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Hepatitis

Globally, viral hepatitis represents a high burden of disease and mortality. It is estimated that 57% of cases of liver cirrhosis and 78% of cases of primary liver cancer are due to hepatitis B or C virus infections. Recognizing the important public health problem by hepatitis, in 2010, the 63rd World Health Assembly designated July 28 as the World Hepatitis Day and called for a comprehensive response in the fight against hepatitis. Since then, PAHO and WHO have mobilized to join efforts and develop strategies to combat hepatitis at both global and regional levels.

WHAT IS VIRAL HEPATITIS?

Viral hepatitis is inflammation of the liver caused by a virus. There are five different hepatitis viruses: hepatitis A, B, C, D and E. Find out more about how each of the different viruses are transmitted, prevented and treated below.

HEPATITIS A

Transmission: hepatitis A is mainly spread through eating contaminated food or drinking contaminated water. The disease is often endemic in countries with a lack of safe water and poor sanitation.

Prevention: a vaccine exists to prevent hepatitis A. Treatment within a few weeks of exposure to the virus can also bring short term immunity. The risk of exposure can be greatly reduced by practicing good hygiene and sanitation and avoiding drinking water that has come from a potentially unsafe source.

Treatment: there is no treatment for hepatitis A. Hepatitis A only causes acute hepatitis so the body is often able to clear the infection itself within a few weeks. However, hepatitis A infection can sometimes cause further complications.

HEPATITIS B

Transmission: hepatitis B is transmitted through contact with the blood or other body fluids of an infected person. For example, it can be spread from mother to child during childbirth, through sharing razors or toothbrushes, having unprotected sex, and sharing needles and syringes to inject drugs.

Prevention: hepatitis B vaccination is very effective in preventing infection. If you have not been vaccinated, it is best to use condoms, and to avoid sharing needles or items such as toothbrushes, razors or nail scissors with an infected person to reduce chances of exposure. You should also avoid getting tattoos or body piercings from unlicensed facilities. If you think you are likely to be exposed in future, vaccination is highly recommended. Children born to mothers with hepatitis B should be vaccinated within 12 hours of birth, as this can prevent an infection that is likely to progress to chronic hepatitis B.

Treatment: although there is currently no real cure for hepatitis B, drugs such as alpha interferon and peginterferon and a variety of antiviral drugs are available. These drugs slow the replication of the virus and occasionally result in its clearance. Most importantly, they greatly reduce the risk of the complications that hepatitis B can cause such as liver cirrhosis and liver cancer.

HEPATITIS C

Transmission: hepatitis C is spread through blood-to-blood contact. The most common modes of infection include unsafe injection practices, inadequate sterilisation of medical equipment and unscreened blood and blood products. It can also be transmitted through certain sexual practises where blood is involved. Whether it can be transmitted sexually without the presence of blood remains unclear. If it does happen it appears to be extremely rare although the risk may be increased by the presence of other sexually transmitted infections.

Prevention: currently there is no vaccination for hepatitis C. To reduce risk of exposure, it is therefore necessary to avoid sharing needles and other items such as toothbrushes, razors or nail scissors with an infected person. You should also avoid getting tattoos or body piercings from unlicensed facilities.

Treatment: treatment can cure hepatitis C infection. Until recently treatment hs involved a combination of interferon, generally pegylated, long-lasting interferon, and ribavirin but there is increasing use of potent direct acting antiviral drugs. People with different hepatitis C genotypes respond differently to treatment, some more successfully than others but the differences between the genotypes is disappearing as cure rates with the new drugs approach 100%.

HEPATITIS D

Transmission: hepatitis D is passed on through contact with infected blood.

Prevention: hepatitis D only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can therefore prevent hepatitis D infection by getting vaccinated against hepatitis B. Avoid sharing needles and other items such as toothbrushes, razors or nail scissors with an infected person. You should also avoid getting tattoos or body piercings from unlicensed facilities.

Treatment: treatment for hepatitis D consists of interferon but it is not very effective. 

HEPATITIS E

Transmission: like hepatitis A, hepatitis E is mainly transmitted through eating contaminated food or drinking contaminated water. Outbreaks generally occur where there is a lack of safe water and poor sanitation.

Prevention: currently there is a vaccine to prevent hepatitis E, but it is not widely available. Reduce the risk of exposure to hepatitis E by practicing good hygiene and sanitation, and avoiding drinking water that has come from a potentially unsafe source.

Treatment: there is no treatment for hepatitis E but people usually recover by themselves. It can, however, be fatal in some cases

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