Dubai: The prevalence of Hepatitis B and C (HBV and HCV) in the UAE ranges from 0.24 to 1.64 per cent, but specialists point out that nearly 70 per cent of patients remain undiagnosed.
As the UAE marks World Hepatitis Day on July 28, doctors said the two strains that cause acute and chronic liver infections like cirrhosis, liver failure and cancer, have many carriers as they do not show any symptoms. What is more, these two can be prevented, treated and in the case of HCV, can also be cured.
The UAE government plans to eliminate HCV in approximately a decade. It has aligned its goal with that of the World Health Organisation (WHO), which aims to eliminate HCV by 2030.
What is Hepatitis?
Dr Shiva Kumar, chair of Gastroenterology and Hepatology at Cleveland Clinic Abu Dhabi, said: “Hepatitis is inflammation of the liver caused by a viral infection that, if left untreated, can go on to damage the liver. Viral hepatitis is of five kinds — A, B, C , D and E. While A and E strains only cause acute infections and are self-limiting, the D strain is incomplete and can only replicate in the presence of Hepatitis B strain. Therefore, the spotlight is on HBC and HCV. The viruses cause cirrhosis, cancer and eventually liver failure.”
Typical symptoms in case of acute infection are loss of appetite, nausea, vomiting, fever and jaundice.
Dr Aamerah Shah, specialist family medicine at American Hospital Dubai, said: “According to WHO statistics, Hepatitis B and C affect 325 million people worldwide causing 1.4 million deaths a year. It is the second major killer infectious disease after tuberculosis, and nine times more people are infected with hepatitis than HIV. Hepatitis is preventable, treatable and in the case of hepatitis C, curable. However, worldwide, over 80 per cent people living with hepatitis lack facilities for prevention, testing and treatment. As part of a strategy announced by the WHO two years ago, the aim is to reduce new infections by 90 per cent and mortality by 65 per cent.”
Who is at risk?
Dr Kumar said: “Because of the disease being asymptomatic, it is important for healthcare providers to screen the high-risk population. Anyone who has had a history taking IV medicines or fluids with used needles that may be contaminated with infected blood, those who receive blood transfusions or have used blood products prior to 1991 when the tests were developed for its detection, are all at risk.”
Once screened and found positive for Hepatitis C, an individual has a 99 per cent chance of being cured. Modern protocols that include strong antiviral agents administered from eight-22 weeks have proven to be every effective.
In case of HBV, there is a vaccination that can suppress the virus to a large extent and is found to be highly effective in managing the condition. Once the virus is inactive, it ceases to cause any harm.
• All newborns must be vaccinated for Hepatitis B, which is universally done in a series of three doses.
• At-risk patients for Hepatitis B and C must be screened and treatment provided to prevent the spread of infection.
• In addition, food handlers, those working in laboratories handling blood and other fluids and beauty salon workers are advised to get the vaccination for HBV and HCV to as their exposure to infections is high.
• Vaccination for Hepatitis A is available, but not mandatory and can be administered in two doses, six months apart.
The A to G of Hepatitis:
All viral strains of hepatitis infect the liver, causing inflammation and interfere with important liver functions, leading to liver cirrhosis, failure and even cancer. While some are detected easily as thy cause acute symptoms, some strains go undetected because they cause chronic infections (lasting for over six months) with no symptoms.
Hepatitis A (HAC): Primarily spreads through contaminated food and water where these two elements come in contact with human waste. Spread through restaurants and food handlers who may have the virus and among children and workers in day care centres where hand hygiene is poor. Causes acute infection.
Hepatitis B (HBC): The virus is spread through direct blood and body fluids in case of blood transfusion, body tattoo, body piercing, sexual contact, patients undergoing haemodialysis and from mother to child during birth. Causes chronic infection that is asymptomatic and silent.
Hepatitis C (HCV): HCV usually is spread by using contaminated needles shared with others, blood transfusion, haemodialysis and needle sticks. Causes chronic liver infection.
Hepatitis strains D, E and G: Hepatitis D is an incomplete virus, which can replicate only in the presence of HBV. Hepatitis E is also caused due to use of contaminated needles, during direct blood and body fluids contact that happens in case of haemodialysis, blood transfusion, child birth and physical intimacy. It is a strain similar to HAC and causes acute infection.
Little is known about the newly-discovered strain G.