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NOHep: A Global Movement to Eliminate Hepatitis by 2030

According to the World Hepatitis Alliance, 10 million people are newly infected with viral hepatitis every year. More than one million people die from the disease yearly—more than malaria or HIV/AIDS. Astonishingly, the organization reports that less than 1% of those infected receive treatment. But, with better awareness and understanding of how to prevent hepatitis, 4,000 lives could be saved daily.

In 2016, the first ever global strategy for the elimination of viral hepatitis (GHSS) was developed. It sets ambitious targets and a goal to eliminate hepatitis as a public health threat by 2030. This is the first time commitments have been made to make the elimination of viral hepatitis a reality. Additionally, with the 2015 UN Sustainable Development Goals (SDGs) including a reference to combat hepatitis, the time is now to drive global change. Now more than ever there is a need for a unified global commitment to help drive elimination by 2030. Visit NOHep.org for more information.

What is Hepatitis?

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis, or liver cancer, says the World Health Organization (WHO). Hepatitis viruses are the most common cause of hepatitis in the world, but other infections, toxic substances (such as alcohol or certain drugs), and autoimmune diseases, can also cause the disease.

Five main hepatitis viruses, referred to as types A, B, C, D, and E, have been identified. These five types are of greatest concern because of the illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Types and Causes

Hepatitis A virus (HAV)

According to WHO, this virus is present in the feces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening.

Hepatitis B virus (HBV)

This virus is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients.

Hepatitis A and B can both be prevented with vaccines. Cases of Hepatitis A have dramatically declined in the U.S. over the last 20 years largely due to vaccination efforts. The Hepatitis A vaccine is recommended for all children at one year of age and for adults who may be at increased risk.

Unfortunately, many people became infected with Hepatitis B before the Hepatitis B vaccine was widely available. The hepatitis B vaccine is recommended for all infants at birth and for adults who may be at risk.

Hepatitis C virus (HCV)

Discovered just 20 years ago, this virus is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.

Hepatitis C is the most common cause of chronic liver disease in the U.S., the most common cause of liver scarring (cirrhosis), the most common reason for liver transplantation, and, now, the most common cause of liver cancer. The Centers for Disease Control and Prevention (CDC) reports that between 75% and 85% of those infected with the hepatitis C virus develop a chronic infection.

Symptoms of the disease can include:

  • Jaundice (yellowing of the skin and eyes);
  • Tiredness;
  • Stomach ache;
  • Nausea;
  • Muscle aches;
  • Diarrhea;
  • Loss of appetite;
  • Fever; and
  • Headaches.

Most Common: Types B and C

Together, hepatitis B virus (HBV) and hepatitis C (HCV) are the leading cause of liver cancer in the world, accounting for 78% of all cases. Nearly one out of every three people in the world (approximately 2 billion people) has been infected by HBV, and one in 12 live with chronic HBV or HCV infection. While most people who have been infected with these viruses are unaware of their infection, they face the possibility of developing debilitating or fatal liver disease at some point in their lives and unknowingly transmitting the infection to others.

To diagnose hepatitis B the blood needs to be checked for the hepatitis B surface antigen (HBsAg). The HBs antigen is a part of the virus and will usually appear in the blood six to 12 weeks after infection. If the test is positive, you have hepatitis B. In that case, your doctor should conduct further tests to check if your hepatitis B infection is new or old, if it is harming your body or not, and if you need treatment or not. If you have naturally cleared the virus, or if you have been vaccinated against hepatitis B, you will have antibodies to hepatitis B (anti-HBs). Your body made these to destroy the virus. If you have anti-HBs you are protected against future infection by the hepatitis B virus.

For hepatitis C, your doctor will first check for hepatitis C antibodies (anti-HCV). If the test is positive, this means you either have the virus now, or have had the virus and cleared it. Hepatitis C antibodies usually take seven to nine weeks to appear in the blood after infection. If your immune system is weakened (perhaps by HIV) your body may take longer to produce hepatitis C antibodies or it may not produce any at all. If the first test is positive, your doctor will then test for the virus itself (hepatitis C RNA). If this is positive, you have hepatitis C.

If diagnosed with hepatitis B or C you will face many challenges, but it’s better to confront the disease head on, know how to avoid transmitting the infection to others, and consider your treatment options and self-management strategies as early as possible.

Hepatitis Risk Assessment

The online Hepatitis Risk Assessment is designed to determine an individual’s risk for viral hepatitis and asks questions based upon CDC’s recommendations for testing and vaccination. The site allows individuals to answer questions privately, either in their home or in a health care setting, and print recommendations to discuss with their doctor.

Prevention

Safe and effective vaccines provide protection against hepatitis A and B. The CDC recommends that all newborns and individuals up to 18 years of age and adult participating at risk of infection be vaccinated. Three injections over a six to 12 month period are required to provide full protection.

To protect yourself from any type of hepatitis, you should:

  • Wash your hands after going to the bathroom and before preparing food or eating;
  • Use latex condoms to lower the risk of transmission;
  • Avoid tap water when traveling to certain countries or regions. Ask your doctor about risks before you travel or call the CDC at 877-FYI-TRIP;
  • Avoid sharing drug needles; and
  • Avoid sharing personal items—such as toothbrushes, razors, and nail clippers—with an infected person.

For further information about whether you might be, or have been, at risk and how you can get tested, contact the providers at CCHC Southern Gastroenterology Associates in New Bern by calling (252) 634-9000 or visiting www.cchchealthcare.com.

(Sources: National Institutes of Health, World Health Organization, Centers for Disease Control and Prevention, World Hepatitis Alliance, and the American Liver Foundation.)