Viral Hepatitis – different types, causes, symptoms & treatment
Viral Hepatitis is a cause for major health care burden in India and is now equated as a threat comparable to the “big three” communicable diseases – HIV/AIDS, malaria and tuberculosis.
Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are predominantly enterically (faecal-oral) transmitted pathogens that means these viruses enter into our body through contaminated food or water. Hence food & personal hygiene are the most important steps for prevention. Both these viruses are responsible to cause sporadic infections as well as epidemics of acute viral hepatitis (Jaundice) at any age, mostly among children.
Common symptoms are tiredness, loss of appetite, aversion to food, passing high coloured urine, yellowish discoloration of eyes & palm. If jaundice level increases, itching all over the body and pale coloured stool are the common symptoms.
Hepatitis A & Hepatitis E are usually self-limiting, and treatment consists of supportive care. Full clinical and biochemical recovery are observed within a few weeks in most patients, and complete recovery is observed within six months in nearly all patients.
Apart from personal hygiene, there is a vaccine available for hepatitis A virus, particularly to high-risk groups such as chronic liver disease & travelers from low endemic areas to developing countries.we equated as a threat comparable to the “big three” communicable diseases – HIV/AIDS, malaria and tuberculosis.
Hepatitis B & Hepatitis C viruses:
Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are predominantly spread via parenteral route that means these viruses enter into our body through contaminated needle prick/blood & blood products/unsafe sex/infected mother to baby.
Hepatitis B & Hepatitis C are notorious to cause chronic hepatitis (i.e., virus will persist in blood for more than 6 months) which can lead to grave complications including cirrhosis of liver (chronic liver damage from a variety of causes leading to scarring and liver failure) and hepatocellular carcinoma (primary liver cancer).
In the case HBV, patients would require regular follow up lifelong. There are two stages in HBV - HBV carrier and chronic hepatitis B. HBV carrier does not require antiviral medication but chronic Hepatitis B needs anti-HBV drugs mostly life-long.
In HCV, there are new antiviral drugs which almost completely cure the disease if we diagnose the disease at an early stage. Once HCV leads to cirrhosis of liver, it will be an irreversible damage.
Hepatitis D (HDV):
It is rare in India. It is a defective virus i.e., it requires simultaneous presence of Hepatitis B virus (HBV) to be active. Hence, HDV will present in only those who have HBV. Presence of both HBV & HDV simultaneously will cause severe liver damage. The incidence and prevalence of HDV infections is more in Mediterranean countries.
Acute Liver Failure (ALF):
Viral Hepatitis can present itself as an acute liver failure (sudden loss of majority of liver cells (>90%) as well. They require liver intensive care support and majority of them might require emergency liver transplantation.
Acute liver failure is uncommon with Hepatitis C virus (HCV) infection. Acute liver failure associated with Hepatitis E virus (HEV) is particularly associated with high mortality in pregnant women.
Dr Joy Varghese,
Director - Hepatology & Transplant Hepatology,
Gleneagles Global Health City, Chennai
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