28 July is World Hepatitis Day, which aims to promote better awareness and understanding of viral hepatitis, and ultimately seeks a world free from the disease. Every year 1.4 million people die from viral hepatitis but many of these deaths could be avoided.
Hepatitis is an inflammation of the liver. There are five different types of viral hepatitis – hepatitis A, B, C, D and E – and each is caused by a different virus that can lead to acute (short-term) or chronic (long-term) infection. This inflammation can cause scarring, liver failure or liver cancer – in fact, hepatitis causes around 80% of all liver cancer cases worldwide.
Hepatitis is one of only four diseases that has its own WHO global campaign day, (along with AIDS, malaria and tuberculosis), highlighting the scale of the problem it poses for public health. 28 July was chosen as the date for World Hepatitis Day in honour of Baruch Blumberg, who won the Nobel Prize for identifying the hepatitis B virus and also developed a vaccine for the disease.
Early symptoms of viral hepatitis can be similar to the flu, including muscle/joint pain, fever, nausea, vomiting and headache. However, in many cases, symptoms are not noticeable, meaning people can be unaware they have been infected.
Hepatitis A and E are usually acute infections that most people fight off within a few months. Hepatitis B, C and D can develop into chronic infections that can last for many years. If this happens, symptoms include extreme fatigue, depression and jaundice (yellowing of the skin and eyes).
Transmission and prevention
The different types of hepatitis are spread in different ways. Ingesting food or water that has been contaminated by the faeces of an infected person is the usual route for hepatitis A and E infections. As such, good hygiene and sanitation, as well as avoiding potentially unsafe drinking water, can reduce the risk of infection.
Hepatitis B and C are spread through contact with infected blood (and, in the case of B, other bodily fluid like saliva or semen). They can also be passed down from mother to child during childbirth. Hepatitis D is also spread through blood contact, but can only be caught by people already infected with hepatitis B, as the latter allows the former to survive in the body.
Using condoms and avoiding sharing needles, toothbrushes and razors with infected people can prevent infection by these forms of hepatitis. Demanding safe practice and sterile equipment during health procedures or when getting tattoos and piercings is also recommended.
In England, 90% of cases of hepatitis C are caused by sharing needles to inject drugs. The hepatitis C virus can also survive outside the body for up to 3 weeks, meaning it can be transmitted through contact with environmental surfaces as well.
Vaccines and treatment
Vaccines to prevent infection from hepatitis A and B are widely available. While there is currently no vaccine to prevent hepatitis C, testing is quick and painless, and new treatments can cure around 85% of cases. Drug users are particularly at risk from hepatitis, but social stigma often prevents them getting diagnosed and treated.
Hepatitis B cannot be cured but it can be treated with interferons and antivirals, which can sometimes clear the infection. Hepatitis A and E are often fought off by the body within a few weeks.
The overwhelming majority of deaths from hepatitis are caused by the hepatitis B and C viruses. Advances in medicine mean we are now able to protect children from hepatitis B for life, treat people who are infected with hepatitis B, and cure hepatitis C. In spite of this, over a million people every year die unnecessarily from infection.
As this year’s World Hepatitis Day tagline suggests, viral hepatitis can be prevented – but many are unaware how. Giving people the information they need, and providing them with appropriate sanitation and healthcare, could prevent millions of unnecessary deaths worldwide.