Raising Awareness of Viral Hepatitis on World Hepatitis Day

Viral hepatitis is a major health problem and one of the leading causes of death globally.  Approximately 1.34 million people die each year all around the world, and million others are infected, most of which do not even know.  Since hepatitis is not limited to one location or one group of people, everyone around the world needs to understand the disease burden and the steps they can take for prevention, testing and treatment.  

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The ABC’s of Hepatitis

Hepatitis” means “inflammation” of the liver and it can be caused by things such as bacterial and viral infections, toxins, certain drugs, some diseases, and heavy alcohol use. There are currently five hepatitis viruses that have been identified that specifically attack the liver and cause “viral hepatitis”. The most common types are A, B, and C, but there is also D and E.

All of the hepatitis viruses cause a new or “acute” infection, but only the hepatitis B and C viruses can result in a “chronic” infection that increases the risk of a person developing cirrhosis, liver failure or liver cancer.

Hepatitis A virus (HAV):

Hepatitis A virus can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. It is highly contagious and usually transmitted when the virus is taken in by mouth from contact with objects, food, or drinks that are contaminated by the feces (or stool) of an infected person.

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The best way to prevent an infection is by getting vaccinated with the 2-dose series of hepatitis which is routinely recommended for all children, travelers to certain countries, and persons at risk for the disease. Fortunately, the vaccine has helped reduce the incidence of hepatitis A, but there are still outbreaks in the U.S. every year. In 2014, there were an estimated 2,500 cases of acute hepatitis A infections in the United States. So far in 2017, there have been 275 cases in San Diego alone, resulting in 194 hospitalizations and 8 deaths.

Hepatitis B virus (HBV):

Hepatitis B virus can be transmitted through the body fluids of an infected person. This can happen through intimate contact, contact with the blood or open sore of an infected person, sharing needles, syringes, razors or toothbrushes, or from a mother to her baby at birth. Unlike hepatitis A, it is not routinely spread through food or water. However, it is possible to spread to babies when they receive pre-chewed food from an infected person.  Surprisingly, hepatitis B virus can survive outside the body for as long as 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

Many people with chronic hepatitis B virus infection do not know they are infected since they do not feel or look sick. It is believed that 90% of people living with hepatitis B are unaware of their infection status. Unfortunately, this means they are often unknowingly spreading it to others.

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For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. The younger a person is when infected, the greater their risk of developing chronic disease.  For example, approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults. This is why the birth dose of hepatitis B vaccine is so critical in preventing chronic infections that can lead to serious health issues, like cirrhosis or liver cancer.  (To understand why babies need the vaccine at birth, see a guest post written by Carolyn Aldigé, President and Founder of the, Prevent Cancer Foundation here.)

In the U.S. an estimated 850,000-2.2 million persons have chronic hepatitis B. However, rates of acute hepatitis B in the U.S. have declined by approximately 82% since 1991, when the routine vaccination of children was implemented. Yet, in 2015, it was estimated that 257 million people are still living with hepatitis B infection worldwide.

Hepatitis C virus (HCV):

Hepatitis C virus is a blood-borne virus. For some people, hepatitis C is a short-term illness. However, in 75%–85% of cases the infection becomes chronic and may even cause death. Unfortunately, about 80% of people living with hepatitis C are unaware of their infection because they are not clinically ill. The CDC estimates that there were 19,659 deaths as a result of hepatitis C infections in the U.S. in 2014, but it’s believed that this is only a fraction of the deaths attributable in whole or in part to chronic hepatitis C.

Unfortunately, there is no vaccine for Hepatitis C.  Although there are limited types of treatments available, the best way to prevent infection is by avoiding behaviors that can spread the disease. In 2015, it was estimated that 71 million people were living with hepatitis C infection worldwide.

Personal Stories of Hepatitis

Even if people are knowledgable about hepatitis, there are still plenty of people who remain unaware that they are infected. They then unknowingly contribute to the continued transmission of infection, which in turns results in a high rate of fatal liver disease that could possibly be avoided.

Take Alan as an example. When it comes to assessing your risk for hepatitis, knowing your family history is crucial. Many of Alan’s immediate family members passed away due to liver cancer, but it was never clear that the cancer was caused by hepatitis.  It wasn’t until Alan himself became ill that the family realized the role hepatitis B played in these deaths.

In this video, Alan talks about the virus and how silence can be dangerous.

“I think about the millions of other people who could lose the same joy I have, because they simply don’t know they have the virus. And about how lucky I am that my early treatment gave my liver a chance to regenerate itself.”

 

Now that he has been properly diagnosed, he has been talking openly about his diagnosis, in hopes that it will help others. He explains that once someone in your family tests positive, everyone in the family should seek testing. Those who test negative should be vaccinated if they haven’t already been, and those who test positive should seek medical care right away.

Alan is just one of many people who are sharing their stories of Hepatitis B as part of the Hepatitis B Foundation’s #justB campaign.

The Role of Vaccination

The good news is that hepatitis vaccines can help prevent disease and save lives. With the introduction of vaccines, we’ve seen a huge reduction in the number of children under five living with chronic HBV infection. In fact, it is estimated that Hepatitis B vaccine is preventing approximately 4.5 million infections per year worldwide.

Janet and Kurt’s story, which has appeared on Shot by Shot, really emphasizes the importance of the Hep B birth dose. As anxious parents with plans to adopt a baby, they were faced with the knowledge that the birth mother had tested positive to hepatitis B. After contacting the Hepatitis B Foundation, they learned how a birth dose of vaccine, administered within 12 hours of birth, could help prevent transmission from mother to baby and give their daughter a chance to forego chronic liver disease.

 

The World Health Organization believes that the elimination of viral hepatitis is achievable, but a greater awareness of hepatitis and a better understanding of the vaccines and treatments are imperative.  The elimination of viral hepatitis is not just a public health goal, but a goal for every individual, since every single person could be affected by viral hepatitis.  We all  have a part to play to achieve elimination – whether you share your own story or share this information to help educate others – help us in our fight against viral hepatitis.

To learn more about hepatitis on World Hepatitis Day, and to help raise awareness, check out these valuable resources:

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