ALL ABOUT HEPATITIS !

What is Hepatitis?

Hepatitis means inflammation (itis) of the liver (hepar), an irritation or swelling of the liver cells. There are many causes of hepatitis which include viral infections A, B and C that most of us have heard of, but also the disease also includes auto-immune hepatitis, fatty liver hepatitis, alcoholic hepatitis and toxin induced hepatitis. Globally, it is estimated that around 250 million people are affected by hepatitis C. Moreover, an estimated 400 million people are chronic carriers of hepatitis B.

The History of Hepatitis:

Hepatitis was believed to exist in viral form from ancient times. It is known that a disease existed that affected the liver and caused yellowing of the skin (jaundice). Between the 1800s and early 1900s, 2 types were identified as either serum type or viral type. In 1963 there was a major breakthrough which identified the cause of serum hepatitis and named the hepatitis B virus (HBV). Ten years later the cause of infectious hepatitis was found and named the Hepatitis A virus (HAV), and although scientists knew other viruses existed it was not until 1989 that the hepatitis C virus (HCV) was isolated.

Although the hepatitis delta virus (HDV) was known about since the mid 1970s, it was only in the late 1980s -1990s that it was understood to exist only in the presence of hepatitis B. In 1990, hepatitis E virus (HEV) and in 1995, Hepatitis G virus (HGV), were identified. Other viruses, hepatitis F virus (HFV) and transfusion transmission virus (TTV) are thought to exist, but are not as yet proven.

HEPATITIS A:

Hepatitis A is a liver disease caused by the hepatitis A virus. Hepatitis A can affect anyone. In the United States, hepatitis A can occur in situations ranging from isolated cases of disease to widespread epidemics. Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis A virus infection in persons 12 months of age and older. Immune globulin is available for short-term prevention of hepatitis A virus infection in individuals of all ages.

SIGNS & SYMPTOMS:

jaundice, fatigue, abdominal pain, loss of appetite, nausea, diarrhea, fever

TRANSMISSION:

- HAV is found in the stool (feces) of persons with hepatitis A.

- HAV is usually spread from person to person by putting something in the mouth (even though it might look clean) that has been contaminated with the stool of a person with hepatitis A.

PREVENTION:

- Hepatitis A vaccine is the best protection.

- Short-term protection against hepatitis A is available from immune globulin. It can be given before and within 2 weeks of coming in contact with HAV.

- Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food.

HEPATITIS B:

Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Hepatitis B vaccine is available for all age groups to prevent hepatitis B virus infection.

SIGNS & PREVENTION:

jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting, joint pain

TRANSMISSION:

- Occurs when blood from an infected person enters the body of a person who is not infected.
- HBV is spread through having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use might reduce transmission), by sharing drugs, needles, or "works" when injecting drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth.

Persons at risk for HBV infection might also be at risk for infection with hepatitis C virus (HCV) or HIV.

HEPATITIS C:

Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV). You may be at risk for hepatitis C and should contact your medical care provider for a blood test if you:

1. were notified that you received blood from a donor who later tested positive for hepatitis C.

2. have ever injected illegal drugs, even if you experimented a few times many years ago

3. received a blood transfusion or solid organ transplant before July, 1992

4. were a recipient of clotting factor(s) made before 1987

5. have ever been on long-term kidney dialysis

6. have evidence of liver disease (e.g., persistently abnormal ALT levels)

SIGNS & SYMPTOMS:

jaundice, fatigue, dark urine, abdominal pain, loss of appetite, nausea

TRANSMISSION:

- Occurs when blood from an infected person enters the body of a person who is not infected.

- HCV is spread through sharing needles or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth.

PREVENTION:

- There is no vaccine to prevent hepatitis C.

- Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water, or "works", and get vaccinated against hepatitis A & B.

- Do not share personal care items that might have blood on them (razors, toothbrushes).

- If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B.

- Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.

- HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.

- If you are HCV positive, do not donate blood, organs, or tissue.

HEPATITIS D:

Hepatitis D is a liver disease caused by the hepatitis D virus (HDV), a defective virus that needs the hepatitis B virus to exist. Hepatitis D virus (HDV) is found in the blood of persons infected with the virus.

SIGNS & SYMPTOMS:

jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting, joint pain, dark (tea colored) urine

TRANSMISSION:

- Occurs when blood from an infected person enters the body of a person who is not immune.

