What is hepatitis?
According to the World Health Organisation (WHO), “Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer.” Scientists have identified five different hepatitis viruses: hepatitis A, B, C, D and E. These forms that get the most attention because they pose the greatest threat of serious illness and epidemic. They all cause liver disease, however, they do so in significantly different ways.
Hepatitis A virus (HAV): “HAV is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person. Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could die from fulminant hepatitis. The risk of hepatitis A infection is associated with a lack of safe water, and poor sanitation and hygiene (such as dirty hands).”
Hepatitis B virus (HBV): “HBV can cause both acute and chronic disease. The virus is transmitted through contact with the blood or other body fluids of an infected person. … It can be prevented by currently available safe and effective vaccine.”
Hepatitis C virus (HCV): “The HCV virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. The hepatitis C virus is a bloodborne virus and the most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, and the transfusion of unscreened blood and blood products. There is no vaccination for it.”
Hepatitis D virus (HDV): “HDV is a ribonucleic acid (RNA) virus that requires hepatitis B virus (HBV) for its replication. HDV infection occurs only simultaneously or as super-infection with HBV. The virus is transmitted through contact with the blood or other body fluids of an infected person. Infection can be prevented by vaccination.”
Hepatitis E virus (HEV): “HEV is transmitted via the faecal-oral route, principally via contaminated water.”
Worldwide statistics (WHO)
According to the World Health Organisation, globally, 400 million people live with hepatitis, and 6-10 million people are newly infected annually. Many people live with chronic hepatitis for decades without symptoms or feeling sick. Here is a breakdown:
- In developing countries with poor sanitary conditions and hygienic practices, most children (90%) have been infected with the hepatitis A virus before the age of 10 years.
- An estimated 257 million people are living with hepatitis B virus infection (defined as hepatitis B surface antigen positive).
- In 2015, hepatitis B resulted in 887,000 deaths, mostly from complications (including cirrhosis and hepatocellular carcinoma).
- Globally, an estimated 71 million people have chronic hepatitis C infection.
- Approximately 399,000 people die each year from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma.
- Approximately 15 million people across the world are chronically coinfected with HDV and HBV.
- Every year, there are an estimated 20 million HEV infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E, and 56,600 hepatitis E-related deaths.
The Jamaican situation
In Jamaica, the most common forms of the virus are hepatitis A, B and C. According to Marsha Clarke, “Each year, between 150 and 450 persons are identified with either the hepatitis B or C virus, while being screened through the blood-donation process in Jamaica.” She surmises that more than 40,000 Jamaicans could be living with the hepatitis viruses without being aware – that is 0.5 per cent to 1.5 per cent of the donors screened by the Blood Transfusion Service of Jamaica. This number does not take into account the thousands of others who could be affected and are never screened for blood transfusions.
Cannabis and Hepatitis C
It was reported in the January-March 2017 issue of Pharmacognosy Research (a peer-reviewed health journal) that a team of scientists led by Dr Henry Lowe had discovered medicinal properties in cannabidiol that could combat the hepatitis C virus (HCV). Cannabidiol is one of the two major bioactive compounds in the marijuana plant.
A Gleaner article on the issue quoted Dr Lowe as saying that there is currently no vaccine against hepatitis C and that there is only one drug to treat HCV which costs over US$85,000 per treatment. He proposed the development of a cost-effective treatment that would be readily accessible to especially the poor populations of developing countries, who are also more vulnerable to the disease. Lowe’s team comprised himself, Dr Ngeh Toyang and Professor Wayne McLaughlin.