Hepatitis - Jaundice

Hepatitis / Jaundice

There are about 325 million people with hepatitis B and/or hepatitis C in the world, but unfortunately about 300 million of these 325 million people are unaware that they have hepatitis B or hepatitis C. For this reason, detecting and treating patients with viral hepatitis is the key point in the fight against viral hepatitis.

According to WHO (World Health Organization) data, 2.8 million people are newly infected every year and 1.4 million people die of this disease every year. This disease is an important health problem in our country as it is all over the world.

What is viral hepatitis?

It describes the inflammatory reaction that occurs in the liver when a hepatitis virus reacts in the liver.

What are the symptoms of hepatitis?

Acute (newly developing) hepatitis can vary from person to person. In some people it causes only a complaint of weakness, while in others it can show itself with many symptoms. These symptoms are often non-specific complaints such as jaundice (first in the eyes, then throughout the body), itching, nausea, vomiting, loss of appetite, muscle and joint pain, fever, pain in the upper right abdomen and dark urine color.

Since the symptoms of acute hepatitis may resemble those of other diseases, patients should see an Infectious Diseases specialist for early diagnosis and treatment.

How is viral hepatitis diagnosed?

When viral hepatitis is suspected clinically, the person is screened with an ELISA blood test. A person whose screening tests are positive must see an Infectious Diseases specialist for further examination and treatment.

How is hepatitis transmitted?

The hepatitis virus types (A, B, C, D, E) differ from one another and are divided into two groups in terms of transmission.

Hepatitis A and E can be transmitted through contaminated food, water or by the oral route.

Hepatitis B, C and D can be transmitted through blood and body fluids or from mother to baby during birth. For this reason, care must be taken during blood product transfusions, ear piercing, tattooing, dental treatment, manicures, pedicures and sexual intercourse.

Who are the risk groups for hepatitis C?

Every adult over 18 should be tested at least once in their lifetime for HBV (HBsAg, anti-HBs, anti-HBc) and HCV; pregnant women should be tested in every pregnancy. The risk groups are:

1. People who have migrated from or lived in a high-risk region
2. People who currently or formerly use intravenous drugs and intranasal cocaine
3. Healthcare workers who come into contact with HCV-positive blood
4. People who are HIV-positive
5. People with unexplained abnormalities in liver tests (or liver disease)
6. Children born to an HCV-positive mother
7. People who have been on hemodialysis for a long time
8. Current sexual partners of HCV-positive people

Who are the risk groups for hepatitis B?

Every adult over 18 should be tested at least once in their lifetime for HBV (HBsAg, anti-HBs, anti-HBc) and HCV; pregnant women should be tested in every pregnancy. The risk groups are:

1. People who have migrated from or lived in a high-risk region
2. People living in the same household as, and sexual partners of, HBsAg-positive people
3. People who use intravenous drugs
4. People with multiple sexual partners or a history of a sexually transmitted disease
5. Prison inmates
6. People with chronically (long-term) elevated ALT and AST levels
7. People infected with HCV or HIV
8. Hemodialysis patients

What is the course of hepatitis?

Hepatitis A and E usually do not become chronic; however, hepatitis E can rarely become chronic in people who have had an organ transplant or have a suppressed immune system. The human immune system clears hepatitis A and E from the body in less than 6 months.

However, while hepatitis B, C and D types are cleared from the body by the immune system in some people (that is, they do not become chronic), in others they can become chronic and can cause infection by remaining in the body for longer than 6 months. If these chronic types are not treated, they pave the way for cirrhosis (irreversible destruction of the liver) and liver cancer.

Is there a vaccine for hepatitis?

A vaccine is available for two of the 5 types of hepatitis I mentioned above. These are hepatitis A and hepatitis B, and everyone who has not had these diseases is recommended to be vaccinated.

Is there a treatment for viral hepatitis?

Only supportive treatment is available for hepatitis A and E viruses. Hepatitis A and E are as important as the viral hepatitis types (B, C and D) that can become chronic, even if rarely. This is because they can cause fatal hepatitis, which we call fulminant hepatitis (severe liver failure). Hepatitis E can be severe during pregnancy, especially in the 3rd trimester; the mortality rate can rise to 20-25%. Pregnant women should pay attention to hygiene. For this reason, rest and liver-supportive treatment are applied to these patients.

For the hepatitis B virus, effective and safe treatments with a once-daily single tablet, a low side-effect profile and a high resistance barrier have been developed, particularly with oral tablet therapies developed within the last 10-15 years. These treatments suppress the virus in the body and thus reduce or stop liver damage. These treatment options used around the world are available in our country.

In recent years there have been developments that have greatly excited the medical world and have especially created hope in hepatitis C. Until 2-3 years ago, injection and tablet therapy was used as hepatitis C treatment. Although this treatment had both severe side effects and long treatment durations, the chance of cure was around 50-60%. The duration of this treatment was 1 year, and many patients had to stop the treatment halfway because of severe side effects. However, these drugs are no longer used or recommended today. Today, a treatment response of 98% is achieved in 3 months with a single-tablet regimen and a low side-effect profile. These treatments provide a sterilizing response (clearance from the body) and thus stop liver damage. However, because of the high cost, only some of these treatment options used around the world are available in our country.

 

Specialist Dr. Emre Y. VUDALI

Specialist in Infectious Diseases and Clinical Microbiology