- HBV is spread through having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission);

- By sharing drugs, needles, or "works" when "shooting" drugs;

- Through needlesticks or sharps exposures on the job; or

- From an infected mother to her baby during birth.

PREVENTION:

- Hepatitis B vaccination

- HBV-HDV coinfection

- pre- or post-exposure prophylaxis (hepatitis B immune globulin or vaccine) to prevent HBV infection

- HBV-HDV superinfection

- education to reduce risk behaviors among persons with chronic HBV infection

HEPATITIS E:

Hepatitis E is a liver disease caused by the hepatitis E virus (HEV) transmitted in much the same way as hepatitis A virus.

SIGNS & SYMPTOMS:

Jaundice, Fatigue, Abdominal pain, Loss of appetite, Nausea, vomiting, Dark (tea colored) urine

TRANSMISSION:

- HEV is found in the stool (faeces) of persons and animals with hepatitis E.

- HEV is spread by eating or drinking contaminated food or water.

- Transmission from person to person occurs less commonly than with hepatitis A virus

- Most outbreaks in developing countries have been associated with contaminated drinking water.

PREVENTION:

- Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food

- Avoid drinking water (and beverages with ice) of unknown purity, uncooked shellfish, and uncooked fruits or vegetables that are not peeled or prepared by the traveler.

DEPRESSION IS MORE DAMAGING THAN ANGINA, ARTHRITIS, ASTHMA AND DIABETES:

Depression is more damaging to everyday health than chronic diseases such as angina, arthritis, asthma and diabetes, researchers said. And if people are ill with other conditions, depression makes them worse, the researchers found.

"We report the largest population-based worldwide study to our knowledge that explores the effect of depression in comparison with four other chronic diseases on health state," the researchers wrote in the Lancet medical journal. Somnath Chatterji of the World Health Organisation, who led the study, said researchers calculated the impact of different conditions by asking people questions about their capacities to function in everyday situations -- such as moving around, seeing things at a distance and remembering information. "Our main findings show that depression impairs health state to a substantially greater degree than the other diseases," the researchers wrote.

The team used World Health Organisation data collected from 60 countries and more than 240,000 people to show on average between 9 percent and 23 percent had depression in addition to one or more of four other chronic diseases -- asthma, angina, arthritis and diabetes.
The most disabling combination was diabetes and depression, the researchers said. "If you live for one year with diabetes and depression together you are living the equivalent of 60 percent of full health," Chatterji said in a telephone interview.The findings show the need to provide better treatment for depression because it has such a big impact on people with chronic illnesses, Chatterji added. "What tends to happen is a health provider doesn't look for anything else but the chronic illness," he said. "What we are saying is, these people will also be depressed and if you don't manage the depression you can't improve a person's health because depression is actually worsening it."

NEW TREATMENT BOOSTS SURVIVAL CHANCES FOR CHILD LEUKAEMIA:

A prototype method of treating infants with a form of leukaemia boosts their chances of survival compared with the standard drug regimen, according to a paper published in next Saturday's Lancet. In general, children with acute lymphoblastic leukaemia have a good chance of survival -- about 80 percent today, compared with only 10 percent 40 years ago. But this success rate drops significantly in infants aged under 12 months, where it falls to a range of 17-45 percent.Dutch doctors carried out a study of 482 infants from 22 countries who were aged under one year and had been diagnosed with the disease. In addition to the standard drug for acute lymphoblastic leukaemia -- a treatment called Prednisone -- the children were given tiny doses of drugs usually designed for treating a related form of cancer, acute myeloid leukaemia.The key ingredient was Cytabarine, which in lab-dish tests have been shown to be highly effective against lymphoblasts, as immature lymphocyte cells are called.At the 38-month followup mark, 260 (58 percent) of the patients who received this "hybrid" treatment were in complete remission.Meanwhile, a separate study highlights new combination chemotherapy for chronic lymphyocytic leukaemia, the commonest form of leukaemia in the developed world.Institute of Cancer Research doctors in Britain found that fludarabine (marketed as Fludara) and chlorambucil (Leukeran), when used together, were no better than fludarabine alone or chorambucil alone in boosting a patient's chance of survival five years after treatment.However, the combination more than tripled the chance that the disease had not progressed by the time of the five-year checkup.