What is Hepatitis?
Hepatitis simply means the inflammation of the liver. The liver is a vital organ located in the right upper area of the abdomen. It processes nutrients, filters the blood🩸, metabolizes drugs💊, and fights against infections🦠. When the liver is inflamed or damaged, these functions would be compromised.
Causes of Hepatitis
Hepatitis is usually caused by a virus. However, there are other possible causes of hepatitis including autoimmune hepatitis (when one’s body produces antibodies against own liver tissue) and hepatitis which occurs as a secondary result of heavy alcohol use🍷, toxins, and some medications💊.
Common Symptoms of Hepatitis
The symptoms include fever, fatigue, loss of appetite, jaundice, nausea, abdominal pain, and joint pain.
It is not possible to differentiate the types of viral hepatitis based on these symptoms alone. Laboratory tests like liver function tests (LFT), ultrasound, or liver biopsy are needed for the diagnosis of hepatitis.
Types of Hepatitis
There are 5 types of Hepatitis, identified by alphabets A, B, C, D, and E. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C. Hepatitis A is usually acute while hepatitis B, C, and D are most likely chronic. Hepatitis E is usually short-lived but can be particularly dangerous in pregnant women🤰.
Hepatitis virus A (HAV)
This type of virus is commonly transmitted by consuming food or water contaminated by the feces of the infected hepatitis A person. Thus, most people in areas of the world with poor sanitation have been infected with this virus. Certain sex practices can also spread HAV. Hepatitis A cases are usually mild, with most people making a full recovery and remaining immune from further HAV infections. However, certain HAV infections can also be severe and life-threatening. The good news is that safe and effective vaccine are available to prevent HAV. It is a series of two vaccines for a complete dose.
Treatment: Hepatitis A usually is self-limiting and does not require treatment. Sufficient bed rest is recommended if symptoms cause a great deal of discomfort. Be sure to stay hydrated and replenish nutrition in cases of vomiting🤮 and diarrhea.
Hepatitis virus B (HBV)
Hepatitis B is transmitted via contact with infectious body fluids including blood🩸, semen, or vaginal secretions. This means sharing needles💉 during injection drug abuse, sharing razors, or having sex with an infected partner would increase the risk of contracting hepatitis B. At times, accidental needle stick injuries may occur on healthcare workers who care for the infected HBV patients. HBV can also be transmitted from infected mothers to infants at the time of birth or from family member to infant during early childhood. Thankfully, safe and effective vaccines are also available for this viral infection (a series of three vaccines for full dose).
Treatment: Acute hepatitis B does not require treatment. Long-term, chronic hepatitis B needs to be treated with antiviral medications. However, this medication regime could be costly as it must be continued for several months or even years. The treatment requires regular monitoring and follow-up.
Hepatitis virus C (HCV)
Just like Hepatitis B, Hepatitis C is also mostly infected through exposure to infected blood which may happen during transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and via injection drug use💉. Sexual transmission is also possible but is much less common than that of Hepatitis B. The downfall is that there is no vaccine for HCV but it can be treated with antivirals.
Treatment: Both acute and chronic hepatitis C also requires antiviral medications. For those with chronic Hepatitis C, a combination of different antiviral drugs may be needed. People who develop liver cirrhosis (scarring) may consider a liver transplant.
Hepatitis virus D (HDV)
Hepatitis D is also known as delta hepatitis. It is a serious liver disease but is usually very rare and only occurs among people who are infected with the hepatitis B virus. HDV is also contracted via contact with infected blood. To date, there is no vaccine for HDV but since Hepatitis D occurs concurrently with Hepatitis B, the vaccines against Hepatitis B would indirectly provide protection from HDV infection as well.
Treatment: As of now, there is no antiviral medication for hepatitis D treatment. The best way to prevent Hepatitis D is by getting a vaccination for hepatitis B.
Hepatitis virus E (HEV)
Like Hepatitis D, Hepatitis E is also a serious but uncommon type of liver disease. For its mode of transmission, it is a waterborne disease just as Hepatitis A which is transmitted from ingestion of infected fecal matter. Hence, Hepatitis E is also usually associated with contaminated water supply💧 in countries with poor sanitation like Africa, Central America, Middle East, and Asia. Vaccines against HEV infection have been developed but are not widely available in many countries.
Treatment: Currently, there is no specific medical therapy available to treat hepatitis E. It typically resolves on its own. Infected people are advised to have adequate rest, sufficient hydration, and nutrients. Close monitoring and care need to be provided for infected pregnant women.
Prepared by: Chew Ee Wei, a HTM Pharmacist.
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