World Hepatitis Day: 5 common myths around the infection debunked

Nearly 350 million people in the world are living with viral hepatitis, and at least one person dies from it every 30 seconds, according to the World Health Organization (WHO). In India, nearly 40 million people are chronically infected with hepatitis B, and six to 12 million people are chronically infected with hepatitis C.  

But the good news is that hepatitis is preventable and treatable. Dr. Tedros Ghebreyesus, WHO Director-General, said at the World Hepatitis Summit in 2022 that it can be treated and prevented with "services that can be delivered easily and cheaply at the primary health care level." 

So, this World Hepatitis Day, we spoke to Dr. Govind Nandkumar, surgical gastroenterologist, Manipal Hospitals, and Dr. Harsh Kapoor, chairman, department of gastroenterology and hepatology, Metro Group of Hospitals, to debunk some of the most common myths associated with the infection.

Myth 1: All types of hepatitis infections are life-threatening

There are broadly five types of hepatitis viruses: A, B, C, D, and E. Of these, A and E are self-limiting, which means illnesses caused by them resolve after four to eight weeks. 

Hepatitis B and C infections may go into the chronic phase and affect the liver. 

However, hepatitis C can be cured within eight to twelve weeks. As for hepatitis B, there is a vaccine but no cure. Although medications to manage hepatitis B are available, which can help prevent liver damage

WHO explains hepatitis D as an infection that occurs when "people become infected with both hepatitis B and D simultaneously (co-infection) or get hepatitis D after first being infected with hepatitis B (super-infection)." It can be prevented by immunization, but the success rate of its treatment is low. 

Dr. Govid Nandkumar explained that one could also have fulminant hepatitis— hepatitis due to unrecognized medicines and toxic substances to the liver. He said, "It often happens due to unknown and unsafe medicine like concoctions or powder, or overingestion of certain medicines, or autoimmune diseases, and this may become chronic." However, depending on the cause, acute liver failure can sometimes be reversed with treatment. 

Myth 2: People can contract hepatitis C by kissing, hugging, and shaking hands

"No, kissing does not spread hepatitis C," said Dr. Kapoor. Although this myth is most commonly believed to be true, the hepatitis C virus is blood-borne, and, according to the WHO, it "does not spread through breast milk, food, water or casual contact such as hugging, kissing and sharing food or drinks with an infected person." 

Dr. Nandkumar explained, "It does not spread via handshakes or by hugging each other (sic)." Hepatitis C spreads by coming in contact with blood from an infected person. 

Myth 3: You can't be infected with hepatitis C multiple times 

According to Dr. Kapoor, "There have been no reported cases of contracting the virus again, but this cannot be said with certainty as there are different genotypes of viruses. The hepatitis C virus does not provide immunity against the virus, and therefore one can get the virus again."

According to the Centers for Disease Control and Prevention (CDC), United States' national health agency, "You can be infected again even if you have cleared the virus or were successfully treated and cured." Therefore, people who inject and share needles, syringes, or other drug preparation equipment should be tested for hepatitis C on a regular basis. 

Myth 4: Asymptomatic patients can't be the carrier of infection

When someone gets hepatitis, they can transmit it to others. However, not everyone carrying the infection would show any symptoms because the virus may be dormant in a few people. So, such persons may be asymptomatic, but they can still infect others. 

Dr. Nandkumar said, "Some carriers have hepatitis B but may not show any symptoms of the infection. However, these carriers should take precautions to prevent transmission." 

CDC explains, "Many people with hepatitis B don't know they are infected with the virus because they don't feel or look sick. However, they can still spread the virus to others."

Myth 5: Hepatitis C only spreads through sexual activities

The link between hepatitis C and sexual activity is often misunderstood and can result in creating a stigma around those suffering from the infection. According to the CDC, "The hepatitis C virus is usually spread when someone comes into contact with blood from an infected person." It also adds that the risk of transmission from sexual contact is believed to be low, but the risk increases for those who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV.

Dr. Nankumar explained that it is misleading to say that the virus only spreads through sexual transmission. There are other causes, such as using unsafe needles. However, "one should always be cautious and adopt safer sex practices."