Hepatitis is an health condition that affects the liver and causes it to become inflamed. There are several causes of hepatitis in which viral infection is the most prevalent. Autoimmune disorder can also cause hepatitis, it occurs when the immune system releases chemicals that mistakenly target and affect the liver tissues. Other causes of hepatitis include toxins, the use of some drugs and excessive intake of alcohol. The liver performs varieties of functions such as production of bile for digestion, activation of enzymes, detoxification of toxins in the body, synthesis of plasma proteins and storage of sugar, vitamins and minerals. When the liver is affected it functions are altered thereby leading to serious health problems that can results into death when left untreated.
What causes hepatitis?
There are two major factors that cause hepatitis namely infectious and non-infectious factors.
The infectious factors refers to all microscopic organisms that affect, damage and cause inflammation to the liver. The most common type is caused by viral infection, examples include hepatitis A, B, C D and E virus. Each of these viruses causes inflammatory conditions to the liver and are highly infectious. They can be spread through human contact, sexual contact, food and water, contact with infected blood, sharing of razors, needles and other intravenous drug equipment.
The non infectious factors that can cause hepatitis include the use of certain medications, high intake of alcohol, autoimmune disorder and toxins. Excessive intake of alcohol affect the liver and can cause cirrhosis, fibrosis and liver failure. Autoimmune disorder occurs when the antibodies released by the immune system to fight off infectious pathogens in the body mistakenly attacks and damage the tissues of the liver. This can cause serious damage to the liver and lead to liver malfunctions and failure.
The use of certain drugs and exposure to toxic substance are conditions that can also lead to the development of hepatitis.
What are the types of hepatitis?
There are five major types on hepatitis and they include:
This type of hepatitis is caused by hepatitis A virus (HAV). The symptoms of hepatitis A usually range from mild to severe and it may last for several weeks to months. People recover from the infection usually develop a lifetime immunity against the disease. HAV is usually present in the faeces of people that have the infection. Hepatitis A is commonly spread when an individual consumes food and water that are contaminated with the feces of an infected person.
The factors that can increase your chances of getting infected with hepatitis A include drinking unclean and untreated water, poor sanitation, unhygienic preparation and handling of foods, engaging in unsafe sexual practice, residing in an area where hepatitis A is most prevalent and using or injecting illegal drugs. According to the United States centre for disease control and prevention in 2018, about 24,900 people were affected with hepatitis A in the United States. People who are likely to experience severe symptoms of hepatitis A are those with compromised immune systems such as older adults, people who have HIV and those with underlying health conditions like chronic liver disease.
Hepatitis B is caused by a virus called hepatitis B virus (HBV). It is usually spread through contact with infected bodily fluid such as blood, semen, vaginal fluids and other bodily fluids. Engaging in unsafe sex, having multiple partners, sharing of razors, syringes and other contaminated medical equipment, blood transfusion and living in an area where hepatitis B is most common are factors that can increase your chances of getting hepatitis B.
Older adult above 60 years, infants and those with chronic health conditions such as kidney disease, HIV and chronic liver disease are people who are likely to get hepatitis B. According to the World Health Organisation (WHO) in 2015 hepatitis B affected an estimated 257 million people and claimed 887,000 lives worldwide. In the United States about 862,000 people are being affected with chronic hepatitis B according to CDC. Acute infection is most common in adults while infants are most likely to develop chronic infection. Getting a chronic infection can increase your chances of developing cirrhosis, chronic liver damage and liver failure.
This kind of hepatitis is caused by hepatitis C virus (HCV). It is transmitted through infected blood or other body fluids. They can be spread by sharing of syringe that is used for intravenous drug use, casual contacts and blood transfusion. It cannot be spread through mosquito bite, breastfeeding and coughing. An estimated 71 million people were affected by hepatitis C and 399,000 people lost their lives to the disease in 2016 globally according to WHO.
Hepatitis D virus (HDV) causes hepatitis D. It can be transmitted through direct contact with blood or other bodily fluids that contains hepatitis D virus. It occurs only in people who already have hepatitis B. It can be spread through sexual contact, injection of intravenous drug using contaminated syringes, blood transfusion and mother to child during birth. It is important to note that hepatitis D cannot occur in the absence of hepatitis B.
Hepatitis D causes acute and chronic infection. The acute infection occurs over a short period of time and may go on its own. The chronic infection is a long term infection that last longer than acute infection. It can lead to complications such as liver cirrhosis and liver damage.
Hepatitis E is caused by hepatitis E virus (HEV). It is usually spread through the consumption of water or foods that is contaminated with the feaces of an infected person. Hepatitis E is most prevalent in places with poor sanitation and unclean water supply. According to WHO, hepatitis E affect about 20 million people worldwide yearly and killed an estimated 44,000 people in 2015. The most effective way of preventing the occurrence of hepatitis E is by drinking clean and treated water and maintaining proper and hygienic handling of food.
What are the symptoms of hepatitis?
Most people with hepatitis do not develop any symptoms and may not be aware that they already have the infection. However, when the symptoms of hepatitis occur, they include:
- Body pains
- Abdominal cramps
- Dark coloured urine
- Loss of appetite
- loss of body weight
- Jaundice (skin and eyes turn yellow)
The symptoms of acute infection appears quickly and lasts for few months while chronic infection symptoms do not usually come up earlier but in most cases they might have caused serious damages to the liver before they are being noticed. Chronic infection are long-term infection.
How is hepatitis diagnosed?
