The Hepatitis virus can damage the liver. It spreads through exchange of body fluids or feces and results in cirrhosis, liver cancer, inflamed or scarred liver. The liver is a vital organ that is responsible for processing nutrients, filtering the blood and fighting infections. It also helps detoxify blood, produce hormones as well as storing energy and vitamins for the body. All these functions are affected by the hepatitis virus which results in severe physical problems. In some cases it disappears by itself while in others it may last for a lifetime and may require medications, vaccines, immunizations, lifestyle modifications and even a liver transplant in cases of serious liver damage.
Which types of hepatitis virus have been identified so far? What causes them and which treatment options are available for each kind of hepatitis virus?
The various known types of hepatitis virus are hepatitis A, B, C, D, E and G. Hepatitis A, B and C are the most common forms of Hepatitis virus, multiplying primarily in the liver cells and affecting its functions. All these viruses lead to liver diseases but differ in their mechanism, effects on the body and in the way which they are characterized and transmitted as described below:
Hepatitis A Virus (HAV): It is an acute, non-chronic, short term disease, also known as infectious virus. It doesn’t have severe complications and is transmitted by food, water which is contaminated or feces of a person who is infected by hepatitis virus. It can be prevented by vaccinations because the liver can be healed within a few months.
Hepatitis B Virus (HBV): It is transmitted by sharing tooth brushes, razors, blood or by having sex with a person who is infected or to new born babies by their infected mothers and may lead to cirrhosis, failure of liver or liver cancer (hepatocellular carcinoma). It can be prevented through antiviral medications and vaccines.
Hepatitis C Virus (HCV): It is transmitted by infectious blood, needles, body fluids, sex with person who is infected resulting in cirrhosis, failure or cancer of liver. It spreads easily making the immune system weak. It is preventable and mostly patients recover from the effect of the virus. Vaccines are not available for HCV but its treatment may be possible by antiviral drug therapies which prevent the virus from replicating.
Hepatitis D Virus (HDV): It is rare kind of virus, also known as ‘Delta Hepatitis’, is developed only with HBV and only further worsens the condition of an HBV patient. It spreads through blood of a person who is infected by the virus. Medications and vaccines are not available for HDV, but ongoing vaccinations of patients for HBV can protect them from contracting the infection.
Hepatitis E Virus (HEV): This is a waterborne disease transmitted in places with poor sanitation or by water and food that is contaminated. Treatment may help, but it is not curable due to non-availability of vaccinations and therapies.
Hepatitis G Virus (HGV): This is a recently discovered virus, also known as GGBV-C, and is similar to HCV. Ongoing research may help to find out the effects and causes of the virus.
Some other forms of hepatitis or complications include the following:
Acute fulminant hepatitis: It is a rare disease mostly developed with HAV and HBV causing severe, inflamed or failure of liver, coma, bruising or bleeding that mostly results in loss of life within few days or weeks. Acute HBV cannot be treated with antiviral drugs, but acute HCV can be treated with the medications used for chronic HCV. It is rarely diagnosed but may not eradicate the virus in majority of the patients
Chronic viral hepatitis: It is developed in people suffering from HBV and HCV, transmitted by needles, blood or fluids of people with infections. It is impossible to eradicate completely and causes chronic or inflamed liver, cirrhosis, failure of liver or liver cancer. Medications may help in preventing from the development of liver diseases or its progression. Smoking or alcohol consumption may aggravate the problem so it is advisable to stop the further intake of toxic products
Autoimmune hepatitis: It is caused by the development of antibodies that attack the liver, disrupting its functions and causing severe and inflamed liver. Treatment is mostly effective with medications but it is not curable.
Alcoholic or toxic hepatitis: Excess use of alcohol causes inflamed liver, injuring its cells resulting in cirrhosis, thick, scarred, damaged or permanent failure of liver. The overdose of medicines or exposure to toxic products or substances also results in this form of hepatitis.
Which signs and symptoms indicate the presence of hepatitis virus?
Some of the people with infectious or chronic hepatitis like hepatitis B and C are asymptotic till the damage affects the liver functions while in acute hepatitis, the symptoms starts appearing after 15 to 180 days of development of infection for all kinds of hepatitis viruses which includes:
- Fever, flu like symptoms
- Weight and appetite loss
- Vomiting, nausea or fatigue
- Urine that is dark colored or pale
- Bowel movements
- Light coloured stools or diarrhoea
- Painful abdomen and joints
- Jaundice, yellow appearance of skin or eyes
How can we confirm the diagnosis of hepatitis virus?
Viral hepatitis is diagnosed based on its type, symptoms, severity of the illness and physical findings. If suspected patient should undergo examinations or tests which include the following:
Medical history and physical examinations: It is done to check the risk factors of the abdomen, liver, color of eyes-skin, infectious or non-infectious hepatitis and medical history of the patient.
Blood tests: It is done to check the abnormalities, functions of liver, enzyme levels, viral proteins, viral DNA or RNA and presence of antibodies in the liver.
Nucleic acid tests: This test confirms activeness and speed of the virus being reproduced in the liver.
Liver biopsy: It measures the extent or severity of infection, damage or inflammation caused or to detect liver cancer.
Paracentesis: It is tested by extracting fluid of the abdomen to find out the reason for accumulation of fluid.
Liver function tests: It is done through blood test to check the efficiency or functions of liver, enzyme levels, damage and stress on the liver.
Elastography: It is tested through emitting sound waves to measure and check the liver and its stiffness. A scarred liver loses its elasticity and hence this test is useful.
Surrogate markers: It is done using a blood test to assess for cirrhosis and fibrosis progression.
Abdominal ultrasound: Ultrasound uses sound waves to take a closer look at organs within the abdomen for liver and its surrounding organs that shows the enlargement, damage, abnormalities in working of liver, presence of tumors or fluid in the organs.
Who are at higher risk to get affected by viral hepatitis?
People who are more affected or likely to get infected or contracted to develop viral hepatitis may include:
- People working in health care professions
- Sewage or water treatment workers
- Lower socioeconomic background and uneducated people having multiple sex partners or intravenous drug abusers
- Asian and pacific islanders
- Places where sanitation is poor and food or water is contaminated
- Day care centers which are contaminated with HAV
- HIV patients or people with hemophilia
How can we avoid contracting the hepatitis virus?
Some types of hepatitis viruses can be life-threatening or difficult to treat and, therefore, it is advisable to take necessary preventive measures to reduce the risk of contracting the infection in the first place. These include the following:
- Maintaining good hygiene and washing hands after using the toilet can reduce the chances of contracting the hepatitis viruses A and E.
- Avoiding sharing needles, razors, tooth brushes and staying away from spilled blood can help in prevent the spreading of hepatitis viruses B, C and D.
- Avoiding sexual contact with infected persons or multiple partners can help reduce the risk of contracting hepatitis viruses B and C.
- Vaccinations may prevent the development of hepatitis virus A and B.
- Avoiding over-consumption or abuse of alcohol and other toxic substances.
- Eat food that is properly cooked or, if raw, thoroughly washed and cleaned and also drinking only boiled or purified water.