Hepatitis

Hepatitis is a medical condition characterized by the inflammation of the liver and the presence of inflammatory cells in the organ tissues. Hepatitis as a medical condition can heal on its own or it can progress to fibrosis and liver cirrhosis. Hepatitis is said to be acute if it lasts less than 6months and it is said to be chronic if it persists longer. Hepatitis is commonly caused by a group of viruses known as the hepatitis viruses but it can also be caused by toxins (alcohol, certain medication, some industrial organic solvents, and plants), other infections and auto-immune diseases. There are 8 types of hepatitis which are: hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E, hepatitis F, hepatitis G and hepatitis H.

Hepatitis A

Hepatitis A refers to liver inflammation caused by infection with the hepatitis A virus (HAV).  HAV is one of several viruses that can cause hepatitis. Unlike hepatitis B and hepatitis C, hepatitis A does not cause chronic (ongoing, long-term) disease. Although the liver does become inflamed and swollen, it heals completely in most people without any long-term damage. Once you have had hepatitis A, you develop lifelong immunity and cannot get the disease again. Because of the way it is spread, the hepatitis A virus tends to occur in epidemics and outbreaks.

 Since hepatitis A virus is found in stools of people with hepatitis A it is mainly transmitted through fecal-oral route. The virus can also be spread by eating raw or undercooked shellfish collected from water that has been contaminated by sewage. The hepatitis A virus can be transmitted through blood transfusions, although this is very rare. People who are infected can start spreading the infection about a week after their own exposure. People who don’t have symptoms can still spread the virus. The risk of infection is greatest in areas with poor sanitation or poor personal hygiene standards. (Everton 98)

Many people with hepatitis A don’t show any symptoms at all. Hepatitis A symptoms are so mild at times that they go unnoticed. Hepatitis A symptoms, if any, are more likely to show in older people than children. Symptoms usually develop between the 2^nd and 6^th week after infection. They are normally not severe and usually go away on their own over time. Most common symptoms associated with hepatitis A are; nausea, diarrhea (especially in children), vomiting, rash, fatigue, jaundice, pain in the liver area. Although they can last for as long as 9months, the symptoms usually last for less than 2months.

There is no specific medicine to cure infection with hepatitis A virus. Treatment of hepatitis A mainly focuses o relieving the symptoms that accompany with its infection. Incase one has been exposed to someone infected with Hepatitis A virus there is treatment that could prevent the individual from infection called immune globulin which is effective if given 2weeks after exposure.

Hepatitis B

           Hepatitis B is an infectious hepatitis caused by the hepatitis B virus (HBV). This infection can manifest in two possible phases which are acute and chronic. Acute hepatitis B lasts for less than 6months while chronic hepatitis B persists for a longer period. Chronic hepatitis B can lead to a form of liver cancer known as hepatocellular carcinoma. Hepatitis B is the most common and serious liver infection in the world.

Hepatitis B virus is transmitted via blood or fluids contaminated with blood. It can also be transmitted via mother-newborn during or shortly after birth. Use of contaminated needle sticks or having unprotected sex with hepatitis B infected persons increase the risk of transmission.

Hepatitis B is diagnosed through a series of blood tests which determine presence of the virus in the blood, and or the viral load of the virus.  Common symptoms of hepatitis B include; appetite loss, fatigue, nausea and vomiting, itching all over the body, pain over the location of the liver, jaundice, dark urine and pale colored stools. When you have any of these symptoms occurring for more than 2days, you need to seek medical health. Other tests may be done to rule out other medical conditions because blood tests alone may not be able to guide the treatment of hepatitis B. An ultrasound or liver biopsy may therefore be done to detect liver damage or even cancer of the liver caused by chronic hepatitis B. (Everton 230)

Acute hepatitis B usually clears out on its own and does not require medical treatment. If very severe, symptoms such as vomiting or diarrhea are present; the affected person may require treatment to restore fluids and electrolytes. However there are no medications that can prevent acute hepatitis B from becoming chronic.

If a person has chronic hepatitis B, they should see their health care provider regularly.

