Hepatitis
Hepatitis is an inflammation of the liver. It is usually caused by the viral infection or liver damage by heavy alcohol use, toxins, some medications, or by certain medical conditions. Some forms of hepatitis are mild while some can progress to fibrosis (scarring), cirrhosis or liver cancer.
Hepatitis often causes no noticeable symptoms; so many people are unaware they’re infected. Some people have no symptoms whereas others develop yellow discoloration of the skin, whites of the eyes, vomiting, abdominal pain, diarrhea, and loss of appetite.
There are 5 main types of hepatitis, referred to as type A, B, C, D and E. The most common types are A, B, and C.
Hepatitis A
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). It is transmitted through ingestion of food and water that is contaminated with the faeces of an infected person or close person-to-person contact. It is rarely dangerous and does not lead to any chronic infection. Some people have mild illness that lasts for a few weeks. It is common in area with a lack of adequate sanitation.
Hepatitis B
Hepatitis B is an infection of liver caused by Hepatitis B virus. Hepatitis B virus is transmitted through contact with the blood or other body fluids such as semen, vaginal fluids of an infected person. Sharing needles and unprotected sexual activity increases the risk. A person can be infected and pass on the virus without being aware. It does not cause any permanent damage but in some people it may cause chronic infection that can be fatal.
People with acute hepatitis B have mild symptoms for a short period and then they get better on their own. But some people are not able to clear the virus from the body which causes chronic infection. Chronic hepatitis is defined by the presence of virus for 6 months or longer. Person with chronic HBV infection can develop liver cancer or cirrhosis.
Hepatitis C
Hepatitis C is a contagious, viral liver disease caused by the hepatitis C virus. The hepatitis C virus is a bloodborne virus and the main cause of spread is through blood-to-blood contact with an infected person. The most common mode of Infection is through unsafe injection practices and inadequate sterilization of medical equipment. Most people with hepatitis C do not realize that they have it.
Hepatitis C virus causes both acute and chronic hepatitis infection. Chronic hepatitis C is a long-lasting infection with the hepatitis C virus. Without treatment, chronic hepatitis C can cause very serious complications like liver cancer or severe liver damage that leads to liver failure.
Hepatitis D
Hepatitis D develops only in people who have hepatitis B. Hepatitis D virus requires hepatitis B virus for its replication. It is transmitted through contact with blood or any other body fluid of infected person. It may also be transmitted from infected mother to child at birth. Hepatitis D can never occur in the absence of hepatitis B and its symptoms are similar to those of hepatitis B.
Hepatitis D occurs in both acute and chronic form. Hepatitis D is considered as the most serious form of chronic hepatitis in humans. Most people with chronic hepatitis D develop cirrhosis. These people with cirrhosis are at higher risk of developing liver cancer.
Hepatitis E
Hepatitis E is a liver disease caused by hepatitis E virus. It is transmitted mainly through contaminated food and water. Hepatitis E virus is most commonly found in geographical areas lacking clean water and sanitation. Most people recover fully from hepatitis E within few months. In certain people, this could lead to serious complications over time. The symptoms of hepatitis E can vary, but they may be serious in some cases. Hepatitis E may also be dangerous for those who have a history of liver disorder.
How does it spread?
Hepatitis A
Hepatitis A is transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A. Food get contaminated when a person with hepatitis touches it without washing hand after using washroom.
Hepatitis A can also be spread through infected feces, poor sanitation, and sexual contact.
Hepatitis B
A person can get hepatitis B from many reasons, by sharing an infected person’s needles, razors or toothbrush. Hepatitis B can also be passed from infected mother to her child during birth.
Hepatitis C
Hepatitis C is transmitted through exposure to infected blood. A person can get hepatitis C by using unsterilized medical equipments like syringes, by injecting drugs using an infected needle and by receiving unscreened blood or blood products. A mother may pass the virus to her child at birth.
Hepatitis D
The routes of HDV transmission are the same as for HBV. Hepatitis D can only infect people with active hepatitis B infection. It is passed most often through sharing IV drug needles with an infected person. The transmission of hepatitis D from mother to child during birth is rare.
Hepatitis E
Transmission of hepatitis E is mainly by drinking contaminated water or eating contaminated food. Other routes of transmission includes from mother to her child at birth or through transfusion of infected blood products. Transmission from person to person appears to be uncommon.
What are the symptoms of Hepatitis?
The most common symptoms of hepatitis are:
- Jaundice
- Loss of appetite
- Nausea and vomiting
- Fever
- Fatigue
- Dark urine
- Abdominal pain
- Diarrhea
How is hepatitis diagnosed?
The diagnosis is based on signs and symptoms and is confirmed by blood test. Blood test is used to determine the presence and quantity of hepatitis virus and antibodies in body. Sometimes doctor may suggest getting a liver biopsy if there’s a chance of liver damage.
Treatment
Hepatitis A
There is no specific treatment for hepatitis A. Hepatitis A virus almost goes away on its own. No medication is needed for hepatitis A. Most people who have hepatitis A will recover on its own over few weeks or months. Doctor may recommend bed rest, eating healthy food and drinking lots of fluid and avoiding alcohol.
Hepatitis B
Acute hepatitis B lasts for few months and may not cause any symptoms. It does not require treatment whereas chronic hepatitis B can be treated with antiviral medications. The most common oral drugs used for treatment of hepatitis B are lamivudine and adefovir dipivoxil.
There is also hepatitis B vaccination available. These vaccines can prevent the transmission of virus from mother to infant.
Hepatitis C
Hepatitis C is usually not treated unless it becomes chronic. Chronic hepatitis C may be treated with an antiviral medication like ribavirin. However, ribavirin should be taken in combination of peginterferon. The treatment may last from 24 to 48 weeks. This combination of drug of pegylated interferon and ribavirin is the most effective therapy for the treatment of hepatitis C. Unlike hepatitis A and hepatitis B, vaccine for hepatitis C is not available.
Blood test and regular visit to doctor is necessary during this period. The doctor may look for any physical changes or track treatment progression, using blood tests to make sure that the treatment is working properly.
Hepatitis D
There is no specific treatment for hepatitis D. Antivirals used to treat hepatitis B has little effect on hepatitis D. In most cases, hospitalization should be considered for patients who are severely ill for supportive care.
Hepatitis E
Generally, hepatitis E does not require treatment. Doctor may recommend taking a balanced diet, to drink plenty of water and to avoid alcohol. In rare cases, a person may require hospitalization.
Liver transplantation
Liver transplant is surgery to remove a diseased or injured liver and replace it with a healthy one from a donor. Liver transplant may be necessary if the liver is severely damaged from chronic hepatitis infection, resulting in decreased liver function and ultimately, liver failure. When the liver can no longer perform its vital functions a transplant may be the only option.
Chronic hepatitis C infection cannot be cured by liver-transplant alone. Liver-transplant patients with chronic hepatitis C can be treated with direct-acting antivirals to clear hepatitis C infection after a liver transplant.
Who is at risk?
- Those who are in close contact with a person who has hepatitis.
- People who inject illegal drugs are also at risk.
- Health care workers who are exposed to blood are at high risk.
- Babies born to mother with hepatitis.
- Chronic HBV carriers are at risk for infection with HDV.
- People who have undergone long term hemodialysis treatment.
- People who received a blood transfusion or organ transplants before 1992 also have a higher risk. Before that year, donated blood was not screened for the hepatitis C virus.
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