While the world is currently battling the COVID-19 pandemic, it would be counterintuitive of governments and health-promoting organizations to give a room for other disease-causing viruses such as Hepatitis viruses and HIV among others. It is thus our concern as medical students that we ought to pledge joining forces with other health professionals and the rest of the world in celebrating the World Hepatitis Day 2021which takes place on 28th July, every year. From our view as medical students, on an annual basis we play the role of advocacy and raising awareness through community outreaches, radio and televisions talks as some of the pivotal means of reaching out to the public. However, unlike in the past years, we had difficulty reaching out to the communities due to the Covid-19 pandemic preventive measures such as avoiding crowded areas and social distancing.
Briefly, hepatitis is a broad term that means inflammation of the liver which is commonly caused by viruses (viral hepatitis A, B, C, D and E). It can also come as an effect of chemicals, drugs (alcoholic hepatitis), metabolism abnormalities (non-alcoholic hepatitis) and autoimmune diseases of the liver (Autoimmune hepatitis). Viral hepatitis is the one with much incidence of causing hepatitis worldwide where the World Health Organization (WHO) in 2019 estimated that 296 million people worldwide were living with hepatitis B, 58 million people with hepatitis C and about 2.3 billion people worldwide that were infected with one or more of the hepatitis viruses. These infections altogether lead to around 1.4 million deaths per year. HBV and HCV are responsible for 90% of hepatitis effects.
Viral hepatitis represents a disease entity caused by at least five unrelated viruses whose primary site of effect is the hepatocyte of the liver. Hepatitis A and E viruses cause only short-term and acute infection but hepatitis B, C and D viruses can cause chronic infection. Below is a detailed account of their etiology and epidemiology of the hepatitis viruses:
Hepatitis A, is an acute self-limited disease resulting from infection with hepatitis A virus (HAV).
- Risk: People in under developed countries
- Incubation period: Average 28 days
- Effects and Outcome of infection: Acute and it can be resolved
- Major modes of transmission: Fecal-oral route
- B virus (HBV), Can produce an acute hepatitis which may last up to 6 months (with or without symptom) and infected people are able to pass the virus in that time., While chronic infection is the persistence of HB for 6months or more after acute infection and places the individual at risk of death from chronic liver disease or primary hepatocellular carcinoma.
- Risky personnel: All ages but mostly adults
- Incubation period: 2-5 months
- Effects and Outcome of infection: acute and chronic
- Major modes of transmission: Parenteral, Sexual and Exposure to infected blood
Hepatitis C virus (HCV), infection produces a persistent infection that is often associated with chronic liver disease.
- Risky personnel: All ages but mostly adults.
- Incubation period: 14-180 (average 56).
- Effects and Outcome of infection: Acute and Chronic which result in liver cirrhosis.
- Major modes of transmission: Parenteral, Sexual and Blood or blood product.
Delta hepatitis, is caused by hepatitis delta virus (HDV), an “incomplete” virus and the only viroid known to infect man, it requires an active HBV infection to replicate.
- Risky personnel: it is only possible if person is already affected by HBV OR affected by both of them
- Incubation period: 2-26 weeks
- Effects and Outcome of infection: Acute and chronic effects
- Major modes of transmission: Parenteral
Hepatitis E virus (HEV), is the cause of almost all cases of transmitted non-A, non-B hepatitis and is not known to produce a persistent infection. However, the serological exclusion of the known hepatitis viruses continues to leave cases of hepatitis that clinically appear to be viral in origin.
- Risky personnel: Adults and severe in pregnant women
- Incubation period: 15-64 days
- Effects and Outcome of infection: Acute and resolved
- Major modes of transmission: Fecal – oral.
- HAV: Pre-exposure vaccination, hygiene and there is no drug or therapies to treat HAV.
- HBV: Pre/pro exposure vaccination.
- HCV: Blood donor screening and No vaccine for HCV
- HDV: Pre/post exposure vaccination and interferon.
- HEV: Hygiene and resolve on its own within four to six weeks
Written by: Christian TUNGA, SCOPH Publication Assistant
Edited by: Elysée BYIRINGIRO, MEDSAR VPPRC