Every year, 28th of July, is marked as the ‘world hepatitis day’. It brings together, the world, to raise awareness about viral hepatitis and to make real change globally. It is estimated that 290 million people are unaware that they have viral hepatitis. Without finding the missing cases, it is next to impossible, to hope for a cure. On this world hepatitis day, we aim to find ‘The Missing Millions’ by taking action and raising awareness.

Now let’s have a look at what is hepatitis.


Hepatitis is a condition in which there is inflammation of the liver. It can be self- limiting or may lead to scarring, loss of liver function and, sometimes, liver cancer.



  1. Viral hepatitis – this is the most common cause of hepatitis and can be caused by one of the 5 types of viruses.
  2. Alcoholic hepatitis – this is caused by excessive intake of alcohol over a long period of time which gradually damages the liver.
  3. Autoimmune hepatitis -this is caused when the body’s immune system attacks the liver and causes its damage.


World Hepatitis Day focuses on viral hepatitis.



Hepatitis A : this is caused by hepatitis A virus and is transmitted through contaminated food or water. This infection usually recovers completely without any treatment.

Hepatitis B : this is caused by hepatitis B virus. It is transmitted through infected body fluids like semen, vaginal fluid or blood. People, at risk, are IV drug abusers, health care workers or sex workersIt can also be passed on from infected mothers to infants during the time of birth.

Hepatitis C: this is caused by hepatitis C virus. It is transmitted through exposure to previously infected needles and blood products. Sexual transmission is also possible but less common than hepatitis B.

Hepatitis D: this is caused by hepatitis D virus. It occurs as a superinfection in patients already infected by hepatitis B virus and never occurs as an isolated infection. As a result, this causes a more serious infection and extensive liver damage.

Hepatitis E: this is caused by hepatitis E virus and is transmitted through contaminated food or water. Disease is usually self-limiting and cured completely. However, the infection can be serious and sometimes fatal if contracted during pregnancy.



Symptoms of acute hepatitis are usually nonspecific and develop quickly. These are fatigue, nausea, vomiting, dark yellow colored urine, pale stools, abdominal pain and yellow discoloration of skin and eyes.

Symptoms of chronic hepatitis develop gradually over months to years and occur when significant damage to the liver has taken place. Such symptoms include swelling of legs, ankles, feet and abdomen, bleeding disorders, yellow discoloration of skin and eyes and sometimes confusion.


Diagnosis of hepatitis can be made by following ways:

  • history and physical exam
  • liver function tests
  • blood tests
  • ultrasound
  • CT scan
  • liver biopsy



Hepatitis A and E infection do not need any treatment as the illness is self-limiting and resolves completely in a few days to few weeks.

Hepatitis B and C infection are treated with antiviral medication. There is no treatment available currently for hepatitis D, however, the severity of infection can be reduced by actively treating hepatitis B infection, as this occurs as a super infection in patients who have been previously infected with hepatitis B virus.




Viral hepatitis can be prevented by number of ways.

  • For hepatitis A and E infection: vaccine is available for hepatitis A and can be given to adults and children. It is also advisable to drink boiled water and avoid eating raw fruits and vegetables in areas where hepatitis A and E are endemic.
  • Hepatitis B and C: Hepatitis B can be prevented by hepatitis B vaccine, that is given to all newborn children and to high risk adults. Practicing safe sex, avoiding sharing of needles and careful screening of blood and blood products is another way to prevent hepatitis B and also hepatitis C infection.
  • Regarding prevention of hepatitis D infection, currently no vaccine is available. The only way to avoid it is by preventing hepatitis B infection, as this always occurs in presence of hepatitis B.



This world hepatitis day aims to identify the missing cases and decrease the global burden of the disease, something that has been a challenge for many decades. It is important to find out those who have been infected but are unaware of the disease. This can be done by large scale testing, primarily in areas where there is high prevalence of hepatitis B and C, and also by testing high risk groups such as IV drug users, health care professionals, sex workers etc.

Once the missing cases are identified, it will be way easier to treat the patients, cure the disease and also prevent further transmission of the disease. This way we can win the fight against viral hepatitis and have a hepatitis free world.


Dr. Beenish Sajjad,

General Practitioner

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