By Omogoroye Olumide
HEPATITIS
World Hepatitis Day which is commemorated each year on 28 July, aims to raise global awareness of hepatitis. According to the official website - www.worldhepatitisday.org - the theme for this year's World Hepatitis Day is "find the missing millions". An estimated population of over 290 million people worldwide are living with the infection unaware I.e. they have the infection but have not been diagnosed.
What is Hepatitis?
Hepatitis is an inflammatory condition of the liver. It's usually caused by a viral infection, although, there are other causes of hepatitis. These includes autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies (body soldiers) against your liver tissues.
The liver
The liver is a large, meaty organ that sits on the right side of the belly. It is located in the right upper area of the abdomen beneath the diaphragm. It is the second largest organ of the body-weighing about 3 pounds. The liver is reddish-brown in color and feels rubbery to the touch. Normally you can't feel the liver, because it's protected by the rib cage.
It performs many vital functions that affects metabolism throughout the body. Some of it functions include:
- bile production, which is essential for digestion.
- synthesis of clotting factors.
- storage of glycogen (a form of sugar), minerals, and vitamins (A,D,E, and K).
- breakdown of carbohydrates, fats, and proteins.
- filtering of toxins from the body.
- excretion of bilirubin (a product of broken-down red blood cells), cholesterol, hormones, and drugs.
- synthesis of blood proteins, such as albumin.
- activation of enzymes, which are specialized proteins essential to body functions etc.
Fast facts on the liver
- The liver is classed as a gland.
- This vital organ carries out more than 500 roles in the human body.
- It is the only organ that can regenerate.
- The liver is the largest solid organ in the body.
- Alcohol abuse is one of the major causes of liver problems in the industrialized world.
Hepatitis is a major disease of the liver. Worldwide, hepatitis (especially hepatitis B and hepatitis C) was responsible for 1.34 million deaths in 2015. The World Health Organization (WHO) also reports that deaths from hepatitis have increased 22 percent since 2000. Dying of viral hepatitis in Africa is becoming a bigger threat than dying of AIDS, malaria or tuberculosis, says the World Health Organisation (WHO). Yet hepatitis does not usually get the awareness and funding it deserves.
Nigeria joined the league of other nations to sign up to the GHSS and was among the few countries in Africa to develop firm goals towards the elimination of viral hepatitis. Nigeria’s Federal Ministry of Health, at a briefing on July 30, 2018, said the government was articulating strategies that would lead to a reduction in the number of more than 22 million Nigerians infected with hepatitis B and the more than 4 million with hepatitis C.
Hepatitis B, according to the Ministry of Health, has a national prevalence of 11% while hepatitis C has a prevalence of 2.2%. Both have become leading silent killers in the country; more than half of the nation’s population have never been tested and therefore do not know their infection status.
Treatment options vary depending on the type of hepatitis. Some forms of hepatitis are prevented through immunizations and lifestyle precautions. There is a vaccine for the prevention of hepatitis A and B and it is available in Nigeria. I will advise one takes the vaccine to prevent the infection.
The 5 types of Hepatitis
Viral infections of the liver that are classified as hepatitis include hepatitis A,B,C,D, and E. A different virus is responsible for each type of virally transmitted hepatitis.
Hepatitis A
Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV). HAV is found in the stool and blood of people who are infected. Hepatitis A is very contagious. It is spread when someone unknowingly ingests the virus — even in microscopic amounts — through close personal contact with an infected person or through eating contaminated food or drink. Symptoms of hepatitis A can last up to 2 months and include fatigue, nausea, stomach pain, and jaundice. Most people with hepatitis A do not have long-lasting illness. Hepatitis A usually doesn’t require treatment because it’s a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. The best way to prevent hepatitis A is to get vaccinated. The hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between ages 12 and 18 months. It’s a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine.
Hepatitis B
Hepatitis B is also vaccine-preventable liver infection caused by the hepatitis B virus (HBV). Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth. Not all people newly infected with HBV have symptoms, but for those that do, symptoms can include fatigue, poor appetite, stomach pain, nausea, and jaundice. For many people, hepatitis B is a short-term illness. For others, it can become a long-term, chronic infection that can lead to serious, even life-threatening health issues like cirrhosis or liver cancer. Risk for chronic infection is related to age at infection: about 90% of infants with hepatitis B go on to develop chronic infection, whereas only 2%–6% of people who get hepatitis B as adults become chronically infected. Acute hepatitis B doesn’t require specific treatment. Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment. The best way to prevent hepatitis B is to get vaccinated.
