Hepatitis Information Kit

What is hepatitis?

Just as the name implies, hepatitis is an inflammation of the liver cells. Hepatitis may be asymptomatic at first but as it develops symptoms might include:     

Pain in abdomen Fatigue Fever Jaundice Nausea

It is important to keep in mind that these symptoms do not appear in every case of hepatitis. If caught late, the damage done to the liver could be irreparable.

Each case is different, however they are often mild and patients make a full recovery. Despite this fact, hepatitis can be a life-threatening condition in other cases.

The complications of hepatitis are various and include cirrhosis and liver cancer

What causes hepatitis?

Hepatitis can be caused by a variety of things such as alcohol, certain drugs, infections and auto-immune conditions. The commonest cause of hepatitis however is viral by transmission from an infected person.

There are 5 main types of Hepatitis viruses: A, B, C, D and E. However, the most commonly known and researched are the types A, B and C.

What is the difference between them?

The main differences between the 5 types are their mode of transmission, prevention and treatment since all 5 types bring about the same condition.

Hep A (HAV) It is transmitted via the feco-oral route meaning that the virus is present in the faeces of an infected person.

Transmission is usually caused by lack of hygiene of the infected person or because of a lack of proper sanitation.

HAV can be prevented by ensuring that there is a proper sanitation system and by educating people on the importance of personal hygiene. There are also safe vaccines which have been proven to be effective.

Hep B (HBV) It is transmitted through body fluids such as blood and semen. HBV can be transmitted via sexual intercourse or through the use of contaminated needles, both in medical operations and also in intravenous drug abusers. It could also be transmitted from a mother to her child during birth.

Whilst effective vaccines for HBV exist, the best precaution is caution during medical interventions and also during intercourse by making sure to use proper protection and avoid having multiple partners.

Hep C (HCV) The main path of transmission is via blood. Just like HBV, it is transmitted through the improper use of needles, such as drug abusers who recycle needles, and in medical settings due to negligence and accidents.

There is currently no vaccine for HCV, so the best preventive measure is caution when it comes to making use of needles. It is also often the case that drug abusers are provided with sterile needles to make sure that they are not infected with HBV and HVC.

Hep D (HDV) This kind of infection only occurs with HBV. When there is infection of both HBV and HDV, there is a worsening of the condition which leads to a worse outcome. Vaccines for HBV also provide protection against HDV.

Hep E (HEV) Is transmitted mainly through contaminated food and water. Once again, the best kind of prevention against this type of hepatitis is through careful control and monitoring since whilst there are vaccines for HEV they are not widely available.

How is hepatitis treated?

As mentioned before, it is sometimes the case that there are no signs of hepatitis and the disease can go unnoticed in the patient for years. Blood tests can be used to determine if a person is infected and with which type since the type will determine the treatment.

The first step taken after diagnosis should always be that of protecting the people who live with and are close to the patient. This is done by ensuring that the proper hygienic measures are taken, as well as avoiding unprotected sex in the case of HBV.

It is essential that patients suffering from Hepatitis are always monitored to assess the progress. This is done by making use of blood tests and visual methods such as CT scans and ultrasounds to ensure that no damage is being done to the liver.

It is also important to ensure that no further damage is done to the liver. Alcohol and other substances which could damage the liver should be avoided.

HAV usually needs no medication and goes away by itself.

Only the symptoms have to be managed in this type of hepatitis. Smaller portions of food should be eaten if the nausea is too much and strenuous exercise should be avoided.

HBV is to be monitored and kept from spreading in order to avoid damage to the liver. Antiviral medications are a line of treatment but the advantages must be weighed against the disadvantages for the use of such medications.

HCV must be treated medically. A number of drug combinations exist, the use of which varies from person to person

Hepatitis in Malta Research results from 2013 show that there are 700 people suffering from hepatitis in Malta however it is estimated that around 300 people suffer from hepatitis and are not aware of it due to the fact that hepatitis can be present in a person without showing any signs and symptoms.

The people deemed most at risk were drug inject people and those who frequently get tattoos done due to the use of needles in these processes.

From the results obtained it was found that the majority of the people affected were of an age between 21 and 50 years of age.

72% of the patients were found to be male whilst the leading cause of hepatitis was due to intravenous drug injections accounting for 68% of the cases.

As part of a harm minimizing project around 350,000 needles were distributed free of charge in Malta during that year to decrease the number of drug inject people recycling needles.

Whilst some people disagree with this initiative since they see it as a way of supporting drug addicts one must keep in mind that as a health provider, the health of the patient comes first.

This initiative serves to minimize the damage already being done by the drugs themselves as it helps prevent the spread of Hepatitis B and C as well as other serious blood transmitted conditions such as HIV.

Vaccinations Whilst there are no strict guidelines regarding vaccinations for hepatitis it is advisable to get vaccinated. People working in the health system are required to be vaccinated for hepatitis as protection against possible accidents.

Dosage varies according to age but the regimen is the same for all ages in non-compromised patients.

3 doses must be given. The second dose follows 1 month after the first and the third follows 5 months after the second.

The dose for those under 16 is 0.5ml whilst for those 16 and over it is 1.0ml.

Adverse reactions The hepatitis B vaccine is generally well tolerated. The most frequently reported systemically adverse reactions are: 

Irritability



Fever

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Diarrhea

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Fatigue

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Diminished appetite



Rhinitis

The hepatitis B vaccine is not associated with increased incidence of exacerbations of multiple sclerosis. Of those children experiencing a side effect, most will have only a very mild reaction such as soreness at the infection site or low grade fever.

Adults are slightly more likely to experience such mild symptoms. Serious allergic reactions following hepatitis B vaccinations are rare.

Contraindications Those who had a serious allergic reaction to one dose of the hepatitis B vaccine should not have another dose.

Patients with a history of hypersensitivity to yeast should not receive the vaccine.

People with a moderate or severe acute illness should postpone receiving the vaccine until there condition has improved.