Low awareness, misinformation, myths and stigma are stopping people from accessing hepatitis services, resulting in over one million deaths worldwide, each year.
Ahead of World Hepatitis Day on 28 July, we spoke to Barbara Hare, Viral Hepatitis Nurse, about the different types of hepatitis and what we are doing locally to treat those with it.
“Hepatitis is an inflammation of the liver that affects specialised cells called hepatocytes. Among the different types, hepatitis B, C, and D are the forms we most often focus on in healthcare, as they can cause chronic infection and lead to serious long-term complications, such as cirrhosis and liver cancer.
“Hepatitis D is a less common but particularly serious infection, as it only affects people who already have hepatitis B – either at the same time (co-infection) or as a later superinfection – adding further risk to the individual’s liver health.
“While less talked about, hepatitis A and E are also types of viral hepatitis. These infections are usually short-term and transmitted through contaminated food or water. Unlike hepatitis B, C, or D, they tend to clear on their own without the need for medical treatment.
“The early symptoms of hepatitis B and C can be subtle or mistaken for other illnesses: people might feel generally unwell, feverish or experience muscle and joint aches, fatigue, right-sided abdominal discomfort or jaundice. Darker urine is also a possible sign.
“In many cases, adults infected with hepatitis B clear the virus naturally within six months. If the virus remains in the body beyond that point, it’s classified as a chronic infection. While there is still no cure for hepatitis B or D, we now have daily antiviral tablets that can suppress hepatitis B, which in turn helps to control hepatitis D as well. However, not everyone needs to start treatment right away, as some people’s immune systems can manage the virus without medication.
“Like hepatitis B, roughly 15% to 25% of people infected with hepatitis C will clear the virus naturally without treatment, usually within the first six months. However, if the virus persists beyond that, it is considered a chronic infection and can lead to progressive liver damage over time.
“Fortunately, hepatitis C is now one of the most curable chronic viral infections, thanks to major advances in treatment. A short course of tablets taken for just 8 to 12 weeks can cure around 97% of cases, with most people experiencing few, if any, side effects.
“Testing is vital. Chronic hepatitis B, C, and D infections can quietly damage the liver over time and increase the risk of hepatocellular carcinoma (liver cancer). Antiviral treatment not only reduces this risk but also slows disease progression. Patients with cirrhosis are offered regular liver monitoring to help detect early signs of liver cancer, because early detection can make all the difference.
“Even if someone was told years ago that no treatment was available, it’s worth getting re-tested. The landscape has changed dramatically in recent years, and more options are now available than ever before.
“Globally, the World Health Organisation has set a target to eliminate viral hepatitis as a public health threat by 2030. Testing plays a crucial role in achieving this goal. It not only opens the door to treatment but also helps stop the spread. Close contacts of people with hepatitis B can be vaccinated and contacts of people with hepatitis C can be tested and treated. At present, there’s no vaccine for hepatitis C or D, making screening and early treatment even more important.
“In East Sussex, I run community-based hepatitis C clinics in local substance misuse services and a charity supporting marginalised individuals. I also work with people facing homelessness, many of whom struggle to access traditional healthcare and may only present to A&E. Alongside a peer from The Hepatitis C Trust, we meet people where they are, often in our outreach van, offering testing, treatment and tailored support to help them engage with care and improve health outcomes.
“Together with my colleague, Marie Francis, we provide nurse-led clinics for people with hepatitis B, C, or D. These allow patients to be seen quickly after referral, without needing to go through the gastroenterology team, ensuring faster access to care and support.”