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Raising awareness of hepatitis

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World hepatitis day is observed on 28 July each year. Its aim is to increase global awareness and understanding of both hepatitis B and hepatitis C. Together, these viral infections represent one of the major threats to global health. They are known as “silent viruses”: those infected mostly suffer no symptoms.

Both forms of the disease have acute and chronic phases. In those affected, symptoms in the acute phase include nausea, flu-like symptoms and jaundice. In around 5 per cent of hepatitis B and over 75 per cent of hepatitis C cases the virus persists for more than six months and the disease enters the chronic phase. If untreated, cirrhosis of the liver can develop, often as long as 20 years after the acute infection, which can lead to hepatic cancer and death.

Infection is uncommon in developed countries and is largely confined to certain groups such as injecting drug users, those with high-risk sexual behaviour and certain ethnic communities. However, in developing countries, particularly China, central and south-east Asia, and sub-Saharan Africa, the diseases are common. The World Health Organization estimates that hepatitis B and C are responsible for over 600,000 and 350,000 deaths per year worldwide, respectively.

Hepatitis B is the more infectious disease and can be spread not only through blood contact, as in hepatitis C, but also via saliva, semen and vaginal fluids. In developing countries chronic hepatitis B is particularly prevalent in children, and 90 per cent of those infected by their mothers at birth will develop the chronic form of the disease. However, if vaccination is carried out shortly after birth, the disease can be prevented. No vaccine is available for hepatitis C, but it can be eradicated by combination antiviral drug treatment. Treatment will not eradicate hepatitis B, but may prevent or reduce liver damage. Antiviral drugs are not usually an option in developing countries, and the hepatitis B vaccine is the mainstay of prevention, with WHO recommending that all infants be vaccinated. For hepatitis C, the emphasis is on prevention by education, avoiding unsafe injections and practising safe sex.

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