Liver is one of the most important organs of the body. It helps the body to digest food, remove toxins and store energy. Hepatitis is a condition in which the liver becomes inflamed. There are different causes for developing hepatitis, such as viral infection, heavy use of alcohol, medicines, toxins, infections, autoimmune diseases, and non-alcoholic steatohepatitis (NASH). There are five types of viral hepatitis, namely A, B, C, D and E. Out of these, Hepatitis A, B, C are the most common types. Hepatitis affects the liver’s ability to function properly.
According to a report published by the WHO in April 2017, there are approximately 325 million people who are affected with hepatitis C or B worldwide. The WHO Global hepatitis report, 2017 indicates that majority of these patients do not have access to life saving testing and treatment. Patients with long-term untreated hepatitis are at a high risk of developing chronic liver disease, cancer and ultimately death.
In 2015, viral hepatitis caused approximately 1.34 million deaths. It has been observed that the number of deaths from hepatitis is on the rise.
Viral hepatitis is now recognized as a major public health challenge that requires an urgent response, according to Dr. Margaret Chan, Director-General at WHO. He mentions that vaccines and medicines to tackle hepatitis are available, and WHO is committed to ensuring that these tools reach all those who need them.
There are five different types of viral hepatitis, namely Hepatitis A, B, C, D and E. These are all caused by different viruses, namely:
a) Hepatitis A: It generally spreads through contaminated food or water. However, it can also spread through certain sex practices. These infections are not severe, and patients make complete recovery. They also develop lifelong immunity against the disease. However, in some cases, the disease can become severe and life threatening.
Symptoms of hepatitis A are:
b) Hepatitis B: It spreads when a healthy person comes in contact with infectious body fluids, such as blood, vaginal secretions or semen, which contain HBV. Most patients with hepatitis B infection make recovery in a few months and they develop a lifelong immunity against the virus. However, there are a few people who do not recover from the disease even after 6 months and are known as carriers. These people can infect other people through unprotected sex, shared needles or contact with blood or open sores. In these patients, the disease might get cured on its own or it can develop into chronic hepatitis.
Symptoms of hepatitis B are:
Symptoms do not appear 1 to 6 months after the infection. It can only be diagnosed after a blood test.
c) Hepatitis C: It spreads through direct contact with body fluids, especially through use of infected injection and sexual contact. It is the most serious form of viral hepatitis. It can be acute hepatitis, which lasts for about six months or chronic, which can be lifelong. Acute hepatitis C often develops into chronic infection.
Symptoms of hepatitis C are:
d) Hepatitis D: It occurs concurrently or as super-infection with hepatitis B, since hepatitis B virus is vital for the replication of hepatitis D virus. The infection spreads through contact with blood or other body fluids of the infected person. Currently, there are no antiviral therapies available for treating hepatitis D.
Symptoms of hepatitis D are:
Acute hepatitis D infection occurs when the person gets infected with both HBV and HDV simultaneously. Most of the people recover from the infection on their own. But in some cases, the disease can develop into chronic form.
Hepatitis E: It spreads through contaminated food and water and therefore, the disease is more prevalent in areas with poor sanitation. It is more common in developing countries due to poor hygiene practices in these areas. There are vaccines available to prevent hepatitis E infection, but are not widely used.
Symptoms of hepatitis E are:
Following are the factors that increase a person’s chances of developing viral hepatitis:
If you observe any changes in your skin color or color of eye’s white portion, along with loss in appetite, weight loss, pain in the upper right abdomen and bloating, you might have some trouble with your liver. If you feel tired all the time and observe changes in your urine and stool colors, you should visit a health care provider and get yourself checked. If you have multiple sex partners or indulge in anal sex or use share needles for injecting drugs, you must get yourself checked for hepatitis B and C regularly, as in about 80% of the cases, they do not show any symptoms. If you have visited any country where proper sanitation methods were not followed, it is advised to screen yourself for hepatitis.
However, certain other diseases like anemia might also show symptoms, such as fatigue, weight loss, loss of appetite, etc. Fever, headache, nausea and muscle pain is common in flu infection as well. Therefore, blood tests are necessary for correctly diagnosing hepatitis.
Hepatitis A is a highly contagious infection of liver which is caused by hepatitis A virus. The virus spreads through contaminated food and water or through close contact with the infected person. Mild cases of hepatitis A do not require any treatment and is cured on its own. Most of the patients suffering from hepatitis A recover completely without any permanent damage to liver.
To prevent getting infected by hepatitis A virus, following practices can be followed:
Vaccination against hepatitis B virus provides protection for about 15 years and possibly longer. The Centers for Disease Control and Prevention (CDC) emphasizes upon vaccination of all newborns, individuals up to the age of 18 years, and adults who are at risk of developing the infection. There are three injections that are given over a period of 6 to 12 months.
