Question

Differentiate between hepatitis A, B, C, and viral hepatitis.

Answer 1

Hepatitis is an inflammatory condition of the liver. It's commonly caused by a viral infection, but there are other possible causes of hepatitis as well.

Common Types of Hepatitis:

1. Hepatitis A (HAV):

Hepatitis A (HAV) is caused by the hepatitis A virus. HAV is found in the stool (feces) of HAV-infected persons. HAV is usually spread from person to person by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A. This can happen when people don't wash their hands after using the toilet and then touch other people's food.

Common Causes:

Household contacts of infected persons, Sex partners of infected persons, Persons, especially children, living in regions of the U.S. with consistently elevated rates of hepatitis A during 1987-1997*, Persons traveling to countries where hepatitis A is common (everywhere except Canada, Western Europe, Japan, Australia, and New Zealand), Men who have sex with men, Injecting and non-injecting drug users

Incubation period:

15 to 50 days There is no chronic (long-term) infection. Once you have had hepatitis A you cannot get it again. About 15% of people infected with HAV will have prolonged illness or relapsing symptoms over a 6–9 month period.

Treatment:

There is no treatment for hepatitis A.

Hepatitis A vaccine is the best protection. It is recommended for people >2 yrs of age who are in risk groups for HAV infection. It is recommended as a routine vaccination for children living in certain states and geographic areas where hepatitis A occurs at consistently higher rates than average. For a recent exposure to someone with HAV or if travel is imminent (leaving in less than 4 weeks) to an area of the world where hepatitis A is common, see your doctor about your need for a dose of immune globulin (IG). Always wash your hands with soap and water after using the toilet, changing a diaper, and before preparing and eating food.

2. Hepatitis B (HBV):

Hepatitis B (HBV) caused by the hepatitis B virus. HBV is found in blood and certain body fluids. It is spread when blood or body fluid from an infected person enters the body of a person who is not immune. HBV is spread through having sex with an infected person without a condom, sharing needles or "works" when "shooting" drugs, needle sticks or sharps exposures on the job, or from an infected mother to her baby during birth. Exposure to blood in ANY situation can be a risk for transmission.

Common Causes:

Persons with more than one sex partner in a 6-month period, Persons diagnosed with a sexually transmitted disease, Men who have sex with men. Sex partners of infected persons, Injecting drug users, Household contacts of infected persons, Infants born to infected mothers, Infants/children of immigrants from areas with high HBV rates, Health care and public safety workers who are exposed to blood, Haemodialysis patients.

Incubation period:

45 to 160 days, average 90 days Chronic infection occurs in 90% of infants infected at birth; 30% of children infected at age 1–5 years; 6% of persons infected after age 5 years. In the U.S., 5000 people die each year from HBV. Death from chronic liver disease occurs in 15–25% of chronically infected persons. People who have chronic HBV infection have a much higher risk of liver failure (cirrhosis) and liver cancer.

Treatment:

HBV-infected persons should have a medical evaluation for liver disease every 6–12 months. Alpha-interferon and lamivudine are the two drugs licensed for the treatment of persons with chronic hepatitis B. These drugs are effective in up to 40% of patients. Liver transplant is the last resort, but livers are not always available.

Hepatitis B vaccine is the best protection. Routine vaccination is recommended for all persons 0–18 years of age, and for persons of all ages who are in risk groups for HBV infection. For optimal protection all babies should be given their first dose of hepatitis B vaccine at birth before leaving the hospital. Whenever a woman is pregnant, she should be tested for hepatitis B; infants born to HBV infected mothers should be given HBIG (hepatitis B immune globulin) and vaccine within 12 hours of birth. Persons who have more than one steady sex partner should use latex condoms correctly and for every sexual encounter. (The efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission.).

3. Hepatitis C (HCV):

Hepatitis C (HCV) caused by the hepatitis C virus. HCV is found in blood and certain body fluids. It is spread when blood or body fluids from an infected person enters another person's body. HCV is spread through sharing needles or "works" when "shooting" drugs, through needle sticks or sharps exposures on the job, or sometimes from an infected mother to her baby during birth. It is possible to transmit HCV from sex, but it is uncommon.

Common Causes:

Injecting drug users, Health care and public safety workers Who should be tested for HCV? People with increased risk of HCV infection include:

Injecting drug users, Recipients of clotting factors made before 1987, Hemodialysis patients, Recipients of blood/solid organs before 1992, People with undiagnosed liver problems, Infants born to infected mothers (after 12 months of age), Health care/public safety workers (only after known exposure) People for whom testing may or may not be indicated: People having sex with multiple partners, People having sex with an infected steady partner.

Incubation period:

14 to 180 days, average 45 days chronic infection: 75–85% of infected persons. Chronic liver disease: 70% of chronically infected persons. In the U.S., 8–10,000 people die each year from HCV. People who have chronic HCV infection have a much higher risk of liver failure (cirrhosis) and liver cancer. Chronic HCV-related liver disease is the leading indication for liver transplant.

Treatment:

HCV-positive persons should have a medical evaluation for liver disease every 6–12 months. Interferon, pegylated interferon, and ribavirin are the only drugs licensed for the treatment of persons with chronic hepatitis C. Interferon can be taken alone or in combination with ribavirin. Combination therapy is currently the treatment of choice and can eliminate the virus in up to 40% of patients. Get vaccinated against hepatitis A, and ask your doctor if you need hepatitis B vaccine as well.

There is no vaccine to prevent hepatitis C. HCV can be spread by sex, but this is rare. If you are having sex with more than one steady partner, use condoms correctly and every time to prevent the spread of sexually transmitted diseases. (The efficacy of latex condoms in preventing infection with HCV is unknown, but their proper use may reduce transmission.) You should also get vaccinated against hepatitis B.

4. Viral Hepatitis:

Viral Hepatitis is the inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases Viral hepatitis symptoms are similar no matter which type of hepatitis a person has.

Common Causes:

The hepatitis A virus is transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person.

Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water If symptoms occur, the individual may experience any or all of the following: jaundice, fever, loss of appetite, fatigue, dark urine, joint pain, abdominal pain, diarrhoea, nausea, and vomiting. Very rarely, a new case (acute) of viral hepatitis can cause liver failure and death. Sometimes in these instances a liver transplant (if a liver is available) can save a life. Note: Symptoms are less common in children than adults, and people who have HCV infection are less likely to experience symptoms.

Incubation period:

15 to 45 days, there is no chronic (long-term) infection. About 35% of people infected with viral hepatitis will have prolonged illness or relapsing symptoms over a 3–5 month period

Treatment:

Bed rest, abstaining from alcohol, and taking medication to help relieve symptoms. Most people who have viral hepatitis get well on their own after a few weeks. Viral Hepatitis is treated with drugs, such as lamivudine and adefovir dipivoxil.