Everything You Should Know About Hepatitis
Although many people have heard of hepatitis, they may not know exactly what the disease is or how it is contracted. The three most common types are hepatitis A, B, and C. These infections can cause long-term liver problems, but many people don’t know that they have the disease.
More than 350 million people across the globe have hepatitis B, according to the Centers for Disease Control and Prevention. The CDC estimates that 41,000 people may have hepatitis C, and there were approximately 4000 new cases of Hepatitis A in the U.S. in 2016.
Types of Hepatitis
Hepatitis is not a virus; it is liver inflammation. Hepatitis can be caused by injury, toxins, or viruses.
There are five types of viral hepatitis: A, B, C, D, and E. All types of hepatitis affect the liver. They may cause similar symptoms, but each type is transmitted differently and produces different outcomes.
Hepatitis A usually lasts for a short period of time. Depending on someone’s age and health, they may not have any symptoms, or they may feel sick for a few weeks or months. It is rare for hepatitis A to be serious or life-threatening. Also, individuals who contract hepatitis A develop natural immunity and can’t get the illness again.
On the other hand, hepatitis B and C can be acute or chronic. The younger you are when you contract hepatitis B, the more likely you are to develop a chronic infection, according to the Hepatitis B Foundation. Hepatitis B is the leading cause of liver cancer, while hepatitis C is the primary cause of liver transplants in Americans.
Hepatitis D, or HDV, can only occur along with hepatitis B. If someone contracts an HDV infection, it can accelerate liver damage.
Hepatitis E doesn’t produce chronic effects. This strain of the virus is usually found in areas where food and water are not sanitized. Symptoms usually go away on their own within a few weeks.
What Causes Hepatitis?
Hepatitis B, C, and D are spread through bodily fluids, including the blood. Although saliva doesn’t typically carry these strains of hepatitis, it could be contaminated with blood if you or someone else has open sores in the mouth. People can get hepatitis B, C, and D from sexual activity, sharing needles, unsafe tattoo techniques, sharing razors or toothbrushes, or being born to an infected mother.
Hepatitis A and E are transmitted when someone ingests particles of feces from an infected person or animal. Food can be contaminated if someone who is infected doesn’t wash their hands well before handling it. Seafood, in particular, can be tainted by sewage in the water. People can contract these forms of hepatitis if they eat undercooked meat from animals that have the virus.
Although some resources say that you can get hepatitis A from sexual activity, it is not transmitted through bodily fluids. However, if you are in close contact with particles of an infected person’s stool, you may be at risk.
Signs and Symptoms
The symptoms of the different types of hepatitis are similar. Surprisingly, many people don’t notice any signs. This can be dangerous if they have the chronic forms of hepatitis because the disease can cause liver damage or cancer if it goes untreated.
The symptoms of hepatitis include:
- Jaundice, a yellowing of the skin and eyes
- Pale stools
- Abdominal pain or nausea
- Dark urine
- Joint pain
Hepatitis A has an incubation period of about two to seven weeks. Therefore, someone may develop symptoms long after they’ve been exposed to the virus. Symptoms are more common in older children and adults than in younger people. Many infants and children who have had hepatitis A don’t have signs of the disease.
According to Medical News Today, hepatitis B is usually a short-term illness that produces few or no symptoms. The infection will become chronic in up to six percent of adults, however. An ongoing infection can lead to liver cancer.
The Mayo Clinic says that hepatitis C also starts out as an acute infection that produces few symptoms. Up to 50 percent of individuals can combat the disease before it becomes chronic.
With hepatitis B and C, symptoms of chronic infection usually occur because the liver has become damaged enough to produce noticeable signs of the disease. In addition to the symptoms listed above, people with chronic hepatitis B or C may:
- Bruise easily
- Bleed easily
- Lose their appetite
- Have itchy skin
- Experience swelling in the legs
- Lose weight
- Feel confused or drowsy
- Have slurred speech
- Develop spider angiomas
Treatment options for the different types of hepatitis vary. If you have an acute infection and don’t have any symptoms, you will likely require no treatment. Those who experience symptoms should treat acute illnesses with rest, proper nutrition, and plenty of fluids.
