How does Hepatitis A differ from Hepatitis B and C in terms of severity. What are the transmission routes for different types of hepatitis. Which forms of hepatitis have available vaccines. How do mortality rates compare between Hepatitis B and C globally.

Understanding Hepatitis: A Global Health Concern

Hepatitis, an inflammation of the liver, comes in several forms, each with its own characteristics, severity, and impact on global health. This article delves into the five main types of viral hepatitis – A, B, C, D, and E – comparing their transmission routes, prevalence, severity, and available preventive measures.

Hepatitis A: The Traveler’s Risk

Hepatitis A is often considered the mildest form of viral hepatitis. Why is this the case? Unlike its counterparts, Hepatitis A rarely develops into a chronic condition and many patients recover without specific treatment.

Transmission of Hepatitis A primarily occurs through:

• Contaminated water or food
• Fecal-oral route
• Close personal contact with an infected individual

The World Health Organization (WHO) estimates approximately 1.4 million new Hepatitis A infections annually. While it’s prevalent worldwide, developing countries with poor sanitation and inadequate water purification systems bear the brunt of this disease.

Vaccination: A Preventive Measure

One of the most effective ways to prevent Hepatitis A is through vaccination. Travelers to high-risk areas are often advised to get vaccinated before their trip, earning Hepatitis A the moniker “travel hepatitis.”

Hepatitis B: A Serious Global Threat

Hepatitis B presents a more severe health risk compared to Hepatitis A. How dangerous is Hepatitis B? It can be life-threatening and often leads to chronic liver inflammation, potentially resulting in cirrhosis or liver cancer.

In 2015, an estimated 257 million people worldwide were living with chronic Hepatitis B. The virus claims approximately 600,000 lives annually, underscoring its severity and the urgent need for prevention and treatment.

Transmission and Prevention

Hepatitis B spreads through:

• Blood contact
• Exchange of body fluids with an infected person
• Mother-to-child transmission during childbirth

Recognizing the global epidemic of Hepatitis B, the WHO recommended in 2017 that all countries implement universal vaccination for newborns. This vaccine provides effective protection against both Hepatitis B and, indirectly, Hepatitis D.

Hepatitis C: The Silent Epidemic

Hepatitis C is often referred to as a “silent epidemic” due to its ability to progress without noticeable symptoms for years. Why is Hepatitis C considered more dangerous than Hepatitis B in some aspects?

1. No vaccine is currently available for Hepatitis C
2. Many people carry the virus without knowing it
3. It can lead to severe liver damage before diagnosis

Hepatitis C claims about 350,000 lives annually. The primary mode of transmission is through blood contact, with shared needles among drug users being a common route of infection.

Treatment Advancements

Recent developments in antiviral drugs have shown promising results in treating Hepatitis C. Long-term treatment with these medications has led to significant improvements in many patients’ conditions, offering hope for those affected by this challenging disease.

Hepatitis D: The Hepatitis B Companion

Hepatitis D presents a unique case in the hepatitis family. Why is Hepatitis D dependent on Hepatitis B? The Hepatitis D virus requires a surface protein from the Hepatitis B virus to replicate.

This dependency means that Hepatitis D can only develop in individuals who already carry Hepatitis B. However, there’s a silver lining: vaccination against Hepatitis B also provides protection against Hepatitis D, effectively preventing both infections with a single vaccine.

Hepatitis E: The Monsoon Menace

Hepatitis E is particularly prevalent in Southeast Asia, with outbreaks often coinciding with monsoon seasons or flooding events. Why does Hepatitis E pose a greater risk during these times? The primary transmission route is through fecal contamination of drinking water, which becomes more likely during periods of heavy rainfall and flooding.

While generally less severe than Hepatitis B or C, Hepatitis E can be more dangerous than Hepatitis A. It poses a particular threat to pregnant women, for whom the infection can be fatal without proper treatment.

Vaccination Developments

In 2012, China approved the first vaccine against Hepatitis E, marking a significant step forward in preventing this form of hepatitis. However, the vaccine’s availability remains limited in many parts of the world.

Comparing the Impact: Which Hepatitis is Worse?

