Hepatitis can’t wait, writes guest expert Caroline.
It’s World Hepatitis Day and an important opportunity to prioritize liver health, including awareness of the different risk factors of hepatitis and prevention as well as recovery tools.
In this timely blog post, Caroline disentangles the different forms of hepatitis and clearly conveys how alcohol is a risk factor. She explains the thought-provoking concept of alcohol use as social contagion in the case of hepatitis.

As the name tells us, hepatitis is the inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis, according to the U.S. Centers for Disease Control and Prevention (CDC).

As the global community commemorates World Hepatitis Day 2022 on July 28, I’d like to disentangle the different forms of hepatitis. It is one of those diseases where alcohol is a major risk factor, but is often not addressed. Let’s change that.

Understanding Viral Hepatitis

I think a good place to start is drawing the distinction between viral and non-viral hepatitis. 

Viral hepatitis is most common and is caused by viruses A, B, C, D, and E.

  • Hepatitis A is common in areas with poor sources of clean water. Luckily, it has a vaccine.
  • Hepatitis B, by contrast, is caused by a virus and can only be spread directly by blood and body fluids, such as intravenous drug use. It also has a vaccine and a number of antivirals remedies.
  • Hepatitis C just like Hepatitis B is spread through blood, poorly controlled medical procedures, and body fluids. Unfortunately, it has no vaccine.
  • Hepatitis D relies on current infection with the Hepatitis B virus. The ‘D on B scenario’ has the most severe effects for people. Luckily, vaccination against Hepatitis B is completely effective against Hepatitis D.
  • And finally, there is Hepatitis E. Like A it is mainly found in areas with poor sources of drinking water but does not have a vaccine.

Non-infectious Hepatitis

Conversely, there are other ways than viral infection that the liver tissue can become inflamed and ultimately damaged, including from a long list of parasites and bacteria that can cause severe trouble. The good part is that in almost all these cases, there is a specific remedy to use against the various organisms, once the cause is identified. 

In the non-infectious hepatitis category, the number one position as risk factor has to be given to alcohol damage to the liver. Alcohol use is a very common cause of chronic liver inflammation, and it is part of a sliding scale from fatty tissue build-up through to hepatitis, cirrhosis, and finally outright liver cancer.

Interestingly, the liver is a very quiet, essential, non-complaining organ. Alcohol-induced hepatitis begins quietly, often without any symptoms and many people fail to recognize the damage that chronic heavy alcohol use may be doing to their liver. 

In the non-infectious hepatitis category, the number one position as risk factor has to be given to alcohol damage to the liver.”

Caroline Kahiu

It is also not contagious and one cannot pass the disease onto others the same way one might pass a virus. However, chronic heavy alcohol use can be “viral” in the social scene because when people consume alcohol together, they reinforce in each other and the community behaviors and norms that can lead to alcohol-induced hepatitis. We can think of alcohol use and the alcohol norm around it as social contagion.

Consuming alcohol heavily – on a single occasion or over time – exerts a serious toll on just about every organ in the body. The liver is perhaps the most familiar non-brain target of alcohol harm. As the chief organ responsible for metabolizing alcohol, the liver is especially vulnerable to injurt due alcohol. People are at greater risk if they use alcohol heavily over many years. But not everyone who gets alcohol-induced hepatitis fits this profile. Some people are more sensitive to alcohol, and their livers already react to low-dose use. Other people consume more alcohol without inducing hepatitis.  

Genetic differences may partially explain this difference. One is more at risk if there is a family history of alcohol use disorder or liver disease. Sex differences also play a part. People who are assigned male at birth can tolerate more alcohol than those who were assigned female at birth. However, everyone is different. What we know for sure is that there is no “safe” amount of alcohol use. 

Consuming alcohol heavily – on a single occasion or over time – exerts a serious toll on just about every organ in the body.”

Caroline Kahiu

There is no specific medical treatment for alcohol-induced hepatitis. The goal is to reduce liver inflammation, help the liver heal and recover, manage complications and support the person through recovery. Recovery requires a long-term behavior change, including environments and norms that shape behavior, and quitting alcohol consumption. 

On World Hepatitis Day 2022, World Health Organisation is highlighting the need for bringing hepatitis care closer to the primary health facilities and communities so that people have better access to treatment and care, no matter what type of hepatitis they may have. This is important because at the primary care level people should be able to receive care for co-morbidities. We know that people with health conditions due to alcohol often face multiple, both chronic and infectious conditions, such as cancer, HIV/ AIDS, tuberculosis, hepatitis, alcohol use disorder and/ or other mental health conditions.

Each and every one of us needs to make a commitment to love our liver because Hepatitis Can’t-Wait.