ISSN: 1391 - 0531
Sunday, October 01, 2006
Vol. 41 - No 18

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’.

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.

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.

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.

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)

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Copyright 2006 Wijeya Newspapers Ltd.Colombo. Sri Lanka.