By Leandrae T. Lapinig
If current infection trends continue, the World Health Organization (WHO) warned viral hepatitis could kill more people than malaria, tuberculosis, and human immunodeficiency virus (HIV) combined by 2040.
Viral hepatitis is an inflammation of the liver that is caused by a variety of infectious viruses and noninfectious agents leading to a range of health problems, some of which can be fatal. There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E.
While they all cause liver disease, the United Nations health agency says they differ in important ways, including modes of transmission, severity of the illness, geographical distribution, and prevention methods.
In particular, types B and C lead to chronic disease in hundreds of millions of people, and together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths. An estimated 354 million people worldwide live with hepatitis B or C, and for most, testing and treatment remain beyond reach.
Worldwide scourge
Hepatitis causes liver damage and cancer and kills over a million people annually. Of the 5 types of hepatitis infections, hepatitis B and C cause most of the disease and deaths. An estimated 354 million people worldwide live with hepatitis B or C.
“Millions of people are living with undiagnosed and untreated hepatitis worldwide, even though we have better tools than ever to prevent, diagnose and treat it,” deplored Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
As stated earlier, there are 5 main hepatitis viruses, and they are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread.
“Hepatitis A and E are typically caused by ingestion of contaminated food or water,” the WHO said. “Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids.”
Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment, and, for hepatitis B, transmission from mother to baby at birth, from family member to child, and also by sexual contact.
What concerns health experts, however, is acute hepatitis. Symptoms include vomiting, diarrhea, or abdominal pain; jaundice (yellow discoloration of the eyes and skin); nausea; and pale stools.
“Typically, acute hepatitis passes without any serious immediate consequences. In some cases, acute hepatitis B or C infection may lead to chronic infection and cause scarring, loss of function, or cancer,” the WHO said.
Acute hepatitis is a more serious condition in adults than children. “Adults show signs and symptoms of illness more often than children, and the severity of disease and fatal outcomes are higher in older age groups,” the WHO said.
Hepatitis B and C
Let’s take a closer look at the two viruses that cause B and C. The hepatitis B virus (HBV) can survive outside the body for at least 7 days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine.
The incubation period of the HBV ranges from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B, especially when transmitted in infancy or childhood.
In highly endemic areas, HBV is most commonly spread from mother to child at birth (perinatal transmission) or through horizontal transmission (exposure to infected blood), especially from an infected child to an uninfected child during the first 5 years of life.
The WHO said hepatitis B is also spread by needlestick injury, tattooing, piercing and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal, and seminal fluids.
“Transmission of the virus may also occur through the reuse of contaminated needles and syringes or sharp objects either in health care settings, in the community or among persons who inject drugs,” the WHO warned. “Sexual transmission is more prevalent in unvaccinated persons with multiple sexual partners.”
Hepatitis B is preventable with a vaccine. However, there is no vaccine for hepatitis C, although it can be treated with antiviral medications.
Early detection and treatment can prevent serious liver damage and improve long-term health. “Acute hepatitis C infections are usually asymptomatic and most do not lead to a life-threatening disease,” the WHO said. “Around 30% (15–45%) of infected persons spontaneously clear the virus within 6 months of infection without any treatment.”
The remaining 70% (55–85%) of persons will develop chronic HCV infection. Of those with chronic HCV infection, the risk of cirrhosis ranges from 15% to 30% within 20 years.
Hepatitis C is spread through contact with infected blood. This can happen through sharing needles or syringes, or from unsafe medical procedures such as blood transfusions with unscreened blood products.
The WHO said hepatitis C is not spread through breast milk, food, water, or casual contact such as hugging, kissing, and sharing food or drinks with an infected person.
Fortunately, hepatitis C can be cured. “However, only 21% of people living with hepatitis C infection are diagnosed and only 13% have received curative treatment,” the WHO said. “Just 10% of people living with chronic hepatitis B are diagnosed, and only 2% of those infected are receiving the lifesaving medicine.”
Despite there being a vaccine and effective treatment for hepatitis B and a cure for hepatitis C, the UN health agency said only few countries in the world are on track to achieve the WHO target of eliminating viral hepatitis by 2030.
In a statement, the WHO said it “remains committed to supporting countries to expand the use of those tools, including increasingly cost-effective curative medication, to save lives and end hepatitis.” – ###
