HEPATITIS is perhaps a less well known disease, but more than 400 million people are living with it worldwide. Of this number, sadly almost one and half million will die every year, however with better awareness, this figure could be greatly reduced.

This is where World Hepatitis Day comes in – it aims to raise awareness of the global impact of hepatitis and is one of just four disease-specific global awareness days officially endorsed by the World Health Organisation.

Hepatitis simply means inflammation of the liver. There are currently known to be five strains, A to E. A is usually transmitted via food prepared in unsanitary conditions, but the body normally clears this rapidly, with no lasting problems. Hepatitis B and C, the focus of this article, are transmitted via blood and bodily fluids, so by unprotected sex with someone who already has the virus, sharing needles, and also from a hepatitis positive mother to her baby during childbirth.

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People given blood or blood products before September 1991 are also at risk of hepatitis C specifically, as screening for this and HIV was not performed before this time.

If you contract hepatitis, there are two phases, called acute and chronic for simplicity. In the acute phase, which can last up to six months after infection, you may feel generally unwell, in a manner similar to a flu-like illness. Features specific to hepatitis include pale urine, dark stools and the most commonly known symptom, jaundice, where the skin and whites of the eyes become yellow. At the opposite end of the scale, carriers may be completely symptom free.

Thankfully, for many the body will naturally rid itself of hepatitis, with no further complications. However, a group will go on to develop chronic hepatitis. The problem is that those without symptoms in the acute phase may be unaware they are infected and hence unlikely to seek medical attention.

Chronic infection – especially that which the individual is unaware of – poses two major problems. Firstly, he or she will remain infective, so can pass on the virus to another person. Secondly, a proportion of those who have chronic hepatitis will develop cirrhosis or scarring of the liver. Some of these unfortunately will end up with liver cancer.

Despite what appears to be a bleak backdrop, there are many promising developments. Currently all pregnant mothers are screened for hepatitis B, and if found to be positive, their baby will be immunised immediately after birth. In addition, from August 1 this year, the hepatitis B vaccine will be included in the routine childhood schedule, where previously it was only given to those babies identified as high risk. This is excellent news as the majority of babies who develop hepatitis B will have no symptoms initially, but will still go on to develop the problems associated with chronic infection.

There is currently no cure for hepatitis B; however there are medications which can reduce the effects of the virus on the liver, hopefully preventing the development of cirrhosis or liver cancer. Whereas there is no vaccine against hepatitis C at the present, we now have treatment which can permanently clear the virus from the bloodstream, and hence prevent further liver damage.

All of these treatments are offered by liver specialists; but the take home message is simple. As the viruses are transmitted in blood and bodily fluids, avoiding unprotected intercourse with casual sexual partners is strongly advised. Any needles and other items used for recreational drugs can transfer hepatitis. Most areas now have a clean needles exchange policy as well as support for those wishing to come off drugs.

The majority of those who had blood products before 1991 will now have been identified, but if you are in this group and haven’t been tested, or you feel you may have exposed yourself to hepatitis, please discuss this with your routine GP, who will most likely offer a blood test.

It is ignorance of the disease which kills. The virus can lie undetected for several years and only come to light when a person becomes very ill, by which time treatment may be less effective or not work at all.

A negative test will hopefully put many people’s minds at rest, yet a positive test means advice, support and treatment can be offered at the earliest opportunity.

*Useful Websites www.worldhepatitisday.org; www.britishlivertrust.org; www.hepctrust.org

*World Hepatitis Day took place on July 28