Hepatitis

By Dr. Vikas Singla in Gastroenterology, Hepatology & Endoscopy

Jul 28 , 2021 | 2 min read

Hepatitis is inflammation of the liver. It can be either acute (short duration) or chronic (>6months). Hepatitis viruses are the most common cause of hepatitis in the world but other etiologies include, toxic substances (alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. Viral hepatitis can be asymptomatic or self-limiting, but sometimes progress to fibrosis (scarring), cirrhosis or even liver cancer.

There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. Hepatitis A and E causes acute hepatitis whereas, types B and C cause chronic infection leading to chronic liver disease, cirrhosis and cancer. Hepatitis D infection is very rarely seen in India. Hepatitis A and E are caused by ingestion of contaminated food or water.

Acute hepatitis may be asymptomatic in most cases or sometimes develop symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. In most cases it is self-limiting, but in ~ 1% it may be fatal.

Hepatitis A – children in India by the age of 10 years, > 90% of them test positive for hepatitis A mild, Infection may be asymptomatic in most or symptoms may last for 2-6weeks. Most people making a full recovery and remaining immune for life from further HAV infections. Hepatitis A is more common in areas with poor sanitation. Safe and effective vaccines are available to prevent HAV.

Hepatitis E is the most common hepatitis infection in India amongst adults and the reason for this is the consumption of contaminated food. Most infections are self-limited, however can be fatal in approx 1% of the infected, especially pregnant individuals. No vaccine is available yet for HEV

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are transmitted through exposure to infective blood, semen, and other body fluids. Transmission occurs through transfusions of contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. HBV and HCV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. HBV and HCV together are responsible for the major burden of chronic liver disease (cirrhosis) and most common cause of liver cancer. 15%–25% of chronically infected people with HBV develop chronic liver disease, including cirrhosis, liver failure, or liver cancer. More than 50% of people who get infected with the hepatitis C virus develop a chronic infection. 5%-25% of people with chronic hepatitis C develop cirrhosis over 10–20 years. Safe and effective vaccines are available to prevent HBV. There is no vaccine for HCV, however there are drugs which have >95% efficacy in treating HCV infection. People at risk for infection with Hepatitis B and C include: people with multiple sexual partners, partners having hepatitis B/C, men who have sex with men, injection drug abusers, people who live with a person who has hepatitis B/C, health care workers at risk for exposure to blood or blood-contaminated body fluids, Hemodialysis and peritoneal dialysis patients.

Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.