28 July is World Hepatitis Day. This year’s theme is ‘Prevent Hepatitis. Act Now’.
Viral hepatitis is caused by 5 distinct hepatitis viruses.
An estimated 1.45 million people die from Hepatitis each year.
- Hepatitis A is a viral liver disease that can cause mild to severe illness.
- The hepatitis A virus is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person.
- Almost everyone recovers fully from hepatitis A, but very small proportions die from fulminant hepatitis.
- Hepatitis A infection risk is associated with a lack of safe water and poor sanitation.
- Epidemics can be explosive and cause significant economic loss.
- Improved sanitation and the hepatitis A vaccine are the most effective ways to combat the disease.
- Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
- The virus is transmitted through contact with the blood or other body fluids of an infected person. It may also be transmitted from an infected mother to her child at birth (vertical transmission).
- An estimated 240 million people are chronically infected with hepatitis B (defined as hepatitis B surface antigen positive for at least 6 months).
- Approximately 780 000 persons die each year from hepatitis B infection — 650 000 from cirrhosis and liver cancer due to chronic hepatitis B infection and another 130 000 from acute hepatitis B.
- Hepatitis B prevalence is highest in sub-Saharan Africa and East Asia, where between 5–10% of the adult population is chronically infected.
- Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. A small subset of persons with acute hepatitis can develop acute liver failure which can lead to death.
- In some people, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.
- More than 90% of healthy adults who are infected with the hepatitis B virus will recover naturally from the virus within the first year.
- Hepatitis B is an important occupational hazard for health workers.
- Acute hepatitis B virus infection is characterized by the presence of HBsAg and immunoglobulin M (IgM) antibody to the core antigen, HBcAg.
- During the initial phase of infection, patients are also seropositive for hepatitis B e antigen (HBeAg). HBeAg is usually a marker of high levels of replication of the virus. The presence of HBeAg indicates that the blood and body fluids of the infected individual are highly contagious.
- Chronic infection is characterized by the persistence of HBsAg for at least 6 months (with or without concurrent HBeAg).
- Persistence of HBsAg is the principal marker of risk for developing chronic liver disease and liver cancer (hepatocellullar carcinoma) later in life.
- There is no specific treatment for acute hepatitis B.
- The hepatitis B vaccine is the mainstay of hepatitis B prevention.
- WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by 2 or 3 doses to complete the primary series.
- The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults. Protection lasts at least 20 years and is probably lifelong.
- Hepatitis C is a liver disease caused by the hepatitis C virus: the virus can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
- The hepatitis C virus is a bloodborne virus and the most common modes of infection are through unsafe injection practices; inadequate sterilization of medical equipment in some health-care settings; and unscreened blood and blood products.
- Hepatitis C is not spread through breast milk, food or water or by casual contact such as hugging, kissing and sharing food or drinks with an infected person.
- 130–150 million people globally have chronic hepatitis C infection.
- A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer.
- 350 000 to 500 000 people die each year from hepatitis C-related liver diseases.
- Antiviral medicines can cure hepatitis C infection, but access to diagnosis and treatment is low.
- The current standard treatment for hepatitis C is combination antiviral therapy with interferon and ribavirin, which are effective against all the genotypes of hepatitis viruses (pan-genotypic).
- Antiviral treatment is successful in 50–90% of persons treated, depending on the treatment used, and has also been shown to reduce the development of liver cancer and cirrhosis.
- There is currently no vaccine for hepatitis C, however research in this area is ongoing.
- Every year there are an estimated 20 million hepatitis E infections, over 3 million symptomatic cases of hepatitis E, and 56 600 hepatitis E-related deaths.
- Hepatitis E is usually self-limiting but may develop into fulminant hepatitis (acute liver failure).
- The hepatitis E virus is transmitted via the faecal-oral route, principally via contaminated water.
- Hepatitis E is found worldwide, but the prevalence is highest in East and South Asia.
- China has produced and licensed the first vaccine to prevent hepatitis E virus infection, although it is not yet available globally.
Link to the World Hepatitis Day 2015 Web Page:
Links to World Hepatitis Day Posters:
Links to posters for social media:
Link to the Hepatitis A fact sheet (updated 15 July 2015):
Link to the Hepatitis B fact sheet (updated 17 July 2015):
Link to the Hepatitis C fact sheet (updated 17 July 2015):
Link to the Hepatitis E fact sheet (updated 16 July 2015):