Hepatitis, the silent killer in all its strains

The ‘silent epidemic’ of viral hepatitis continues to significantly affect many unknowing victims. Approximately one million people die each year from causes related to viral hepatitis.

Hepatitis is an inflammation of the liver and has five main viruses, referred to as types A, B, C, D and E.

Hepatitis A is found in the faeces of infected persons and is most often transmitted through contaminated water or food. The virus attacks the liver and causes mild-to-severe illness.

This strain is closely associated with inadequate sanitation and poor personal hygiene, even though certain sexual practices can also spread the virus, which is one of the most common vaccine-preventable diseases in residents and travellers.

Hepatitis B is a more serious disease spread through infected blood and other bodily fluids such as semen and vaginal secretions, in a manner very similar to HIV. Hepatitis B is, however, approximately 100 times more infectious than HIV and can also be transmitted from infected mothers to infants at birth or from family members to infants in early childhood.

 The majority of hepatitis B sufferers fully recover but a percentage become carriers who can transmit the virus unknowingly to others. This group can go on and develop chronic hepatitis and experience scarred tissue or hardening of the liver.

 Hepatitis C is often a silent condition that is most commonly transmitted through exposure to infected blood. Most people go on to develop chronic hepatitis C without even knowing it.

Patients often experience fatigue, a diminished appetite, joint and muscle pain as well as yellowing of the skin and eyes, urine of a dark yellow colour and an increased tendency to bleed or bruise.

Sexual transmission of Hepatitis C is possible but much less common. The risk is, however, higher if one has many sexual partners.

Hepatitis D infection occurs only in those who are infected with Hepatitis B, and the dual infection can result in a more serious disease and worse outcomes. However, chronic hepatitis D is seen in less than five per cent of co-infected patients.

 Hepatitis E, like hepatitis A, is typically transmitted through the consumption of contaminated water or food. This form of hepatitis is common in any country with a hot climate and is most commonly seen in teens and adults between the ages of 15 and 40.

Safe and effective vaccines to prevent hepatitis E have been developed but are not widely available.

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Milk thistle and liver disease

In the world of alternative medicine, milk thistle is the treatment of choice for liver disease, particularly chronic infection with hepatitis C... or is it?

In a careful, double-blinded study financed by the National Institutes of Health, researchers at the University of North Carolina found that milk thistle had no real effect on people with chronic hepatitis C.

The study, one of the most rigorous to date on this topic, followed 154 people with the disease for 24 weeks. Some were given a placebo while others received silymarin, the active ingredient in milk thistle, three times a day in either normal or high doses.

By monitoring enzymes indicative of liver function, the researchers found that the herbal extract did not create any improvement compared with the placebo. Nor did milk thistle differ much from the placebo with regard to side effects.