When comparing the different forms of hepatitis, several factors come into play:

• Chronicity: Hepatitis B and C are more likely to become chronic
• Severity of symptoms: Hepatitis B and C can lead to more severe liver damage
• Availability of vaccines: Hepatitis A and B have effective vaccines, while C does not
• Mortality rates: Hepatitis B and C have higher mortality rates globally

While Hepatitis A and E can cause acute illness, they rarely lead to chronic conditions. Hepatitis B and C, on the other hand, pose greater long-term health risks due to their potential for chronic infection and severe liver damage.

Global Health Initiatives and Future Outlook

The World Health Organization and other global health bodies have implemented various initiatives to combat viral hepatitis. These efforts include:

• Promoting universal vaccination against Hepatitis B
• Improving access to clean water and sanitation to prevent Hepatitis A and E
• Developing new treatments for Hepatitis C
• Raising awareness about transmission routes and prevention methods

As research continues and new treatments emerge, the outlook for managing and preventing hepatitis improves. However, challenges remain, particularly in developing countries where access to healthcare and preventive measures may be limited.

The Role of Individual Action

While global initiatives play a crucial role, individual actions are equally important in preventing the spread of hepatitis. What can individuals do to protect themselves and others?

• Get vaccinated against Hepatitis A and B
• Practice good hygiene, especially when traveling to high-risk areas
• Avoid sharing needles or personal items that may come into contact with blood
• Get tested regularly if you’re in a high-risk group
• Seek medical attention if you suspect you’ve been exposed to any form of hepatitis

By combining global health initiatives with individual responsibility, we can work towards reducing the impact of all forms of hepatitis worldwide.

Emerging Research and Future Challenges

The field of hepatitis research is constantly evolving, with new discoveries and challenges emerging regularly. What are some of the current areas of focus in hepatitis research?

• Development of a Hepatitis C vaccine
• Improving treatment options for chronic Hepatitis B
• Understanding and mitigating the long-term effects of hepatitis on liver health
• Addressing the increasing prevalence of non-alcoholic fatty liver disease, which can interact with viral hepatitis

As our understanding of hepatitis grows, so does our ability to combat these diseases. However, challenges remain, particularly in terms of global access to treatment and prevention measures.

The Impact of Climate Change

Climate change poses new challenges in the fight against hepatitis. How might climate change affect the spread of hepatitis? Rising temperatures and changing precipitation patterns could lead to:

• Increased flooding events, potentially exacerbating the spread of Hepatitis A and E
• Changes in vector populations that may influence the transmission of certain viruses
• Population displacement, which could strain healthcare systems and increase disease transmission risks

Addressing these challenges will require a multidisciplinary approach, combining medical research with environmental and social sciences.

The Economic Burden of Hepatitis

Beyond the health impacts, hepatitis poses a significant economic burden on individuals, healthcare systems, and societies as a whole. What are the economic implications of hepatitis?

• Direct medical costs for treatment and management of chronic conditions
• Lost productivity due to illness and premature mortality
• Strain on healthcare resources, particularly in developing countries
• Economic impact on families caring for individuals with chronic hepatitis

Understanding and addressing these economic factors is crucial for developing comprehensive strategies to combat hepatitis globally.

Cost-Effectiveness of Prevention

While treatment for chronic hepatitis can be expensive, prevention measures such as vaccination and improved sanitation are often highly cost-effective. How do prevention efforts compare to treatment in terms of cost-effectiveness?

• Hepatitis B vaccination programs have shown significant returns on investment in many countries
• Improving water and sanitation infrastructure can prevent multiple diseases, including Hepatitis A and E
• Early detection and treatment of Hepatitis C can prevent costly complications later on

Investing in prevention not only saves lives but can also lead to substantial economic benefits in the long term.

The Role of Technology in Hepatitis Management

Advancements in technology are playing an increasingly important role in the prevention, diagnosis, and treatment of hepatitis. How is technology shaping the future of hepatitis management?

• Improved diagnostic tools for faster and more accurate detection
• Telemedicine applications for remote monitoring of chronic hepatitis patients
• Data analytics for tracking disease trends and predicting outbreaks
• Artificial intelligence in drug discovery and personalized treatment plans

These technological advancements offer the potential to improve hepatitis care, particularly in underserved areas where access to specialist care may be limited.

