VIRAL HEPATITIS: WHAT YOU SHOULD KNOW

Hepatitis refers to the inflammation of the liver. It has varying cause but the most common are the viral causes such as hepatitis A, B, C, D and E. Other causes include; autoimmune hepatitis, drug induce hepatitis, alcohol induce hepatitis, hepatitis due toxins etc

Autoimmune hepatitis develop when the body makes antibodies against its liver tissue

Alcohol hepatitis usually develop from long term heavy intake of alcohol

Drug induced hepatitis results from a harmful (toxic) amount of certain medication

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VIRAL HEPATITIS

Viral hepatitis of caused by hepatitis virus such as hepatitis A, B, C, D and E. Of these, hepatitis A, B, C are the most common

Hepatitis A 

caused by hepatitis A virus (HAV) is transmitted through the ingestion of contaminated food and water or through direct contact with an infectious person. Most people recover fully from hepatitis A with lifelong immunity. However, a very small proportion of people infected with hepatitis A could die from fulminant hepatitis.

Risk factors that propagate hepatitis A infection are – a lack of safe water,  poor sanitation and hygiene

Hepatitis B

caused by hepatitis B virus(HBV) is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus (HBV). It can be transmitted from mother to child during birth and delivery. Injection drug use, having sex with an infected partner or sharing razors with an infected person increase your risk of getting hepatitis B.

Hepatitis C – Is a liver disease caused by the hepatitis C virus (HCV). It is a major cause of liver cancer. It is a bloodborne virus. The most common mode of transmission is through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood. Less commonly, it can be transmitted sexually and can be passed from an infected mother to her baby

Hepatitis D

occurs only amongst people who are infected with the Hepatitis B virus. It is transmitted through contact with infectious blood. Those at risk are intravenous drug abusers and men who have sex with men

Hepatitis E

caused by the hepatitis E virus (HEV) is transmitted via the fecal-oral route, principally via contaminated water.  It is found worldwide, but the disease is most common in East and South Asia

Of the above 5 viral cause of hepatitis, A, B and C are the most common and their symptoms are similar

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SYMPTOMS OF VIRAL HEPATITSIS

Symptoms of hepatitis A, B and C may include

  • fever
  • malaise, or a general feeling of being unwell
  • loss of appetite
  • diarrhea
  • Nausea and vomiting
  • abdominal pain
  • dark-colored urine and jaundice
  • pale stools
  • loss of weight
  • muscle or joint ache
  • jaundice or a yellowing of the eyes
  • itchy skin

For chronic hepatitis, symptoms may include;

  • Jaundice (yellow skin, whites of the eyes, and tongue)
  • swelling of the lower extremities
  • confusion
  • blood in the feces or vomit

In some cases, the virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer with an associated risk of death.

DIAGNOSIS

Hepatitis is diagnosed through history taking, physical examinations and investigations. The investigations include; live function test and other blood test, ultrasound, liver biopsy

TREATMENT AND PREVENTION

For hepatitis A – There is no specific treatment.  Improved sanitation, food safety and immunization are the most effective ways to combat it. Several injectable inactivated hepatitis A vaccines are available

Also there is no specific treatment for acute hepatitis B. Therefore, care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhea.

Chronic hepatitis B is treated with antiviral medications

Treatment is aimed at slowing the progression of the disease, reduce incidence of cirrhosis, liver cancer and improve long term survival.  Hepatitis B vaccine is the mainstay of hepatitis B prevention

For hepatitis C, antiviral medications are used to treat both its acute and chronic forms. There is no effective vaccine against hepatitis C. Its prevention depend on reducing the risk of exposure to the virus in health-care settings and in higher risk populations such as people who inject drugs and men who have sex with men, particularly those infected with HIV or those who are taking pre-exposure prophylaxis against HIV.

Treatment success rate are generally low for hepatitis D.  Usually co-infection of hepatitis D and B is considered the most severe form of chronic viral hepatitis due to more rapid progression towards liver-related death and liver cancer.  Hepatitis D infection can be prevented by hepatitis B immunization.

There is no specific treatment capable of altering the course of acute hepatitis E. As the disease is usually self-limiting, hospitalization is generally not required except for people with fulminant hepatitis.

Prevention is the most effective approach against the disease and that can be achieved through good hygienic practices by maintaining quality standards for public water supplies and establishing proper disposal systems for human faeces.

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