Hepatitis or inflammation of the liver, when caused by viruses is called Viral Hepatitis. It is one of the major reasons for the development of Jaundice, Cirrhosis, and other liver-related complications including Liver Cancer.
Hepatitis viruses are broadly classified into two categories based on the way they are transmitted. Faeco-orally transmitted viruses are Hepatitis A and E viruses and they are transmitted via unhygienic food or water. Parenterally transmitted viruses are Hepatitis B, C, and D viruses and are transmitted via blood and blood products, needle sharing practices among injection drug abusers, and unsafe sexual activities.
A person, when infected with the Hepatitis virus, may not have any symptoms. Some may develop symptoms of Acute Hepatitis that are fever, lack of hunger, vomiting, and jaundice. Acute Symptomatic Hepatitis is usually caused by Hepatitis A, E, and B and very rarely by Hepatitis C. On the other hand, Hepatitis B and C may cause Chronic Hepatitis. The problem with Chronic Hepatitis is that it often goes undiagnosed since it may not cause symptoms or may cause mild symptoms like fatigue and vague abdominal discomfort. Chronic Hepatitis may progress to Liver Cirrhosis and subsequently Liver Failure. The patient then develops jaundice, body swelling, blood vomiting, etc. By this time, the liver damage is fairly advanced and difficult to manage.
Treatment depends on the type of Hepatitis – Acute or Chronic. In acute hepatitis, management is mostly symptomatic and supportive. It resolves completely in most of the patients but very few may develop acute liver failure and require a liver transplant.
The timely diagnosis of Chronic Hepatitis in the early stages of liver damage is very important. We now have very effective drugs that can cure Hepatitis C completely. Although, the currently available drugs for Hepatitis B usually are not curative but are highly effective in halting liver damage progression and prevent the development of Liver Cancer.
Once the patient is diagnosed in the cirrhosis stage, management is centered around managing complications and the patient eventually may need a liver transplant.
Prevention strategies are simple, consumption of hygienic food and drink and hand washing for faeco-oral viruses. For parenterally transmitted viruses, avoidance of unsafe sexual activities, use of condoms, avoidance of needle sharing are needed. We have a very effective vaccine for Hepatitis B which is also a part of the government universal immunization program. Hepatitis A vaccine is also available and highly effective. A vaccine was under development for Hepatitis E but is not available commercially and we don’t have a vaccine for Hepatitis C so far.
World Hepatitis Day is observed every year on 28th July to raise awareness about Hepatitis. In 2020, the theme is ‘Find the Missing Millions’ which underlines the fact that worldwide 290 million people are living with Hepatitis unaware. You can also join the fight against Hepatitis by spreading awareness among your peers.
Dr. Manik Lal Thakur, Consultant – Gastroenterology – Medical, Narayana Multispeciality Hospital, Jessore Road, Kolkata