Hepatitis C
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C is spread through contact with blood from an infected person. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment used to prepare and inject drugs. For some people, hepatitis C is a short-term illness, but for more than half of people who become infected with the hepatitis C virus, it becomes a long-term, chronic infection. Chronic hepatitis C can result in serious, even life-threatening health problems like cirrhosis and liver cancer as seen also in hepatitis B. People with chronic hepatitis C can often have no symptoms and don’t feel sick. When symptoms appear, they often are a sign of advanced liver disease. Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment.
People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant.
Currently, there is no vaccination for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs. Getting tested for hepatitis C is important, because treatments can cure most people with hepatitis C in 8 to 12 weeks.
Hepatitis D
Hepatitis D, also known as “delta hepatitis,” is a liver infection caused by the hepatitis D virus (HDV). Hepatitis D only occurs in people who are also infected with the hepatitis B virus. Hepatitis D is spread when blood or other body fluids from a person infected with the virus enters the body of someone who is not infected. Hepatitis D can be an acute, short-term infection or become a long-term, chronic infection. Hepatitis D can cause severe symptoms and serious illness that can lead to life-long liver damage and even death. People can become infected with both hepatitis B and hepatitis D viruses at the same time (known as “coinfection”) or get hepatitis D after first being infected with the hepatitis B virus (known as “superinfection”). No antiviral medications exist for the treatment of hepatitis D at this time. According to a 2013 study, a drug called alpha interferon can be used to treat hepatitis D, but it only shows improvement in about 25 to 30 percent of people. Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop.
Hepatitis E
Hepatitis E is a liver infection caused by the hepatitis E virus (HEV). HEV is found in the stool of an infected person. It is spread when someone unknowingly ingests the virus – even in microscopic amounts. In developing countries, people most often get hepatitis E from drinking water contaminated by feces from people who are infected with the virus. Symptoms of hepatitis E can include fatigue, poor appetite, stomach pain, nausea, and jaundice. However, many people with hepatitis E, especially young children, have no symptoms. Except for the rare occurrence of chronic hepatitis E in people with compromised immune systems. most people recover fully from the disease without any complications. There is a vaccine for hepatitis E in China but it's not available in most countries including Nigeria and the United States.
Causes of noninfectious hepatitis
- Alcohol and other toxins
Excessive alcohol consumption can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of the liver. You need to stop drinking if you receive an alcoholic hepatitis diagnosis. You may be able to reverse the damage to your liver by avoiding alcohol in the early stages of the disease. Once more significant damage has occurred, the changes within the liver become permanent. Significant damage can lead to conditions such as cirrhosis, blood clotting problems, and high levels of bilirubin. Even if the damage is too severe to reverse, you should still quit drinking to prevent further harm to your liver. In people with permanent liver damage due to alcohol, there’s a 30 percent increase in survival rate among those who stop drinking compared to those who continue to drink. There’s always a benefit to quitting drinking. If you have an alcohol addiction and need help to stop drinking, talk to your doctor about the different treatment options for addiction.
There are many excellent hospitals and clinic facilities that specialize in alcohol detoxification and recovery. Treatment for alcoholic hepatitis may include medications that reduce inflammation in your liver and improve liver function.
Other toxic causes of hepatitis include overuse or overdose of medications and exposure to poisons.
- Autoimmune system response
In some cases, the immune system mistakes the liver as a harmful object and begins to attack it. It causes ongoing inflammation that can range from mild to severe, often hindering liver function. It’s three times more common in women than in men. Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 percent of people with this condition. Azothioprine (Imuran), a drug that suppresses the immune system, is often included in treatment. It can be used with or without steroids. Other immune suppressing drugs like mycophenolate (CellCept), tacrolimus (Prograf) and cyclosporine (Neoral) can also be used as alternatives to azathioprine for treatment.
How is hepatitis diagnosed?
