A well-known disease that can exist in several forms, hepatitis still affects many patients who ignore it and can, in some cases, lead to cirrhosis or liver cancer. Invited Thursday of Sans rendez-vous , on Europe 1, Pr Patrick Marcellin, hepatologist at the Beaujon de Clichy hospital, recalled the characteristics of the main forms of hepatitis, and specified the different treatments or vaccines available.
What is hepatitis?
Hepatitis in the general sense is an inflammation of the liver, which can be caused by five viruses, A, B, C, D, and E. Viruses D and E "are rarer", specifies Patrick Marcellin, who also recalls the distinction necessary between "acute hepatitis, which will last a few days or weeks" and chronic hepatitis, "which will last, more than six months, years, even tens of years". Chronic hepatitis can eventually lead to a risk of cirrhosis or liver cancer.
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These diseases are sometimes difficult to diagnose, due to symptoms that can remain discreet for years. "The liver suffers in silence," explains Patrick Marcellin, and infections can progress to cirrhosis and liver cancer without the affected patients being aware of having been infected with hepatitis. "We consider that we do not know more than half of the cases of hepatitis B", he illustrates, while "at least 70,000 patients have chronic hepatitis C and do not know it".
Hepatitis A
Hepatitis A is sometimes nicknamed "traveler's hepatitis". "Rare in France", as Patrick Marcellin recalls, it is caught by wastewater or contaminated food, most often in Africa or Asia. "In France, it often concerns subjects returning from holidays, the incubation being of the order of two to three weeks".
"The most frequent" viral hepatitis in the world, hepatitis A "is generally mild and almost always heals". On the other hand, a rare form can be serious: fulminant hepatitis, which has a very high mortality rate, "80% if you do not have an emergency liver transplant", specifies Patrick Marcellin.
Hepatitis B
For hepatitis B, which concerns "300 million carriers worldwide", "the risk is not acute hepatitis, but chronic", explains the guest from Europe 1. Its transmission is generally made to the birth, from mother to child. But this mode of transmission is very rare in France, being "prevented by systematic vaccination at birth, and systematic screening of pregnant women", specifies Patrick Marcellin.
The B virus can also be transmitted sexually. "It is an STD, confirms Patrick Marcellin," more contagious than HIV "." A subject carrying the virus B has 10 million, 100, or even a billion viruses per milliliter of blood, "he adds. for this virus too, "prevention works very well", with in particular a compulsory vaccine for children born after 2018, and highly recommended for others. This vaccine, assures Patrick Marcellin, "is perfectly harmless and is very effective".
Once caught, hepatitis B is never completely cured. "We cannot completely destroy the virus. However, we can block it and avoid liver disease," says the hepatologist. These treatments, he adds, are "very well tolerated".
Hepatitis C
Discovered in 1989, hepatitis C is "a virus that has been hidden for a long time", explains Patrick Marcellin, but which nevertheless affected "1% of the French population at the time", and mainly concerned "transfused people, drug users in intravenously, and transplant recipients. " It can also be caught sexually, but rarely. "Hepatitis C is rare in heterosexual intercourse", confirms the doctor, but "there have been epidemics in populations of homosexual people with risky practices, as in the case of a hemorrhagic report".
Since 2014, a treatment exists against hepatitis C, with "the arrival of the first direct antivirals which block the multiplication of the virus". And according to Patrick Marcellin, "the treatment is very effective".