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Posts Tagged ‘liver failure’

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):

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Hepatitis B: Why Worry, Why Vaccinate?

HepBmayHepatitis B is a liver infection that is caused by the hepatitis B virus which is spread when blood or other body fluid infected with the hepatitis B virus enters the body of a person who is not infected.

Prevalence of hepatitis B infection

Data from 2009 indicates that an estimated 800,000 to 1.4 million people are living with chronic hepatitis B in the United States alone. With so many people living with this chronic infection, it’s not surprising that approximately 3,000 deaths from chronic liver disease occur each year that are also directly associated with viral hepatitis. While you may believe that you or your family members are at low risk of contracting hepatitis B, the fact is that many people in the U.S. are infected and many people don’t even know they’re infected since they often don’t feel or look sick.  In fact, nearly 2 out of 3 people infected with hepatitis B are not aware that they have the virus.  Therefore, they don’t take the necessary precautions to prevent the spread of infection to others, including their own children.

Fortunately, 90% of persons who become infected with hepatitis B as adults will clear the infection from the body within 6 months, while the remaining 10% who are unable to clear it will go on to suffer with chronic infection that often leads to inflammation and scarring of the liver.  Then, about 15%-25% of those people with chronic infections will go on to develop serious liver conditions such as liver damage, liver failure, or even liver cancer.

Unfortunately, when a baby is infected at birth or during infancy the percentages are reversed.  Only 10% clear the infection on their own and the remaining 90% will go on to develop chronic hepatitis B infection. This is why the hepatitis B vaccine is so important for newborns.

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Why Infants Should Receive the Hepatitis B Vaccine at Birth

In honor of Hepatitis Awareness Month

HepB112315The CDC recommends that the Hepatitis B vaccine be administered to infants soon after birth and before hospital discharge.   Parents, who are often uninformed regarding the risks of contracting this disease or the chronic long-term effects of liver failure, cirrhosis, and liver cancer that come from being infected, may question why their child needs  a vaccination at such a young age.

During the recent airing of the PBS Frontline piece entitled, “The Vaccine War,” one parent defended her anti-vaccine views by questioning why her newborn child would need a vaccine against a sexually transmitted disease.  This comment explains the need for public education regarding the risks of the hepatitis B virus (HBV). Once parents understand the ways in which their child may become infected and the unique risks that the virus poses to their infant child, they should realize that vaccinating at birth can prevent chronic effects later in life.

According to information provided by the Immunization Action Coalition and the CDC, an estimated 1.25 million people are chronically infected with the hepatitis B virus in the United States alone, resulting in an estimated 2,000-4,000 deaths each year.  Surprisingly, 30%-40% of these chronic infections were acquired during childhood.  This fact alone presents a compelling case for vaccinating infants – before they become infected.

Parents need to understand that the hepatitis B virus can be spread by infectious blood and body fluids, and not solely through sexual contact.  As a parent myself, I can recall countless times that I have tended to children, both my own and others, who have suffered scrapes, cuts, nose bleeds and even bites from frustrated playmates.  These are realistic opportunities for exposure since the CDC has stated that the virus remains viable and infectious in the environment for at least 7 days and can remain present in inanimate objects absent of visible blood. Since only 7 out of 10 infected adults show any signs or symptoms, and infected children under age 5 rarely show any symptoms at all, it is obvious how the infected population can easily, and unknowingly, be transmitting the disease to others.

Many of those who become infected with the hepatitis B virus contract the disease from their unknowingly infected mother at birth.   Deborah Wexler from the Immunization Action Coalition explains,

“There are so many parents and healthcare professionals who think this vaccine is wrongly given at birth for an STD that might be acquired later in life.   But the most important reason for it is to prevent HBV infection early in life with the possible life-long complications  of chronic disease in the form of liver failure and liver cancer that affect so many who are infected at birth.  I wish this message were more broadly disseminated, but it is a difficult message to discuss due to its complexity, the need to explain how medical errors might occur and why testing isn’t infallible, or how exposures could occur in an infant.”

While OBGYNs suggest mothers be tested prior to delivery, there are many instances when this does not occur, or when it is possible that the mother contracts the disease in the period after testing, but before birth.  Properly identifying infected mothers is complicated since there can be errors in test ordering, result interpretation or even test inaccuracy.  Therefore, administering the first dose of the hepatitis B vaccine soon after birth minimizes the risk for infection from the mother or from other infected persons who may be living in the household.  Additionally, the hepatitis B vaccine can actually help prevent infection in infants who are born from mothers with the virus in their blood. This serves as another important fact to support vaccinating your child according to the recommended schedule.

Studies also indicate that the long-term chronic health issues related to this virus, such as liver failure, cirrhosis, and liver cancer, are directly related to when a person is first infected.  For example, 90% of infants who are infected will ultimately develop chronic symptoms later in life, however, when the illness is contracted at an older age, the chronic effects are less prominent.  Only 30% of children age 1-5 who contract hepatitis B will go on to develop these chronic issues.  Once again, these figures demonstrate the benefit of starting infants on the multi-dose vaccination series as soon as possible after birth in order to provide the greatest preventative effect on the population.

Perhaps you have other concerns or information to share regarding the hepatitis B virus.  Feel free to comment here or respond with a question so that you can be part of the conversation.