What is Hepatitis?

Hepatitis is an inflammation of the liver that can lead to short-term illness, chronic infections, and severe health complications. The causes of hepatitis include drugs, toxins, excessive alcohol consumption, and certain medical conditions, but it is most commonly caused by a virus. In North America, the predominant viral types of hepatitis are hepatitis A, B, and C.

Types of Hepatitis

Each type of hepatitis has unique characteristics and methods of transmission, though symptoms tend to be similar across the types. Hepatitis A, B, and C can all present as acute infections lasting about six months, while hepatitis B and C can become chronic, persisting for longer durations.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus, primarily transmitted through the consumption of food or water contaminated with fecal matter from an infected individual. This form of hepatitis is often associated with inadequate sanitation, unsafe water, and poor personal hygiene, putting individuals in developing nations at heightened risk.

Hepatitis B

Hepatitis B is spread through contact with infectious body fluids, such as blood, vaginal secretions, or semen containing the hepatitis B virus. The Centers for Disease Control and Prevention (CDC) estimates that nearly 1.2 million people in the United States and 350 million globally are living with this chronic condition.

Hepatitis C

Hepatitis C is transmitted through direct contact with infected body fluids, particularly through injection drug use and sexual contact. It is the most prevalent bloodborne viral infection in North America, with approximately 4 million Americans currently living with a chronic form of this infection, according to the CDC.

Symptoms

Many individuals with hepatitis may remain asymptomatic and unaware of their infection. When symptoms do occur in acute infections, they can manifest anywhere from two weeks to six months post-exposure. Chronic viral hepatitis symptoms may take years to develop. Common symptoms across hepatitis A, B, and C include:

  • Loss of appetite
  • Vomiting
  • Fatigue
  • Low-grade fever
  • Weakness
  • Stomach pain
  • Muscle or joint aches

Less common symptoms may include:

  • Dark urine
  • Yellowing of the skin or eyes
  • Pale or clay-colored stool

Diagnosis

Due to the similarity in symptoms among different types of hepatitis, laboratory tests are crucial for accurate diagnosis. The following tests may be utilized to identify a hepatitis virus infection:

  • Blood tests
  • Nucleic acid tests
  • Liver biopsy
  • Extraction of abdominal fluid
  • Medical imaging

Treatment

Treatment approaches differ for acute and chronic hepatitis. Acute hepatitis typically resolves within two months without long-term effects, and management focuses on rest, hydration, and symptom relief. In contrast, chronic hepatitis B and C often require antiviral medications to eliminate the virus. Medications for chronic hepatitis B include Adefovir, Entecavir, Interferon, Lamivudine, Telbivudine, and Tenofovir, while treatments for chronic hepatitis C consist of drugs like Daclatasvir, Elbasvir, Ledipasvir-sofosbuvir, and Sofosbuvir. Not all patients with chronic viral hepatitis require medication, as some may not experience significant liver damage.

Prevention

Preventing hepatitis is crucial due to its potential severity and treatment challenges. Here are key preventive measures:

Hygiene

Hepatitis A is primarily spread through contaminated food and water. Practicing good hygiene is essential to avoid infection, especially when traveling to developing countries. Recommended practices include:

  • Consuming freshly cooked food
  • Avoiding local water, ice, and raw or undercooked shellfish
  • Washing hands with soap after using the restroom

For Hepatitis B and C

These types are often transmitted through infected bodily fluids during sexual contact. To reduce the risk of infection, individuals should:

  • Avoid sharing needles, toothbrushes, or personal care items
  • Practice safe sex using condoms

Vaccines

Vaccination is an effective method for preventing hepatitis. Vaccines are available for hepatitis A and B, while research is ongoing for a hepatitis C vaccine, with two clinical trials currently in progress.

Written by Man-tik Choy, Ph.D.

References

  • Healthline. (n.d.). Retrieved July 8, 2019, from https://www.healthline.com/health/hepatitis#causes
  • MedicineNet. (n.d.). Hepatitis (Viral Hepatitis, A, B, C, D, E, G). Retrieved July 8, 2019, from https://www.medicinenet.com/viral_hepatitis/article.htm
  • World Health Organization. (July 8, 2019). Hepatitis A. Retrieved July 10, 2019, from https://www.who.int/news-room/fact-sheets/detail/hepatitis-a
  • World Health Organization. (July 5, 2019). Hepatitis B. Retrieved July 10, 2019, from https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
  • World Health Organization. (July 9, 2019). Hepatitis C. Retrieved July 10, 2019, from https://www.who.int/news-room/fact-sheets/detail/hepatitis-c