Hepatitis

Hepatitis is an inflammation of the liver. There are five main types of the hepatitis virus – A, B, C, D and E. Hepatitis B and C lead to chronic disease in hundreds of millions of people globally, and together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis-related deaths. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis.

As of 2019, an estimated 116 million people in the Western Pacific are living with hepatitis B and 10 million with hepatitis C. While there are evidence-based, effective and safe interventions to diagnose, treat, and prevent chronic hepatitis B and C, most people remain undiagnosed and untreated. 

Hepatitis B and C infections lead to chronic liver disease in hundreds of millions of people. They are the most common causes of liver cirrhosis and liver cancer.

Most people with hepatitis A, B, C, E, or D have little or no symptoms, and often do not know they have it. Each form of the virus, however, can cause more severe symptoms. Symptoms of hepatitis A, B and C may include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the skin and whites of the eyes). In some cases, the virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer. These patients are at risk of death.

Hepatitis D (HDV) is only found in people already infected with hepatitis B (HBV); however, the dual infection of HBV and HDV can cause a more serious infection and poorer health outcomes, including accelerated progression to cirrhosis. Development of chronic hepatitis D is rare.

Hepatitis E (HEV) begins with mild fever, reduced appetite, nausea and vomiting lasting for a few days. Some persons may also have abdominal pain, itching (without skin lesions), skin rash or joint pain. They may also exhibit jaundice, with dark urine and pale stools, and a slightly enlarged, tender liver (hepatomegaly), or occasionally acute liver failure.

Safe and effective vaccines are available to prevent hepatitis B virus. This vaccine also prevents the development of hepatitis D virus and given at birth strongly reduces transmission risk from mother to child. Chronic hepatitis B infection can be treated with antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival. Only a proportion of people with chronic hepatitis B infection will require treatment. A vaccine also exists to prevent infections of hepatitis E, although it is not currently widely available. There are no specific treatments for hepatitis B and E viruses and hospitalization is not usually required. It is advised to avoid unnecessary medications due to the negative effect on liver function caused by these infections.

Hepatitis C can cause both acute and chronic infection. Some people recover on their own, while others develop a life-threatening infection or further complications, including cirrhosis or cancer. Antiviral medicines can cure more than 95% of persons with hepatitis C infection, thereby reducing the risk of death from cirrhosis and liver cancer, but access to diagnosis and treatment remains low.

Hepatitis A virus is most common is low- and middle-income countries due to reduced access to clean and reliable water sources and the increased risk of contaminated food. A safe and effective vaccine is available to prevent hepatitis A. Most hepatitis A infections are mild, with the majority of people recovering fully and developing immunity to further infection.

Protect yourself against hepatitis by always using sterile injections, always using your own razors and blades, practising safe sex, using safe tattooing and piercing equipment, and vaccinating infants against hepatitis B.