The liver is one of the most vital organs in the body. It plays numerous roles to keep an individual in perfect shape. These include filtering all blood before passing it to the rest of the body, breaking down (detoxifying) harmful substances such as drugs and alcohol, production and excretion of bile to aid in digestion of fats in the gut, and metabolism of the food we take such as carbohydrates to generate energy. The liver is also responsible for synthesizing blood proteins such as albumin and clotting factors to limit bleeding in case of blood vessel injury. These are but a few of the functions it performs, which denotes its significance.
The World Hepatitis Day occurs annually to raise awareness on the global burden of hepatitis and lobby for changes to facilitate prevention, diagnosis and treatment. This year’s theme is “Hepatitis can’t wait” so as to convey the urgency of intervention, and limit the disease from becoming a public health threat. Hepatitis refers to the inflammation of the liver, which consequently compromises its functions. It is primarily caused by infection with Hepatitis viruses transmitted through unprotected sex, contaminated food and drinks, and contact with an infected individual’s body fluids such as blood. Non-viral causes include heavy alcohol use, toxins, certain medication and auto-immunity (self-destroying immune system).
Viral hepatitis impacts not less than 350 million people globally which indicates the disease burden at hand. The responsible viruses are named alphabetically from A to E. They cause both short-lived (acute) and long-term (chronic) liver disease. Hepatitis A and E are transmitted fecal-orally, meaning through food and water contaminated with an infected persons faeces. The rest are passed through contact with an infected person’s body fluids such as semen or blood. The signs and symptoms range from mild to severe, and usually present a few weeks after infection. They include yellowing of the skin and whites of the eyes (jaundice), abdominal pain (especially in the right upper aspect), dark urine, pale stool, poor appetite, nausea and vomiting, fatigue and joint pain. If it becomes long-term, there is risk of developing liver cirrhosis, liver failure or liver cancer.
It is possible for someone to be infected with two of the viruses at the same time, which is termed co-infection. Doctors are able to diagnose patients by taking a thorough medical history, abdominal examination, performing Liver Function Tests (LFTs) and tests to detect viral infection, taking a liver sample (biopsy) for examination, or doing an abdominal ultrasound. Treatment options are based on the type of hepatitis and whether it’s long or short-term. Hepatitis A and E are usually short-lived, hence tend to resolve on their own without medication. Antiviral medication is available for Hepatitis B and C, whereas Hepatitis D is only treated with a specific drug called alpha interferon. Hepatitis due to a self-destructing immune system is treated using immune suppressants.
Besides managing the prevailing disease burden, the main goal of this campaign is essentially to preclude new cases – ‘Prevention is better than cure’. Vaccinations have become a key approach in averting Hepatitis A and B. It is therefore paramount to strengthen immunization services globally from childhood up to adulthood. Maintaining proper hygiene and avoiding untreated water, raw or undercooked foods will minimize the risk of contracting Hepatitis A and E. Having protected sex and avoiding contact with contaminated blood e.g. through sharing needles and razors, will reduce the chances of infection with Hepatitis B, C and D. This will go a long way in achieving the World Health Organization’s vision of eliminating hepatitis as a public health concern by 2030, and save lives!
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