The Promise of Gene Editing

Emerging gene editing technologies, such as CRISPR-Cas9, are opening new avenues for hepatitis treatment. What potential does gene editing hold for hepatitis patients?

• Possibility of “curing” chronic Hepatitis B by eliminating the virus from infected cells
• Enhancing the immune response to better fight hepatitis infections
• Developing new animal models for hepatitis research

While still in early stages, these technologies hold promise for revolutionizing hepatitis treatment in the coming decades.

As we continue to unravel the complexities of hepatitis and develop new strategies to combat these diseases, it’s clear that a multifaceted approach combining medical research, public health initiatives, and technological innovation will be key to reducing the global burden of hepatitis. By staying informed and supporting ongoing research and prevention efforts, we can all play a part in creating a world where hepatitis no longer poses a major threat to global health.

the facts from A to E – DW – 10/06/2020

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Gudrun Heise

10/06/2020October 6, 2020

Hepatitis attacks the liver and in the worst case can result in cirrhosis or liver carcinoma. But not all forms of Hepatitis are alike.

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Hepatitis A

Hepatitis A can result in an inflammation of the liver, but usually does not develop into a chronic illness. In some cases, patients will recover even without treatment. The virus is often contracted through contact with contaminated water or food, as well as through contact with feces, or a contact-infection between humans.

The virus is spread worldwide. The World Health Organization (WHO) estimates there are about 1.4 million new infections every year. The most affected populations are in developing countries, which have insufficient hygiene, such as a lack of sanitation and water purification. Travelers are also at risk of contracting a form of “travel-hepatitis.” But the good news is there is a vaccination against Hepatitis A.

Hepatitis B

You can protect yourself with a vaccine against this very dangerous form of Hepatitis. Hepatitis B can be life threatening. In 2017 the World Health Organisation recommended that all countries vaccinate new born children, considering that there is a worldwide epidemic.

About 257 million people worldwide suffered from chronic Hepatitis B in 2015. Every year an estimated 600,000 people die from it. 

The virus is transmitted through the blood or other body fluids from an infected person. The disease usually results in a chronic inflammation of the liver – often leading to cirrhosis or liver carcinoma.

Hepatitis C

Hepatitis C can be as deadly as Hepatitis B. However, sometimes it takes a milder course, resulting in only an acute infection. But it is more dangerous than Hepatitis B, because there is no vaccination against it – yet. Many people carry the Hepatitis C virus without knowing it. It is transmitted mostly through the blood.

When the virus was discovered in 1988, scientists called it the “Non-A-Non-B-Virus”. At the time, it was impossible to test blood donations for the virus. This led to a large number of infections through blood transfusions. Today, the most common path of infection is through syringes – for instance, among drug users who share needles. About 350,000 people die from Hepatitis C every year.

Recent tests to treat Hepatitis C with antiviral drugs have been promising. In several cases, patients who received long-term treatment showed a significant improvement in their condition.

Hepatitis D

Hepatitis D can develop in people carrying Hepatitis B. The virus needs a surface protein of the more common Hepatitis B to multiply. But if you are vaccinated against Hepatitis B, you automatically develop immunity against Hepatitis D.

Hepatitis E

Hepatitis E is most common in South East Asia and often occurs during the monsoon season or freak flooding, due to fecal contamination of drinking water. The illness can be more severe than Hepatitis A and – depending on the treatment – can be fatal. Woman during pregnancy are especially at risk. China approved the first vaccine against Hepatitis E in 2012.

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1 September 2019 | Q&A

What is hepatitis?

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis.

There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.  

Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. 

 

What are the different hepatitis viruses?

Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways.

Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.

Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.

Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.

Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.

Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available. 

 

The most aggressive hepatitis leading to cirrhosis of the liver is now curable

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Irina Nevinnaya

Now, when everyone is focused on the new coronavirus, other infections are somehow not heard. But no one has canceled them, and tens, hundreds of thousands of people are infected with them every year.

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On World Hepatitis Day, experts warned that the incidence of especially dangerous hepatitis C is on the rise, and that of hepatitis B is improving thanks to vaccination. More good news: the most aggressive hepatitis D, which leads to cirrhosis of the liver in just a few years after infection, is now curable.

