Hepatitis in simple terms means the liver inflammation, which is commonly caused by virus. It can alsobe caused by drugs/alcohol, chemicals, autoimmune disease etc.,. It can be an acute infection or chronic infection. It is acute when it lasts less than six months and is chronic when it persists longer.
- Acute hepatitis can be self limiting and can lead to acute liver failure.
- Chronic hepatitis have no symptoms, and may progress over time to fibrosis and cirrhosis.
PATHOGENESIS
- Virus enter into blood stream and spread in the liver.
- They infect the hepatocytes and multiply.
- They change the antigen structure on the virus site.
- The body begins to use self mediated immune response attempting to damage the hepatocytes.
5 main types of viral hepatitis
- Hepatitis A [HAV] – Found in the feces of infected people
- Hepatitis B [HBV] – Spreads through infected blood fluids
- Hepatitis C [HCV] – Most serious type and spread through blood
- Hepatitis D [HDV] – Can only be contracted if you are having HBV
- Hepatitis E [HEV] – Transmitted via food or water
HAV
- Symptoms take about 2-3 weeks to show up
- No specific treatment
- Vaccine is available.
- Rarely it is fatal.
- Children are most commonly affected here
HBV
- Symptoms take about 2.5 months to show up.
- 90% recovery within 6 months.
- Vaccine is available.
- Any age people can get affected by this HBV
HCV
- Symptoms take about 2-6 months to show up.
- 80% of people have no symptoms
- No vaccine.
- Treated with antiviral drugs.
- Adults are more prone to this
HDV
- Symptoms take about 2.5 months to show up.
- There are no cures. Prevention is the only method.
- No vaccine
- Any age people can get affected.
HEV
- Symptoms take about 40 adsy to show up.
- Here also prevention is the only weapon.
- No vaccine available.
- Young adults are affected.
The following table is the comparative analysis of A, B and C types of hepatitis.
| Attribute | Hepatitis A | Hepatitis B | Hepatitis C |
| Incubation time | 15-50 days | 60-150 days | 14-182 days |
| Route of transmission | fecal-oral | percutaneous mucosal body fluids | percutaneous mucous |
| Causes of transmission | close contact sexual contact contaminated food/water | infected mother, sexual contact syringe, needle sharing | needle syringe drug sharing infected mother tattoo |
| acute infection in younger people | 30% | 30-50% | 20-30% |
| acute infection in older people | 70% | Very less | 10-20% |
| acute to chronic conversion | No | Infant= 90% 1-5 yrs= 25-50% adults= 5% | 50% |
| test for acute | IgM anti HAV | HbsAg, IgM HbC | No |
| test for chronic | No | HbsAg, Total HbC | anti HCV NAT |
| severity | normal recovery death and complication are rare | recover mostly 15-25% cancer cirrhosis liver failure | 5-25% cirrhosis 1-4% carcinoma |
| treatment for acute | supportive | no medication supportive methods | IDSA drug |
| treatment for chronic | no | antiviral drugs | HCV genotyping |
| vaccination | all children people at risk region sexual contact liver disease | all children drug use history sexual contact liver problems travellers hemodialysis patients | no |
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