FAST FACTS:  What is hepatitis?

Every year on July 28, the World Health Organization marks World Hepatitis Day in an effort to step up local and global efforts to combat the disease. 

In the Philippines, hepatitis B is a major public health problem. The Hepatology Society of the Philippines (HSP) says that around 7.3 million adult Filipinos (or 16.7% of the population) are chronically infected with the hepatitis B virus (HBV), almost double the rate of the entire Western Pacific region. 

Despite a high number of cases, many Filipinos still face stigma and discrimination due to their hepatitis diagnosis. According to a report released by the HSP  in 2013, there is a lack of understanding among the general public on how hepatitis is transmitted. 

So, what is hepatitis? How does the disease spread? And how is it treated?

Hepatitis 

Hepatitis is the inflammation or swelling of the liver, most commonly caused by viral infections. According to the World Health Organization (WHO), the five main strains of hepatitis are A, B, C, D, and E. The five strains differ in transmission, treatment, and rarity. 

While each strain can cause liver disease, they differ in how they are transmitted, their symptoms, and how they are treated. 

The strains

Here are the differences between the five strains, as explained by the WHO: 

Hepatitis A is caused by the hepatitis A virus. It is found in the feces or stool of an infected person, and is transmitted through contaminated food or water. Unlike hepatitis B and C, hepatitis A does not cause chronic liver failure. 

However, it can lead to severe symptoms such as fever, diarrhea, and loss of appetite, among others. 

Hepatitis B is caused by the hepatitis B virus, or HBV. It is transmitted through bodily fluids such as blood, saliva, vaginal fluids, and semen. 

According to the World Hepatitis Alliance, HBV is most commonly spread from mother to child at birth in a process known as perinatal transmission. The virus can cause chronic infections leading to liver cancer and cirrhosis.

Hepatitis B is a major global health problem, and in the Philippines, it is highly endemic. 

According to the 2024 Global Hepatitis Report released by WHO, the Philippines is among 10 countries that accounts for nearly two-thirds of the world’s burden of hepatitis B and C. The country also logged 5.7 million hepatitis B infections in all ages in 2022. The other countries in the top 10 include China, India, Indonesia, Nigeria, Pakistan, Ethiopia, Bangladesh, Vietnam, and the Russian Federation. 

The WHO said a lack of awareness and education on hepatitis, as well as a lack of funding and resources, are the main challenges in tackling hepatitis in the Philippines.

Hepatitis C is mostly transmitted through blood-borne fluids, such as through transmissions of infected blood and contaminated needles. Like hepatitis B, hepatitis C can also cause chronic infections, and can lead to death. Unlike hepatitis A and B, C does not have a vaccine, but it can be treated with antiviral medications. 

A 2019  WHO  article reported that six in 1,000 people have chronic hepatitis C. 

Hepatitis D infections only occur in individuals who have already been infected with HBV. Dual HBV and HDV infections can cause a more severe outcome. The only method for treating HDV is through the HBV vaccine. 

The last strain of hepatitis is Hepatitis E. Like Hepatitis A, it is found in the feces of infected individuals and is transmitted through consumption of contaminated water or food. According to WHO, hepatitis E vaccines have been developed but are not yet widely available. 

Treatment centers 

In the fight to treat and raise awareness of hepatitis, the Philippines has several treatment centers and facilities. The Hepatology Society of the Philippines has released directories for referral facilities in the National Capital Region and in the Davao region. 

Meanwhile, Cebu province also has several hospitals which offer free testing for hepatitis. These hospitals include the Cebu Provincial Hospitals in Balamban and Carcar, the Danao City Social Hygiene Clinic, the Vicente Sotto Memorial Medical-Kaambag Clinic, among others. 

Despite the high numbers of hepatitis B and C infections in the Philippines, the government has continued efforts to address the disease. According to the Department of Health (DOH), the country is expecting 3 million more pentavalent vaccine doses arriving at the soonest possible time. 

The pentavalent vaccine provides protection against diphtheria, pertussis, tetanus, hemophilus influenza type B, and hepatitis B. – Katarina Ruflo/Rappler.com

Katarina Ruflo is a Rappler intern. She is currently pursuing a degree in Political Science with a major in International Relations and Foreign Service at the University of San Carlos, Cebu.