– Every year in Russia there are 45-50 thousand more patients with chronic hepatitis C – these are those who are under the supervision of doctors, – said the chief freelance infectious disease specialist of the Russian Ministry of Health Vladimir Chulanov. – The incidence of hepatitis B has decreased to 0.6 cases per 100 thousand of the population – this is already the level of prosperous European countries. This happened solely due to widespread vaccination: in total, more than 100 million people have already been vaccinated against hepatitis B in Russia.

The rarest, but also the most aggressive is hepatitis D, which accompanies hepatitis B. This is such a feature of this virus – it cannot enter the body itself, but it easily “attaches” to the conductor, which is the hepatitis B virus.

” For hepatitis D, we usually give the most unfavorable prognosis. It has a rapid progression, and of those who are diagnosed with this for the first time, 60-70 percent already have cirrhosis of the liver,” the chief infectious disease specialist explained.

The trouble is that all hepatitis only sometimes proceed in an acute form, more often they attack imperceptibly – the liver does not hurt, and a person attributes other possible symptoms to fatigue, a cold, and other insignificant causes.

Here are the signs of hepatitis B, C, D:

– fatigue;

– poor appetite, nausea;

– subfebrile temperature;

– pain in the joints;

– dark color of urine;

– yellowing of the skin and eyeballs.

Today, the only sure way to prevent infection with hepatitis D is vaccination against hepatitis B. There is no vaccine yet for hepatitis C. But unlike hepatitis B (there is no cure for it), hepatitis C, and now D, have become curable. A few years ago, an effective antiviral drug was created that acts on the C virus. Moreover, it does not stop its destructive effect (as, for example, in the case of HIV therapy – it is lifelong), but actually completely destroys it. There has been a breakthrough in the treatment of hepatitis D: the new drug, according to experts, is effective even at the stage of liver cirrhosis that has already begun. Initially developed in Germany, the drug molecule was brought to the status of a drug in Russia. And since May 2020, our drug has become available for treatment in hospitals.

If hepatitis A is a typical infection of “dirty hands”, then viruses B, C, D are transmitted through the blood and its components. You can become infected with a dirty needle during an injection, during a blood transfusion, and also by having unprotected sex with an infected person.

The main protection is to limit contact with body fluids: use disposable injection syringes and disposable medical instruments. Make sure that you perform a manicure-pedicure with scissors, tweezers and files disinfected in accordance with all the rules (or it’s better to completely abandon the edged manicure). And of course, be confident in your partner.

Rossiyskaya gazeta – Week – Federal issue: №172(8226)

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What is hepatitis – Pro Palliative

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Not all types of hepatitis are dangerous

90 002 Hepatitis B

Hepatitis C

There are a lot of myths around hepatitis. Unfortunately, sometimes even people with medical education believe in them. Doctors, nurses and volunteers in hospices often fear contracting viral hepatitis, but the risk of getting the virus in a hospice is no greater than at a dentist’s appointment, in a nail or tattoo parlor.

Hepatitis patients are often treated with neglect. One of the most striking cases that I know of was that of a young HIV-positive man who was diagnosed with liver cancer while also diagnosed with hepatitis C. The tumor was only a few centimeters long, and after it was removed, there was not even a need for chemotherapy. This focus was discovered in August, and the patient was operated on only in January. The young man was sentenced. He was denied operations even in large cancer centers: “We will not operate on you because you have hepatitis C and HIV.”

How can I get palliative care for a patient with HIV? Doctors, social workers, palliative experts — about the present and future of palliative care for HIV-positive patients in Russia

The story ended happily because there were doctors who operated on him. They understood that if all the rules are observed, there is no risk of infection of medical personnel. These rules are simple, but in Russia they are neglected, and then they loudly shout about the danger of those infected with hepatitis and HIV. The simplest thing in surgical interventions is not to transfer sharp instruments to a colleague, but to place them on a sterile table so that the other surgeon can take them as safely as possible.

Doctors in Europe and the United States treat HIV and hepatitis C with no fear. Restriction in access to medical care due to the presence of an infection in a person can be punished very seriously – fines, dismissals, up to criminal liability.

