/ 28 July 2011

‘Hepatitis affects everyone, everywhere’

One in 12 people worldwide are living with hepatitis B or C. This, the World Health Organisation (WHO) says, translates to four million people living with the virus in South Africa. Of these, 18 000 die every year. Doctors see it as a silent killer because few people have any outward symptoms before they develop life-threatening complications.

With hepatitis having a greater prevalence than HIV/Aids, the WHO has named July 28 as World Hepatitis Day. The theme for this year is, “This is Hepatitis … Know it. Confront it. Hepatitis affects everyone, everywhere.”

Professor Wendy Spearman, head of the department of hepatology at the University of Cape Town, said the country was struggling with endemic hepatitis B. This was the most dangerous of the five main strains (A,B,C,D and E) and kills about 600 000 people a year worldwide. In addition, two billion people have had it at one time or another. This, the WHO said, makes it one of the most common viral infections.

Hepatitis, the name for the family of viral diseases which affect the liver, comes from many different sources depending on the strain. B and C, which are the WHO’s main focus as they are the most deadly strains, are caught through contact with infected body fluids. If left untreated hepatitis leads to cirrhosis (scarring) of the liver and liver cancer. At this late stage the only hope for a patient is a liver transplant.

Spearman said there is a vaccine for hepatitis B, which has been universally available in South Africa since 1995. However, if someone does catch it, they must then undergo expensive treatment to keep it dormant. Even though two billion people have had the B strain, humans have enough antibodies to ensure that in 90% of case it goes away in the first six months, says Spearman.

Professor Patrick Arbuthnot, director of the Antiviral Gene Therapy Research Unit at the University of the Witwatersrand, said the danger for the remaining 10% who still have hepatitis after six months is that most are asymptomatic. This means they do not know they have hepatitis until further complications force them to get tested.

Both professors said South Africa was dealing well with responses to hepatitis, but in rural areas the prevalence was far higher. Spearman said in some areas of the Eastern Cape and KwaZulu-Natal up to 20% of the population was infected with a type of hepatitis.

Arbuthnot said children between the ages of two and seven in rural areas in the Eastern Cape and KwaZulu-Natal were most at risk due to their weak immune systems. He said that transmission from mother to child was rare.

WHO guidelines for prevention say it is important not to share razors, needles, toothbrushes and unsterilised medical equipment. Spearman said lifestyle changes were also important. Heavy drinking, smoking and the consumption of fatty foods put extra strain on the liver and left it vulnerable.