Risks and Severity

There is a vaccine against hepatitis A and hepatitis B, but there is no vaccine against hepatitis C. Screening for HBV and HCV is recommended for certain at-risk individuals.

Chronic hepatitis 

Hepatitis is said to be chronic if it is not cured after 6 months. 70 to 80% of hepatitis C cases become chronic with an increased risk of developing cirrhosis or cancer of the liver (Belgian Healthcare Knowledge Centre, KCE).

There is also a risk of reinfection following a prior infection for people who take intravenous drugs and men who have sex with men (MSM) living with HIV.

The progression of hepatitis B depends on the person's age at the time they become infected. If it occurs in an adult, it becomes chronic in 5% to 10% of cases.  Chronic HBV infections can lead to severe liver problems if left untreated.

An HBV and HIV co-infection is common and increases the risk of complications (cirrhosis of the liver or liver disease) (MSMGF).

Cirrhosis of the liver

Cirrhosis of the liver is a degeneration of the liver tissue after it has been attacked repeatedly by alcohol, toxins, viruses, etc.

This is often a silent disease that is detected later during a blood test.

Cirrhosis causes water retention and symptoms can include a swollen stomach and legs.

20% to 25% of chronic hepatitis cases evolve into cirrhosis if the treatment doesn't work sufficiently or if it isn't followed properly.

Liver Cancer

Liver cancer is the ultimate complication of cirrhosis. Liver cancer can also result from a cancer that is localised in another organ in the body and spreads to the liver through metastasis.

Hepatitis B and C are the types most likely to evolve into cancer.

Fulminant Hepatitis

Very rare, fulminant hepatitis is characterised by a major loss of function in the liver, which can no longer fulfil its role.

There is a massive destruction of liver tissue and an organ transplant is necessary.

It mainly occurs in people suffering from hepatitis B or toxic hepatitis.

It is fatal with a rapid progression for approximately 1 out of 4 people.

Its symptoms include red patches on the skin and nose bleeds as well as a confused mental state which occasionally progresses to a coma.

In conjunction with the Laboratoire Clinique de Saint-Luc (Saint Luc Clinical Laboratory) — UCL Brussels, Sciensano hosts the National Reference Centre for the hepatitis B, C, D, and E viruses, which analyses the viral strains of hepatitis. Sciensano also carries out epidemiological surveillance of the different types of viral hepatitis in Belgium and monitors the quality of the vaccines.

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