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What You Need To Know About Hepatitis

INTRODUCTION

The meaning of the word Hepatitis can be gotten from two words; “HEPAT” which usually signifies anything that has to do with the liver and “ITIS” which is a word termination denoting inflammation of the part indicated by the word stem to which it is attached. HEPATITIS is, therefore, an inflammation of the liver tissue. This condition can either be self-limiting or can progress to some chronic diseases like cancer which makes it a very deadly disease. Hepatitis viruses are the most prevailing cause of hepatitis all over the world. Although, some other infections and autoimmune diseases can also cause hepatitis. Autoimmune hepatitis occurs when the body makes antibodies against the liver.

It is quite surprising to find out that this deadly disease that has ravaged the health world for over 5 decades was discovered unintentionally. Dr. Baruch Blumberg, an American physician, a geneticist and a researcher at the National Institute of Health (NIH) was researching on the genetics of how susceptible people were to different diseases. While studying haemophiliac patients who had received multiple blood transfusions and would be exposed to the blood they had received from donors, Dr. Blumberg and his team discovered an unusual antigen from an Australian native. After further research they found it to be the antigen that caused hepatitis B. It was officially recognized in 1967. Dr. Blumberg was awarded the Nobel Prize for Medicine based on his discovery of Hepatitis B Virus (HBV).

Hepatitis can be diagnosed by liver function tests, ultrasound, liver biopsies and some physical exams.

There are five types of viral hepatitis which include: Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D and Hepatitis E. A different virus is responsible for each one of them. Hepatitis A is usually short-term while Hepatitis B, C, and D are more likely to cause chronic conditions like cirrhosis and even cancer. Hepatitis E is also short-term but particularly dangerous to pregnant women.

HEPATITIS A:  It is an infectious disease of the liver caused by the Hepatitis A Virus (HAV). It is a self-limiting viral disease which is most prevalent in places with poor hygiene and low socioeconomic status. It is most commonly transmitted by consuming contaminated food or water from the feces of someone infected with hepatitis A. Most cases of hepatitis A infection are mild with many of the patients making full recovery and remaining immune from further HAV infections. Certain sex practices can also result in hepatitis A. The incubation period is about 30 days with a range of about 15-50 days. Massive hepatic necrosis could occur but more commonly in hepatitis B or C.

HEPATITIS B: It is an infectious disease of the liver caused by Hepatitis B Virus (HBV). It can cause both acute and chronic infections. At the initial stages, the patient appears to be asymptomatic. HBV can be transmitted through exposure to different body fluids like blood and semen. In areas where it is prevalent, the most common cause is an infection from the time of birth or contact with other people’s blood during childhood. However, intravenous drug use and sexual intercourse are the most frequent route of infection in places where the disease is rare. It is endemic worldwide specifically in areas like China, Southeast Asia, Sub-Saharan Africa, most Pacific Islands and the Amazon Basin. The incubation period is 90 days with a range of about 40-180 days and the clinical course is more variable than hepatitis A.

HEPATITIS C: It is an infectious disease of the liver caused by the Hepatitis C Virus (HCV). It is mostly transmitted through exposure to infected blood. It is the most common cause of post-transfusion hepatitis. It can also follow parenteral drug abuse or other intimate forms of contact with an infected person. This is the most common acute sporadic form of hepatitis and approximately 50 percent of acutely infected people develop chronic hepatitis. Although the chronic infection is usually mild and asymptomatic, cirrhosis may occur. HCV has no vaccine.

HEPATITIS D: It is an infectious disease of the liver caused by Hepatitis D Virus (HDV). It is also called delta hepatitis. These infections occur in only those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious outcome. Hepatitis B Virus provides protection from HDV infection.

HEPATITIS E: It is an infectious disease of the liver caused by Hepatitis E Virus (HEV). It is transmitted through the feco-oral route, usually via contaminated water or food. The incubation period is between 15-60 days and there is a prodromal phase. Chronic hepatitis does not occur but acute hepatitis can be fatal in pregnant women. It is the most common cause of hepatitis in developing countries of the world and is increasingly being recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.

CAUSES

The major causes of hepatitis are the different viruses which are HAV, HBV, HCV, HDV, and HEV. They are each responsible for the five different types of hepatitis. These are regarded as the infectious causes of hepatitis.

There are also some non-infectious or toxic causes of hepatitis. They include excessive consumption of alcohol, exposure to poisons and overuse of medications. These toxins directly injure the cells of the liver and over time cause permanent damage leading to liver failure and cirrhosis, a thickening and scarring of the liver.

In some cases, the immune system mistakes the liver as harmful and begins to attack it. It causes inflammation which ranges from mild to severe thereby hindering liver function. This is known as the autoimmune cause of hepatitis which is three times more common in women than in men.

SYMPTOMS

Infectious forms of hepatitis, like hepatitis B and C that are chronic, are usually asymptomatic at their initial stages. Symptoms start to occur when liver function is affected.

Symptoms of acute hepatitis include:

Dark urine

Fatigue

Loss of appetite

Abdominal pain

Yellow skin and eyes

Unexplained weight loss

TREATMENTS

Treatment options for hepatitis depend on the type of hepatitis one has and whether it is acute or chronic.

Hepatitis A: It usually does not require treatment because it is a short-term illness, but bed rest may be recommended if symptoms cause a great deal of discomfort in the patient. Hepatitis A vaccine is available to prevent this infection. Children usually start vaccination between the ages of 12-18 years.

Hepatitis B: Acute hepatitis B does not require treatment. Chronic hepatitis B can be treated with antiviral medications which is very costly. Adequate and regular medical evaluations and monitoring should also be given to determine the virus response to treatment.

Hepatitis C: Both the acute and chronic forms of hepatitis C can be treated using antiviral medications. Patients who develop liver cirrhosis as a result of the chronic form are good candidates for liver transplant.

Hepatitis D: There is currently no antiviral medications that exist for hepatitis D. A study carried out in 2013 showed that an “alpha interferon” drug could be used to treat hepatitis D. This drug showed an improvement in about 25-30 percent of people.

Hepatitis E: There are currently no specific medical therapies that are available to treat hepatitis E. Due to its acute nature, patients are just advised to get adequate rest, drink plenty of fluids, get enough nutrients and avoid alcohol as much as possible. However pregnant women infected with it require very close monitoring and care.

Autoimmune hepatitis: Corticosteroids are very important in the early treatment of autoimmune hepatitis. It is effective in about 80 percent of patients with this condition. Imuran, an immunosuppressant is often included in the treatment. It may be used with or without corticosteroids.

PREVENTION

Keeping a clean environment and practicing good hygiene is a very key way to avoid contracting hepatitis A and E. Hepatitis B, C and D which are contracted through contaminated blood can be prevented by not sharing needles, razors and other sharp objects that might be contaminated. Practicing safe sex by using condoms and dental dams can also help decrease the risk of contracting hepatitis B and C. The use of vaccinations is also a very important key to preventing hepatitis.

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