Every July 28 is observed as World Hepatitis Day to raise global awareness of hepatitis B and C. It is aimed also at encouraging prevention, diagnosis, and treatment of the disease. In this interview with Assistant Editor, CHINWE MADUAGWU, Dr Emuobor Odeghe, Consultant Physician and Gastroenterologist, Lagos University Teaching Hospital (LUTH) shades light on the disease.
TNE: What is hepatitis?
Hepatitis means inflammation of the liver. Whenever an organ is injured, it responds by inflammation. Simply put, hepatitis means the response of the liver to all types of injury.
TNE: How is hepatitis contracted?
There are different causes and different types of hepatitis. Therefore the way it is contracted depends on the cause. There are mainly five types of viral hepatitis, that is, hepatitis A to E. Hepatitis A and E viruses are contracted by eating or drinking contaminated food and water.
Hepatitis B and C viruses are contracted from infected body fluids such as blood, for example through transfusion of infected blood, or sharing of contaminated sharp objects such as pedicure sets, syringes by intravenous drug abusers. Hepatitis B can also be transmitted from an infected mother to her baby and also through sex.
Hepatitis D always exists with hepatitis B. By this, it means that hepatitis D cannot survive on its own. It always needs hepatitis B.
Hepatitis A, B, C, D, E are viruses that can infect the liver and damage it.
In Nigeria, Hepatitis B is mainly spread in early childhood through the sharing of personal items such as toothbrushes, contact with body fluids from oozing skin lesions and infected wounds.
TNE: Why are there different types of hepatitis and what are the differences?
There are different types of hepatitis because different things can cause hepatitis.
The causes of hepatitis include the hepatitis viruses mentioned above; diabetes; obesity; alcohol; some drugs; infections; genetic disorders; inherited conditions; autoimmune disorders. Autoimmune disorders are some types of liver diseases that are caused by abnormal functioning of the immune system.
However, the commonest and most important are those caused by hepatitis B and C viruses. This is because they have a propensity to remain in the liver and cause chronic infection. It is this chronic infection that eventually leads to liver cirrhosis, liver failure and liver cancer. One can say therefore that these two, B and C are the most serious of the hepatitis types.
TNE: What are the symptoms that should alert an individual that he/she has hepatitis?
Unfortunately, many people do not have any symptom. By the time symptoms appear the disease is usually advanced and treatment is less than effective. That is why we tell people to go to reputable hospitals or laboratories to screen themselves for hepatitis B and C viruses. Do not wait for symptoms to occur.
However, the symptoms that may be present in people with hepatitis include yellowness of the eyes, dark coloured urine, fever, abdominal pain, swelling of the abdomen, weight loss. Some may vomit blood or their relatives may notice a change in their behaviour or confusion. Some may lose consciousness.
TNE: Is hepatitis a serious health challenge in Nigeria?
Yes it is. Hepatitis B is the commonest cause of liver disease and liver cancer here. Liver cancer is becoming one of the commonest cancers in Nigeria. It is also one of the most deadly cancers in Nigeria and worldwide. Many people who have it die from it even in developed countries.
TNE: What’s the statistics of those affected by hepatitis in Nigeria and worldwide?
About 23 million Nigerians have chronic hepatitis B virus infection, for hepatitis C it is about 3-4 million.
Worldwide about 330 million people have chronic hepatitis B and C viruses. More than 700,000 people die from hepatitis B every year worldwide. I am not sure of the statistics from Nigeria.
TNE: Of the different types which is more prevalent in Nigeria and why?
Hepatitis B is very prevalent, about 13% of Nigerians have chronic HBV infection. However, studies show that at least 60% of Nigerians have serological evidence of exposure to the virus. This means that if we all (all Nigerians) did further advanced tests for hepatitis B virus, at least 60-70% of us will be positive, and this shows that we have been exposed to the virus previously.
Chronic HBV can lead to liver cirrhosis and liver cancer.
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TNE: What is involved in the treatment of the disease?
The treatment will depend on the cause of the hepatitis. Drugs are available for HBV and HCV. For hepatitis caused by alcohol, the treatment is to stop taking alcohol.
For that caused by diabetes and obesity, treatment involves control of blood glucose, maintenance of a healthy weight by exercise and diet.
TNE: Can hepatitis be prevented?
Hepatitis A virus infection can be prevented by vaccination but currently there is no vaccination for hepatitis C and E.
Hepatitis B can be prevented by vaccination of all newborns within the first day of life and vaccination of all children and adolescents, and all adults who are at risk of being infected such as health care workers.
Hepatitis A and E infection can be prevented by maintaining good personal hygiene and environmental sanitation and provision of clean water.
It is important for all Nigerians to screen themselves for hepatitis B. Those who test negative should be vaccinated, while those who test positive should be evaluated by a doctor.
TNE: So, why a day dedicated to hepatitis?
World Hepatitis day is observed on July 28 to raise global awareness of hepatitis B and C. Its aim is to encourage prevention, diagnosis, and treatment of HBV and HCV. It has been led by the World Hepatitis Alliance since 2007.
July 28 was chosen because that is the birth date of Baruch Bloomberg, the American Physician who discovered hepatitis B virus.