May 19 marks the World Day against Hepatitis B and C, two viral liver diseases caused by the virus of the same name. According to the World Health Organization (WHO), there are 257 million people in the world with chronic hepatitis B virus infection and 71 million people with chronic hepatitis C virus infection.
The best way to prevent these pathologies is to disseminate information about them.
Hepatitis B is a disease caused by the hepatitis B virus (HBV), which affects the liver. Depending on its duration in the patient, it can be classified into two types:
- Acute hepatitis B (less than six months): this is the most typical type of hepatitis B, but most likely the patient’s immune system will clear it and the patient will recover fully within a few months, although there is also the possibility of it becoming a chronic infection.
- Chronic hepatitis B (six months or more): the reason the disease lasts and becomes chronic is because the immune system is not able to fight the infection. In fact, it can last a lifetime and may lead to serious diseases such as cirrhosis and liver cancer. According to WHO, there are 257 million people in the world with chronic hepatitis B virus infection.
In the case of hepatitis C, HCV infection of the liver causes inflammation of the liver, causing it to stop functioning properly and giving the patient jaundice, i.e. yellowing of the skin. As it affects produce various extrahepatic manifestations (mixed cryoglobulinemia, dysfunction of the salivary and lacrimal glands, and some nephropathies) it is not considered an exclusively hepatic disease, but as one of the systemic diseases. Two types are distinguished:
- Acute hepatitis C: it is usually asymptomatic and is rarely associated with fulminant hepatitis, which is a life-threatening condition. Although it is estimated that around 15% of infected persons can eliminate the virus thanks to their immune system without treatment, this type of hepatitis C usually becomes chronic in 80-90% of cases.
- Chronic hepatitis C: this is the usual form. Its symptoms are mild or non-existent until advanced stages of the disease develop, such as cirrhosis and its complications.
Prevention is fundamental
Hepatitis B has a preventive vaccine. In Spain, it is given to all children at birth and is generally administered in 2, 3 or 4 injections over a period of 1 to 6 months.
Adults at high risk of hepatitis B should also be vaccinated. They are considered high risk:
- Health care workers and those who live with someone who has hepatitis B.
- People with end-stage kidney disease, chronic liver disease, or HIV infection.
- People with multiple sex partners and homosexual men.
- People who use recreational injection drugs.
The hepatitis B vaccine is very safe and effective. In fact, it is the first “cancer vaccine” because it can protect you from hepatitis B, which is the cause of 80% of all liver cancers worldwide.
In contrast, there is no vaccine for hepatitis C, so prevention focuses on reducing exposure to the virus. Effective prevention measures are:
- Avoid sharing or reusing needles, syringes or other equipment for preparing and injecting drugs or other substances.
- Do not use someone else’s personal items (razors, nail clippers or cuticle clippers, toothbrushes or glucose monitors), since they may have been in contact with the blood of an infected person, even in small amounts.
- Tattoos or skin piercings should only be performed in authorized centers.
Pathologies associated with and/or aggravated by hepatitis B and C
A chronic infection caused by hepatitis B virus (HBV) can lead to serious complications, such as:
- Cirrhosis or scarring of the liver: inflammation associated with a hepatitis B infection can lead to extensive scarring of the liver (cirrhosis), which can affect liver function.
- Liver cancer: People with chronic hepatitis B have an increased risk of liver cancer.
- Liver failure: Acute liver failure is a disease in which the liver’s vital functions stop working. When this happens, a liver transplant is necessary to live.
- Other conditions: People with chronic hepatitis B may have kidney disease or inflammation of the blood vessels (vasculitis).
Hepatitis C infection that remains for many years can cause significant complications, such as the following:
- Liver fibrosis (Cirrhosis): after having hepatitis C for 20 to 30 years, it is possible to have cirrhosis. Liver fibrosis can make it difficult for the liver to function.
- Liver cancer: A small number of people with hepatitis C may develop liver cancer.
- Liver failure: Advanced cirrhosis can cause the liver to stop working.
Diagnosis of hepatitis B and C
The method for detecting these diseases is very simple: just a drop of blood with a finger prick and wait 15 minutes to know the result.
In the case of hepatitis c, since it can cause liver damage, doctors usually use one or more of the following tests to evaluate:
- Magnetic resonance elastography
- Transient elastography
- Liver biopsy