Hepatitis C

This is a very infectious disease primarily affecting the liver and is caused by hepatitis C virus. The infection is normally termed asymptomatic because normally most people have few if any symptoms after the initial infection. Chronic infection can however lead to scarring of the and ultimately to cirrhosis which appears after very many years. Certain symptoms that could maybe be related to this disease and are normally very mild include; appetite loss, fatigue, abnormal pain, jaundice, itching and flu-like symptoms, this are normally almost unrecognizable because they are so mild that they may seem normal(Everton 265)

Hepatitis C is spread by blood-to-blood contact. There are various ways through which one may contract;

a)Injection drug use: those who currently use drug injection as their delivery route for drugs are at increased risk for getting hepatitis C because they may be sharing needles.

b)Blood products: blood transfusion, blood products (immunoglobulin, Rhogam, platelets and plasma) or organ transplantation are also risk factors for hepatitis C.

c)Iatrogenic medical or dental exposure: people can be exposed to HVC through inadequately or improperly sterilized medical or dental equipment. These equipment may harbor contaminated blood if improperly sterilized; needles, hemodialysis equipment, jet air guns e.t.c

d)Blood exposure: people may be exposed to HVC through accidental exposure to blood through needles, sticks or blood splatter to the eyes or open wounds at work.

e)Vertical transmission: this is transmission from an infected mother to child during birth process.

f)Sexual exposure

g)Body piercings and tattoos

h)Shared personal care items e.g. toothbrushes, cuticle scissors e.t.c

Diagnosis of hepatitis C is rarely made during the acute phase of the disease due to its asymptomatic nature. Those who experience acute phase symptoms are rarely ill enough to seek medical attention.  Chronic hepatitis C may also only be suspected on the basis of one’s medical history e.g. if one maybe has a history drug use and is having liver complications.

HVC testing begins with serological blood tests used to detect antibodies to HVC. This can be tested within 15weeks to 6months of exposure depending on the patient. RNA testing or nucleic acid testing methods are also used when antibody testing is negative but suspicion of hepatitis C is high. These RNA tests can measure how much of the virus is present in the blood.( Ryan 55)

The 1^st way to deal with hepatitis C is prevention. We must prevent all those risk factors that can lead to blood-to-blood contact e.g. sharing personal items, drug use, and tattoos e.t.c

In May 2011, the Food and Drug Administration approved 2 drugs for Hepatitis C. The first one is boceprevir and the other is telaprevir. Both drugs block an enzyme that helps the virus reproduce. The drugs are intended to improve on standard treatments using the injected drug pegylated interferon alpha and the pill ribavirin. These are administered for a period of 24 to 48 weeks depending on hepatitis C virus genotype. Treatment is normally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests.

Hepatitis D

Hepatitis D also known as HDV and classified as Hepatitis delta virus is a disease caused by a small circular enveloped RNA virus. It is considered to be a sub viral satellite because it can propagate only in the presence of hepatitis B virus. Transmission of HDV can occur either via simultaneous infection with HBV (co infection) or superimposed on chronic HBV or HBV carrier state (super infection).

Both super infection and co infection with HDV results in more severe complications compared to infection with HBV alone. These complications include a greater likelihood of experiencing liver failure in acute infections and a rapid progression to liver cirrhosis with an increased chance of developing liver cancer in chronic infections. In combination with hepatitis B virus, hepatitis D has the highest mortality rate of all the hepatitis infections of 20%.

HDV is also transmitted through similar routes to those for hepatitis B that is through blood fluids, sexual transmission and mother-child during birth if mother is infected. Infection is largely restricted to persons at high risk of hepatitis B infection particularly drug users and persons receiving clotting factor concentrates (Fauquet 8) 

Treatment of hepatitis D is focused on dealing with symptoms and complications of hepatitis D. most people with hepatitis D recover completely within a few months; but others develop chronic hepatitis D which may lead to liver damage, liver cancer and even loss of life. No drugs have been approved to treat chronic hepatitis but liver transplantation has shown to be an effective treatment for people with severe liver disease caused by hepatitis D.