What is Hepatitis and what causes it?
Hepatitis basically refers to the inflammation of the Liver. A number of things can cause the Liver to be inflamed, like excessive alcohol intake, hard drugs and toxic chemicals, however, the most common cause of hepatitis is the ‘Hepatitis Viruses’. There are five types of hepatitis viruses, which are Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D and Hepatitis E viruses. All of them are RNA viruses except the Hepatitis B Virus, which is a DNA virus.
Characteristics of each Hepatitis Virus
Hepatitis A Virus (HAV) mainly causes an acute infection, which means that the onset of the disease is sudden. It is transmitted through the faecal-oral route, meaning that a healthy person can get infected by eating food or drinking water that has been contaminated by the faeces of an infected person. Hepatitis A is usually treated by managing the symptoms, eating enough food nutrients and getting proper bed rest. The illness eventually resolves on its own and rarely requires serious medication.
Hepatitis B Virus (HBV) causes both acute and chronic infection, meaning that it first starts out as a sudden infection, but when the body’s immune system is not able to effectively clear out the virus, it becomes prolonged and causes gradual but consistent harm to the body. It is transmitted through sexual intercourse, blood to blood contact (using infected needles) and perinatally (from mother to child). Treatment depends on the type of infection. When it is acute, the symptoms are managed and no specific treatment is required. If it becomes chronic, it can be treated with antiviral medications, but these are costly and may need to be taken over the course of several months or even years.
Hepatitis C Virus (HCV) also causes both acute and chronic infection, and it is transmitted through blood contact and perinatally (mother to child). It may also be transmitted through sex, but this is very rare. Antiviral medications are used to treat both the acute and chronic forms of infection. If the infection progresses to become chronic, it can cause liver cirrhosis, which is a very serious condition where the infected person’s liver becomes hardened and unable to function effectively. To treat this, the patient may require a liver transplant. It can also cause liver cancer.
Hepatitis D Virus (HDV) mainly causes a chronic infection. This particular virus needs the Hepatitis B Virus (HBV) in order to infect host cells. It does this in two ways:
– By co-infection, where it infects the body’s cells at exactly the same time as the Hepatitis B Virus.
– By superinfection, where it infects the body’s cells after the Hepatitis B Virus has already infected the cells and weakened them.
So basically, you can think of HDV as a sneaky virus that is powerless on its own and has to work with the Hepatitis B Virus in order to cause harm to the body. Like the HBV and HCV, it is also transmitted through sex, blood contact and perinatal route. Currently, no antiviral medications have been fully endorsed for the treatment of Hepatitis D, but if Hepatitis B is effectively treated or the infected person is vaccinated, then Hepatitis D will also resolve.
Hepatitis E Virus (HEV) causes an acute infection and it is transmitted through the faecal-oral route. It does not require any specific treatment, as the disease is acute and will eventually resolve with proper nutrition and adequate rest. So, it is very much similar to the Hepatitis A Virus (HAV).
So in summary, Hepatitis B, Hepatitis C and Hepatitis D are transmitted from mother to child (perinatally) and through blood contact. Hepatitis B and Hepatitis D are transmitted through sex. Hepatitis A and Hepatitis E are transmitted faecal-orally.
Note that if a person has Hepatitis D, it means the person also has Hepatitis B. Hepatitis D is just an ‘addition’ to Hepatitis B to cause more problems. Also note that Hepatitis B and Hepatitis C can be life-threatening and are capable of causing liver cirrhosis and cancer.
Signs and Symptoms of Hepatitis
The regular symptoms of hepatitis include fever, headache, fatigue, nausea and vomiting, diarrhoea, and pain in the upper right side of the abdomen. Excessive vomiting and diarrhoea results in dehydration and weight loss. As the disease progresses and causes more damage, other signs like jaundice, hepatomegaly, production of dark-coloured urine and pale-coloured stools may also be observed.
Diagnosis of Hepatitis
This is done through lab tests such as Liver function tests (LFT), which determine the level of damage to the liver, and also, blood films from the patient can be examined for lymphocytosis, which is a condition where numerous abnormal white blood cells can be seen under the microscope during an active viral infection. These methods (LFT and Blood film examination) are simply indicators of liver damage and viral infection, but the actual confirmation of hepatitis is by Serological testing, which involves screening the suspected person’s blood sample for the presence of antibodies produced against the Hepatitis virus. If the person is confirmed to be Hepatitis positive, immediate treatment must begin to prevent further progression of the disease.
Prevention of Hepatitis
Some preventive measures against the disease include ensuring that food and water sources are clean, sterilizing surgical equipment and instruments for drawing blood, avoiding contact with spilled blood, not sharing toothbrushes, and avoiding unprotected sex. However, the most effective method of prevention is by vaccination, which boosts immunity against the virus by about 97%. Note that all types of hepatitis have vaccines except Hepatitis C, which currently has no vaccine.
It is important that you get vaccinated against hepatitis, and it is even more important for healthcare professionals, because they are at the greatest risk of infection by direct contact with an infected patient’s body fluids.
World Health Organization (2019). Hepatitis. https://www.who.int/news-room/q-a-detail/hepatitis.
Centers for Disease Control and Prevention (2019). What is Viral Hepatitis? https://www.cdc.gov/hepatitis/abc/index.htm.