VIRAL HEPATITIS IS PREVENTABLE

A reader of this column sent this, “I am 35 years; I just found out I have hepatitis B virus. I never used drugs and I don’t drink. I’m so afraid right now, and I can’t stop crying. I don’t have a clue as to how I contracted it. The different tests listed by my doctor scare me. Dear doctor, kindly advise me’’.

My response as an expert goes to everyone that has tested positive to hepatitis B or C virus. They should be optimistic, as some people have been able to flush out the virus from their system within six months.

The tests are just the beginning of treatment, be patient with your doctor so that proper diagnosis could be done after which treatment follows.

The United States Centres for Disease Control and Prevention has declared the month of May as Hepatitis Awareness Month and May 19 as Hepatitis Testing Day in some countries.

The day provides an opportunity to remind the public and health care providers about the essence of hepatitis testing. Millions of Nigerians have chronic hepatitis, most of whom do not know that they are infected.

Viral hepatitis

Hepatitis is an inflammation of the liver. It can be caused by alcohol, drugs, bacteria, viruses and other toxins.

Viral hepatitis refers to hepatitis resulting from infection of the liver by viruses. These include the hepatitis A, B, C, D and E. The most common forms of viral hepatitis are hepatitis A, hepatitis B and hepatitis C.

Hepatitis A is acute, with no long-term effects. Hepatitis can be acute or long-term (chronic). An acute infection will last only a short time. Although symptoms could be severe, most people recover from the illness within six months with no lasting effects.

Chronic hepatitis is ongoing, and can last for the rest of a patient’s lifetime. Having chronic hepatitis B may lead to permanent liver damage, including liver cirrhosis and cancer. Hepatitis C, if left untreated, can be life threatening.

Transmission

Hepatitis A

It usually spreads through food or water. Food can be tainted when it is touched by a person with hepatitis who does not wash his hands after using the bathroom. This transfers tiny amounts of infected stool to the food.

Raw shellfish, fruits, vegetables and undercooked foods are common means of hepatitis A outbreak. The virus can also spread in daycare centres if employees are not careful about hand washing after changing diapers.

Hepatitis B

It is spread by contact with the blood or body fluids of an infected person or through unprotected sex. It is also possible to get hepatitis B by sharing an infected person’s needles, razors or toothbrush. An infected mother can pass the virus to her baby during childbirth. Hepatitis B is not spread by hugging, sharing of food or coughing.

Hepatitis C: It spreads through infected blood. Sharing needles or other items used to inject drugs is the most common cause of infection. Getting a tattoo or body piercing with an infected needle is another means of exposure. A mother may pass the virus to her child at birth.

Signs and symptoms

People with chronic infection may or may not have symptoms. Those who do not develop symptoms are referred to as carriers.

Symptoms are fatigue, tiredness, unexplained weakness, flu-like symptoms, dark urine, pale stool, abdominal pain, loss of appetite, unexplained weight loss, yellow skin and eyes, which may be signs of jaundice.

Treatment

Treatment of acute hepatitis B is supportive measure in most cases. It consists of bed rest, nutritional support and symptomatic management such as simple analgesia and anti-nausea medication. The treatment of chronic HBV can be life-long. It is explained here:

General (lifestyle modification): Alcohol consumption should be ceased; cigarette smokers should be advised to quit; weight reduction with sound nutritional advice is ideal. Patients should be encouraged to eat plenty of vegetables, legumes and fruits. They should also eat plenty of cereals, preferably whole grain, lean meat, fish, poultry, milk, yoghurt, cheese and drink water regularly.

Medication: Anti-viral drug treatment is used to manage HBV infection. Some individuals have been able to achieve cure. The long-term aim of treatment is to arrest or reverse the progression of liver damage, with the ultimate goal of preventing cirrhosis, cancer of the liver and liver failure.

Newborn treatment: The concurrent administration of two injections – hepatitis B immunoglobulin and hepatitis B vaccine – to newborn immediately after birth is effective in preventing vertical transmission of the virus. If the neonate has taken the two ‘injectables’, mother with HBV infection can breastfeed safely.

Preventions

Hepatitis A and Hepatitis B can both be prevented with vaccines. Hepatitis A vaccine is recommended for all children and for adults who may be at increased risk. Hepatitis B vaccine is recommended for all infants at birth and for adults who may be at risk. For an individual that has already acquired hepatitis B, it is too late to vaccinate against HBV, but further liver injury by another virus — hepatitis A — can be prevented.

Sexual partners of HBV positive persons should be counselled to guard against exposure to infectious body fluids such as semen and vaginal secretions, by using condoms during sex. They can also receive full immunisation against hepatitis B virus.

I plan to conduct a seminar on World Hepatitis Day, which comes up on July 28. Save the date!