DALLAS – Viral hepatitis does not discriminate. Patients may be young, old, male, female, rich, poor and of any ethnicity. According to the Centers for Disease Control and Prevention, an estimated 4.4 million Americans are living with chronic hepatitis and most are not aware that they are infected. World Hepatitis Day, launched in 2008 by the World Hepatitis Alliance and observed annually on July 28, aims to raise awareness and influence improvement in disease prevention and access to testing and treatment.
In Dallas County, the number of reported cases of hepatitis C nearly tripled from 2003 to 2010 and cases of chronic hepatitis B grew nearly five-fold in that period.
According to Pranavi Sreeramoju, MD, infectious disease chief at Parkland Health & Hospital System, “People need to be educated about the serious health consequences of hepatitis B and C infection, assess whether they may be at risk, and if so, get tested. About 1,800 people die every year in the U.S. from hepatitis B and 16,000 people die from hepatitis C.”
These infections are as devastating as HIV/AIDS, tuberculosis or malaria, even though they generally do not receive as much media or political attention.
“The incidence of viral hepatitis infection is higher among those with a low socio-economic status compared to the general population,” Dr. Sreeramoju added. “At Parkland, our goal is to prevent new infections and to provide the latest evidence-based treatment to people living with the disease.”
Those most at risk of infection are individuals with multiple sexual partners, injection drug users, men who have sex with men and commercial sex workers. The risk of acquiring these infections via blood transfusions and organ transplantation is very low currently because of tremendous improvements in safety related to these procedures, Dr. Sreeramoju stated.
Viral hepatitis is an inflammation of the liver, with the most common types being Hepatitis A, B and C. Chronic viral hepatitis caused by the B or C virus is the leading cause of liver cancer and the most common cause for liver transplantation. In contrast, hepatitis A is generally transmitted through water and food contamination. It is a self-limited disease that does not lead to chronic infection or chronic liver disease. Hepatitis A is preventable with food and water safety precautions and hepatitis A vaccine.
Chronic Hepatitis B, which has been termed a “silent epidemic,” is a serious disease that can result in long-term health problems and even death. An estimated 600,000 people die from the disease worldwide each year. Hepatitis B vaccine is included in the childhood immunization schedule. Adults who must be vaccinated against hepatitis B include healthcare and public safety workers, adults engaged in high risk sexual behaviors or injection drug use, persons on dialysis and international travelers.
Hepatitis C infection is the most common chronic blood borne infection in the United States; approximately 3.2 million persons are chronically infected. Although Hepatitis C virus is not efficiently transmitted sexually, persons at risk for infection through injection drug use are urged to seek care in public health settings where STD and HIV prevention and control services are available. There is no vaccine for Hepatitis C and avoiding behaviors that spread the disease, especially injection drug use, is the most effective prevention.
Hepatitis D and E are both serious liver diseases but are rare in the United States. There is currently no vaccine for either. Hepatitis D is spread through blood contamination while Hepatitis E is usually associated with water supplies contaminated with fecal matter.
“In Texas, there is a great need for prevention, early diagnosis and treatment of hepatitis B and C,” Dr. Sreeramoju said. “Hepatitis can be prevented. Parkland offers vaccination and testing for those at high risk, and offers treatment for patients with hepatitis. We want people to get educated about hepatitis and seek appropriate preventive or medical care as needed.”
To find locations of Parkland outpatient clinics providing testing and vaccination for hepatitis, please visit our website at www.parklandhospital.com.
