Could you have hepatitis and not know it?

According to the World Health Organisation, Africa has one of the highest hepatitis infection rates in the world. Sadly, many people are unaware they have it.

Hepatitis affects 60 million people in Africa. Worldwide, an estimated 325 million people are living with chronic hepatitis-B virus (HBV) or hepatitis-C virus (HCV) infections.

What makes this particularly concerning is that many are unaware that they have hepatitis and are at risk of a slow progression to chronic liver disease, cancer and even death.

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 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, medication, alcohol, toxic substances and certain autoimmune diseases.

What are the different hepatitis viruses?

There are five 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.

  • 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 infection. 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 injuries while caring for HBV-infected 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 recognised as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed.
    How is it caused and 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.

Treatment and protection from hepatitis

Treatment options vary depending on which type of hepatitis you have. You can prevent some forms of hepatitis through immunisation and lifestyle precautions.

Jackie Maimin, CEO of Independent Community Pharmacy Association (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 with anyone
  • Make certain any needles or other sharp implements – for drugs, ear piercing, manicuring or tattooing – are properly sterilised
  • Be careful about the water you drink when travelling abroad
  • Have your family vaccinated

“Vaccination against Hepatitis B forms part of the Expanded Programme of Immunisation for infants and has very effectively lowered the rate of new infection in children. All children should receive the three recommended doses of hepatitis B vaccine,” says Maimin.

“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. Hepatitis A vaccination consists of two injections spaced six months apart.”

Safe and effective vaccines against most of the different types of hepatitis are available. The ICPA advises you to visit your local pharmacy and ask for advice and guidance if you think you may be at risk.

Source: Independent Community Pharmacy Association


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