lcp

Viral Hepatitis: Learn About Its A-B-C And More For Liver Health

Written by Dr. Lynda Odoh - Anikwe on Fri, 11 November 2022

Key Highlights

  • Hepatitis A, Hepatitis B, and Hepatitis C are considered to be the most common types of viral hepatitis.
  • Hepatitis D and E are less common in comparison.
  • Viral hepatitis is essentially inflammation in the liver that impairs liver functions and liver tissue regeneration.
  • If the liver inflammation lasts for less than 6 months, it's termed acute hepatitis; if it lasts longer than 6 months, it's termed chronic hepatitis.
  • Liver function tests are the report card of your liver's functionality.
  • Vaccination is the best way to prevent the spread of viral diseases.
viewbox

Our liver is a silent worker, toiling day and night for our well-being. Its functions are absolutely at the top of our health priorities. Unfortunately, it happens many times that liver health is taken for granted. That's when the liver gets affected by liver diseases. One such liver disease is viral hepatitis.

Viral hepatitis causes are, as the name suggests, different types of a virus, the most common types being Hepatitis A, B, and C viruses. Viral hepatitis symptoms are similar to the symptoms of other liver diseases (including fatty liver disease and non-viral hepatitis), and these symptoms may include abdominal pain at the liver location; nausea; fatigue; yellow tinge on skin, eyes, and nails; the darker color of the urine, etc.

Left undiagnosed and untreated, viral hepatitis can cause severe damage to the liver - and, by extension, to the entire body. One of the main functions of the liver is toxin removal, and an impaired liver means toxin build-up in the blood.

Important liver functions

Our liver performs around 500 functions, the most important of which are:

  • Producing bile that helps in the breakdown of fats in the small intestines
  • Production of proteins, blood plasma, and cholesterol
  • Conversion of excess glucose into glycogen and storing it
  • Purifying blood of any toxins or impurities
  • Converting poisonous ammonia to urea and sending it out through urine
  • Processing hemoglobin
  • Resisting infections and eliminating bacteria from the bloodstream
  • Clearing bilirubin from the natural breakdown of red blood cells
  • Regulation of blood clotting, for its iron content

All these are very significant for the optimal functioning of our bodies. Even though the importance of liver health has been highlighted in the past, our knowledge of the liver, its diseases, and its well-being remains limited.

One such disease that plagues liver health is viral hepatitis. Inadequate awareness about the risks and symptoms of the disease leads to its spread. So, let's understand all about the prevention of viral hepatitis, viral hepatitis tests, and viral hepatitis diagnosis.

What is viral hepatitis?

Hepatitis is defined as inflammation of the liver. It can result from a variety of causes such as autoimmune diseases, heavy alcohol use, drugs, or toxins. However, the most frequent and common cause of hepatitis is a viral infection.

Hepatitis caused by viruses is referred to as viral hepatitis. Hepatitis A, Hepatitis B, and Hepatitis C are considered to be the most common types of viral hepatitis. Hepatitis D and E are less common in comparison.

The severity of hepatitis can range from mild and self-limiting to extreme illnesses that might require a liver transplant.

Hepatitis can be further classified based on the duration of inflammation or the degree of liver damage as "acute" or "chronic" hepatitis. If the liver inflammation lasts for less than 6 months, it's termed acute hepatitis. If it lasts longer than 6 months, it's termed chronic hepatitis.

Acute hepatitis is usually self-resolving, but in serious cases, can lead to further damage to the liver, causing liver failure. Acute hepatitis can be cured with treatment.

Chronic hepatitis can cause liver damage that includes liver fibrosis, cirrhosis, and hepatocellular carcinoma, which are serious and irreversible conditions that can lead to death or life-long treatment.

Types of viral hepatitis

Viruses A, B, C, D, and E are responsible for Hepatitis A, B, C, D, and E, respectively. There's also a Hepatitis G virus, which is rather rare. It's unclear whether the Hepatitis G virus is pathogenic in humans or not.

Hepatitis A, B, and C viruses are responsible for causing most acute viral hepatitis cases worldwide. Hepatitis C is the most common cause of chronic hepatitis.

Viral hepatitis causes

The following are the causative agents of viral hepatitis and how they can be transmitted.

1. Hepatitis A

Hepatitis A is an RNA virus from the Picornaviridae family. The most common mode of transmission of Hepatitis A is the fecal-oral route. It spreads from contact with food, water, or objects contaminated by fecal matter from an infected person.

