![]() ![]() All hepatitis viruses cause acute hepatitis, which can result in fulminant hepatitis in rare cases and may be fatal. The natural history of the hepatitis viruses can be categorized based on whether they cause chronic infection. Natural History and Mortality from Viral Hepatitis The prevalence of hepatitis C infection is extremely high in a few countries, most notably, the Arab Republic of Egypt and Pakistan, where high incidence continues, largely the result of weak prevention measures, such as reuse of syringes and needles in health care settings ( Ahmed and others 2013 Mostafa and others 2010). For hepatitis C infection, the regions with the highest prevalence are West and Central Africa, Eastern Europe, and Central Asia. The areas of highest prevalence for hepatitis B are West Africa, where in some countries more than 8 percent of the population is infected, and East and Central Asia ( map 16.1). ![]() The prevalence of hepatitis B and C varies considerably in different regions. An estimated 250 million people live with chronic hepatitis B infection 80 million have chronic hepatitis C infection ( Gower and others 2014 Schweitzer and others 2015). Most (96 percent) hepatitis deaths are caused by hepatitis B virus (HBV) and hepatitis C virus (HCV)-these two viruses cause chronic, lifelong infection resulting in progressive liver damage leading to cirrhosis and hepatocellular carcinoma ( figure 16.1).īecause infection with the hepatitis viruses is often asymptomatic, there are no reliable estimates of the incidence of acute and chronic viral hepatitis. Furthermore, while deaths from infectious diseases such as HIV/AIDS, malaria, and tuberculosis are decreasing, deaths from hepatitis increased by 63 percent between 19. In 2013, an estimated 1.45 million persons (95 percent uncertainty interval 1.38 million to 1.54 million) died from viral hepatitis this estimate includes deaths due to acute hepatitis, as well as hepatitis-related liver cancer and cirrhosis ( Stanaway and others 2016). According to the Global Health Estimates, deaths from acute and chronic hepatitis in 2012 were the tenth leading cause of death and the sixteenth leading cause of disability. Viral hepatitis is caused by five distinct viruses (hepatitis A, B, C, D, and E), which have different routes of transmission and varying courses of disease ( table 16.1). ![]()
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