Health – Unpacking Hepatitis
July 28 is World Hepatitis Day, yet most South Africans know little of these potentially deadly liver infections — and are unaware that they may have them. But there are things you can do to help prevent them
There’s another killer stalking silently among us, preying particularly on the most vulnerable – infants and children under the age of five, people with compromised immunity, sex workers, health workers and intravenous drug users. It’s liver infection, caused by the hepatitis B and C viruses. It’s the eighth leading cause of death globally, causing the same number of deaths each year as HIV/ Aids, reports the World Hepatitis Alliance.
“Viral hepatitis is pandemic, recording about 3 000 deaths a day worldwide,” says Tiara Deans, founder and chairperson of the Hepatitis Foundation South Africa (HFSA), and Goodwill Global Ambassador. “I founded HFSA in 2017 as there’s virtually no awareness, no meds and pretty much no support within our borders. Viral hepatitis wreaks havoc on internal organs and is the leading cause of cirrhosis and cancer. I’m still struggling with its effects. But I’m a warrior,” Dean says, adding that she shares all her knowledge on her Facebook page: Hepatitis C Raising Awareness in South Africa.
SIGNS OF INFECTION
Hepatitis B and C present with the same signs, although Deans says less than 5 % of people are aware of their condition, and there is, as yet, no routine screening that can enable early treatment. The signs are flu-like and easy to dismiss: Feeling generally unwell
Fever
Extreme fatigue and weakness Joint pain
Decreased appetite
Nausea and vomiting
Dark yellow urine
Pale or grey stools
Jaundice (yellowing of skin or eyes) Pain in the right upper abdomen (liver area)
Both hepatitis B and C can cause short-term (acute) infection in the first six months. If you’re an adult with a healthy immune system, you’re able to clear the infection, but for those with lowered immunity or other health conditions, as well as babies and young children, it can develop into long-term (chronic) infection with serious results. Up to one in four people who have hepatitis B get chronic liver disease, such as cirrhosis, liver scarring and liver cancer, inflammation of blood vessels and anaemia.
Up to one in five people with hepatitis C also get cirrhosis, but it’s more likely to become a chronic condition than B is – the US Centers for Disease Control (CDC) note that 1-5 % die of it or of liver cancer. Yet, hepatitis C is considered less serious because it’s become curable – and although hepatitis B is now manageable with treatment, it can’t be cured, as yet.
The big difference between B and C is the way you contract them. You get hepatitis B from contact with the body fluids of an infected person – semen, vaginal fluids and blood. You get hepatitis C only from blood-to-blood contact, mainly through unsafe injection practices and inadequate sterilisation of medical equipment.
Fortunately, neither B nor C is spread by coughing, sneezing, kissing, hugging someone infected, sharing their food, or by breastfeeding. However, if you’re pregnant and infected, you can pass on hepatitis B to your baby during childbirth. The CDC reports that 90 % of infants with the virus develop a chronic infection.
COULD YOU BE INFECTED?
You need to get checked out if you live with someone who has either hepatitis B or C, if you were born to an infected mother, or if you’re a health or public safety worker exposed to people’s blood and other fluids. You’re also at risk if you have an STI – and you’re more likely to get STIs if you have multiple sex partners, especially if you don’t use condoms.
You’re also at great risk if you inject drugs and share needles, which expose you to both hepatitis B and C. In a recent South African study by TB/HIV Care and partners, half of the injecting drug users surveyed had hepatitis C! Sharing razors or toothbrushes with contaminated blood on them, or having tattoos or piercings done where equipment isn’t sterilised and new needles aren’t used for each client, can also expose you to hepatitis C.
If you have HIV, you’re at particularly high risk of contracting hepatitis C, because they have similar paths of transmission – a quarter of people with HIV are coinfected with hepatitis B or C.
HOW TO PROTECT YOURSELF
It should, by now, be obvious: Practice safe sex – use condoms, and dental dams for oral sex. Never share needles, razors, toothbrushes or nail clippers. Wear latex gloves (or put plastic bags over your hands) if wiping up blood, and seal any bloodied items in a plastic bag before disposal.
If you have compromised immunity, or are a health worker, sex worker or in any other way at high risk, go for blood tests.
Most importantly, get vaccinated against hepatitis B. There’s no vaccine yet for hepatitis C.
WHEN TO SEE A DOCTOR
If you have any of these symptoms, go for a check-up. Get medical attention immediately if you know you’ve been exposed to hepatitis B and haven’t been vaccinated. For more info, contact the HFSA on www.hepatitis-sa.co.za.