•History and physical exam
To diagnose hepatitis, first a doctor has to take the history of the patient to determine any risk factors associated with infectious or noninfectious hepatitis. During a physical examination, the doctor may press down gently on the patient's abdomen to see if there’s pain or tenderness. The doctor may also check to see if the liver is enlarged. If the skin or eyes are yellow, the doctor will note this during the exam.
•Liver function tests
Liver function tests use blood samples to determine how efficiently the liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if the patient doesn't show any signs on a physical exam of liver disease. High liver enzyme levels may indicate that the liver is stressed, damaged, or not functioning properly.
•Other blood tests
If the liver function tests are abnormal, the doctor will likely order other blood tests to detect the source of the problem. These tests can check for the viruses that cause hepatitis. They can also be used to check for antibodies that are common in conditions like autoimmune hepatitis.
•Ultrasound
An abdominal ultrasound uses ultrasound waves to create an image of the organs within the abdomen. This test allows the doctor to take a close look at the liver and nearby organs. It can reveal:
–fluid in the abdomen
–liver damage or enlargement
–liver tumors
–abnormalities of the gallbladder
Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of abnormal liver function.
•Liver biopsy
A liver biopsy is an invasive procedure that involves the doctor taking a sample of tissue from the liver. It can be done through the skin with a needle and doesn’t require surgery. Typically, an ultrasound is used to guide the doctor when taking the biopsy sample. This test allows the doctor to determine how infection or inflammation has affected the liver. It can also be used to sample any areas in the liver that appears abnormal.
Tips to prevent hepatitis
–Get the vaccines for hepatitis A and hepatitis B.
–Use a condom during sex.
–Don't share needles to take drugs.
–Practice good personal hygiene such as thorough hand-washing with soap and water.
–Don't use an infected person's personal items.
–Take precautions when getting any tattoos or body piercings.
–Take precaution when traveling to areas of the world with poor sanitation. (Make sure to get the vaccines.)
–Drink bottled water when traveling.
It is very important that you take these preventive measures if you participate in risky behaviors. Take preventive steps, too, if you work in places like a nursing homes, dormitories, daycare centers, or restaurants where there you have extended contact with other people and a risk of coming into contact with the disease.
People with chronic hepatitis B and C are encouraged to avoid alcohol because it can accelerate liver disease and failure. Certain supplements and medications can also affect liver function. If you have chronic hepatitis B or C, check with your doctor before taking any new medications.
Thanks for taking your time to read this long but detailed article. I will encourage you to take the preventive measures against the infection and share this article with people around you to increase the awareness of hepatitis infection.
HEPATITIS
World Hepatitis Day which is commemorated each year on 28 July, aims to raise global awareness of hepatitis. According to the official website - www.worldhepatitisday.org - the theme for this year's World Hepatitis Day is "find the missing millions". An estimated population of over 290 million people worldwide are living with the infection unaware I.e. they have the infection but have not been diagnosed.
What is Hepatitis?
Hepatitis is an inflammatory condition of the liver. It's usually caused by a viral infection, although, there are other causes of hepatitis. These includes autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies (body soldiers) against your liver tissues.
The liver
The liver is a large, meaty organ that sits on the right side of the belly. It is located in the right upper area of the abdomen beneath the diaphragm. It is the second largest organ of the body-weighing about 3 pounds. The liver is reddish-brown in color and feels rubbery to the touch. Normally you can't feel the liver, because it's protected by the rib cage.
It performs many vital functions that affects metabolism throughout the body. Some of it functions include:
- bile production, which is essential for digestion.
- synthesis of clotting factors.
- storage of glycogen (a form of sugar), minerals, and vitamins (A,D,E, and K).
- breakdown of carbohydrates, fats, and proteins.
- filtering of toxins from the body.
- excretion of bilirubin (a product of broken-down red blood cells), cholesterol, hormones, and drugs.
- synthesis of blood proteins, such as albumin.
- activation of enzymes, which are specialized proteins essential to body functions etc.
Fast facts on the liver
- The liver is classed as a gland.
- This vital organ carries out more than 500 roles in the human body.
- It is the only organ that can regenerate.
- The liver is the largest solid organ in the body.
- Alcohol abuse is one of the major causes of liver problems in the industrialized world.
