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World Hepatitis Day

Hepatitis_DrSamayNaderyHepatitis C patients will soon receive a new generation treatment for their condition at St. Maarten Medical Center (SMMC). SMMC Internist, Dr. Samay Nadery, said St. Maarten is moving towards the new generation of the medication; which is two different tablets once a day for three months. The benefits compared to classical treatment include fewer side effects; shorter treatment duration; 90 per cent success rate and smaller chance of relapse.

Nadery said his first patient will receive the new generation medication "very soon. Before this treatment was available, his patient received the classical treatment and there was a relapse after six months. "So now we are trying the new medication. Studies show that the new generation treatment is more tolerable and I believe this time my patient's treatment will be more successful."

Nadery's comments come as the world celebrates World Hepatitis Day today, Tuesday, July 28. The World Health Organisation (WHO) has set World Hepatitis Day as one of four official disease-specific world health days, to be celebrated each year.

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 five main hepatitis viruses, referred to as types A, B, C, D and E. These five 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 can lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Worldwide, more than 400 million people are living with Hepatitis B or C. Every year almost 1.4 million people die from viral hepatitis. That is about 4,000 lives a day. SMMC has joined with millions across the world to take part in raising awareness about viral hepatitis on World Hepatitis Day.

The facts

Nadery, who has been working at SMMC for just over 18 months, said while screening is not widely done on the island for viral Hepatitis, the number of his patients with Hepatitis B and C virus is significant.

The transmission for blood borne Hepatitis B, C and D is via blood, semen and other fluids of the body. Hepatitis A and E are acquired due to unsafe water, inadequate sanitation and poor hygiene.

There is also acute and chronic hepatitis. Hepatitis A and E are acute and won't cause chronic liver disease. Almost everyone recovers fully from Hepatitis A, if needed with medical alternatives. As it relates to Hepatitis E, like Hepatitis A, there is no specific antiviral treatment. Each year an estimated 56,600 people die from Hepatitis E related cases, Nadery said.

In our region, Hepatitis B and C are more common. Hepatitis D is only found in people who already have Hepatitis B. Nadery has not come across this in St. Maarten. Globally, approximately 130-150 million people have chronic Hepatitis C infection. Nadery says this is "a huge number."

And 500,000 people die each year from Hepatitis C-related liver disease. Yet, if Hepatitis C infection is treated, more than 90 per cent of patients will be cured because there are good new treatment options for Hepatitis C. An even greater number of patients are living with Hepatitis B, globally accounting to 240 million resulting in 780,000 deaths each year due to complications of the infection.

Symptoms

Acute Hepatitis can present with fever, jaundice, dark urine, yellow eyes and skin and/or discomfort in the right side of the abdomen. If these complaints are combined, one should see their doctor. If it is a chronic problem with complications, besides the abovementioned, one can get oedema, where the abdomen gets bigger or the person can bleed easily. "In most cases, when I get a patient with Hepatitis B or C, it is at the late stage of the disease with complications," says Nadery. Sometimes a patient has Hepatitis B or C, but does not have any complaints until the damage to the liver is getting worse.

New treatment options

Persons living with Hepatitis B or C should always visit their doctor regularly to discuss options on when to begin treatment. Hepatitis B and C does not always require treatment at the beginning. Treatment for Hepatitis B infection does not provide a cure, but can suppress the replication of the virus. Therefore, persons who start Hepatitis B treatment continue it for life.

When treatment is necessary for Hepatitis C, the goal is to cure. There is a new generation treatment that makes treatment easier than with the classical treatment. "My first patient will receive the new generation medication very soon... Studies show that the new generation treatment is more tolerable and I believe this time my patients' treatment will be more successful," said Nadery.

Prevention

Vaccination is the most effective way to protect against Hepatitis A. This is optional for persons who are travelling to countries where there is a high risk of contracting the disease.

In St. Maarten, there is also vaccination for Hepatitis B for children. Healthcare professionals are also required to take the vaccination for protection in case of accidental exposure. However, the Hepatitis vaccination is not only for children or healthcare workers. If you think you are at risk, you should request the vaccination from your doctor.

Persons at high risk such as people who inject drugs, people with multiple sex partners, and travellers to and from high risk countries should be screened for Hepatitis regularly. Currently, screening for and reporting on Hepatitis is not structurally done in St. Maarten. With the new hospital information system at the SMMC, reporting Hepatitis cases treated at the hospital can be more efficient and the figures can be used by external parties to raise awareness and maximise efforts to help eliminate the disease.

For every death a voice

Persons in the community can help to raise awareness about Hepatitis in simple ways. The World Health Organisation is asking 4,000 people to stand up and be counted in the quest to raise awareness of viral hepatitis. Persons interested can be a voice for the 4,000 lives that will be lost on World Hepatitis Day this year. Simply tweet #4000voices or upload an image to contribute to a collage, SMMC says.

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