2. Hepatitis B

Hepatitis B virus is a DNA virus and is a member of the Hepadnaviridae family. It is transmitted parenterally and sexually in contact with mucous membranes or body fluids of infected individuals. Transfusion of blood and blood products, sharing needles, or hemodialysis are some ways in which this virus can be transmitted. The Hepatitis B virus does not spread via stool, urine, or sweat. About 9 in 10 pregnant women with acute Hepatitis B virus infection will pass the virus to their babies.

3. Hepatitis C

Hepatitis C virus is an RNA virus and is a member of the Flaviviridae family. Hepatitis C can spread via parenteral, perinatal, and sexual routes. The most common way of getting infected is by sharing contaminated needles among IV drug users, frequent blood transfusions, and organ transplantation from infected donors. Sexual and perinatal transmission is not very common.

4. Hepatitis D

Hepatitis D is an RNA virus and a single species in the Deltavirus genus. Due to the genetic composition of the virus, those infected with the Hepatitis D virus are also susceptible to the Hepatitis B virus. Hepatitis D virus spreads via an infected person's body fluids, blood, or mucous membranes.

5. Hepatitis E

Hepatitis E is an RNA virus of the Hepevirus genus. The primary mode of transmission is the fecal-oral route. Fecally contaminated water is the most common means of spreading this virus. Person-to-person transmission is rare. However, occasionally maternal-neonatal transmission can occur.

6. Hepatitis G

Hepatitis G virus is an RNA virus and is a member of the human pestivirus A species of the Flaviviridae family. The primary mode of transmission is through infected blood and blood products. It is usually a co-infection in people who have chronic Hepatitis B or Hepatitis C infections. It is associated with acute and chronic liver disease, but research has not established it as an agent that causes hepatitis by itself.

Viral hepatitis signs and symptoms

On contracting acute hepatitis, the body is upfront with several symptoms that the patient might experience. However, someone living with chronic hepatitis (like Hepatitis B and C) may not show symptoms until the damage affects their liver's functionality.

Common viral hepatitis symptoms include:

  • Fatigue
  • Fever
  • Loss of appetite
  • Flu-like symptoms
  • Nausea and vomiting
  • Dark urine
  • Light-colored stool
  • Abdominal pain
  • Unexplained weight loss
  • Yellow skin and eyes, which may be signs of jaundice
  • Joint pain

Non-infectious hepatitis

1. Alcohol and other toxins

Alcoholic hepatitis is a condition in which excessive alcohol consumption leads to liver damage and inflammation. The misuse of medications and exposure to toxins can also lead to alcoholic hepatitis. The outcome of excessive drinking and alcoholic hepatitis can be serious, like liver cirrhosis (scarring of the liver tissue) or even liver failure.

2. Autoimmune system response

In some cases, the immune system mistakes the liver as harmful and attacks it. This causes ongoing inflammation that can range from mild to severe, often hindering liver function. It's three times more common in women than in men.

Viral hepatitis diagnosis

For treating hepatitis, it's essential for the doctor to first identify which virus has caused the disease. Usually, doctors will order numerous tests and, based on their results, will recommend further tests. Here are some diagnostic ways used to determine the causative agent in hepatitis.

1. Physical exam and patient history

It's natural for any treating physician to enquire about patient history to evaluate if you have come across any risk factors. During a physical examination, your doctor may press down gently on your abdomen to check for swelling, pain, or tenderness.

Yellow discoloration in your eyes or skin could indicate jaundice and liver ailments. Depending on this preliminary examination, the doctor might ask for further tests.

2. Liver function tests

Liver function tests (LFTs) are the report card of your liver's functionality. They use blood samples to determine how efficiently your liver works. Abnormal test results from a liver function test indicate that there's a problem with the liver. High liver enzyme levels in the test may indicate that your liver is stressed, damaged, under an infection, or not functioning correctly.

3. Other blood tests

With blood tests, it's possible to determine if any foreign agent like a virus is responsible for causing your problems. On receiving abnormal LFTs, your doctor might order blood tests to check for the presence of hepatitis viruses or antibodies in your blood. Doctors may also use blood tests to check for any signs of autoimmune hepatitis.

4. Liver biopsy

A liver biopsy involves taking out a tiny tissue from your liver to get it examined by professionals. It's not a surgical procedure as the doctor might just take your liver sample through a needle. A liver biopsy can help in the assessment of liver damage. They will typically use an ultrasound scan for guidance during this procedure. This test allows your doctor to be sure about what's affecting your liver.

