Viral Hepatitis

Viral Hepatitis Overview

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

Types of Viral Hepatitis

• Hepatitis A, B, C, D, and E are classified as viral infections of the liver.
• Hepatitis A: fecal-oral transmission.
• Hepatitis B: sexual fluids and blood-to-blood transmission.
• Hepatitis C: blood-to-blood transmission.
• Hepatitis D: travels with Hepatitis B.
• Hepatitis E: fecal-oral transmission.

Symptoms of Viral Hepatitis

• Fever.
• Fatigue.
• Loss of appetite.
• Nausea and vomiting.
• Abdominal pain.
• Gray-colored bowel movements.
• Joint pain.
• Jaundice.

Hepatitis A

• HAV is an RNA picornavirus, endemic in many developing countries.
• Typically causes a self-limited infection of less than two months' duration, conferring immunity when resolved.
• HAV remains infectious on environmental surfaces for more than a month.
• Incubation period: 15 to 50 days (average: 28 days).
• Needs supportive treatment.
• Transmission: ingestion of fecal matter from close contact with an infected person, sexual contact, or contaminated food and drinks.
• Prevention: vaccination, hand hygiene, proper food handling, and disinfection of contaminated surfaces.

Hepatitis B

• HBV is an encapsulated DNA virus that replicates within the hepatocyte.
• Transmitted by percutaneous or mucosal exposure to the body fluids of an infected person.
• HBV is 50-100 times more infectious than HIV outside the body.
• Incubation period: 45 to 160 days (average: 120 days).
• Chronic infection serves as the main reservoir for HBV transmission.
• Transmission: percutaneous, mucosal, or non-intact skin exposure to infectious blood or body fluids.
• Adults at risk for HBV infection: injection-drug use, sexual exposure, household contacts, developmentally disabled persons, correctional facilities, occupational exposure, hemodialysis patients, and persons with HCV infection or chronic liver disease.
• Prevention: vaccination, avoiding unprotected sex, percutaneous or mucosal contact with infected blood, body fluids, and contaminated items.

Hepatitis C

• HCV is an RNA virus with great molecular heterogeneity, making vaccine development challenging.
• Chronic HCV infection is the leading cause of liver-related death and hepatocellular carcinoma in the Western world.
• Incubation period: 14 to 180 days (average: 45 days).
• No vaccine available.
• HCV survival: up to 6 weeks on surfaces at room temperature, and up to 5 months in water at low temperatures.
• Prevention: no vaccine for primary prevention, standard precautions remain the foundation of protection against transmission.

Laboratory Findings

• Hepatitis A diagnosis: presence of elevated IgM anti-HAV for 2-4 weeks during the acute phase of the infection, and later by rise in IgG anti-HAV in the convalescent phase.
• Hepatitis B diagnosis: presence of HBsAg, anti-HBc, and anti-HBs.
• Hepatitis C diagnosis: detecting antibodies to the virus (HCV Ab) or viral RNA in the blood.

Prevention and Advice

• Advice to healthcare providers: not to share sanitary and household items that may carry traces of blood, and to avoid percutaneous exposure to infected blood.
• Advice to patients: not to share injecting or snorting equipment, and to avoid percutaneous exposure to infected blood.

Learn about the causes and effects of Viral Hepatitis, a leading cause of liver cirrhosis and liver carcinoma. Understand the inflammatory condition of the liver and its various causes.