The silent enemy of the liver: Hepatitis

Known as the "silent enemy of the liver," hepatitis is a serious infectious disease affecting millions of people worldwide. Viral hepatitis remains a significant public health problem due to its transmission and impact on society. According to World Health Organization (WHO) data, approximately 350 million people are living with hepatitis B. More than 1 million people die each year from complications caused by these diseases. However, hepatitis B and C remain prevalent in Turkey.

Despite the widespread prevalence of the disease, a lack of knowledge and misconceptions about hepatitis unfortunately persist. However, early diagnosis and treatment make it possible to combat the disease. On World Hepatitis Day (July 28th), we discussed the disease, its transmission, and prevention methods with Prof. Dr. Funda Şimşek, Head of Education at the Infectious Diseases and Clinical Microbiology Clinic at Prof. Dr. Cemil Taşcıoğlu City Hospital.

Prof. Dr. Şimşek, who generally defines hepatitis as "an infection of the liver," answers the question of what causes this disease as follows:

Bacteria, viruses, fungi, and some parasites can cause hepatitis. Alcohol, fatty liver, medications, and toxic conditions are also other causes. Viral hepatitis is actually a liver infection caused by liver-specific viral viruses. The most common causes are hepatitis A, B, C, Delta, and E viruses. In addition, other systemic viruses can also cause hepatitis.

The most common types of hepatitis in the population are A, B, and C. So, how are these types transmitted and what consequences do they lead to? We get the answer from Prof. Dr. Şimşek:

Hepatitis B is the most contagious of these. Hepatitis A can be transmitted through contaminated water and beverages, as well as through unhygienic consumption of fruits and vegetables. Hepatitis B and C are more commonly transmitted through blood and blood products. It can also be transmitted sexually and through procedures such as piercings and tattoos performed without proper sterilization. Sharing nail clippers and razors can also lead to infection when living in the same household with someone with hepatitis B. Similarly, mother-to-child transmission is also important. If the mother is a hepatitis B carrier and transmits it to the baby, the infection is more likely to become chronic. Therefore, it is recommended that the mother be screened during pregnancy before birth and, if necessary, receive treatment in the last three months.

Thanks to advances in medicine, many types of hepatitis are no longer a nightmare. Prevention is possible with both vaccination and treatment.

Prof. Dr. Şimşek, noting that there are vaccines for hepatitis A and B, said, “We are actually fortunate in this regard. If we are vaccinated before contracting both hepatitis A and B, there is nearly 100% protection. There is no vaccine for hepatitis C, but with newly developed medications, we can achieve a cure rate of up to 98% if the patient is suitable, with a two- to three-month treatment of one pill per day.”

Hepatitis B can become chronic after infection. It can even lead to cirrhosis and liver cancer. Therefore, hepatitis B patients need to be monitored even after recovery. Prof. Dr. Şimşek outlines the things chronic hepatitis B patients should pay attention to in their daily lives:

Patients with chronic hepatitis should avoid alcohol because they have an inflammatory condition called inflammation in the liver. It's essential to inform their doctor that they have hepatitis B when they start taking medication. There are medications that can damage the liver or are eliminated by the liver. Therefore, it's important to be careful. There are no specific dietary criteria. They simply need to avoid gaining excessive weight and avoiding any conditions that could lead to fatty liver disease.

Although the hepatitis B carrier rate in Türkiye has decreased compared to the pre-vaccine era, it remains at a striking level. Prof. Dr. Şimşek summarizes the current situation as follows:

"Currently, the average is around 4 percent... This corresponds to approximately 2 million people. What really matters here is whether these individuals are aware of their condition. Because we're actually monitoring one-third of hepatitis B carriers... They're unaware of their condition. It can be discovered accidentally during pre-operative or pre-marital screenings."

Hepatitis C can also progress asymptomatically. By the time it's diagnosed, the disease is 70-80% chronic.

Hepatitis A is more likely to cause symptoms because it's more common in childhood. Professor Dr. Şimşek explains, "Because hepatitis A is more common in childhood, it can present with a more pronounced clinical picture. It presents with a low-grade fever, fatigue, loss of appetite, joint pain, yellowing of the eyes, darkening of the urine, sometimes lightening of the stool, and abdominal pain. If hepatitis B and C are caught in the acute phase, they can exhibit the same symptoms."

To protect against hepatitis, those in particularly high-risk groups must be vaccinated. Prof. Dr. Şimşek states, "Healthcare workers, those who receive frequent blood transfusions, hemodialysis patients, those living in crowded settings, and children born to hepatitis B-positive mothers are all at risk, so they absolutely must be vaccinated."

Indeed, hepatitis vaccines are included in the childhood vaccination schedule. This allows children to be vaccinated at designated intervals and thus have the opportunity to be protected from the disease at an early age.