DEFINITION OF HEPATITIS
- Hepatitis is simply the inflammation of the liver
- Hepat (liver) + itis (inflammation)= Hepatitis
- Viral hepatitis means there is a specific virus that is causing the liver to inflame (swell or become larger than normal)
THE LIVER
The Liver Is located in the upper right quadrant of the abdomen
FUNCTIONS OF THE LIVER
- Cleans the blood
- Regulates hormones
- Helps with blood clotting
- Produces bile
- Produces important proteins
- Maintains blood sugar levels
- And much, more
Note that the liver is essential to life.
TYPES OF Viral Hepatitis/ MODE OF TRANSMISSION
There are different types of Hepatitis which are A, B, C, D, and E, but the commonest is Hepatitis B and C. Hepatitis C is common among European countries. In Nigeria, we have more of B and C.
Each type of Hepatitis is transmitted as listed below.
A: through Fecal-oral transmission
B: through sexual fluids & blood to blood
C: through blood to blood
D: through travels with B
E: through fecal–oral transmission
Natural History of Hepatitis
It is important to note that Only 20% will show symptoms Initially when infection.
Healthy Liver – Acute Infection – Chronic Infection -Chronic Hepatitis – Cirrhosis – Liver Cancer
Note: 80% Virus during the chronic stage Continues to Damage Liver
HEPATITIS-A VIRUS (HAV)
- Transmitted through contact with faecal matter containing the virus, ingestion of contaminated food or water
- Causes acute hepatitis; symptoms include
- fever
- malaise
- anorexia
- nausea
- abdominal pain
- dark urine
- jaundice
SIGNS AND SYMPTOMS OF HAV
- Signs and symptoms usually last <2 months
- 10% to 15% of those infected have prolonged or relapsing disease (lasts 6-9 months)
Once recovered, those who have had HAV are immune to the disease.
RISK FACTOR
- Incarceration (3%)
- Transfusion/dialysis blood contact (4%)
- Hospitalization dental work (6%)
- Tattooing piercing (6%)
- HCV-infected household member/sexual partner (7%)
- IDU/snorting (51%)
HEPATITIS B (HBV)
- Most common hepatitis virus
- A DNA virus from the Hepadnaviridae family
- Transmitted through exposure to infected blood and body fluids
- perinatal
- percutaneous
- sexual
- WHO- 2b people worldwide have been infected with Hepatitis B
- 600,000 die every year from the disease
- > 240m develop chronic liver infections from it.
- Nigeria-nearly 2/3 of the population have contact with the virus
- while about 20% of the population is infected, with a good number unaware of it
Symptoms occur in about 70% of patients within 9-21 weeks after exposure to HBV, and include
- fever
- malaise
- anorexia
- nausea
- abdominal pain
- dark urine
- jaundice
HEPATITIS C VIRUS (HCV)
- A single-stranded ribonucleic (RNA) virus.
- Not much is known and written/published about this virus in Nigeria.
- 6 major subtypes; with genotype 1 responsible for more than 70% of infections in U.S.
- Most common bloodborne infection in the U.S.
- There is no vaccine for HCV
- 8% of Americans (3.9 million) infected with HCV; most (2.7 million) are chronically infected (50-80% of those infected) (CDC, 2006)
- 80% of those infected are asymptomatic
- 50-80% of immunocompetent people who become infected become chronically infected
- Among the chronically infected
- 60% to 70% develop chronic hepatitis
- 10% to 20% develop cirrhosis over a period of 20-30 years
- 1% to 5% develop HCC
- End-stage liver disease (ESLD) and HCC cause between 10,000 and 12,000 deaths per year in the U.S.
SOURCES OF INFECTION WITH HCV
- 60% of cases due to past or current IDU
- 60% to 80% of IDUs injecting drugs for at least 5 years are HCV infected vs. 30% of them HIV infected
- Risk of HCV transmission through sexual exposure is low
- However, general population’s frequency of sexual behaviors, plus prevalence of HCV, explains the high proportion (15%) of HCV transmitted through sexual exposure.
- 5% of cases due to
- exposures from hemodialysis
- employment in the health care field
- birth to an HCV-infected mother
- 10% of cases have no recognized source of infection
FACTORS AFFECTING PROGRESSION
- 30yrs or longer if:
- Young at time of infection
- Healthy liver at time of infection
- Female
- 20yrs or less if:
- Drinking alcohol
- Co-infection (HIV, Hep B)
- Damaged liver before infection
SIGNS AND SYMPTOMS
- A few may have specific liver related symptoms initially:
- Pale stool
- Jaundice (yellowing of the skin or eyes)
PREVENTION
The recommendations in the WHO guidelines on the prevention, care and treatment of infection due to hepatitis C virus (HCV) and B virus is to promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of nucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which was updated in 2015.
These recommendations provide opportunities to save lives, improve clinical outcomes of persons living with CHB, reduce HBV incidence and transmission, and stigma due to disease.
- Treatment of acute viral hepatitis and chronic viral hepatitis are different.
- Treatment of acute viral hepatitis involves relieving symptoms and maintaining adequate intake of fluids.
TREATMENT FOR HEPATITIS B &C
- Antiviral medications including entecavir (baraclude), Tenofovir (Viread), lamivudine (Epivir), Adefovir (Hepsera) and telbivudine (Tyzeka) these can fight the virus and slow its ability to damage your liver. For the treatment of HCV. Doctors recommend the combination of sofosbuvir and ribavirin to treat genotype 2 hepatitis C.
- Lifestyle Drug: Avoid alcohol.
- Surgery: Liver transplant
FREQUENTLY ASKED QUESTIONS
- Does Hepatitis C vaccine preventable?
Ans Hepatitis C is treatable but not vaccine preventable.
- Does Hepatitis B have drugs for curative?
Ans Hepatitis B is managed and it is vaccine preventable.
Above all, the first step is knowing your status is to get tested.
So, Get tested Hepatitis is deadlier than HIV.
SERVICES AVAILABLE
- Rapid diagnostic testing for Hepatitis B and C
- Vaccination for Hepatitis B only among adults
- We refer for comprehensive treatment to accredited Gastroenterologists.
- We monitor and follow client treatment.
How to reach us:
- Reach us at EF-DIC facility
- Contact our Community health outreach services providers for home care services by filling the form below or call our hotline or send us an email message.
Our Vision is to attain sustainable human society.