What is Hepatitis? Hepatitis is a type of liver inflammation that can be caused due to several factors including infections, medicines, alcohol, immune system abnormalities, or a lack of blood supply to the liver. The liver is a vital organ in the body that performs a variety of functions including detoxification, energy storage, and blood coagulation control. Hepatitis can affect these liver functions and can cause scarring or fibrosis inside the liver. Many viruses can infect the liver, but viral hepatitis refers to inflammation of the liver caused by one of several viruses that particularly attack the liver. These viruses are denoted by the letters A, B, C, D, and E. The most common viruses in the United States are viral hepatitis A, B, and C. Onlymyhealth editorial team spoke to Dr. Manish Kak, Consultant Gastroenterologist, Manipal Hospital, Ghaziabad, to know about the treatment of viral hepatitis.
How is Viral Hepatitis transmitted?
Viral hepatitis A and E enter the body through the gastrointestinal tract. These viruses are contracted by consuming food or drinking fluids contaminated with the virus, which is commonly found in the stool of an infected individual. Hepatitis A can also be transmitted in overcrowded places, such as day care centres and penal facilities, by eating raw shellfish from sewage-contaminated water, or by sexual (typically anal-oral) contact. Hepatitis E, albeit related to hepatitis A, is uncommon in the United States. This virus is mostly found in the Indian subcontinent and certain areas of Africa. It is primarily spread through fecal-oral contamination (as mentioned above).
Hepatitis B and C viruses are typically spread by contact with infected blood or blood products, as well as through sexual interaction. In the United States, intravenous drug use is the most common mode of hepatitis C transmission. Heterosexual transmission of hepatitis C is uncommon, although males having sex with men is becoming more widely recognised as a risk factor for hepatitis C transmission. Hepatitis B is widely spread sexually as well as through intravenous drug use, and it can even be conveyed from a mother to her foetus during delivery. Hepatitis D (also known as Delta hepatitis) affects only people who are infected with hepatitis B. Hepatitis D is transmitted in the same way as hepatitis B is.
What is Acute Viral Hepatitis and what are its symptoms and consequences?
Acute viral hepatitis is defined as liver inflammation accompanied by symptoms and abnormalities in liver enzymes that last less than six months. All of the viruses described above are capable of causing acute hepatitis. Acute viral hepatitis symptoms can include a low-grade fever, headaches, muscle pains, weariness, loss of appetite, nausea, vomiting, diarrhoea, dark-colored urine, or light-colored faeces. Jaundice, a yellow colouring of the skin and the whites of the eyes, is the most noticeable symptom of acute viral hepatitis. Patients frequently report vague upper abdominal pain. Very few individuals with acute viral hepatitis develop liver failure, which necessitates liver transplantation or results in death.
However, if a person is infected with hepatitis E during pregnancy, it might have serious consequences. With the exception of patients infected with hepatitis C, most cases of acute viral hepatitis recover on their own. More than 80% of people with hepatitis C will develop a chronic infection called chronic hepatitis. Although most people with acute hepatitis B will recover, a considerable number of newborns and young children will acquire chronic hepatitis B.
What is Chronic Hepatitis? What are its consequences?
Chronic viral hepatitis is defined as persistent inflammation and/or abnormalities in liver enzymes that last for more than six months. Unless treated, most persons with chronic hepatitis will have the condition for the rest of their lives. In the United States, chronic viral hepatitis is mostly limited to hepatitis B and C. Chronic viral hepatitis can lead to progressive liver disease, including cirrhosis and its consequences, liver failure, liver cancer, and bleeding disorders, however many people never experience any of these symptoms. Furthermore, chronic hepatitis may be increased in those who use liver-toxic medicines. Most of these problems can be avoided with early detection and treatment, and in the case of hepatitis B, immunisation can prevent acute infection in the event of exposure.
How is Viral Hepatitis diagnosed?
Simple blood tests can easily diagnose viral hepatitis (both acute and chronic). While a liver sample (called a biopsy) is not always necessary, it can be useful in difficult-to-diagnose situations or when deciding on treatment based on the degree of the liver scarring.
How is Viral Hepatitis treated?
- Acute viral hepatitis does not usually require treatment because most individuals recover on their own. Acute hepatitis C is a notable exception, as only 15% of patients will clear the virus on their own, and the majority of people will acquire chronic hepatitis C if not treated. Furthermore, when patients are treated during the acute hepatitis infection stage, there is a very high cure rate.
- Chronic hepatitis therapies are available for the most common causes of chronic hepatitis, hepatitis B and C. Medication that inhibits the virus's capacity to proliferate and replicate is commonly used to treat chronic hepatitis B. These drugs include both oral and injectable treatments. Injectable pegylated interferons and oral drugs known as directly acting antivirals (DAAs) are approved for the treatment of chronic hepatitis B. These DAAs have almost no side effects and are the mainstay of therapy. There is presently no medicine available that will totally eradicate the body of the hepatitis B virus (cure). These drugs keep the virus under control but do not totally eliminate it.
- Treatment duration can range from one year for pegylated interferon to possibly indefinite for oral DAAs. Scientists are working on treatments that will entirely remove the virus and achieve what is known as a functional cure.