KATHMANDU: Hepatitis is an inflammation of liver caused by infection. It can occur because of virus, toxin present in alcohol, medicines used for treatment of tuberculosis, antibiotics and unnecessary intake of ayurvedic medicines among others. If hepatitis occurs due to virus then it is known as viral hepatitis.

According to the World Health Organisation (WHO), viral hepatitis is widely spread, affecting 400 million people worldwide — over 10 times the number of people infected with HIV. Globally, about 1.4 million people die each year from hepatitis.

Viral hepatitis is common in Nepal too. “Hepatitis A and E are common in Nepal, especially during the monsoon months. These types of hepatitis occur due to the intake of contaminated food and water,” informs Dr Bikash Jaishi, DM (Hepatology), Liver Unit, Senior Resident, Bir Hospital, Kathmandu.

“At least 40 to 50 patients of viral hepatitis visit our OPD daily during the rainy season.”

Viral Hepatitis

Different types of hepatitis include — hepatitis A, hepatitis E, and hepatitis non-A and non-E.

Virus causing hepatitis A and E are found in water contaminated with faeces during monsoon season, and if someone drinks such water without boiling or distilling, one is likely to be infected

with hepatitis.“Virus transmits when an uninfected person consumes contaminated food or water. So one must be very careful during monsoon. One must drink boiled water and eat foods washed in purified water,” cautions Dr Jaishi.

Hepatitis B is transmitted through sexual contact, infected blood and secretions like semen as well as infected needles as per the doctor.

It can also transmit from a mother to her child. “There is 50 to 60 per cent chance for the transmission of hepatitis B from a mother to her child. If the mother takes antivirus during her pregnancy, and if immunoglobulin and vaccine are given immediately after the delivery for the child, then the risk of transmission from mother to child decreases,” elaborates the doctor.

So, any infected woman opting to become a mother must “visit the doctor to take precautions”.

Health workers should also take precautions as s/he can be “infected during accidental needle injuries” while treating the hepatitis patients.

“Hepatitis C is transmitted through the sharing of injection equipment from the infected — use of unsterilised and infected needles and syringes, transfusion of blood and blood products. It can also be transmitted sexually or passed from an infected mother to her baby,” shares Dr Jaishi. He further adds, hepatitis B and C are the second major causes of liver cirrhosis. In South Asian countries like Nepal, “people who consume alcohol are likely to be infected with liver cirrhosis”.

Hepatitis D is another type, caused by hepatitis D virus. However, the virus of hepatitis D propagate only in the presence of the hepatitis B virus. “Hepatitis D can’t occur if hepatitis B is absent. So as to prevent hepatitis D infection one must control Hepatitis B,” informs Dr Jaishi.

Symptoms

People suffering from hepatitis experience fatigue, fever, loss of appetite, nausea, pain on the right side of the abdomen, vomiting and laziness.

“If a patient feels lazy and has yellow urine, then know that these are the symptoms of hepatitis. Some may also suffer from constipation or diarrhoea, and pain in joints. However, to find out the type of Hepatitis, tests are necessary,” the doctor cautions.

Ways of prevention

To prevent oneself from acquiring hepatitis A and E viruses, one must take care of their health.

Dr Jaishi points out, “One must consume water and foods that aren’t contaminated. Personal hygiene and sanitation must be maintained. One must be aware of his/her behaviour.”

As per him, hepatitis A and E resolve own its own within two to three weeks if one takes good care of him/her. One doesn’t need to refrain from any kind of food if s/he suffers from hepatitis A and E. Rather the patients should increase an intake of the foods so as to provide nutrients for the liver. However, one must refrain from taking alcohol and unnecessary medicines. The condition of liver worsens if such items are consumed.

Vaccine for hepatitis B is available. One must take three doses of the vaccines — if one dose is taken today then the other dose should be taken after a month. The third dose should be taken after six months of the first dose as per Dr Jaishi. “One must not share personal blades, toothbrush and toothpaste if s/he is suffering from hepatitis B and C. If hepatitis B and C worsen then there is a risk of liver cirrhosis, chronic hepatitis infection and liver cancer.”