Hepatitis

Overview

Hepatitis is a liver inflammation caused by viruses, alcohol consumption, or some medications. There are different types of hepatitis (A, B, C, D, E) transmitted through contaminated food or water, blood, or body fluids. Some common symptoms include fatigue, nausea, jaundice, and abdominal pain. While some types are self-limiting, others can cause chronic liver damage, leading to cirrhosis or cancer. Vaccines are available to prevent some hepatitis types, while antiviral medications can help manage the symptoms.

What is Hepatitis?

Hepatitis is the inflammation of the liver caused by an injury or irritation. Viral hepatitis infection can be transmitted by coming in contact with contaminated food or water, bodily fluids, and blood of an infected person. Some viral hepatitis types can also spread through sexual contact. Leaving the disease untreated can cause severe health complications such as cirrhosis, chronic liver damage and even liver cancer.

Types of Hepatitis

The different types of viral hepatitis are outlined below:

• Hepatitis A: It is a highly contagious viral infection, that is transmitted through contaminated water or food. It can cause mild to severe illness without causing chronic liver damage.
• Hepatitis B: This is a viral infection transmitted through bodily fluids such as blood, semen or saliva. It can also transmit from a mother to a child during pregnancy or delivery. It usually causes acute and chronic liver disease.
• Hepatitis C: They are passed onto an individual when they come in contact with blood or bodily fluids, or during child delivery. It causes chronic liver damage, cirrhosis and liver cancer.
• Hepatitis D: This disease occurs in people who are already infected with hepatitis B virus, causing severe liver damage. It usually transmits through contact with infectious blood.
• Hepatitis E: It spreads through the stool of an infected person when an individual consumes food or water that has been exposed to it. They cause life-threatening complications in pregnant women, older people and those with weakened immune systems.

The other types of hepatitis include the following:

Autoimmune Hepatitis: It occurs when the body's immune system attacks the liver, causing irritation, swelling and damage to the liver. It can lead to complications such as scarring of the liver, or cirrhosis.

Alcoholic Hepatitis: It is an inflammation of the liver caused by excessive alcohol consumption. The disease destroys the liver cells and leads to complications such as cirrhosis, ascites, kidney failure and hepatic encephalopathy.

Symptoms of Hepatitis

An infected individual may notice symptoms including stomach pain, dark urine, low-grade fever, fatigue, pale or greyish stool, jaundice (yellow skin or eye whites), appetite loss and aching joints that indicate the development of hepatitis. The infection can affect liver function, causing liver failure if left untreated. Complications may include cirrhosis, hepatocellular carcinoma (a liver cancer type), kidney failure, bleeding disorders, ascites, hypertension, hepatic encephalopathy and death in severe cases.

Causes of Hepatitis

Hepatitis A can be caused by consuming or drinking food or water that carries the HAV virus through the faecal-oral route. It can also be caused by sexual contact with an infected person. A person can be infected by hepatitis B through contact with the HBV virus found in body fluids including semen, vaginal secretion and blood. Getting needle stick injuries, sharing contaminated needles or having an infected mother during childbirth can raise the risk of having hepatitis B.

HBV infection risk also increases if an individual has received dialysis treatment, is a male assigned at birth and involved in gay sex, takes medicines that weaken the immune system and has been a prisoner. Travelling to regions with high HBV infection rates (Pacific islands, Asia, Eastern Europe and Africa) also increases the risk.

Hepatitis C results from contact with the HCV virus in blood, semen or vaginal secretions. It can spread by sharing needles, having multiple sex partners and being in direct contact with the blood of an infected person. Exposure to blood containing HDV increases the chance of having hepatitis D. One can also get it from being transferred from a pregnant woman to a foetus during childbirth.

Coming in contact with HEV in food or water causes hepatitis E. An individual can also be infected from consumption of under-cooked venison, shellfish or pork. This hepatitis type is fatal in pregnant individuals. Noninfectious hepatitis can be caused by excessive alcohol consumption, causing inflammation and liver damage. In addition, when the immune system mistakenly attacks the liver, it causes persistent inflammation, restricting proper liver function.

Diagnosis of Hepatitis

A medical professional will conduct a physical exam and study the symptoms one is experiencing to identify the occurrence of this disease. To further diagnose the condition accurately, they may conduct a series of tests including liver function tests (LFT), hepatitis virus panel, ultrasound and liver biopsy.

Treatment for Hepatitis

The treatment options for various types of hepatitis are as follows:

Hepatitis A: It is a short-term illness, requiring no additional treatment. One may take an adequate amount of rest if symptoms cause extreme discomfort. A doctor may suggest maintaining nutrition and hydration if one experiences diarrhoea and vomiting.

Hepatitis B: Acute hepatitis B cannot be treated, however, a doctor may recommend antiviral medications for chronic hepatitis B. These commonly used medications for hepatitis B include entecavir (Baraclude®), tenofovir alafenamide (Vemlidy®), telbivudine (Tyzeka®), interferon alfa-2b (Intron A®), tenofovir disoproxil fumarate (Viread®), and peginterferon alfa-2a (Pegasys®).

Hepatitis C: Medications for hepatitis C include sofosbuvir (Sovaldi®), simeprevir (Olysio®), daclatasvir (Daklinza®), ritonavir (Technivie®), grazoprevir (Zepatier®), and pibrentasvir (Mayret®). A liver transplant may be required for an individual who has developed cirrhosis from chronic hepatitis C.

Hepatitis D: Pegylated interferon alpha drugs are recommended to treat hepatitis D.

Hepatitis E: Medications for hepatitis E include ribavirin and peginterferon alfa-2a. Besides, adequate rest, hydration and nutrition are required to manage the adverse symptoms of the infection.

Autoimmune Hepatitis: Its treatment options include the use of corticosteroids (budesonide or prednisone), azathioprine (Imuran), mycophenolate (CellCept), tacrolimus (Prograf), and cyclosporine (Neoral).

Prevention of Hepatitis

Hepatitis is contagious through contact with water, bodily fluids and foods containing infections. To avoid the risk of hepatitis, minimise coming in contact with these substances. Effective hygiene practices can help prevent hepatitis A and E.

If you are travelling to areas that have reported prevalent cases of hepatitis, make sure to avoid raw fruits and vegetables, local water and ice, raw oysters, and undercooked shellfish. To avoid the risk of hepatitis B, C and D, do not touch spilt blood or share needles, razors and toothbrushes. Use condoms and dental dams to prevent the transmission of hepatitis B and C virus. Also, vaccines are available to prevent the risk of hepatitis A, B and D.

Myths and Facts Related to Hepatitis

Here is a breakdown of the myths and facts about Hepatitis:

Myth 1: Poor Hygiene is the Only Cause of Hepatitis
Fact: While Hepatitis A is often transmitted through contaminated food or water, other types of hepatitis, such as hepatitis B and C, can be spread through blood and body fluids, including sharing needles or having unprotected sex.

Myth 2: Hepatitis is Only a Concern for Adults
Fact: Children can also get affected by hepatitis, especially Hepatitis B, which can be transmitted from mother to child during pregnancy or delivery.

Myth 3: Individuals Having Hepatitis Must Avoid Alcohol
Fact: While excessive alcohol consumption can worsen liver damage in people with hepatitis, moderate alcohol intake may be acceptable for some individuals. Consultation with a healthcare provider is essential.