By Angela Success
Hepatitis B is one of the most dangerous diseases in the tropics as it can be transmitted from one person to the other through sweat and other body fluids. Unlike the other forms of the disease, hepatitis B is viral and the alcoholic hepatitis can also lead to liver cirrhosis which causes irreversible damage to the liver and subsequently death of its victim. Viral hepatitis accounts for 1.34 million deaths per year in the world.
According to World Health Organization,, “the world has ignored hepatitis at its peril”. At the 69th World Health Assembly this year, 194 governments adopted the WHO’s Global strategy on viral hepatitis which is geared towards eliminating the type B and C hepatitis in the next 13 years. “NO hep” movement has been launched to eliminate hepatitis by 2030 and its elimination is part of the Sustainable Development Goals. This year’s world hepatitis day theme is Eliminate Hepatitis and Nigeria is one of the countries which are currently carrying up to 50 per cent of the global burden of chronic hepatitis.
Mr. Chidi Ndukwu, laboratory scientist and Director of Diagnostic Medical Checkup Centre spoke on ways to check the disease. Excerpts;
What is hepatitis?
Hepatitis is the inflammation of the liver. Inflammation means the body’s response to a trauma or an infection leading to swellings, redness and heat. When the inflammation occurs in the liver, it is known as hepatitis. Hepa is from the word liver and tis is the scientific or medical term for inflammation. Inflammation of the liver can be caused by a number of conditions. The commonest thing that may cause the inflammation of the liver is hepatitis viruses and there are a number of them. There are non infectious ones like chemical, toxins and alcohol. Once it leads to the liver being inflamed, it is referred to as hepatitis.
What are the types of hepatitis?
Let us divide them into two broad parts; there are infectious and non infectious ones. The infectious ones are those caused by germs and bacteria. The other ones are caused by hepatitis viruses. They are about 5 major classes of hepatitis viruses. We have A, B, C, D and E and all of these are caused by different viruses, different background and different ways of infection. Over 90 per cent of hepatitis is caused by the viruses. For instance, the hepatitis A and E are caused by taking contaminated food or water. They are water borne infection.
Hepatitis B, C and D are transmitted through contact with body fluids like blood and other things. Hepatitis B in particular is the most infective of them all. It is a sexually transmitted disease transmitted the same way as HIV infection and through the use of unsterilised sharp objects like needles, razor blade and also through blood transfusion. Today before any blood is transfused; it must be screened for hepatitis B and C.
In this our environment, Hepatitis B is very common. Each of the viruses has its own characteristics. Hepatitis B is a very deadly virus. It is different from an ordinary inflammation of the liver. Hepatitis can also be caused by some worms. We have also amoebic hepatitis caused by protozoa which can attack the liver and lead to liver abscess and hepatitis. Other non infective ones are those that are not caused by germs, bacteria and viruses or other organisms.
Alcohol is the leading cause of non infective hepatitis. This is different from alcoholic liver sclerosis which is an irreversible destruction of the liver caused by chronic or long term consumption of alcohol. Alcoholic hepatitis is caused by excessive consumption of alcohol frequent or otherwise. It leads to damage to the liver, its inflammation and consequently to hepatitis.
Can alcoholic hepatitis lead to liver cirrhosis?
Yes, it can lead to liver cirrhosis. The liver is the largest organ after the skin, within the body, it is the largest gland. It performs more than 500 functions in the body. Most of this function involves one chemical or the other. Any drug you take passes through the liver and affects it. Most chemicals you take even alcohol are metabolised by it. The liver tries to remove the poison out of it, for example, an overdose of alcohol causes an irreversible liver damage. Most herbal drugs you take have effect on the liver. People who work in saw mills may inhale saw dust into the body which might be toxic to the liver. However, the major causes of hepatitis are the viruses. Non infective hepatitis is caused by a variety of materials.
What tests are necessary to identify the different viruses?
Hepatitis B, C and D, can be identified with rapid tests. You can get the results even in minutes, but for liver function test which is looking at the status of the liver, it may take up to a day or two before the result comes out. For a full hepatitis tests you need blood samples, urine analysis and any other specific antibody test.
What are the symptoms of Hepatitis?
Hepatitis comes in two major forms, acute and chronic hepatitis. When the infection has attacked and inflamed the liver for up to 6 months it is described as acute. Sometimes the liver has the ability to heal itself or it can be treated. Hepatitis A does not get to chronic level; it stops at that acute level and can be cleared by the system. The most common symptom of Hepatitis is jaundice. Yellowness of the eye and the urine, severe weakness, stomach pain especially the upper side of the stomach and sometimes enlargement of the liver. Fever, nausea and vomiting are also some of its symptoms. It must be noted that there might be no sign at all. Most people might have this disease without any of these symptoms. That brings us to the issue of investigation.
Urine analysis is the simplest form of test for it. It can detect high level of liver pigment which will lead to further investigation. In a nutshell, most hepatitis has the same symptoms or none at all. Hepatitis B has acute and chronic stage. It also has a latent stage when the virus has not attacked the liver but is living in the blood. In this instance, the person is just a carrier and does not suffer from it but can easily transfer it to someone else who may die from it while the carrier remains alive. Hepatitis B and A virus can be prevented by the use of vaccines. If the virus has not affected the liver it can also be treated. If one is Hepatitis B negative one can take the vaccine especially for those that work in hospitals and those involved in accident management where blood is involved. Once you take the full range of the vaccine even if you come in contact with any infectious fluid you will be fully protected.
What do you mean by the full range of vaccine for Hepatitis B?
In most cases just as women go for vaccination of their children, some vaccines are given as sensitisation dose, to sensitise the system and then subsequent one are given step by step to increase the antibodies against the diseases so that you will be well protected. If just take only the first stage and stop, it will not give the protection required. Remember you do not need to be sick before going for hepatitis screening. Go for your checkup now.