Viral Hepatitis

MHB Viral Hepatitis

Viral Hepatitis – Overview

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Hepatitis is an inflammation of the liver caused by a variety of infectious viruses and non-infectious agents leading to a range of health problems which could result in fatality. There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E and they all cause liver disease. However, they differ in significant ways such as modes of transmission, severity of the illness, geographical distribution and prevention methods.

Viral hepatitis B and C leads 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.

According to World Health Organization (WHO), about 354 million people worldwide live with hepatitis B or C, and for most, testing and treatment remain beyond reach and in 2019, approximately 290 000 people died from hepatitis C.

Viral Hepatitis types are contacted through ingestion of contaminated food or water, unsafe contact with infected body fluids, receipt of contaminated blood or blood products, Mother-child transmission, sexual contact etc. Symptoms may be mild or severe at the onset of the infection.

Some types of hepatitis are preventable through vaccination while there is currently no effective vaccine against hepatitis C. Hepatitis if not treated with caution at the early stage will progress to cirrhosis and other chronic conditions of the liver.

WHO’s global hepatitis strategy, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.

 

 

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Signs and symptoms of Hepatitis

You may be surprised that a lot of persons even with the emergence of the spread of hepatitis are still oblivious to this viral infection. In Nigeria, about 15 million people are unaware that they are infected with hepatitis. Some still believe it to be an illness of the bourgeoisie in the society and so are immune. However, this is not the case.
Viral hepatitis is responsible for over 1.34 million deaths each year, more than HIV/AIDs, Malaria or Tuberculosis. It is also responsible for two of every three liver cancer deaths according to World Health Organization.
Different types of viral hepatitis A, B, C, D, and E are caused by a different type of virus. Hepatitis A Virus (HAV) is always an acute, short-term disease, while Hepatitis B Virus (HBV), C (HCV), and D (HDV) are most likely to become ongoing and chronic. Hepatitis E Virus (HEV) is usually acute and is considered particularly dangerous in pregnant women.
Unlike the infectious forms of hepatitis that are chronic and whose symptoms do not appear in the beginning until the damage affects liver function, like hepatitis B and C, the symptoms of the acute forms of hepatitis do appear quickly and they include: fatigue, flu-like symptoms; dark urine; pale stool; abdominal pain; loss of appetite; unexplained weight loss; yellow skin and eyes among others.
A lot of persons die slowly from chronic hepatitis because its symptoms are often too subtle to notice but with regular checkups, proper vaccination and timely treatment, we just could outsmart this silent killer.
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BREASTFEEDING WITH HEPATITIS B INFECTION

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV) which is transmitted by blood, semen or other body fluid from an infected person. A pregnant woman with hepatitis B can infect the fetus through the placenta especially in cases of preterm labour, depending on the mother’s viral load. At birth and during breastfeeding, infants may also be infected with the virus through contact with blood and body fluids.

According to World Health Organization, Breastfeeding has been suggested as an additional mechanism by which infants may acquire HBV infection, because small amounts of Hepatitis B surface antigen (HBsAg) have been detected in some samples of breastmilk. This study also found no association between maternal e-antigen status and transmission rates. In other words, any risk of transmission associated with breastmilk is negligible compared to the high risk of exposure to maternal blood and body fluids at birth. This is because breast pathology such as cracked or bleeding nipples or lesions with serous exudates could expose the infant to infectious doses of HBV.
 
To avoid any form of HBV transmission from mother to child. Center for Disease Control (CDC) opined that all infants must receive hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth. The second dose of vaccine should be given at age 1–2 months, and the third dose at age 6 months. This includes infants born to HBV-infected mothers. The infant should be tested after completion of the vaccine series at age 9–12 months, to determine if the vaccine worked and that the infant is not infected with HBV through exposure to the mother’s blood during the birth process.
 
In conclusion, the risk of HBV mother-to-child transmission through breastfeeding is negligible if infants born to HBV-positive mothers receive the HBIG/HBV vaccine at birth. Hence, hepatitis B infected mothers can breastfeed the babies provided the necessary precautions are taken. There is no need to delay breastfeeding until the infant is fully immunized.
 
Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health related articles on all our social media platforms.

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VIRAL HEPATITIS 

Hepatitis is a viral infection that affects human and destroys liver cells. Got the name “Hepa” from the word “liver”. According to the World Health Organization (WHO), after tuberculosis, the second major killer infectious disease is Hepatitis. The different strains of hepatitis viruses are Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Hepatitis D Virus (HDV), and Hepatitis E Virus (HEV).

HBV and HCV are mainly transmitted via infected blood or body fluids and they cause severe damage to the liver. HAV and HEV on the other hand, are transmitted orally through contaminated food or water, while HDV can only infect people who are already infected with Hepatitis B virus.

Hepatitis B virus which is the most common type of hepatitis viruses is not yet curable but preventable via the use of vaccine. The primary treatment goal for patients with HBV infection is to prevent progression of the disease, particularly to cirrhosis, liver failure, and hepatocellular carcinoma (HCC). The use of antiviral treatment such as PEGylated interferon (PEG-IFN) or nucleotide analogues are used to prevent HCC.

For HCV, with the use of antiviral agents (>95%) Spontaneous resolution of acute HCV, infection may occur in 15% to 50% of patients hence, monitoring for spontaneous clearance for a minimum of 6 months before initiating treatment is recommended. Patients with acute HCV infection appear to have an excellent chance of responding to 6 months of standard therapy with Interferon (IFN). However, IFN-sparing regimens are safer and are currently recommended for the treatment of acute HCV infection as with chronic HCV infection. Treatment of chronic HCV infection has two goals. The first is to achieve sustained eradication of HCV which is defined as the persistent absence of HCV RNA in serum 12 weeks after completing antiviral treatment. The second goal is to prevent progression to cirrhosis, hepatocellular carcinoma (HCC), and decompensated liver disease requiring liver transplantation.

Hepatitis A is also preventable especially in individuals with chronic liver damage with the use of Hepatitis A vaccine. A synergistic approach of suppressing viral load and boosting the patient’s immune response with immunotherapeutic interventions is needed for the best prognosis.

According to WHO, 325 million people are living with HBV and HCV, 900,000 annual deaths caused by HBV infection, 90% of people living with HBV, and 81% of people living with HCV are unaware of their status. World Hepatitis Day, observed on July 28 every year aims to raise global awareness of Hepatitis and encourage prevention, diagnosis and treatment. Most strains of hepatitis viruses are not curable but preventable by the use of vaccines aside HCV. Hence, screening of Individuals and vaccination of the unaffected population is important in reducing the spread of the Infection.

Monday Health Burst is an initiative of Centre for Family Health Initiative to tackle issues of basic health concerns. Join us every Monday for more health related articles on all our social media platforms.

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