Hepatitis is a major disease of the liver. Worldwide, hepatitis (especially hepatitis B and hepatitis C) was responsible for 1.34 million deaths in 2015. The World Health Organization (WHO) also reports that deaths from hepatitis have increased 22 percent since 2000. Dying of viral hepatitis in Africa is becoming a bigger threat than dying of AIDS, malaria or tuberculosis, says the World Health Organisation (WHO). Yet hepatitis does not usually get the awareness and funding it deserves.
Nigeria joined the league of other nations to sign up to the GHSS and was among the few countries in Africa to develop firm goals towards the elimination of viral hepatitis. Nigeria’s Federal Ministry of Health, at a briefing on July 30, 2018, said the government was articulating strategies that would lead to a reduction in the number of more than 22 million Nigerians infected with hepatitis B and the more than 4 million with hepatitis C.
Hepatitis B, according to the Ministry of Health, has a national prevalence of 11% while hepatitis C has a prevalence of 2.2%. Both have become leading silent killers in the country; more than half of the nation’s population have never been tested and therefore do not know their infection status.
Treatment options vary depending on the type of hepatitis. Some forms of hepatitis are prevented through immunizations and lifestyle precautions. There is a vaccine for the prevention of hepatitis A and B and it is available in Nigeria. I will advise one takes the vaccine to prevent the infection.
The 5 types of Hepatitis
Viral infections of the liver that are classified as hepatitis include hepatitis A,B,C,D, and E. A different virus is responsible for each type of virally transmitted hepatitis.
Hepatitis A
Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV). HAV is found in the stool and blood of people who are infected. Hepatitis A is very contagious. It is spread when someone unknowingly ingests the virus — even in microscopic amounts — through close personal contact with an infected person or through eating contaminated food or drink. Symptoms of hepatitis A can last up to 2 months and include fatigue, nausea, stomach pain, and jaundice. Most people with hepatitis A do not have long-lasting illness. Hepatitis A usually doesn’t require treatment because it’s a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. The best way to prevent hepatitis A is to get vaccinated. The hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between ages 12 and 18 months. It’s a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine.
Hepatitis B
Hepatitis B is also vaccine-preventable liver infection caused by the hepatitis B virus (HBV). Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth. Not all people newly infected with HBV have symptoms, but for those that do, symptoms can include fatigue, poor appetite, stomach pain, nausea, and jaundice. For many people, hepatitis B is a short-term illness. For others, it can become a long-term, chronic infection that can lead to serious, even life-threatening health issues like cirrhosis or liver cancer. Risk for chronic infection is related to age at infection: about 90% of infants with hepatitis B go on to develop chronic infection, whereas only 2%–6% of people who get hepatitis B as adults become chronically infected. Acute hepatitis B doesn’t require specific treatment. Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment. The best way to prevent hepatitis B is to get vaccinated.
Hepatitis C
People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant.
Currently, there is no vaccination for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs. Getting tested for hepatitis C is important, because treatments can cure most people with hepatitis C in 8 to 12 weeks.
Hepatitis D
Hepatitis D, also known as “delta hepatitis,” is a liver infection caused by the hepatitis D virus (HDV). Hepatitis D only occurs in people who are also infected with the hepatitis B virus. Hepatitis D is spread when blood or other body fluids from a person infected with the virus enters the body of someone who is not infected. Hepatitis D can be an acute, short-term infection or become a long-term, chronic infection. Hepatitis D can cause severe symptoms and serious illness that can lead to life-long liver damage and even death. People can become infected with both hepatitis B and hepatitis D viruses at the same time (known as “coinfection”) or get hepatitis D after first being infected with the hepatitis B virus (known as “superinfection”). No antiviral medications exist for the treatment of hepatitis D at this time. According to a 2013 study, a drug called alpha interferon can be used to treat hepatitis D, but it only shows improvement in about 25 to 30 percent of people. Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop.
Hepatitis E
Hepatitis E is a liver infection caused by the hepatitis E virus (HEV). HEV is found in the stool of an infected person. It is spread when someone unknowingly ingests the virus – even in microscopic amounts. In developing countries, people most often get hepatitis E from drinking water contaminated by feces from people who are infected with the virus. Symptoms of hepatitis E can include fatigue, poor appetite, stomach pain, nausea, and jaundice. However, many people with hepatitis E, especially young children, have no symptoms. Except for the rare occurrence of chronic hepatitis E in people with compromised immune systems. most people recover fully from the disease without any complications. There is a vaccine for hepatitis E in China but it's not available in most countries including Nigeria and the United States.