5. Ultrasound

Ultrasound is also called sonography or diagnostic medical sonography. It's an imaging method that uses sound waves to produce images of structures within your body. This test allows your doctor to take a close look at your liver and nearby organs and examine you for fluid in your abdomen, liver damage, liver enlargement, liver tumors, and abnormalities of the gallbladder.

Treatment for viral hepatitis

Treatment options will vary by the type of hepatitis you have and whether the infection is acute or chronic.

  • Hepatitis A: The symptoms of Hepatitis A can be very painful. It is a short-term illness and may not require treatment. It's known to be painful and bed rest may be necessary. It is common to experience vomiting or diarrhea during this time. Your doctor may recommend some dietary restrictions to maintain your gut health and nutrition.
  • Hepatitis B: The treatment of chronic Hepatitis B requires antiviral medications prescribed by your doctor. There's no specific treatment program for acute Hepatitis B. Treatment for chronic Hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment. The treatment for chronic Hepatitis B can be costly, as it can take several months or years to make a recovery.
  • Hepatitis C: A combination therapy of antiviral medications can treat both acute and chronic forms of Hepatitis C. It might take some time to determine the best form of treatment for Hepatitis C. People who develop cirrhosis or liver disease due to chronic Hepatitis C may be candidates for a liver transplant.
  • Hepatitis D: Pegylated interferon alpha has been used as a treatment for Hepatitis D. The side effects of this medication have made it a no-no for people with cirrhosis, liver damage, or other health conditions.
  • Hepatitis E: This is an acute infection that might not require a line of treatment. Hepatitis E infections often resolve on their own if proper care is taken. It's often advised that you quit alcohol and drink plenty of healthy fluids during the time.

Prevention of viral hepatitis

Some vaccines can help protect against many hepatitis viruses. Minimizing your risk of exposure to substances containing these viruses can also be an important preventive measure.

1. Vaccines

Vaccination is the best way to prevent the spread of diseases. The Hepatitis A vaccine can protect us against HAV. The Hepatitis A vaccine is taken in a series of two doses. There's also a vaccine available for Hepatitis B. Vaccinating newborns with the Hepatitis B vaccine can be very useful in the long run. Vaccination against Hepatitis B can also prevent Hepatitis D. There are currently no vaccines for Hepatitis C or E.

2. Reducing exposure

Reducing exposure to harmful liver viruses is your best shot at being protected from viral hepatitis. These viruses spread from one person to another through contact with bodily fluids, water, feces, and foods containing infectious agents. Minimizing your risk of contact with these substances can help to prevent contracting hepatitis viruses.

3. Practicing effective hygiene

Keeping clean and maintaining hygiene can help in avoiding the Hepatitis A and E viruses. These disease-causing viruses spread through contaminated water. It's best to avoid local water, ice, or raw meat, fruits or vegetables from unknown sources as they might contact the disease-causing virus.

4. Being mindful

You can reduce the risk of Hepatitis B, C, and D by avoiding sharing needles, razors, and toothbrushes. Insist on proper hygiene and medical practice while donating blood or during blood transfusions. Avoid touching spilled blood.

5. Safe sex

Hepatitis B and C can spread through sexual intercourse and sexual contact. Using barrier methods, such as condoms and dental dams, during sexual activity can help decrease the risk of infection. Abstaining from sex is the safest way to prevent sexually transmitted diseases.

Conclusion

Viral liver infections like viral hepatitis can be a task to deal with. Knowing more about these viral hepatitis symptoms and causes, understanding how they spread, their diagnosis, prevention, and treatment can help us prevent or manage these conditions better.

Being vigilant of your water sources, maintaining good hygiene, and indulging in safe and protected sex are some factors that can protect you against viral hepatitis. If you catch such an infection, be alert to the symptoms and see a doctor immediately.

viewbox

Dr. Lynda Odoh - Anikwe

Dr. Lynda Odoh - Anikwe (M. B. B. S) is a MPH  candidate at the University of Manchester. Dr Odoh is also currently a member of the Society of Lifestyle Medicine Nigeria, and aiming to get certified by the International board of lifestyle medicine as a Lifestyle Medicine Physician by the last quarter of 2022.
 

Did you like our Article?

Excited

0

Happy

0

Not Sure

0

Silly

0

Leave a Comment

  1. Mehta P, et al. Hepatitis. [Updated 2021 Dec 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK554549/