected until the liver stops functioning properly, and is only detected by blood tests. It can cause jaundice, swelling in the legs, ankles, and feet, confusion, and blood in your stools or vomit in the later stages.

Situation in Bangladesh and South-East Asia:

According to a World Hepatitis Alliance (WHA) statistical estimate from 2018 in the region of South-East Asia:

  • 39 million people are living with Hepatitis B.
  • Hepatitis C affects 10 million people.
  • 6.5 million symptomatic cases of hepatitis E and 400,000 cases of Hepatitis A are projected each year. 
  • In three countries: the Democratic People’s Republic of Korea, Myanmar, and Timor-Leste, the prevalence of chronic Hepatitis B is more than 8%.
  • Hepatitis C infection rates in the general population were estimated to be 2.7% in Thailand, 1.7% in Myanmar, 1.3% in Bangladesh, 1.3% in India, and 0.8% in Indonesia, 
  • Hepatitis A is present in 50% of individuals who inject drugs.

Diagnosis:

Your symptoms, a physical exam, and blood tests are used to diagnose Hepatitis A, B, and C. Imaging procedures such as a sonogram or CAT scan, as well as a liver biopsy, are sometimes used. A doctor will also do a physical exam and ask questions to determine whether or not a person has been exposed to hepatitis.

Prevention:

Depending on the type of hepatitis, there are different ways to prevent transmission

Hepatitis A

Hepatitis A is primarily transmitted by contaminated food and water. To prevent infection:

  • Thoroughly wash hands after using the restroom and before eating.
  • Ensure food is fully cooked and properly stored.
  • When traveling, exclusively drink bottled water
  • Avoid fruits and vegetables that were washed or produced in contaminated water.
  • If a person is traveling to a location where the virus is widespread, they should consult their doctor about the Hepatitis A vaccine.
Hepatitis B and C

To reduce the risk of transmission:

  • Any sexual partners with whom a person has had contact should be informed about any viruses they may have.
  • During intercourse, use a condom.
  • Only use clean, unused needles.
  • Brushes, razors, and manicure tools should not be shared.
  • Blood and organ donors have to be screened for hepatitis.
  • Hepatitis B and C screening should be done regularly for people who are at a higher risk.
  • Hepatitis B and C are also tested during pregnancy. Anyone who suspects they have Hepatitis should get medical care as soon as possible since a doctor can advise on limiting the risk of complications and avoiding spreading the virus.

The chance of developing Hepatitis B or C infection is increased in HIV patients. Because the body is less equipped to fight the illness, the consequences can be more severe.

We need to keep in mind that immunization can prevent Hepatitis A and B, but not C. Treatment is available for Hepatitis B and C, but not A

Chances of recovery:

The chances of recovery vary depending on the type of hepatitis:

  • Hepatitis A: This particular strain usually lasts two months with no long-term consequences. An individual will likely be immune for the rest of their life.
  • Hepatitis B: Most individuals recover in 90 days and are immune for the rest of their lives. 90 percent of newborns, 20% of older children, and 5% of adults have persistent infections. This can result in serious consequences such as liver cancer or cirrhosis.
  • Hepatitis C: It is a chronic infection that affects 75% – 85% of those infected, with 1% – 5% of those who develop life-threatening consequences. Treatment is available, however about 15% – 25% of those who are treated will recover.

Treatment

Hepatitis A does not have a specific treatment. In most cases of Hepatitis A, the liver recovers without causing long-term damage within six months. However, it is important to consult with your doctor every step of the way throughout your period of infection. To manage your health, you may need to:

  • Rest as much as possible – Many people who have Hepatitis A are fatigued, unwell, and have little energy.
  • Snacking throughout the day to manage nausea – Nausea can make it difficult to eat, so try snacking at different times of the day instead of eating full meals.
  • Avoid drinking alcohol – Your liver cannot process alcohol properly and may potentially cause more liver damage.
  • Use your medications – Inform your doctor about all of your prescriptions, including over-the-counter medications.

Similarly, for Hepatitis B and C infections, consult with your doctor to guide you on how to manage your health. Doctors recommend resting, plenty of fluids, and proper nutrition. Additionally, if the disease turns towards chronic infection, treatment may include:

  • Antiviral medications – Consult your doctor to determine which medicine is best for you. They can help you battle against the virus and reduce the infection’s capacity to harm your liver. These medications are given orally.  For Hepatitis C, the goal is to have no traces of the virus in your body for at least 12 weeks after finishing treatment. 
  • Liver transplantation – For serious complications, liver transplants may be an option. Hepatitis C is rarely cured by a liver transplant alone. The infection is likely to resurface. and will need antiviral treatment as advised by your doctor to protect the transplanted liver from further damage.

To defeat hepatitis, we need proper knowledge and education, precautions, vaccines, and practice healthy behaviors.

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