Hepatitis, which literally means "liver inflammation," is a primary infection that affects the liver and comes in hepatitis types A, B, C, D, E, and G. Hepatotoxic viruses are suspected of being involved in the etiology of this illness type. Now, there is now knowledge of hepatitis F, which is thought to be a hepatitis linked to transfusions. It is not classified as a distinct establishment or entity because it is widely believed to be a type B virus mutation. Even though the liver is the target organ for all viral hepatitis types, these viruses nonetheless differ in terms of their structural makeup, mode of replication, method of transmission, and disease progression.

Some hepatitis types are preventable by vaccination, diagnosis, medicines, and education campaigns. 

Project Global Cure aims to reduce new hepatitis infections in the country. Most common types of hepatitis are like hepatitis B which is preventable but serious liver infection, hepatitis C that leads to inflammation, alcoholic hepatitis caused by drinking too much alcohol, autoimmune hepatitis in which inflammation occurs on attack of immune system upon liver and hepatitis D,A,E …out of these hepatitis A is contagious. 

 

IMAGE SHOWING THAT TARGET ORGAN FOR ALL HEPATITIS VIRUS IS LIVER 

 

 

IMAGE SHOWING STRUCTURE OF DIFFERENT HEPATITIS VIRUSES 

Properties of all hepatitis viruses

 

PROPERTY	HEPATITIS A	HEPATITIS B	HEPATITIS C	HEPATITIS D	HEPATITIS E
Structure of virus	Picorna-hepatocirus made of RNA	Hepadnavirus made of DNA	Flavivirus made of RNA	Defective RNA delta virus	RNA herpes virus
Mode or route of transmission	Fecal-oral route	Contaminated blood, syringes/needles, unsafe sex, perinatal and mother to child	Fecal-oral route	Parenteral	Fecal-oral route
Age groups affected	Children	Any age	Adults	Any age	Young adults
Incubation time or IP	15-45 days	30-180 days	15-160 days	30-180 days	15-60 days
Cancer causing	None	+	+	+/-	None
Fulminant hepatitis causing	0.1%	0.1-1%	0.1%	5-20%	1-2%
Prognosis	Excellent	Worsens with age	Moderate	Acute- good & chronic- poor	Good

 

Early Signs and Symptoms of hepatitis-

Several people with hepatitis exhibit mild or no symptoms. But each form of the virus can cause more severities. Symptoms of Hepatitis A, B, and C may comprise:

• fever
• pain 
• loss of appetite
• diarrhea
• nausea
• abdominal discomfort
• dark-colored urine 
• jaundice

In unusual cases, a chronic liver infection can happen that can advance into cirrhosis or liver cancer, resulting in a fatality.

Hepatitis D is only found in people already infected with hepatitis B; however, the dual infection of both these viruses can cause a more serious infection and poorer health outcomes, including accelerated progression cirrhosis. The advancement of chronic hepatitis D is limited.

Hepatitis E symptoms are:

• mild fever, 
• lessened appetite, 
• nausea, vomiting enduring for a few days. 

 

Some people may also have:

• abdominal pain
• itching 
• skin rash 
• joint pain
• jaundice
• dark urine
• pale stools
• somewhat enlarged, sore liver  
• occasionally acute liver failure

 

Hepatitis Treatment

 

Hepatitis B and hepatitis D are both prevented through vaccinations against the hepatitis B virus. Antiviral medications can be used to treat chronic hepatitis B infection, which can also slow the progression of cirrhosis, lower the risk of developing liver cancer, and increase long-term survival. Those who have chronic hepatitis B will rarely require treatment.

Hepatitis E can be prevented, however not with a widely accessible vaccine. The B and E viruses normally do not cause serious illness, and there is no specific treatment for them. Due to negative effects on liver functioning, it is advised to avoid taking unnecessary drugs.

Some people with hepatitis C recover on their own, while others experience severe infections or complications including cirrhosis or cancer. Hepatitis C can also cause severe and chronic infections. There is no vaccination for hepatitis C. People with hepatitis C can be cured with antiviral medications, but access to diagnosis and treatment is still limited.

Reduced access to dependable, clean water sources and increased danger of tainted food contribute to the highest prevalence of the hepatitis A virus. Hepatitis A can be controlled with a vaccination. The majority of illnesses are minor, and many patients fully recover and build an immunity to infections. Additionally, these infections are rarely serious and life-threatening.

Some general points on all Hepatitis types-

 

1. All hepatitis viruses are RNA viruses leaving HBV.
2. Enteral route for transmission is common to Hepatitis A& E while parenteral-sexual to B & C.
3. HAV can be demonstrated in the stool of infected individuals by IEM.
4. HBV is also called blood borne virus.
5. Vaccination is recommended in infants, children and > in high risk groups.
6. Immunization of pregnant mothers is very much mandatory to prevent newborn as carriers for infection and jeopardizing them with hepatitis risk.
7. HBV is also common in female sex workers.
8. HCV can be detectable by ELISA/RIA or radioimmunoassay.
9. HEV is said to be the primary cause of non-A & B enterically transmitted hepatitis.
10.  Causes of hepatitis are heavy alcohol use, autoimmune drugs or toxins or infection from a person who is carrier of the virus.
11.  Viral infection is the cause of viral hepatitis.
12.  Drugs like minocycline, methyldopa and nitrofurantoin can trigger autoimmune hepatitis.
13.  Genetic factors or alcohol etc., are common causes of alcoholic hepatitis.
14.  Viral hepatitis infection has 4 phases- viral replication phase 1, prodromal phase 2, icteric phase 3 and convalescent phase 4.

Physical examination of viral hepatitis patient or hepatitis symptoms in men-

1. Yellow sclera of eyes
2. Jaundice
3. Appetite loss
4. Fatigue with dehydration
5. Fever
6. Skin urticarial rashes
7. Pedal edema
8. Ascites
9. Spleen enlargement or splenomegaly
10.  Liver enlargement or hepatomegaly

Diagnosis of hepatitis -

• History and physical examination
• Liver function tests
• Blood tests
• Liver biopsy
• Ultrasound 

 

Complications of hepatitis -

• Chronic liver disease
• Cirrhosis
• Liver cancer
• Liver faliure
• Bleeding disorders
• Ascites
• Portal hypertension
• Kidney failure
• Hepatic encephalopathy 
• Hepatocellular carcinoma
• Death

Facts check

Currently, 325 million people globally live with a hepatitis infection.

PGC Resolution

• To offer suggestions and advice about hepatitis testing, prevention, care, and treatment for infections. 
• To produce vital guidelines for viral hepatitis information that outline and monitor the disease's eradication progress.