It is estimated that 4.4 million Americans are living with viral hepatitis, and many of them don’t know it. Unfortunately, the disease can do some damage even when it’s completely asymptomatic. Hepatitis is the leading cause of cirrhosis (scarring of the liver) and if left untreated, may lead to end-stage liver disease and liver cancer.

To raise awareness of this disease, the World Health Organization has designated tomorrow as World Hepatitis Day. Even policymakers are not always fully aware of the impact of hepatitis. Around the world, hepatitis B alone affects 2 billion people—more than one in every four people in the world.

The three main types, A, B, and C, can be transmitted sexually or through infected blood. In addition, type A can be spread through contaminated food, and B and C can be passed from mother to child during labor. Early diagnosis is important because hepatitis necessitates certain lifestyle changes, such as avoiding alcohol or anything else that can harm the liver It also gives infected people a chance to use safer sex practices to avoid further spreading the disease. When treatment is available, it is also important to begin the treatment sooner rather than later.

When symptoms occur, they generally include yellowed skin or eyes, dark urine, extreme fatigue, nausea, vomiting and abdominal pain. However,the disease is not infrequently asymptomatic and, at least in the initial stages, very difficult to detect without testing. In fact, the Centers for Disease Control recommends that everyone born between 1945 and 1965 be tested regularly.

There are vaccines available for types A and B, but none for C. All forms of hepatitis can be prevented by avoiding unprotected sex, touching used needles or syringes, and other contact with bodily fluids. Type A thrives in unclean environments, so proper sanitation is an important part of fighting it.

Hepatitis is difficult to treat, but symptom relief may be possible where needed and doctors can limit the damage it does. Hepatitis A is typically self-limiting,and B can be sometimes—they go away on their own. More commonly, however, the virus remains in the body, either dormant or remaining active; the usual treatments are anti-virals such as interferon. A treatment strategy is usually developed for each patient.

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