Chronic hepatitis B can develop into a serious disease resulting in long-term health problems such as liver damage, liver failure, liver cancer and even death. DR CHRISTOPHER OPIO, a consultant gastroenterologist at Aga Khan University Hospital, discusses a few things you should know about viral hepatitis.

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Hepatitis is an inflammation of the liver, a vital organ that processes nutrients, filters the blood and fights infections. When the liver is inflamed or damaged, its functions can be affected. 

Hepatitis is commonly caused by a viral infection, but toxins, certain drugs, heavy alcohol use and bacterial infections, can also cause hepatitis.

Every 30 seconds, someone dies from a viral hepatitis-related illness. More than 350 million people live with viral hepatitis and nine in 10 people are unaware of their diagnosis.

Viral hepatitis can be fatal

Viral hepatitis types A, B, C, D and E can cause infection and subsequent liver inflammation that can lead to serious diseases, such as liver cancer or even death.

However, people who contract hepatitis A and E usually recover with supportive care.

In the case of the B, C, and D viruses, the infection can become chronic and some patients may die of liver cancer or cirrhosis. However, if the infection is detected in time, it can be treated.

Patients with the hepatitis C virus can recover completely.

There are vaccines that protect against viral hepatitis A, B, D and E.

A nurse loads a syringe with a vaccine against hepatitis in Lynwood, California on Aug. 27, 2013

HAV and HEV are transmitted through faecal material and orally; water and food.

Viral hepatitis A and E are often transmitted through unsafe water, contaminated food and poor sanitation.

HBV and HDV is mainly MTC transmission, blood borne -body fluids, like sexually HCV blood borne – transfusions and injections.

The hepatitis B virus is 10 times more infectious than HIV because of its high viral levels in blood.

Only patients with chronic hepatitis B and liver injury need to be treated.

However, all patients with chronic hepatitis B need to be followed up for life because of the risk of liver damage and liver cancer.

When one starts treatment, it is usually for life (for chronic hepatitis B).

A pregnant woman who has hepatitis B can transmit the virus to her child during birth. Therefore, administering the hepatitis B vaccine to newborns during the first 24 hours after birth is the most effective measure for protecting babies.

Some mothers may be offered drugs for hepatitis B if they have high viral levels since the vaccine alone may not be sufficient in preventing mother to child transmission.

Sharing syringes or razors

Viral hepatitis B, C and D can be transmitted through the body fluids of an infected person. Therefore, people who inject drugs have a high risk of infection, since they sometimes share syringes.

To avoid the risk of infection, do not share razors, syringes or unsterilised instruments used for tattooing or piercing.

Health services should always use safe syringes.

Screening for hepatitis B, C

Before the 1990s, blood transfusions were not screened to detect viral hepatitis. It is recommended that all people over the age of 40 be given a blood test to determine if they are carriers of the virus.

People who have received a blood transfusion in a country that does not screen for viral hepatitis should also be tested.

Hepatitis C can lead to cirrhosis

The hepatitis C virus can survive in a person’s blood for up to 20 years without apparent symptoms, until it causes inflammation and damage to the liver. This can develop into chronic hepatitis, cirrhosis or liver cancer. 

The good news is that hepatitis C can be cured. Today, there are effective medicines that allow patients to make a full recovery in three months.

Advice for adults

A healthy diet is recommended for adults. 

Breakfast, lunch and supper should comprise of 50% of plate vegetables and fruits, 25% animal and plant proteins, 24% carbohydrates and less than 1% healthy fats.

Also drink enough water/fluids of about 2.5 to 3 litres per day for adults.

What worsens liver damage due to viral Hepatitis?

▪️ Alcohol use
▪️ Non-alcoholic liver disease
▪️ Herbal remedies and toxins (alflatoxins)
▪️ Certain medications
▪️ Certain infections and diseases
▪️ HIV
▪️ Patients with cancer on treatment
▪️ Schistosomiasis