Viral Hepatitis: Causes and Effects

Viral Hepatitis: Silent Epidemic

• Viral hepatitis is a major cause of liver cirrhosis and liver carcinoma worldwide.
• Hepatitis refers to an inflammatory condition of the liver, commonly caused by viral infections, but also by autoimmune hepatitis and secondary results of medications, toxins, and alcohol.

Types of Viral Hepatitis

• Hepatitis A:
  • Fecal-oral transmission
  • Incubation period: 15-50 days (average: 28 days)
  • Remains infectious on environmental surfaces for more than a month
  • Needs supportive treatment
  • Prevention: vaccination, hand hygiene, proper food handling, and disinfection of contaminated surfaces
• Hepatitis B:
  • Transmitted by percutaneous or mucosal exposure to infectious body fluids
  • Incubation period: 45-160 days (average: 120 days)
  • 50-100 times more infectious than HIV
  • Remains infectious outside the body for up to 7 days
  • Prevention: vaccination, avoid unprotected sex, and avoid percutaneous or mucosal contact with infected blood and body fluids
• Hepatitis C:
  • RNA virus with great molecular heterogeneity
  • Incubation period: 14-180 days (average: 45 days)
  • No vaccine available
  • Can survive on surfaces for up to 6 weeks and in water for up to 5 months
  • Prevention: standard precautions, avoid percutaneous exposure, and use proper sterilization techniques

Transmission and Prevention

• Hepatitis A transmission:
  • Ingestion of fecal matter, even in microscopic amounts
  • Close contact with an infected person
  • Sexual contact with an infected person
  • Ingestion of contaminated food or drinks
• Hepatitis B transmission:
  • Percutaneous exposure (e.g., needle sticks)
  • Mucosal exposure (e.g., direct contact with mucous membranes)
  • Non-intact skin exposure (e.g., psoriasis, eczema, burns, wounds, cuts, and scratches)
• Hepatitis C transmission:
  • Percutaneous exposure (e.g., needle sticks)
  • Mucosal exposure (e.g., direct contact with mucous membranes)
  • Non-intact skin exposure (e.g., psoriasis, eczema, burns, wounds, cuts, and scratches)

Laboratory Findings

• Hepatitis A diagnosis:
  • Presence of elevated IgM anti-HAV for 2-4 weeks during the acute phase
  • Later by rise in IgG anti-HAV that indicates the convalescent phase
• Hepatitis B diagnosis:
  • Ordering all 3 tests (HBsAg, anti-HBc, and anti-HBs) allows determination of susceptibility, immunity, or active infection
  • If acute hepatitis B is suspected, IgM antibody to the hepatitis B core antigen (IgM anti-HBc) can also be ordered
• Hepatitis C diagnosis:
  • Detecting antibodies to the virus (HCV Ab) or viral RNA in the blood
  • Window period: 2-4 weeks after initial infection for HCV RNA and 2-6 months for HCV Ab

Advice to Health Care Providers and Patients

• Advice to health care providers:
  • Consider each patient as a potential carrier of hepatitis
  • Take necessary precautions to prevent transmission
• Advice to patients:
  • Not to share sanitary and household items that may carry traces of blood
  • Not to reuse injecting or snorting equipment
  • Avoid percutaneous exposure to infected blood and body fluids

Viral Hepatitis: Silent Epidemic

• Viral hepatitis is a major cause of liver cirrhosis and liver carcinoma worldwide.
• Hepatitis refers to an inflammatory condition of the liver, commonly caused by viral infections, but also by autoimmune hepatitis and secondary results of medications, toxins, and alcohol.

Types of Viral Hepatitis

• Hepatitis A:
  • Fecal-oral transmission
  • Incubation period: 15-50 days (average: 28 days)
  • Remains infectious on environmental surfaces for more than a month
  • Needs supportive treatment
  • Prevention: vaccination, hand hygiene, proper food handling, and disinfection of contaminated surfaces
• Hepatitis B:
  • Transmitted by percutaneous or mucosal exposure to infectious body fluids
  • Incubation period: 45-160 days (average: 120 days)
  • 50-100 times more infectious than HIV
  • Remains infectious outside the body for up to 7 days
  • Prevention: vaccination, avoid unprotected sex, and avoid percutaneous or mucosal contact with infected blood and body fluids
• Hepatitis C:
  • RNA virus with great molecular heterogeneity
  • Incubation period: 14-180 days (average: 45 days)
  • No vaccine available
  • Can survive on surfaces for up to 6 weeks and in water for up to 5 months
  • Prevention: standard precautions, avoid percutaneous exposure, and use proper sterilization techniques

Transmission and Prevention

• Hepatitis A transmission:
  • Ingestion of fecal matter, even in microscopic amounts
  • Close contact with an infected person
  • Sexual contact with an infected person
  • Ingestion of contaminated food or drinks
• Hepatitis B transmission:
  • Percutaneous exposure (e.g., needle sticks)
  • Mucosal exposure (e.g., direct contact with mucous membranes)
  • Non-intact skin exposure (e.g., psoriasis, eczema, burns, wounds, cuts, and scratches)
• Hepatitis C transmission:
  • Percutaneous exposure (e.g., needle sticks)
  • Mucosal exposure (e.g., direct contact with mucous membranes)
  • Non-intact skin exposure (e.g., psoriasis, eczema, burns, wounds, cuts, and scratches)

Laboratory Findings

• Hepatitis A diagnosis:
  • Presence of elevated IgM anti-HAV for 2-4 weeks during the acute phase
  • Later by rise in IgG anti-HAV that indicates the convalescent phase
• Hepatitis B diagnosis:
  • Ordering all 3 tests (HBsAg, anti-HBc, and anti-HBs) allows determination of susceptibility, immunity, or active infection
  • If acute hepatitis B is suspected, IgM antibody to the hepatitis B core antigen (IgM anti-HBc) can also be ordered
• Hepatitis C diagnosis:
  • Detecting antibodies to the virus (HCV Ab) or viral RNA in the blood
  • Window period: 2-4 weeks after initial infection for HCV RNA and 2-6 months for HCV Ab

Advice to Health Care Providers and Patients

• Advice to health care providers:
  • Consider each patient as a potential carrier of hepatitis
  • Take necessary precautions to prevent transmission
• Advice to patients:
  • Not to share sanitary and household items that may carry traces of blood
  • Not to reuse injecting or snorting equipment
  • Avoid percutaneous exposure to infected blood and body fluids

This quiz covers the inflammatory liver condition known as hepatitis, its viral and non-viral causes, and its consequences on liver health. Understand the different types of hepatitis and their effects.