Viral Hepatitis

Hepatitis is the condition of liver inflammation. Though there are many factors that cause hepatitis, virus is the most important reason for developing hepatitis. There are many types of hepatitis viruses but among them Type A, B and C are very popular. People who are employed in clinics, hospitals and those who have sex with many persons and those who are using drug through veins are having risk for developing viral hepatitis. Apart from liver these viruses can attack and cause inflammation of other organs also. Hepatitis can be either acute (suddenly) or chronic (long term).

Important Functions of Liver :

Liver is one of the major vital organs in your body. It helps in purifying the blood by acting on harmful chemicals present in it and destroying it. Harmful materials are broken down into small pieces and sent through excretory organs. Liver acts as a store-house for many vitamins, fats and sugars. Albumin is the main protein produced in the liver which is important for clotting of blood. When there is inflammation of the liver, it may not be able to do its work properly thus interrupting normal functions of the body.

Types :

Viral hepatitis can be broadly divided into acute hepatitis and chronic hepatitis. But some experts classify them into HAV, HBV and HCV types.

HAV Hepatitis A :

It is one form of acute hepatitis causing sudden symptoms. In very rare cases it may cause liver failure. Initially hepatitis A was considered to be infectious spreading from one person to the other. The virus can easily spread through water or contaminated food. Hence Hepatitis A is common among people who follow unhygienic health habits. The viruses get transferred through oral secretions during kissing or through stool or human feces. Unclean sanitary conditions can cause spreading of this virus through restaurants and other public places.

Hepatitis B :

Hepatitis B travels through serum or blood transfer. It gets transferred to others through blood transfusions, sexual contacts, and commonly in drug abusers who use the same needle for injecting drugs. This viral infection can spread through body piercing, tattooing process and by sharing razors/toothbrushes with infected people. HBV is chronic type and the infection may last up to years also.

HCV or Hepatitis C :

This type of viruses can spread through shared needles, sexual intercourse, and blood transfusion and drug abusers and hence it is considered to cause chronic infection. Patients with HCV are at the risk of developing liver cancer and liver failure.

Other Types :

Viral hepatitis of Type D, E and G are recognized. HDV is called delta virus which needs another HBV virus to survive. HEV spreads through contaminated water.

Who are at risk?

People who have multiple sex partners, who work in hospitals, clinics and other health care centers, who are involved in sewage cleaning and water treatment plants, who use drugs frequently through veins, who are infected with HIV and hemophiliacs are at high risk of developing viral hepatitis.

Symptoms :

These viruses that cause inflammation of liver initially enter into the host’s body and remain on incubation period for some time. Incubation period is the time interval between the exposure to virus and the onset of illness. Often people infected with HAV or HBV or HCV do not show any symptoms. In some people it causes flu like signs with fever, loss of appetite, nausea/vomiting and fatigue. In severe cases, it may cause yellow coloration on the skin producing jaundice like symptoms.

Tests :

Blood test is the main source for identifying acute viral hepatitis. The doctor will look for the symptoms of fatigue, abdominal pain, dark urine and vomiting sensation. Acute hepatitis can be easily diagnosed by blood test whereas it is difficult to diagnose chronic hepatitis since symptoms will not show unless the infection is advanced.

Liver enzymes called aminotransferases (AST) are normally present within the liver cells. However in case of liver inflammation/injury these enzymes split apart entering into the bloodstream indicating that something is wrong with the liver. In the infected person, blood test report will contain abnormally high levels of AST enzyme indicating liver damage. But this result is reflected only in the case of acute viral hepatitis and not chronic one. In the case of chronic hepatitis the levels of AST are only mildly high thus misleading the doctor.

Blood is also tested for the presence of viral antibodies which are protein particles produced by WBC when they attack bacteria or viruses. These viral antibodies can be detected in blood both in the case of acute and chronic viral hepatitis. Again for chronic hepatitis patients viral antibodies as well as viral proteins are detected in the blood test. The doctor will look for the symptoms closely and order for specific type of viral hepatitis and genetic material tests. Hepatitis A viral protein test, hepatitis B surface antigen test or hepatitis B DNA test is ordered.

Treatment :

In case of acute viral hepatitis your doctor will give suitable medications to give relief from symptoms immediately. However in the case of chronic hepatitis treatment takes a long time. For treating acute viral hepatitis special care will be taken by the doctor while prescribing medications since they may affect the liver further. Liver may not be able to eliminate drugs when it is not functioning normally. Hence some drugs may continue to remain in your blood producing toxicity. Nausea/vomiting symptoms are first arrested through effective drugs. In case of severe dehydration, the person will be put on IV fluids to stop vomiting.

Chronic Hepatitis :

Combination of medications is necessary for eradicating viruses that remain for long term inside the liver. First and foremost stop drinking since alcohol can make the conditions of your liver worse leading to liver cirrhosis. Progressive liver damage can lead to liver cancer or liver failure causing death. Depending on the condition of the patient the doctor will start with medications like interferon (given intravenously) and Rebetol or telaprevir.

In case of HCV alpha interferon is injected and oral drugs like Epivir or hepsera are prescribed. Diagnosing the right type of viral hepatitis is really a challenging task for the doctors. It is necessary to consult gastroenterologists or hepatologists for liver problem. For some cases, the doctor may perform liver biopsy to study the extent of liver damage. It is not enough if you take medications for some time and stop further. Chronic infection is long-lasting and hence prolonged treatment is absolutely necessary for destroying the viruses ultimately. Liver transplantation surgery is done for more serious cases of fulminant hepatitis.

Prevention :

Prevention of viral hepatitis is better than treatment. Vaccination and immunoglobulin are highly effective to prevent this disease. One need to be cautious while using needles/syringes from others. You can avoid getting exposed to the blood of infected people. Avoid having sex with strangers since viruses can spread through semen. Take precaution while sharing public toilets since it can get transmitted through fecal particles.

ISG Immune Serum Globulin is an effective human serum given for hepatitis A. One shot of ISG gives protection against hepatitis A for several months. HBIG hepatitis B immune globulin is effective human serum given for hepatitis B. The rate of success is high if the dosage is given within a week of exposure to hepatitis B viruses. Apart from immune globulin, vaccinations like Havrix and Vaqta are available for preventing hepatitis A.

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