Hepatitis means inflammation or swelling of the liver. A host of factors can result in liver injury, but in Pakistan, the most common cause of such injury is infection. To keep our liver healthy, we must learn some basic facts about these infections. That is what we will do this week.

First, lets us have a look at what the liver does!

The liver is an organ that sits in the upper right corner of the belly. The liver’s main job is to filter the blood coming from the digestive tract before passing it to the rest of the body. It also detoxifies chemicals, metabolizes drugs, and produces juices that help digestion.

The liver also makes proteins required for blood clotting and other functions.

Common symptoms of hepatitis include pain in the upper belly, nausea, vomiting, yellowness of eyes, loss of appetite, fatigue, and dark-colored urine. This condition can be self-limited or progress to long-term liver damage like liver scarring, liver cancer, or liver failure. In the later stages of the disease, a patient can experience belly bloating due to fluid accumulation, altered mental status, bleeding, or even death.

Types of Hepatitis Viruses:

There are five types of hepatitis viruses: Hepatitis A, B, C, D, and E. Some of these viruses come to us through contaminated food and water, while others reach us via blood or sexual contact.

Hepatitis A

Hepatitis A is one of the five viruses that can cause Hepatitis. Abundant in the stool of an infected person, this virus is mainly transmitted from one person to other due to ingestion of contaminated food and water. Hepatitis A is, thus, an illness of third-world countries with poor sanitary conditions.

Symptoms of Hepatitis A are typical of any acute liver disease: pain in the upper belly, nausea, vomiting, yellowness of eyes, loss of appetite, fatigue, and dark-colored urine.

Diagnosis can be confirmed with a blood test.

There is no specific treatment available to cure the virus. But most Hepatitis A infections are mild and resolve on their own. These mild cases get better simply by rest, good nutrition, and fluids. Overall, Symptoms usually last for less than two months. However, some cases can be severe, leading to liver failure and even death.

Good hygienic practices and a vaccine can prevent the Hepatitis A virus. Heating food and liquids to 85 C for at least one minute can kill the virus, but freezing does not.

Hepatitis B

Hepatitis B virus leads to an acute liver illness just like Hepatitis A but can also produce a more indolent version of the disease, which resemble Hepatitis C infection.

Transmission of this virus happens mainly through sharing of body fluids (blood and other body fluids). This sharing can occur via sexual contact or using contaminated instruments, like injection needles, razors, toothbrushes, or non-sterilized medical equipment. An infected pregnant woman can also pass on the infection to her baby. For this transmission to happen, a patient doesn’t have to be symptomatic; any carrier of this virus can transfer it to another person.

In most adult patients, their body fights the infection and heals it in a few months. However, some patients (2-6%) fail to clear the virus on their own, and the disease takes a chronic form, resulting in slow but irreversible damage, ultimately leading to liver cancer and death.

Effective and safe vaccination is available to prevent hepatitis B. Treatment in the form of antiviral drugs is also available. However, outcomes are better if treatment is started early.

Hepatitis C

Hepatitis C can cause both acute and chronic forms of infection. Most patients with the acute infection do not develop any symptoms but the virus continues to damage the liver silently. Thus during the early stages, this infection remains undiagnosed until blood tests are used to look for this infection.

Just like Hepatitis B, it is transmitted from one person to another person through contaminated blood and other body fluids, sharing injection needles, razors, toothbrushes, or reusing medical equipment. It can also be transmitted through sexual contact, but this occurrence is less common. In addition, an infected pregnant woman can transmit this virus to the baby during pregnancy or childbirth.

About 30 percent of infected people clear the virus on their own, but in about 70 percent, it becomes a long-term ( chronic) liver disease. As discussed earlier, most of the time this infection does not cause symptoms in acute disease, and the patient can live with it for years and decades before the signs of liver damage appear. These symptoms include bloating of the belly, vomiting blood, black-colored stools, or altered mental status. Therefore it is important to get annual screening for this infection in countries like Pakistan, where this virus is prevalent. There is no vaccine available to prevent this infection. However, the treatments available for this virus are highly effective, boasting a cure rate of about 99 percent. And as is the rule with most illnesses, the earlier the treatment, the less damage to the liver, thus decreasing the chances of liver scarring and cancer.

Hepatitis D

Hepatitis D is also called the Delta virus. Like all other liver-tropic viruses, Hepatitis D infects and inflames the liver cells, but with one limitation: to produce this inflammation, it needs the support of Hepatitis B. The infection with Hepatitis D occurs either simultaneously with Hepatitis B or in patients already infected with hepatitis B.

Like hepatitis B, it is transmitted through blood, bodily fluids, and sexual contact. Transmission from pregnant mother to baby is also possible though rare. Hepatitis D can be a short-term (acute) or long-term (chronic) infection. In chronic cases, the combination of hepatitis B and D infections results in worse outcomes—rapid progression towards liver failure, liver cancer, or even death.

Vaccines for hepatitis B offer some protection against hepatitis D infection as well. Treatment is also available.

Hepatitis E

Hepatitis E is the liver inflammation caused by the Hepatitis E virus. This virus, last on the known list of hepatitis viruses, is transmitted mainly by ingesting food and water contaminated with the feces of people infected with the Hepatitis E virus. Therefore, just like Hepatitis A, this virus is more common in countries with poor sanitary conditions.

This infection is usually short-term, and most people recover fully from the disease without any complications. Unfortunately, no specific treatment is available to kill the virus and cure this illness. Patients are advised to take rest and get adequate nutrition and fluids. The vaccine is not available, and the only way to protect yourself is by practicing good hygiene and improving sanitary conditions.

“Ignorance can be fatal when it comes to Hepatitis diseases.”