Hepatitis – Causes, Treatment & Types | Hepatitis B – UPSC

Hepatitis

Hepatitis refers to an inflammatory condition of the liver. It disturbs various metabolic processes such as bile production, excretion, fat and protein metabolism, activation of enzymes, and synthesis of proteins.

It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol.

•  Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

It can be acute (inflammation of the liver that presents with sickness — jaundice, fever, vomiting) or chronic (inflammation of the liver that lasts more than six months, but essentially showing no symptoms).

World Hepatitis Day is observed each year on 28^th July to enhance awareness of viral hepatitis.

Causes

• Usually caused by a group of viruses known as the “hepatotropic” (liver-directed) viruses, including A, B, C, D, and E.
• Other viruses may also cause it, such as the varicella virus that causes chickenpox. SARS-CoV-2, the virus causing Covid-19 may injure the liver, too.
• Other causes include drugs and alcohol abuse, fat buildup in the liver (fatty liver hepatitis), or an autoimmune process in which a person’s body makes antibodies that attack the liver (autoimmune hepatitis).

Types of Viral Hepatitis

Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E.

A different virus is responsible for each type of virally transmitted hepatitis.

Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

Hepatitis A

• It is an infectious disease of the liver that is caused by the Hepatitis A virus. It is acute and in most of cases, symptoms could not be recognized in young people. Symptoms include vomiting, nausea, fever, severe abdominal pain, jaundice, weakness, and these symptoms might last longer till eight weeks.
• It is transmitted to others by contaminated food, water, and by being in close contact with the infected person. It can be diagnosed with some simple blood tests. Hepatitis A vaccine helps in preventing disease.

Hepatitis B

• It is an infectious disease caused by an infection with the Hepatitis B virus. It is contracted through flat tired wounds, contact with blood, saliva, fluids of an infectious body.
• Sharing personal belongings such as razors or toothbrush of an infected person can also cause Hepatitis B.
• Hepatitis B symptoms include abdominal pain, fatigue, and jaundice. Symptoms do not come to the limelight until one to six months. It could be diagnosed through a common blood test.
• Hepatitis B Vaccine could be done for both adults and children. It comprises three intramuscular vaccines. Second and third vaccines are provided after one and six months of the first vaccine.

Hepatitis C

• It is an infection that is caused by the Hepatitis C virus in the liver. This can be transferred from needles that have been infected, at the time of birth (i.e. transmitted from infected mother to child), through body fluids of an infected person, having sex with multiple partners specifically with HIV-infected persons. It is also rarely found in semen (cum) and vaginal fluids.
• Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It’s also a sexually transmitted infection (STI) that can be passed on through unprotected sex, especially when blood is present.
• It does not spread through food or water.
• Symptoms include loss of appetite, tiredness, frequently occurring fever, yellowing of your skin or eyes, joint pain, abnormalities in urine, and abdominal pain. These signs occur after six or seven weeks of exposure to a virus. Signs might take even several years to appear in rare cases.
• However, unlike hepatitis B, it is not sexually transmitted and there is no known vaccine for hepatitis C.

Hepatitis D

• It is one of the severe liver diseases that are caused by the virus Hepatitis D (HDV). It spreads from infected blood or wound. Sometimes it might occur in conjunction with Hepatitis B.
• Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B.

Hepatitis E

• Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). It might be circulated through food, water, and contaminated blood.
• Hepatitis E is mainly found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply.  It could be either acute or chronic.

Complications of hepatitis

Chronic hepatitis B or C can often lead to more serious health problems. Because the virus affects the liver, people with chronic hepatitis B or C are at risk for:

• chronic liver disease
• cirrhosis
• liver cancer

When your liver stops functioning normally, liver failure can occur. Complications of liver failure include:

• bleeding disorders
• a buildup of fluid in your abdomen, known as ascites
• increased blood pressure in portal veins that enter your liver, known as portal hypertension
• kidney failure
• hepatic encephalopathy, which can involve fatigue, memory loss, and diminished mental abilities due to the buildup of toxins, like ammonia, that affect brain function
• hepatocellular carcinoma, which is a form of liver cancer
• death

People with chronic hepatitis B and C are encouraged to avoid alcohol because it can accelerate liver disease and failure. Certain supplements and medications can also affect liver function.

Global Scenario:

• Hepatitis B and C together are the most common cause of deaths, with 1.3 million lives lost each year.
• In 2016, 194 governments across the globe adopted WHO’s global strategy which aims at eliminating viral hepatitis by 2030.

Indian Scenario:

• 40 million people are chronically infected with Hepatitis B virus and 6 to 12 million with Hepatitis C virus.
• In 2018, the government launched the National Viral Hepatitis Program. The program is the largest program for Hepatitis B and C diagnosis and treatment in the world.
  • Hepatitis B is included under India’s Universal Immunization Programme (UIP) which provides free of cost vaccination against eleven (excluding Hepatitis B) vaccine-preventable diseases i.e. Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Pneumonia, and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhea.