Hepatitis – Beyond A, B, and C

World Hepatitis Day takes place every year on 28 July, with the aim of bringing the world together under one single theme to raise awareness of viral hepatitis and the impact it has worldwide. The theme for World Hepatitis Day 2018 is “Eliminate Hepatitis”.

Hepatitis B virus and hepatitis C virus are the leading cause of liver cancer in the world, yet more than 80% of those affected with viral hepatitis are unaware of their status.

There are many effective vaccines available for hepatitis B and treatment options available for hepatitis B and C. Eliminating viral hepatitis is highly achievable. According to the World Health Organization’s Global Strategy of Viral Hepatitis, the goal is to do so by 2030.

What is Hepatitis?

Hepatitis is inflammation of the liver, caused by injury or infection. There are several causes of hepatitis, including viruses, bacteria, natural toxins (such as those found in the Amanita phalloides mushroom), industrial toxins, drug (medication) toxicity, and autoimmune diseases.

Types of hepatitis

Viral hepatitis

By far the most well-known, and one of the leading public-health problems worldwide, is viral hepatitis. There are several different types of viruses that cause hepatitis, and they are transmitted through different means. The common hepatitis viruses are designated A, B, C, D, and E. A hepatitis G virus has been identified, but its clinical significance (whether it causes disease by itself, and if so to what extent) is unknown at this time.

Toxic / Drug-induced hepatitis

Drug induced, or toxic hepatitis, is caused by exposure to a substance toxic to the liver, often as a result of medication overdose or a reaction to medication. A common drug component that can cause drug-induced hepatitis is acetaminophen, a pain reliever that is best known as the active ingredient in Tylenol®. For this and many other reasons, it is extremely important to follow your doctor’s instructions, or the manufacturer’s guidelines, when taking any medication, including over-the-counter (OTC) medicines.

Autoimmune hepatitis

Autoimmune hepatitis is caused by the body’s immune system attacking the liver. Approximately 70% of people with autoimmune hepatitis are women. Researchers think there is a genetic predisposition for this condition.

Hepatitis can be acute, meaning it happens suddenly and lasts from several weeks to several months, but full recovery follows. Sometimes, the condition becomes permanent, and the liver is constantly inflamed. This is chronic hepatitis, which can lead to serious consequences such as liver cirrhosis, liver cancer, and premature death.

What are the symptoms of hepatitis?

Not all cases of hepatitis show symptoms. This is especially true in young children who are infected with the hepatitis A virus, and the majority (~80%) of people infected with the hepatitis C virus. When symptoms do exist, they include:

  • Fatigue
  • Muscle aches
  • Nausea and vomiting
  • Dark urine
  • Abdominal cramps or discomfort
  • Jaundice (yellow skin and whites of the eyes)

Symptoms range from mild to severe. Mild symptoms can be mistaken for other illnesses, such as the flu. If you have reason to suspect hepatitis, talk to your doctor and get tested.

How is hepatitis transmitted?

The mode of transmission depends on the type of hepatitis:

  • Autoimmune and drug-induced hepatitis are not contagious.
  • Viral hepatitis A and E can be transmitted through contaminated food and water, and in unsanitary conditions.
  • Hepatitis B and C viruses are transmitted through blood and other bodily fluids.
  • The hepatitis D virus is transmitted through blood, but requires the presence of hepatitis B in the non-infected person to cause an infection.

How can I protect myself against hepatitis?

The easiest way to protect yourself is to practice good hygiene and take care of your body:

  • Wash your hands frequently, especially after using the restroom or before handling food.
  • Avoid excessive alcohol drinking (alcohol can cause toxic hepatitis)
  • Always follow dosage guidelines when taking any medications, prescription, or OTC.
  • Avoid illegal drugs, especially the injectable type. Needles and other shared drug paraphernalia can have contaminated bodily fluids on them.
  • Practice safe sex – multiple sex partners increase your risk of exposure. Use latex condoms if you have multiple partners.
  • Do not share personal items that may have bodily fluids on them (razors, toothbrushes, etc.)
  • Get vaccinated – vaccines are available against Hepatitis A and B. And because hepatitis D infection cannot occur without hepatitis B, a hepatitis B vaccine will protect you against both B and D types.
  • Pregnant women who are infected should talk to their doctors about reducing the risk of transmission to their baby.
  • Healthcare workers should always practice universal precautions.

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