|
The ABCs
of Hepatitis
Today is World Hepatitis Day
By Dr. Upali Weragama
As countries across the globe mark
October 1 as the third annual World Hepatitis (viral
Hepatitis B and C ) Awareness Day, it is important for
us in Sri Lanka to take stock of the situation here.
The term "hepatitis" describes
a common form of liver injury and means "inflammation
of the liver" ("itis" -- inflammation
and "hepa" -- liver). There are many causes
of hepatitis including alcohol, certain drugs and viruses.
 |
| Steven Tyler, left, and Joe Perry
of the group Aerosmith arrive for the 48th Annual
Grammy Awards in February in Los Angeles. Steven
Tyler says he was diagnosed with hepatitis C three
years ago after having the illness for a long time
without any symptoms. AP |
The first virus identified by scientists
in this connection is called Hepatitis B while Hepatitis
C was a virus referred to as "non-A non-B"
hepatitis (distinguishing it from the already identified
Hepatitis A and B viruses) for decades before finally
being identified in 1989.
Almost 600 million people around the
world are infected with either Hepatitis B or C, both
forms of which can lead to cirrhosis (scarring of the
liver) and liver cancer requiring a liver transplantation.
However, both Hepatitis B and C can often be treated
effectively, and in many cases, even cured but in most
cases stigma and fear have become the barriers.
Only by talking openly about the disease
and encouraging people who might be at risk to get tested
can we begin to tackle this problem. Aptly, the theme
for this year is ‘Get Tested’.
What is Hepatitis B?
Hepatitis B is a virus that infects
the liver and unlike Hepatitis C, a vaccine is available
to prevent infection. The vaccine is effective in 95%
of people.
What is Hepatitis C?
Hepatitis C is also a virus that infects
the liver, with about 20% of infected people making
a full recovery without treatment. Unfortunately, the
other 80% of infected people will carry the virus in
their bodies for the rest of their lives (‘chronic’
infection), unless they are treated and cured.
How does one get infected?
The Hepatitis B virus is highly infectious
and is found in the body fluids (blood, sweat, tears,
breast milk and semen) of infected people. It is transmitted
in the following way:
- Unprotected sex
- Blood-to-blood contact, which could
occur through transfusion with infected blood or blood
products, the sharing of needles, razors or toothbrushes
- From mother-to-child during or soon
after birth
- From child-to-child within families
Hepatitis C is spread through direct contact with
infected blood including:
- Blood transfusions before screening
was introduced (in most countries before 1992)
- Sharing equipment for injecting
drugs
- Medical or dental interventions
in countries where equipment is not adequately sterilized
- Tattooing or body piercing if done
using unsterilized equipment
- Needle-stick injuries (for healthcare
workers)
Both Hepatitis B and C are not spread by sneezing
or coughing.
Treatment
|
In the case
of Hepatitis B the virus cannot be eliminated
from the body, only reduced to the point that
it no longer causes harm. In the treatment of
patients with chronic Hepatitis B, the goal is
to see a permanent reduction in the amount of
virus in the blood and a reduction in the amount
of liver inflammation or damage.
Two types of drugs are used in treating chronic
Hepatitis B. The first type -- interferon therapies
-- includes interferon alfa and pegylated interferon
and stimulates the immune system and stops the
virus from growing. The second -- anti-viral therapy
– includes lamivudine or adefovir and prevents
the virus from growing. In both types the success
rate would depend on the treatment used and the
type of Hepatitis B a person is infected with.
Anyone chronically infected with Hepatitis C
should discuss with his/her doctor and decide
on the best treatment available on an individual
basis. If the doctor recommends treatment it is
important to start it as soon as possible. The
treatment would involve the two drugs, interferon
alfa (which helps fight the infection) and ribavirin
(which makes interferon more effective, as ribavirin
alone cannot clear the virus). Interferon alfa
has recently been modified to remain in the body
longer. |
(The writer is a Consultant Physician &
Gastroenterologist attached to the Police Hospital)
| 
