As World Hepatitis Day is observed today, Nigerians have been advised to avoid unsafe/contaminated food/water; avoid sharing sharp objects, such as needles, blades, and clippers. They should also avoid patronising quack medical personnel/facilities, as well as unprotected sexual intercourse.

The medical experts said primary prevention of hepatitis viral infections could be achieved through immunisation and behavioural control.

Dr. Modupe Akinyinka, a Senior lecturer and Consultant Public Health Physician at the Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), said hepatitis is an inflammatory condition of the liver, that is, the liver’s reaction to injury or infection.

She stated that hepatitis viruses are the most common cause of hepatitis, although other infections, including such toxic substances, like alcohol and certain drugs, as well as autoimmune diseases, can also cause the disease.

Akinyinka explained that there are five main hepatitis viruses, referred to as hepatitis A, B, C, D and E. In particular, hepatitis B and C lead to chronic disease in many people and, together, are the most common cause of liver cirrhosis, scarring, and liver cancer.

She said: “Hepatitis A and E are typically caused by the intake of contaminated food or water. Hepatitis B, C, and D usually occur as a result of sharing sharp objects, which have been in contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures, using contaminated equipment. For hepatitis B, it is usually through mother to child transmission at birth, from family member to child, and also by sexual contact.”

A hematologist at Lagos State University Teaching Hospital (LASUTH), Dr. Abosede Lewu, said hepatitis is a common viral infection that affects both young and old people.

She said: “There are many challenges in hepatitis, which include the chances of becoming liver cancer in the future, if it is not well treated and some will lead to cardiac arrest, among others. Some women transmit hepatitis to their children during childbirth. Pregnant women should be given the hepatitis vaccine during pregnancy to avoid transmitting it to their children. Immunisation vaccine should be given to children to prevent them from being affected by hepatitis.

“Statistics have shown that eight to 10 per cent of pregnant women reduces their hepatitis infections before childbirth. Vaccines are the solution, and even adults should go for immunisation, as soon as possible.”

Family Physician, Dr. Chukwuma Ogunbor, said the treatment of viral hepatitis in children should focus on hepatitis B and C, which are the major causes of chronic liver diseases in children and adolescents, and later on for potential cirrhosis and primary hepatocellular carcinoma.

He said: “The risk of developing chronic hepatitis B (HB) infection ranges from 90 per cent in neonatal to five per cent in adults. Hepatitis C induces chronic infection in at least 85 percent of affected persons. Hepatitis B Virus (HBV) and hepatitis C virus (HCV), associated with liver damage, appears to be less severe in children than in adults.

“Presently, lamivudine and a combination of interferon seem to be the best options for treatment of HB infection in the pediatric population, even though they induce the presence of drug-resistant mutations, and new therapies have to be developed to improve reduction and cessation of viral replication and decrease the emergence of mutations.

“Therapy with interferon and ribavirin seems to offer the best results for children and adolescents. Results from a study on pegylated interferon in a pediatric population might lead to better therapeutic responses. The cost of treatment for chronic viral hepatitis is very high and efforts have to continue to extend hepatitis B vaccination to the general population globally to reduce vertical and horizontal transmission of hepatitis C.”

Ogunbor explained that hepatitis A virus (HAV) infection is usually acquired by the fecal-oral route, produces a self-limited disease that does not result in chronic infection or long-term liver disease, and usually produces symptoms of acute viral hepatitis among adolescents and adults after an average incubation period of 28 days range, 15 to 50 days.

He said: “Signs and symptoms usually last months, although 10 to 15 per cent of symptomatic persons has prolonged or relapsing disease lasting to six months. Peak infectivity occurs during the two-week period before the onset of jaundice or elevation of liver enzymes when the concentration of the virus in the stool is highest. Persons with chronic liver disease, who acquire hepatitis A, are at increased risk for fulminant hepatitis.

“If you have chronic hepatitis B and C infections, you may not have symptoms in the beginning. Symptoms may not occur until the damage affects liver function. The signs and symptoms of hepatitis include fatigue, dark urine, pale stool, abdominal pains, loss of appetite, unexplained weight loss, yellow skin, and eyes, which may be signs of jaundice.

“To diagnose hepatitis, your doctor will first take your health history to determine any risk factors you may have for infectious or non-infectious hepatitis. During a physical examination, your doctor may press down gently on your abdomen to see if there is pain or tenderness. Your doctor may also feel to see if your liver is enlarged.

“If your skin or eyes are yellow, your doctor will note this during the examination. Liver function tests require the use of blood samples to determine how efficiently your liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if you do not show any signs or symptoms on a physical examination of liver disease. High liver enzyme levels may indicate that your liver is stressed, damaged, or not functioning properly.”

Ogunbor disclosed that treatment options are determined by which type of hepatitis the patient has, and whether the infection is acute or chronic.

He said: “For instance, hepatitis A does not usually require treatment, as it is a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. Hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between 12 and 18 months. It is a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine.

“Acute hepatitis B does not require specific treatment. Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly, as it must be continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment.

“Hepatitis B can be prevented with vaccination. Hepatitis B vaccination is recommended for all newborns. The series of three vaccines are typically completed over the first six months of childhood. The vaccine is also recommended for all healthcare and medical personnel. (The Guardian)

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