This weekend will see organisations across the world come together in order to raise awareness of hepatitis.
Although many people may not be familiar with the condition, it continues to affect millions of people around the world with millions more at risk of getting the disease.
Although there are many forms of the condition, hepatitis is a term used to describe inflammation of the liver. It can occur as a result of a viral infection or because the liver is exposed to harmful substances such as alcohol.
Symptoms of hepatitis include tiredness, general aches and pains, headaches and fever, as well as loss of appetite, nausea or vomiting, diarrhoea, abdominal pains, jaundice, very dark urine and itchy skin.
According to the World Health Organisation (WHO), millions of people are living with viral hepatitis and millions more are at risk of becoming infected as many with hepatitis B or C are unaware that they continue to carry the virus.
This means they may unknowingly take risks that could spread the disease to others and are also putting themselves at high risk of developing severe chronic liver disease. Approximately one million people die each year from causes related to viral hepatitis – most commonly cirrhosis and liver cancer.
“The fact that many hepatitis B and C infections are silent, causing no symptoms until there is severe damage to the liver, points to the urgent need for universal access to immunisation, screening, diagnosis and antiviral therapy,” said Dr Keiji Fukuda, WHO assistant director general for health security and the environment.
The three most common forms of hepatitis are:
A common type of viral hepatitis. It does occur in the UK but is more common in countries where sanitation and sewage disposal can be poor and the large proportion of people who become infected contract the virus when abroad. In March, four children in Swansea were diagnosed with hepatitis A liver infection.
Although it can be serious in older adults, it is usually a short-term infection and most patients recover with no lasting effects. There no is specific treatment for the infection other than using medication, such as the painkiller ibuprofen, to relieve symptoms.
The virus is excreted in the faeces of infected people and the A form can be passed on to other people when food is contaminated with infected faeces or a contaminated object is put in the mouth.
A vaccination can protect against hepatitis A and is usually recommended for those travelling to countries where the virus is common, including the Indian subcontinent, Africa, Central and South America, the Far East and eastern Europe.
Of those infected by hepatitis B, 10% will become lifelong carriers. These are the people at risk of serious liver damage without treatment to suppress the virus and prevent damage.
A vaccine is available for those at risk of hepatitis B.
It can be transmitted in three ways – by having unprotected sex with someone who is infected (although this is less of a risk with hepatitis C), getting someone’s infected blood into your blood stream (through sharing injecting equipment, having tattoos or piercings done in unhygienic premises) and mothers can pass the infections onto their babies while pregnant or giving birth.
It is fairly uncommon, with cases often confined to drug users.
Simple steps that can be followed to avoid hepatitis B include:
- Do not share any drug paraphernalia. This includes needles, filters, spoons, crack pipes, water, straws or notes for snorting;
- Never share personal items such as razors or toothbrushes;
- Always use a condom when having sex;
- If having tattoos or piercings, always use a reputable practitioner and ensure that the equipment used is sterile
Hepatitis C is transmitted in the same ways as hepatitis B and the same preventative actions should be taken.
It is more common than hepatitis B and the majority of people who become infected with hepatitis C will become lifelong carriers unless treated.
While there is no vaccine against hepatitis C, research is progressing well to develop a jab to prevent the disease. Meanwhile, current treatment, in the form of antiviral medications, is very successful although the medication can have side effects.
Excessive alcohol consumption over a prolonged period of time can damage the liver and cause hepatitis.
It is estimated that as many as one in four moderate to heavy drinkers has some degree of alcoholic hepatitis.
The condition does not usually cause any symptoms and is often detected with a blood test. If a person with alcoholic hepatitis continues to drink alcohol, they could be putting themselves at risk of developing cirrhosis and possibly liver failure.
* A number of events are being held around Wales and by health boards for World Hepatitis Day.
The date of July 28 was chosen for World Hepatitis Day in order to mark the birthday of Professor Baruch Blumberg, awarded the Nobel Prize for his work in discovering the hepatitis B virus.
The theme for the day is “see no evil, hear no evil, speak no evil” and staff from both Cardiff and Vale and Hywel Dda health boards are taking part in an attempt to break a world record for the most people performing the three wise monkey actions at the same time.
Delyth Tomkinson, a clinical nurse specialist in blood-borne viruses treating people in Cardiff and Vale UHB who have hepatitis C, said: “We are taking part in a Guinness World Record attempt to have the most people performing the Three Wise Monkey “see no evil, hear no evil, speak no evil” actions within 24 hours.
“There is a serious point to all of this – hepatitis C is a blood-borne virus that can cause liver disease.
“It is estimated that 12,000 to 14,000 people in Wales are chronically infected, but the majority of people are unaware of their infection. It’s vital that more people get treated so we can prevent untimely deaths.
“People with hepatitis C will not normally have any symptoms which is why many people are living with it without ever realising they have it. Hepatitis C is treatable but the treatment is much more difficult if the disease is caught late. It is vital that people are diagnosed as early as possible to maximise the chance of a cure.
“If you think you could be at risk you should get yourself screened.
“There are a number of ways you can get tested. You could approach your GP, or you could simply complete a self referral form available from the concourse at the University Hospital of Wales.
“If you complete one of these forms you will be sent an appointment to meet with one of our team. The team at UHW are extremely experienced and ready to help you.”
Dr Ian Rees, a consultant gastroenterologist and blood-borne virus clinical lead at Hywel Dda health board, said: “We know there are significant numbers of people out there who may have been infected many years ago.
“We see people who perhaps dabbled with drugs once or twice in the 1970s and have become infected but don’t know it.
“There are also people who may have been told some time ago that they had hepatitis B or C but that there was no treatment for it.
“We urge these people to come forward, contact one of our blood-borne virus nurses and get checked out.”
For more information, visit www.who.int/topics/hepatitis/en