July 28 has been declared as World Hepatitis Day by WHO, but not many are aware about the disease and it often goes undetected unless one goes for a regular screening or the symptoms progress. So what is hepatitis? To put it in simple terms, hepatitis is inflammation of the liver.
“Hepatitis can be caused due to viral infection or when liver is exposed to harmful substances such as alcohol. Hepatitis may occur with limited or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise. Hepatitis is of two types: Acute and chronic,” explains Dr Amit Gupte, Consultant Gastroenterology & Hepatology, Wockhardt Hospital, Mumbai Central. “It can also be due to infection, medication or other causes like gall stone or injury to the liver,” adds Dr Ajay Jhaveri, Consultant Gastroenterologist, Jaslok Hospital and Research Centre.
Some early symptoms of hepatitis are fatigue, flu-like symptoms, dark urine, nausea, fever, abdominal pain, jaundice, pale stool, loss of appetite, unexplained weight loss and, if the person has a chronic liver disease, than it can lead to water accumulating in the stomach and swelling of lower limbs. But these symptoms will also depend on the type of hepatitis, which can be categorised into hepatitis A, B, C, D and E along with alcoholic and autoimmune hepatitis. So it is important to consult a doctor when experiencing such symptoms and get treated in time to avoid further liver damage.
Shedding light on how one can contract it, Dr Akash Shukla, Transplant Hepatologist, Global Hospital, Parel, Mumbai, says, “Hepatitis A is transmitted via ingestion of contaminated food and water or through a direct contact with a person infected with it. Hepatitis B can be transmitted through blood, semen, mother to child and broken skin and often due to unknown transmission. The hepatitis C virus (HCV) spreads commonly through contaminated blood and unsafe needles. Furthermore, hepatitis E is transmitted in a manner similar to hepatitis A. Hepatitis A and E cause acute hepatitis while hepatitis B and C can cause chronic hepatitis, cirrhosis and liver cancer.”
The treatment will depend on the type of hepatitis one has. “For example, if it is viral hepatitis A and E, then it will be symptomatic treatment like paracetamol for fever, antiemetic for vomiting along with good nutritional food. There is also oral medication available for hepatitis B and C. If it is alcoholic hepatitis, then the person will have to go off alcohol, get good nutrition and take a host of medications,” says Dr Jhaveri. “Non Alcoholic Fatty Liver can also cause inflammation of the liver, modern lifestyle diseases like diabetes, obesity can lead deposition of fat on the liver causing inflammation of the liver leading to hepatitis. In this case treatment will be weight loss, controlling diabetes, avoiding sedentary lifestyle, engaging in daily exercises, avoiding junk food,” he further adds.
Adding to this, Dr Gupte says, “Currently, no specific medical therapies are available to treat hepatitis E. Because the infection is often acute, it typically resolves on its own. People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol. However, pregnant women who develop this infection require close monitoring and care, as the illness can be very severe in pregnant women.”
After one is diagnosed with hepatitis, taking medication is not enough. There are a lot of precautions one will have to follow. Speaking about it, Dr Shukla says, “Get vaccinated to keep hepatitis B at bay. Cover open sores or cuts, and avoid sharing equipments like injections, razors and toothbrush, to tackle hepatitis B and C. Get vaccinated and practice safe sex. To keep hepatitis E away, drink boiled water, and avoid eating raw and undercooked food.”
Adding to this Dr Jhaveri says, “Take drugs from a registered medical practitioner, avoid Ayurvedic or herbal medications which are available in the market—these are one of the commonest causes of drug induced hepatitis.”
While hepatitis can be managed with medications and proper treatment, in some cases hepatitis can be life-threatening if there is acute liver failure. “Survival chances with severe hepatitis depends on the age of the person and cause for liver failure. Also, hepatitis needs to be classified, like for example, if it is viral hepatitis B and has affected the liver for more than 20-30 years then the liver has become cirrhotic, in that case if there is acute liver failure it can be life threatening. Viral Hepatitis A can be life-threatening in extreme age groups—the elderly and infants. Also, overdose of paracetamol or acute liver failure due to medication and if not treated in time can be life threatening. Viral Hepatitis E in acute liver failure can be life threatening in pregnant women,” avers Dr Jhaveri.
Another question that come to mind when speaking about hepatitis is whether it lasts for life. “Hepatitis A and E are for short duration (<6 months). Hepatitis B and C last for many years and the condition is called as chronic hepatitis which may develop gradually,” explains Dr Shukla.
Recently, WHO urged nations to invest more in the elimination of hepatitis. “Today 80% of people living with hepatitis can’t get the services they need to prevent, test for and treat the disease,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “On World Hepatitis Day, we’re calling for bold political leadership, with investments to match. We call on all countries to integrate services for hepatitis into benefit packages as part of their journey towards universal health coverage.”
The Indian government has already taken steps to spread awareness about the disease. The government will offer free testing and treatment for both hepatitis B and C, which has already been implemented through reduced medicine costs.