General precautionary measures that can be taken to prevent hepatitis B infection are:
Maintaining proper hygienic conditions
Many people infected with hepatitis C are unaware of their infected status. It is therefore recommended that if a person is at a high risk of getting infected, they should be screened for hepatitis C infection, as recommended by the CDC.
Following precautions can be taken to prevent getting infected by hepatitis C virus:
Hepatitis D occurs only to people infected with hepatitis B. Hence, preventive measures to be taken to protect against hepatitis D include:
It should be noted that vaccination against hepatitis B virus does not provide immunity against hepatitis D virus if the person is already having hepatitis B.
To prevent getting infected with hepatitis E virus, following precautions can be taken:
Hepatitis A is diagnosed by performing blood tests in which antibodies formed against hepatitis A virus are detected. Additionally, RT-PCR tests are done to identify the nucleic material of RNA virus.
There is no way to correctly diagnose hepatitis B infection without blood test. Following tests are undertaken to diagnose hepatitis B:
Patients with hepatitis C are generally asymptomatic and hence they are not detected in their acute phases. Even in patients with chronic disease, the symptoms do not exist, and they only appear when the disease has progressed to a stage in which the liver damage is secondary to serious liver damage.
Diagnosis of hepatitis C occurs in two steps:
Patients who are diagnosed for having chronic hepatitis C undergo further tests to determine the level of liver damage. Also, tests are done to identify which strain of virus has infected the person. There are six strains of the virus and it is possible to be infected by more than one strain.
Diagnosis of hepatitis D involves testing the blood for the presence of antibodies against hepatitis D virus. It is confirmed by detecting genetic material of hepatitis D virus in the blood of an infected person. However, diagnostic tests for hepatitis D are not available readily.
Diagnosis of hepatitis E involves testing the blood for the presence of antibodies against hepatitis E virus, and if it comes positive, then it is tested for the presence of nucleic material of HVE.
A novel test in which the antigen of the virus is tested in serum of the suspected person has been developed. However, it is not yet accepted as a standard test.
No specific treatment for curing hepatitis A is available. Recovering from the diseases requires time which might vary from several weeks to several months. Medicines should only be taken under medical supervision. Acetaminophen or paracetamol should not be given to patients. Hospitalization might become necessary in case of liver failure. The patient should be given enough fluids and adequate nutrition to help him avoid dehydration and malnutrition due to recurring vomiting and diarrhea.
Treatment to Prevent Hepatitis B Infection Immediately after Exposure:
If a person determines that he has been exposed to hepatitis B virus and is unsure of his vaccination status, then he must visit a health care provider within 12 hours and get an injection containing antibodies to prevent himself from getting infected.
He must also get hepatitis B vaccine to prevent the infection.
Treatment of Acute Hepatitis B Infection:
For acute hepatitis B infection, no treatment is available. It is managed by taking proper rest, nutrition and fluids. If the condition becomes severe, anti-viral drugs can be prescribed, or the patient might be hospitalized.
Some medicines, such as metoclopramide and chlorphenamine are prescribed for managing symptoms, such as feeling sick, itching etc.
Regular blood tests are performed to check the disease progression.
Treatment of chronic hepatitis B infection:
If a person develops chronic hepatitis B infection, then he is required to undergo treatment for the rest of his life. Following treatment measures are undertaken to decrease liver damage and prevent further transmission of disease:
It is not always necessary to get a treatment for hepatitis C infection because in many cases, the virus cannot affect a person due to a strong immune response. Some people with chronic infection do not develop liver damage. If the treatment becomes necessary, its aim is to cure the disease which depends on the strain of virus infecting the patient.
There is no treatment for hepatitis D infection, chronic or acute. However, following steps can be taken to minimize the symptoms:
There is no treatment for hepatitis E infection if a person is suffering from it for more than six months i.e. acute hepatitis E. The body cures itself in four weeks after the symptoms appear. In some cases, the patients might be treated with anti-virals like ribavirin.
If a person gets infected with hepatitis virus, he should take the following steps to manage his diseased condition:
OTC medications are not suggested in patients having hepatitis as they can result in damaging the liver. Any medication that is taken for managing the symptoms should be taken only under medical supervision.
For self-managing the disease, following steps should be taken:
Symptoms of hepatitis can be managed naturally by using the following remedies:
Hepatitis is a serious condition of liver, which can be avoided by practicing general hygienic practice and getting proper vaccination. Safe sex practices, non-sharing of needles for drug use help in managing the disease. Acute cases of hepatitis get managed by themselves. However, if it develops into chronic form, it can be severe. Proper care under the supervision of a medical practitioner is recommended. It is possible to lead a normal life with hepatitis.
Academician, Shelly's rich experience as an academic and research professional speaks volume. Her fields of interest are genetics, biotechnology and drug research. Shelly keeps herself abreast with latest scientific researches all around the globe and loves to write about the same.
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