BY: Dr. Sadia Irfan: Together hepatitis B and C represent one of the major threat to global health. Hepatitis B and C are both ‘silent’ viruses, and because many people feel no symptoms, you could be infected for years without knowing it. If left untreated, both the hepatitis B and C viruses can lead to liver scarring (cirrhosis). If you have liver cirrhosis, you have a risk of life-threatening complications such as bleeding, ascites (accumulation of fluid in the abdominal cavity), coma, liver cancer, liver failure and death. In the case of chronic hepatitis B, liver cancer might even appear before you have developed cirrhosis.
In some cases, a diagnosis is made too late and the only option is a liver transplant. If you think you have been at risk, it is important that you get tested as soon as possible and, if diagnosed, consider your treatment options and self-management strategies.
The Difference Between Hepatitis B and C:
While there is a vaccine that protects against hepatitis B infection, there is no vaccine available for hepatitis C.
Both viruses can be contracted though blood-to-blood contact.
Hepatitis B is more infectious than hepatitis C and can also be spread through saliva, semen and vaginal fluid.
In the case of hepatitis B, infection can occur through having unprotected sex with an infected person. Please note that this is much rarer in the case of hepatitis C,While unlikely, it is possible to contract hepatitis B through kissing. You cannot contract hepatitis C through kissing.
Neither virus is easily spread through everyday contact. You cannot get infected with hepatitis B or C by shaking hands, coughing or sneezing, or by using the same toilet. There are different treatments for the two viruses. While treatment can control chronic hepatitis B, it can often cure hepatitis C
Even if treatment is not an option for you, you can do something about your disease. A healthy lifestyle is important. Alcohol, smoking, eating fatty foods, being overweight or extreme dieting (eating no food at all) may worsen your liver disease. Therefore, try to avoid all alcohol, stop smoking, eat a low fat diet with enough fruit and vegetables, and reduce your weight if necessary.
The World Health Organization (WHO) recognises that hepatitis B is one of the major diseases affecting mankind today. Hepatitis B is one of the most common viral infections in the world and the WHO estimates that two billion people have been infected with the hepatitis B virus and approximately 350 million people are living with chronic (lifelong) infections. 500,000 – 700,000 people die every year from hepatitis B.
The hepatitis B virus is highly infectious and about 50-100 times more infectious than HIV. In nine out of ten adults, acute hepatitis B infection will go away on its own in the first six months. However, if the virus becomes chronic, it may cause liver cirrhosis and liver cancer after up to 40 years, but in some cases as little as five years after diagnosis.
Hepatitis B is spread between people through contact with the blood or other body fluids (i.e. semen, vaginal fluid and saliva) of an infected person. The main routes of infection are through sexual intercourse, sharing of contaminated needles,
razors, toothbrushes and medical equipment, and from mothers with hepatitis B to their newborn babies.
Although not all people will have any signs of the virus, those that do may experience the following symptoms:
Jaundice (yellowing of the skin)
Diarrhoea/dark urine/bright stools
Unlike hepatitis C, there is a vaccine that can prevent infection. If you think you are at risk, you should get vaccinated as soon as possible.
First the blood is checked for the HB surface antigen (HBsAg). The HBs antigen is a part of the virus and will usually appear in your blood six to twelve 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, your blood test will show antibodies to hepatitis B (anti-HBs). Your body made these to destroy the virus. It is good to have anti-HBs, because that means you are healthy, and protected against hepatitis B infection.
HBs antigen = bad news (you are infected)
anti-HBs = good news (you are protected)
Treatment Of Hepatitis B:
In most countries a patient with a positive test result will be referred to a specialist who will carry out further tests to determine the degree to which hepatitis B may be affecting the liver, and what may be the best treatment options. In these tests a small sample of liver tissue may need to be taken (a liver biopsy).
In the majority of patients with active HBV, symptoms will not be severe and treatment will not be required. The patient will be monitored and after a few months the patient’s immune system should fight off the virus, giving the patient natural immunity.
In around 5% of adults, 30-50% of young children (aged 1-4), and 90% of infants, HBV infection will become chronic. The virus is more deadly to the young and those that are infected at birth have a 25% chance of developing a life-threatening liver-related illness.
Antiviral medication is given as treatment to those with chronic symptoms to help prevent further liver damage. These medications may be injected or given in pill form. Examples are Interferon Alpha, Lamivudine and Baraclude. Treatment usually lasts 6 months, during which time the patient will be carefully monitored.
Regardless of whether the infection is producing symptoms or not, the patient will be advised to avoid alcohol, get plenty of rest and maintain a healthy diet.
Hepatitis B immunisation:
Three immunisation injections are given over a period of 3-6 months. A blood test is taken once the course of injections is completed to check they have worked. Immunity should last for at least 5 years.
A patient with an active infection will be advised to have regular blood tests and physical check-ups to monitor the virus, even if they are not receiving treatment. All carriers of HBV should expect to be referred to specialist services.
The patient havre to avoid alcohol, fatty foods and follow a low-salt diet. They will also describe any precautions necessary to ensure the patient avoids infecting others with the virus, such as not sharing toothbrushes or shaving equipment.
It is important to use a condom for penetrative sex to prevent passing on the virus. Sexual partners of the patient should be tested and immunised against HBV (if not already infected).
Hepatitis C is different from hepatitis B in that the virus more frequently stays in the body for longer than six months, and therefore becomes chronic. Four out of five people develop a chronic infection, which may cause cirrhosis and liver cancer after 15–30 years. There are approximately 170 million people chronically infected with hepatitis C worldwide. In 2000, the WHO estimated that between three and four million people are newly infected every year.
Hepatitis C is mainly spread through blood-to-blood contact and, similarly to hepatitis B, there are often no symptoms but if they are present can include:
Aching muscles and joints
Anxiety and depression
Loss of appetite
Dark urine/bright stools.