People with hepatitis or HIV infection in Russia, especially in the regions, are alone in their problems. There is no one even to support them psychologically, because they are considered the most insignificant elements of society. Doctors and medical staff are extremely negative and very wary of such patients, many are denied medical care (especially in dentistry, dermatology, etc.). Unfortunately, this is due to the huge ignorance of medical workers and there is no justification for such behavior.

Among infectious disease doctors there are professors who talk about the cure for hepatitis C at lectures, but going down from the podium, they say: “Does anyone really believe in this? Hepatitis lives in the nerve ganglia.” In fact, this is far from the case, and currently viral hepatitis C is cured in 100% of cases, but this does not always happen on time. Treatment is becoming more and more affordable and occurs in 8-12 weeks.

Not all types of hepatitis are dangerous

There are many types of hepatitis viruses: A, B, C, D, E, G, F, TTV. Nature does not stand still, perhaps in the future a new hepatotropic virus will appear, with which we will fight. Hepatitis D only appears when the patient has a B infection. With these two types of hepatitis, an avalanche-like progression of liver disease begins up to the development of cirrhosis, patients very often die and it is almost impossible to treat them. Hepatitis E is now becoming more relevant due to the mass migration of people from Africa to Europe. According to WHO, up to 33 million new cases of infection are recorded in the world per year.

Not all types of hepatitis are dangerous. G, F, TTV are viruses that live in the liver but do not carry any consequences. However, there are some private clinics that actively treat these types of hepatitis, although they are recognized worldwide as not active viruses.

Hepatitis A is called “dirty hands disease”. It almost always resolves in an acute form and is not chronic. The virus does not carry serious consequences and almost never ends lethally. It is clear that in a sparsely populated area in a remote area, a patient with hepatitis A may develop a fulminant form of the disease (acute liver failure), and doctors will not always be able to save such a patient. But this is an extremely rare case.

To protect yourself from hepatitis A, it is enough to get vaccinated. All people entering the health facility should be vaccinated or tested for antibodies to the virus, including non-medical personnel. If your mother says that you definitely “did not turn yellow” from hepatitis as a child, this does not guarantee that you did not get sick with it. Perhaps you suffered it in a subclinical form, for example, you thought that these were signs of poisoning. If antibodies are detected, vaccination against hepatitis A is not needed.

Wash your hands before eating, do not drink unboiled water, always wash vegetables and fruits and do not neglect the heat treatment of food. Hepatitis A is not transmitted by airborne droplets, but by the fecal-oral route.

Hands should be washed with soap and water when caring for the sick, especially after using the restroom and cleaning the room. After changing a patient’s diaper, wash your hands thoroughly. This is a non-specific prophylaxis that people must follow, regardless of which category of patients they work with.

In Russia, the presence of hepatitis A implies hospitalization for 21 days. In this case, the diagnosis occurs already in the “icteric” period, when the patient is not dangerous and practically does not release the virus into the environment. In my opinion, this category of patients needs the usual home bed rest with careful care and supervision of a family doctor.

In terms of infecting other people, the patient is dangerous during the “preicteric” period. The disease manifests itself, like any rotavirus infection: high fever, loose stools, weakness, so it is quite difficult to identify hepatitis A before jaundice appears. Persons who have been in contact with a patient with hepatitis should be under the supervision of a doctor for 45 days. There is no emergency vaccination in the recommendations, but theoretically, in the first 72 hours from the moment of contact, it is possible to vaccinate.

In contrast to hepatitis A with a minimal number of deaths, according to WHO, 44 thousand people die from hepatitis E per year out of 3.5 million infected people. The virus is most dangerous for pregnant women in the second and third trimesters. The hepatitis E virus is present in the feces of an infected person. It enters the body more often through water, poorly processed meat, raw shellfish, blood transfusion, or from mother to fetus. Symptoms of this disease are jaundice, nausea, fever, weakness.

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Most patients recover from hepatitis E, but some of them remain chronic and no doctor knows how to treat. China has developed a vaccine against the hepatitis E virus, but it has not yet been approved by the WHO.

