An insight into hepatitis

The global community join hands to celebrate the World Hepatitis Day which is observed each year on July 28, hoping to raise awareness of viral hepatitis. According to the World Health Organization (WHO), this year’s theme is “Hepatitis can’t wait”, conveying the urgency of efforts needed to eliminate hepatitis as a public health threat by 2030. Prof. Anuradha S. Dassanayake, Consultant Physician and Professor in Pharmacology in the Faculty of Medicine, University of Kelaniya said that in the simplest of terms, hepatitis refers to the inflammation of the liver. “Hepatitis can be caused by a variety of infectious viruses and noninfectious agents leading to a range of health problems, some of which can be fatal,” the WHO explained.

Understanding hepatitis
There are several varieties of viral hepatitis referred to as types A, B, C and E. Prof. Dassanayake commented that other than these viral hepatitis types, hepatitis can arise as a result of agents such as alcohol, medications and drugs, herbs, etc. “Even a simple fatty liver could lead to a form of hepatitis,” he said.

Hepatitis A and E 
Hepatitis A which is also known as “Kaha Una” or “Bowena Sengamalaya” in the common folk’s tongue, is the common type of viral Hepatitis we see in our population. Hepatitis A and E both usually transmit through contaminated food or water and therefore is common in communities that show poor food hygiene practices. “This type of Hepatitis is a mild illness in the small age but can be a very serious fatal illness in adults,” Professor Dassanayake emphasised.  “Hepatitis E is not a major issue in our country but it is a major issue in our neighbouring countries in South Asia,” he said. Therefore, this type is observed among people who visited those countries and immigrant workers from those countries. 

Hepatitis B and C
an estimated 354 million people worldwide live with hepatitis B or C. However, according to Prof. Dassanayake, prevalence of hepatitis B and C is very low in Sri Lanka compared to other countries. Both Hepatitis B and C can transmit through blood transfusions, unsterilised needles (especially common among drug addicts) and injections and unprotected sexual intercourse. Both these types have the potential to develop to the chronic stage of hepatitis which can lead to long term complications such as cirrhosis and liver cancer.

Signs and symptoms include fever, abdominal pain, nausea and vomiting, dark, tea coloured urine and yellowish discolouration of the eyes. 

treatment and vaccination
“The treatment for hepatitis depends on the cause. The symptoms should be treated and the underlying cause should be managed. If complications such as liver failure arises, liver transplantation is a possible treatment option,” Professor Dassanayake described. Hepatitis A was extremely common among children many decades ago. Prof. Dassanayake emphasised that hepatitis A in adults is serious and there is a 1-2% chance of death. To avoid this, vaccination is available for hepatitis A. “Ideally, all non-immune adults should be vaccinated for hepatitis A,” he commented.

In addition, vaccination is also available for Hepatitis B. Hepatitis B can progress to chronic form of hepatitis which result in severe complications. Therefore, Hepatitis B vaccine is included in our immunization program for children.

Unfortunately, no vaccination is available for Hepatitis C and E
To safeguard the liver, one should maintain proper food hygiene and avoid unnecessary medications and herbs. Optimal liver health can be maintained by avoiding excessive alcohol consumption and unhealthy food habits and engaging in physical exercises.