There is a vaccine for hepatitis A. If you have never been vaccinated and know that you have been exposed, you may want to get the vaccine.
Suspected exposure for hepatitis B may also be treated with a post-exposure prophylaxis protocol involving administering the HBV vaccine. This will not cure the disease if you’ve been infected, but it may prevent the condition from becoming chronic or serious.
According to the Liver Foundation, treatment for acute hepatitis C depends on how severe the infection and liver damage are. Although a vaccination for hepatitis C is not available, you may be offered antiviral medications to clear the virus from your body, slow liver damage and reduce the chances of developing cancer.
Some of the drugs that are used to treat hepatitis C include:
- Pegylated interferon, or Peg-IFN
- Ribavirin, or RBV
- Daclatasvir, or Daklinza
- Elbasvir and grazoprevir, or Zepatier
- Glecaprevir and pibrentasvir, or Mavyret
- Ledipasvir and sofosbuvir, or Harvoni
- Ombitasvir, paritaprevir and ritonavir, or Technivie
- Ombitasvir, paritaprevir and ritonavir with dasabuvir, or Viekira Pak
WebMD says that Peg-IFN and RBV boost your immunity but don’t target the virus itself. The other medications are newer options that attack the virus. Some of them cannot be used if you have scarring of the liver. They have different side effects, and people with hepatitis should work with their physicians to determine which drug is appropriate.
Those with chronic hepatitis B and C may undergo regular monitoring to check for liver problems. They may also want to avoid consuming things that can damage the liver, including acetaminophen and alcohol.
Genotyping appears to be the way of the future for successful hepatitis C treatment. Physicians have known for a while that different genotypes of the hepatitis C virus (HCV) respond in different ways to various treatments. Healthline explains that a combination therapy that includes a protease inhibitor, NS5B polymerase inhibitor, and NS5A inhibitor offers patients the best chance at clearing HCV from their bodies. Medical researchers are working on drugs that target different genotypes for the HCV protease, polymerase, and NS5A inhibitors.
Scientists are researching whether combination drug therapy with ribavirin could clear hepatitis C infection in people with specific genotypes. This is similar to the successful way that HIV infection is treated. In a study conducted by Japanese researchers, patients had their viruses genotyped before initiating treatment. A total of 98 patients with genotype 2a were given a 16-week treatment of ombitasvir/paritaprevir/ritonavir and ribavirin. The treatment was 97.9 percent effective at clearing the virus from their bodies.
Another treatment method currently being studied by scientists is combination drug therapy for 12 to 16 weeks followed by an extended period of interferon-a monotherapy. Scientists at the Stanford University Medical Center found a 15 to 30 percent improvement in the cure rate of patients who continue the interferon-a monotherapy for a period of 12 to 18 months.
According to a research study published in BioMed Central, researchers are also looking into internal ribosome entry site (HCV IRES) inhibitors. Scientists are looking at whether the internal ribosome entry site inhibitors could be combined with interferon and new immune system modulators in order to help patients with resistant strains of HCV to clear the viruses from their bodies.
The future of hepatitis B treatment involves the development of new classes of drugs. According to the American Association for the Study of Liver Diseases, there are just two classes of drugs that work against hepatitis B virus infection. There are several generations of those drug classes, with the newest drugs offering higher efficacy and fewer side effects. Adding a third class of drugs to halt viral entry or replication could help more people clear their hepatitis B infections. Studies in small groups of patients found that sequential treatment of the drugs had a slightly higher rate of success at losing the positive HBsAg, which is a marker of chronic infection of hepatitis B virus, compared to initiating two anti-viral drugs simultaneously.