To diagnose hepatitis your doctor will review your medical history and perform physical examination on you. The medical history review involves analysing your past health records in order to determine your susceptibility to hepatitis infection. Your doctor will also performe a physical examination on you by checking your abdomen for the symptoms of inflammation. He or she will also screen you properly to detect other symptoms of hepatitis such as jaundice (yellowing of eyes and skin), the colour of your urine and so on.
If your doctor suspect any signs of hepatitis he/she may order for the following test so as to accurately diagnose hepatitis:
- Liver function test: this test is used to determine the health status of the liver. It involves collecting the blood sample of the patients and subjecting to laboratory test in order to detect the level of liver enzymes, bilirubin and proteins in the blood which are the key determinant of the liver’s health. If the result of the liver function test is abnormal then your doctor may order for another test in order to detect the specific cause of the damage on the liver.
- Blood test: this case involves screening the blood sample of the patient so as to detect the virus that can be responsible for the hepatitis infection. The blood test can show both acute and chronic infection.
- Ultrasound: it involves the use of high-frequency sound waves to produce a detailed image of the liver in order to check for abnormalities or damages that might have affected it. It shows your doctor the site of infection on the liver and may help him subject possible treatment for the infection. Ultrasound can detect tumors and other damages on the liver.
- Liver biopsy: this is a medical procedure that involves collecting the tissue sample of the liver so as to check for abnormalities on it and the severity of the infection. It is usually carried out by your doctor by inserting a needle into your liver, obtaining the tissue sample on it and subjecting the sample to laboratory test in order to accurately diagnose hepatitis and the degree of damages that might have affected the liver.
How can hepatitis be treated?
The treatment of hepatitis solely depend on the type you have and whether it is acute or chronic infection. The following are the treatment options for different types of hepatitis:
There is no specific treatment for hepatitis A as people who are affected usually recover on their own within several weeks to months. However your doctor may recommend some medications to reduce the symptoms of diarrhoea as well as replace fluids that you lost during diarrhoea and vomiting. Vaccine is readily available to effectively prevent hepatitis A and it is usually recommended to people that are traveling to places where the disease is most common.
There is no specific treatment for acute hepatitis B infection. However your doctor may recommend some medications that will ease the symptoms of diarrhoea, replace lost fluids and those that will prevent the complications of hepatitis B. In the case of chronic hepatitis B infection, your doctor will recommend several oral antiviral medications that will suppress and reduce the viral load and those that will effectively treat the infection.
There is a vaccine that is available to prevent hepatitis B. WHO recommends that the vaccine should be given to all infants within 24 hours after birth. People who are at higher risk of infection such as public health workers, travellers to places where hepatitis B is prevalent and those with underlying health conditions such as people with chronic liver disease and HIV infection should also get vaccinated against Hepatitis B.
The treatment of hepatitis C is aimed at curing the infection and preventing the complications of the disease such as liver cirrhosis, liver cancer and liver failure. Chronic hepatitis C is usually treated with combination of several antiviral medications that are sometimes very expensive. WHO recommends that people with chronic hepatitis C infection above the age of 12 should be treated with pan-genotypic direct acting antivirals (DAAs). People with liver cirrhosis or liver failure will require liver transplant to survive.
It is important to note that there is currently no vaccine available to prevent hepatitis C, therefore precautionary measures should be taken to prevent the disease.
Currently, there is no known medications that can effectively cure hepatitis D infection. However, the most common drug that is used to treat it is called pegylated interon alfa (peg – IFNa) which may present some unwanted side effects in patient that use the drug. The aim of using this drug is to lower the chances of developing hepatitis D complications. Hepatitis B can be prevented by getting hepatitis B vaccines.
There is currently no Known medications to treat hepatitis E. Since hepatitis E is usually an acute infection, people suffering from the disease can recover on their own even without being hospitalized. Your doctor may recommend that you take plenty of fluids, develop healthy diet and get enough rest so as to facilitate quick recovery from the disease. People who have weak immune system and pregnant women should seek medical care to prevent severe symptoms of the disease.
How can hepatitis be prevented?
The following are the precautionary measures that can be taken to prevent being infected with hepatitis:
Vaccines are substances that enhances your immune system to fight off infections. Effective and safe vaccines to prevent hepatitis infection are readily available for hepatitis A and B. Hepatitis E vaccine is only licensed for use in China and and not available in any other place in the world. Hepatitis D can be prevented by taking hepatitis B vaccines.
Infants, teenagers, older adults and those with higher risk of infections such as public health workers, caregivers, international travelers to where the disease is most common are required to take hepatitis vaccines to get immune to the disease.
Maintenance of hygiene and good sanitation
Maintaining proper hygiene and ensuring good sanitation is one of the effective ways of preventing most infections. Hepatitis A and E are usually contracted through consumption of contaminated food and water and this infections can only be prevented by:
- Drinking clean and treated water
- Avoiding undercooked foods
- Ensuring proper handling of food
- Avoiding raw fruit and vegetables
- Ensuring good preparation of food at appropriate temperatures
Ensure safe blood transfusion
Hepatitis B, C and D are usually transmitted through blood therefore blood should be well tested and screened before they are being given out for transfusion in the clinic. You should also avoid touching blood spills, sharing razors, needles and intravenous drug equipment such as syringes so as to prevent being infected with the disease.
Practice safe sex
Hepatitis A, C and D can be spread through unsafe sexual intercourse therefore condom should be used regularly during sexual activity to lower your risk of the infection.