Hepatitis B is the most dangerous type of hepatitis virus

Hepatitis B is the most dangerous type of hepatitis virus. According to WHO, 257 million people are chronically infected with it, 686 thousand die from it every year. The Asia-Pacific region is home to about 90% of all infected in the world. It is expected that in the next generation among the inhabitants of this region the number of infected people will decrease, as they began to vaccinate against hepatitis B. The vaccine was invented in 1982, and its effectiveness is 95%.

There are no drugs for a complete functional cure yet – antiviral therapy does not destroy the virus, but slows down the development of cirrhosis and liver cancer. The virus can exist outside of humans for up to seven days. It is transmitted through blood and other body fluids (saliva, urine, semen, menstrual fluid, etc.), through sexual contact, from mother to fetus in utero or during childbirth. If a drop of an infected person’s blood enters a pool, there is a risk that the pool water will become infected. A person can get an infection in this pool through cuts on the skin, through microtrauma. People with psoriasis and xerosis who have dry and damaged skin are also at risk of infection.

All hepatitis in the acute phase are manifested by the same symptoms – jaundice, nausea, fever. If a person with hepatitis A gets better after turning yellow, then a person with hepatitis B gets even worse. Jaundice in hepatitis B is an indicator that the immune system saw the virus and began to fight it: the body’s immune cells went to the liver and began to destroy the virus. Therefore, the patient is ill, he has a fever, he is all yellow. In this battle, the body will win with a probability of 90%. And if a person does not turn yellow and does not understand how and when he became infected, most likely, his body did not notice the virus.

Non-specific prophylaxis against hepatitis B virus – no contact with infected people. If you work with patients who may be infected with this type of hepatitis, follow the requirements for working with used disposable medical instruments, wear personal protective equipment (rubber gloves, goggles) when working with open wounds and body fluids, wash your hands before handling and immediately after them, use modern methods of blood sampling (vacutainers).

You don’t have to wear a “plague suit” every time you enter a patient’s room. You are fully protected if you are vaccinated.

Hepatitis B consists of three antigens: surface antigen, cardiac antigen and intermediate antigen. In order for our body to reject hepatitis B, it must have a defense against the surface antigen. The vaccine against this type of hepatitis is an artificially created piece of surface antigen. It stimulates the immune system so that a person does not get sick.

Hepatitis B vaccination is recommended for people requiring blood transfusions, dialysis patients, family members and sexual partners of people with chronic hepatitis B, healthcare workers and other people who work with blood, women planning pregnancy, people who have unprotected sex, people who inject drugs. Also, hepatitis B vaccination is needed for everyone who has not been vaccinated before and does not have the necessary protection against hepatitis B (sufficient level of antibodies to HBsAg).

If you are under 35, you can go to your local health center and get vaccinated against hepatitis A and B free of charge. You can get vaccinated against two hepatitis at once. Vaccinations are carried out according to the plan: from hepatitis B – three times at intervals of a month and six months, from hepatitis A – twice.

Hepatitis C is a gentle killer

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According to WHO, about 72 million people are infected with hepatitis C in the world. Approximately 399,000 infected people die each year, mostly from cirrhosis and liver cancer. The hepatitis C virus is called the “gentle killer”. It is transmitted in the blood through unsafe injection, through the transfusion of blood and its products. Sexual transmission and infection from mother to fetus are extremely rare.

Hepatitis C can be transmitted by household means through razors, toothbrushes. There is a risk of getting a virus during a manicure, during dental procedures and examinations of internal organs with non-sterile equipment.

One day I asked an endoscopist friend of mine from a very prestigious clinic to examine patients with hepatitis C and HIV. It turned out that in this clinic there is a very large flow of patients, and endoscopes do not have time to sterilize – they are simply wiped with a disinfectant.

So both children and pensioners can get hepatitis C, not just injection drug users. If you notice that the medical facility has not processed the instruments, and you are offered to look at a certificate from a previous patient that he is not infected, you should not worry about this. Firstly, his certificate may be fake, and secondly, he may be in a phase when the virus has not yet been detected.

If hepatitis B has the ability to “sleep” (a person became infected 20-30 years ago and carried it in an inactive form), then hepatitis C cannot “sleep”.