By Hauwa Ali
According to the World Health Orgainisation (WHO), the world is currently facing a new outbreak of unexplained acute hepatitis infections affecting children, adolescents and adults. In 2019 alone, an estimated 78 000 deaths occurred worldwide due to complications of acute hepatitis A to E infections.
The World Hepatitis Day is observed each year on 28 July to raise awareness of viral hepatitis, which leads to inflammation of the liver caused by a variety of infectious viruses that leads to severe diseases and liver cancer.
The theme of this year’s World Hepatitis day is: ‘Bringing hepatitis care closer to you’, which WHO say, highlights the need for bringing hepatitis care closer to the primary health facilities and communities so that people have better access to treatment and care, no matter what type of hepatitis they may have.
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, 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.
Hepatitis A Key facts
• Hepatitis A is an inflammation of the liver that can cause mild to severe illness.
• The hepatitis A virus (HAV) is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person through bodily fluids, including oral or anal sex.
• Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could die from fulminant hepatitis.
• The risk of hepatitis A infection is associated with a lack of safe water and poor sanitation and hygiene (such as contaminated and dirty hands).
• A safe and effective vaccine is available to prevent hepatitis A.
• Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease but it can cause debilitating symptoms and rarely fulminant hepatitis (acute liver failure), which is often fatal.
Hepatitis B Key facts
• Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
• The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments.
• WHO estimates that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections each year.
• In 2019, hepatitis B resulted in an estimated 820 000 deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
• Hepatitis B can be prevented by vaccines that are safe, available and effective.
• Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It is a major global health problem. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.
Prevention
A safe and effective vaccine that offers 98% to 100% protection against hepatitis B is available. Preventing hepatitis B infection averts the development of complications including chronic disease and liver cancer.
Hepatitis C Key facts
• Hepatitis C is an inflammation of the liver caused by the hepatitis C virus.
• The virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness to a serious, lifelong illness including liver cirrhosis and cancer.
• The hepatitis C virus is a bloodborne virus and most infection occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusions, injection drug use and sexual practices that lead to exposure to blood.
• Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. There are an estimated 3.2 million adolescents and children with chronic hepatitis C infection.
• WHO estimated that in 2019, approximately 290 000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).
• Antiviral medicines can cure more than 95% of persons with hepatitis C infection, but access to diagnosis and treatment is low.
• There is currently no effective vaccine against hepatitis C.
Hepatitis D Key facts
• Hepatitis D virus (HDV) is a virus that requires hepatitis B virus (HBV) for its replication.
• Hepatitis D virus (HDV) affects globally nearly 5% of people who have a chronic infection with hepatitis B virus (HBV).
• HDV infection occurs when people become infected with both hepatitis B and D simultaneously (co-infection) or get hepatitis D after first being infected with hepatitis B (super-infection).
• Populations that are more likely to have HBV and HDV co-infection include indigenous populations, recipients of haemodialysis and people who inject drugs.
• Worldwide, the number of HDV infections has decreased since the 1980s, due mainly to a successful global HBV vaccination programme.
• The combination of HDV and HBV infection is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and hepatocellular carcinoma.
• Hepatitis D infection can be prevented by hepatitis B immunization, but treatment success rates are low.
Hepatitis E Key facts
• Hepatitis E is an inflammation of the liver caused by infection with the hepatitis E virus (HEV).
• Every year there are an estimated 20 million HEV infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E.
• WHO estimates that hepatitis E caused approximately 44 000 deaths in 2015 (accounting for 3.3% of the mortality due to viral hepatitis).
• The virus is transmitted via the fecal-oral route, principally via contaminated water.
• Hepatitis E is found worldwide, but the disease is most common in East and South Asia.
• A vaccine to prevent hepatitis E virus infection has been developed and is licensed in China, but is not yet available elsewhere.
According to WHO, more than 350 Million globally live with viral hepatitis and every 30 seconds, someone dies of hepatitis related disease including liver failure, cirrhosis and liver cancer. How can the world beat this?
WHO estimated that about 80% of people living with hepatitis are unable to access or afford care even though there are tests, treatment and prevention tools available, but they are not affordable.
Governments must scale up the use of effective tools against hepatitis and make treatment more affordable, and to be most effective, hepatitis care must be delivered in communities through strong primary care.
Prevention is key in achieving a breakthrough in any disease. Hepatitis A and B vaccines are currently available and WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by 2 or 3 doses of hepatitis B vaccine at least 4 weeks apart to complete the vaccination series. Protection lasts at least 20 years and is probably lifelong.
Improved sanitation, food safety and immunization are the most effective ways to combat hepatitis other strains of hepatitis.
We can prevent the spread of hepatitis by taking hygiene seriously and making sure to take the available hepatitis vaccines, especially for children. We can all join the fight against hepatitis by playing our parts.
Together, we can beat hepatitis to its bearest minimum.