Causes of noninfectious hepatitis
- Alcohol and other toxins
Excessive alcohol consumption can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of the liver. You need to stop drinking if you receive an alcoholic hepatitis diagnosis. You may be able to reverse the damage to your liver by avoiding alcohol in the early stages of the disease. Once more significant damage has occurred, the changes within the liver become permanent. Significant damage can lead to conditions such as cirrhosis, blood clotting problems, and high levels of bilirubin. Even if the damage is too severe to reverse, you should still quit drinking to prevent further harm to your liver. In people with permanent liver damage due to alcohol, there’s a 30 percent increase in survival rate among those who stop drinking compared to those who continue to drink. There’s always a benefit to quitting drinking. If you have an alcohol addiction and need help to stop drinking, talk to your doctor about the different treatment options for addiction.
There are many excellent hospitals and clinic facilities that specialize in alcohol detoxification and recovery. Treatment for alcoholic hepatitis may include medications that reduce inflammation in your liver and improve liver function.
Other toxic causes of hepatitis include overuse or overdose of medications and exposure to poisons.
- Autoimmune system response
In some cases, the immune system mistakes the liver as a harmful object and begins to attack it. It causes ongoing inflammation that can range from mild to severe, often hindering liver function. It’s three times more common in women than in men. Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 percent of people with this condition. Azothioprine (Imuran), a drug that suppresses the immune system, is often included in treatment. It can be used with or without steroids. Other immune suppressing drugs like mycophenolate (CellCept), tacrolimus (Prograf) and cyclosporine (Neoral) can also be used as alternatives to azathioprine for treatment.
How is hepatitis diagnosed?
•History and physical exam
To diagnose hepatitis, first a doctor has to take the history of the patient to determine any risk factors associated with infectious or noninfectious hepatitis. During a physical examination, the doctor may press down gently on the patient's abdomen to see if there’s pain or tenderness. The doctor may also check to see if the liver is enlarged. If the skin or eyes are yellow, the doctor will note this during the exam.
•Liver function tests
Liver function tests use blood samples to determine how efficiently the liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if the patient doesn't show any signs on a physical exam of liver disease. High liver enzyme levels may indicate that the liver is stressed, damaged, or not functioning properly.
•Other blood tests
If the liver function tests are abnormal, the doctor will likely order other blood tests to detect the source of the problem. These tests can check for the viruses that cause hepatitis. They can also be used to check for antibodies that are common in conditions like autoimmune hepatitis.
•Ultrasound
An abdominal ultrasound uses ultrasound waves to create an image of the organs within the abdomen. This test allows the doctor to take a close look at the liver and nearby organs. It can reveal:
–fluid in the abdomen
–liver damage or enlargement
–liver tumors
–abnormalities of the gallbladder
Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of abnormal liver function.
•Liver biopsy
A liver biopsy is an invasive procedure that involves the doctor taking a sample of tissue from the liver. It can be done through the skin with a needle and doesn’t require surgery. Typically, an ultrasound is used to guide the doctor when taking the biopsy sample. This test allows the doctor to determine how infection or inflammation has affected the liver. It can also be used to sample any areas in the liver that appears abnormal.
Tips to prevent hepatitis
–Get the vaccines for hepatitis A and hepatitis B.
–Use a condom during sex.
–Don't share needles to take drugs.
–Practice good personal hygiene such as thorough hand-washing with soap and water.
–Don't use an infected person's personal items.
–Take precautions when getting any tattoos or body piercings.
–Take precaution when traveling to areas of the world with poor sanitation. (Make sure to get the vaccines.)
–Drink bottled water when traveling.
It is very important that you take these preventive measures if you participate in risky behaviors. Take preventive steps, too, if you work in places like a nursing homes, dormitories, daycare centers, or restaurants where there you have extended contact with other people and a risk of coming into contact with the disease.
People with chronic hepatitis B and C are encouraged to avoid alcohol because it can accelerate liver disease and failure. Certain supplements and medications can also affect liver function. If you have chronic hepatitis B or C, check with your doctor before taking any new medications.
Thanks for taking your time to read this long but detailed article. I will encourage you to take the preventive measures against the infection and share this article with people around you to increase the awareness of hepatitis infection.
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