Hepatitis: Prevention And Treatment

According to the World Health Organization, 325 million people globally live with a hepatitis infection and 900,000 deaths per year are caused by hepatitis B virus infection.

What, then, is hepatitis?
Hepatitis is a disease characterised by the inflammation of the liver. The liver is the second largest organ in the body after the skin which is responsible for the metabolism of fats, proteins, carbohydrates, removal of toxins in the blood, production of clotting factors that help in blood loss, excretion of drugs, cholesterol, and a whole lot more. Inflammation happens when tissues in the body are infected or injured which is characterised by swelling.

This swelling can damage the liver and affect how these liver functions are being carried out. Hepatitis can be acute (less than six months) or can be a chronic infection that is more than six months.

What causes hepatitis?
Hepatitis can be caused by infectious agents or noninfectious agents. The different types of hepatitis with their causes include:
Viral Hepatitis: The five main strains of hepatitis virus include hepatitis A, B, C, D, and E. Viral hepatitis is the most common type of hepatitis with A, B, and C as the commonest causes. Hepatitis D virus is commonly found in people already infected with hepatitis B. Other viruses that can cause hepatitis include Epstein Barr virus, cytomegalovirus, and yellow fever virus.

Alcoholic Hepatitis: This happens when there is consistent heavy alcohol use by an individual over a long period.
Autoimmune Hepatitis: This happens when the immune system of the body attacks the liver. The cause, however, is generally unknown, but heredity and environmental factors play a role.

Toxic Hepatitis: Since the liver is responsible for the excretion of certain materials in the body, some of the toxins can be harmful to the liver. Also poisons, chemical substances can cause injury to the liver. Drugs like paracetamol in the wrong dose can cause damage to the liver. Isoniazid is also another drug that can cause harm to the liver. They should only be taken with a doctor’s prescription.

How is Hepatitis spread?
Hepatitis A and E can be contracted through contaminated food or water contaminated by the excreta of an infected person, thus poor sanitation, overcrowding can facilitate spread.

Hepatitis B, C, and D are transmitted through blood and blood products. Hepatitis B and D can further be transmitted via other bodily fluids, including unprotected sexual intercourse. Others include sharing of intravenous needles, among others.

What are the symptoms of hepatitis?

Some people with hepatitis can be asymptomatic, that is, show no clinical symptoms of disease or know they are infected. Each type of Hepatitis virus, however, can cause severe symptoms depending on the onset.

The following are the signs and symptoms you may experience if you have hepatitis.
• Fever
• Jaundice (Yellowness of the whites of the eyes and skin)
• Abdominal discomfort
• Dark coloured urine
• Fatigue
• Loss of appetite
• Nausea

Symptoms can start within 15 days to 6 months if it is an acute infection and in some cases, it may cause a chronic infection which causes scarring of the liver tissues (Cirrhosis) or cancer.

How is hepatitis diagnosed?
A doctor can diagnose hepatitis by asking you questions about your symptoms, doing a physical examination, and order for tests which include but are not limited to blood tests to check for viral hepatitis, an ultrasound scan, and maybe a liver biopsy to check the extent of damage to the liver.

What are the treatment options for hepatitis?
This depends on if the disease is acute or chronic. Most cases of acute hepatitis are often mild and do not require antiviral medications or hospitalisation.

The goal is to ensure adequate nutrition, hydration, prevent further spread of the disease. People who would most likely require admission are pregnant women, the elderly, and people with underlying medical conditions.

Chronic hepatitis B infection can be treated with antiviral drugs. However, only a portion of people would require treatment. Treatment helps to slow disease progression to cirrhosis, decrease the incidence of liver cancer and improve long-term survival overall. Also, according to WHO, antiviral drugs cure about 95% of hepatitis C infections while some people would recover on their own.

In alcoholic hepatitis, drinking would need to be stopped permanently. If chronic hepatitis progresses to liver failure or cancer, a liver transplant would be needed.

How can we prevent hepatitis?
Vaccines have been developed against the hepatitis B virus. It is available in Nigeria as part of the immunisation schedule and it is given at birth to prevent mother-to-child transmission. It is also available for adults in three doses. Vaccines are also available for the hepatitis A virus.
Preventing hepatitis also involves:
• Good personal and community hygiene
• Awareness/education
• Lifestyle changes (cultural approach to native scarifications and surgical procedures, safe sexual practices)
• Blood and blood product transfusion safety
• Use of single-use syringes, needles, biopsy needles etc
• Proper sterilization of medical instruments
• Avoid unsafe injection practices
• Avoid sharing of sharps by intravenous drug users
• Avoid sharing personal items such as toothbrushes, nail clippers.

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