Hepatitis- A Review of Viral Disease
Abstract
The liver is one of the key and principal organs of the body and virus of hepatitis potentially develops an inflammation of the liver due to an increase in particular enzymes. There are many types of hepatitis, but the commonly known virus is hepatitis A, B and C. Hepatitis has a long history since the time immemorial due to inadequate sanitary conditions. The infection of hepatitis A is related to picornavirus, and major symptoms include nausea, abdominal pain, fever, and anorexia. Moreover, the visitors traveling to endemic countries are at higher risk. Hepatitis B is related to ‘serum hepatitis’ and the virus comprises of circular double-stranded DNA having a single-stranded region of DNA. Hepatitis B is frequently spread due to perinatal transmission, unprotected sexual activities, exposure to infected blood as well as various body fluids including menstrual and vaginal fluids. Moreover, the transmission of hepatitis B and C virus may happen through the reuse of syringes and needles, infected razors as well as during dental and surgical treatment. The interferon-alpha and lamivudine are commonly employed medicine to treat Hepatitis B. The virus of Hepatitis C belongs to flavivirus family that may result in an acute and chronic infection and remain unrecognized for an extended period. The chronic hepatitis C may result in liver cirrhosis and liver cancer. The polymerase chain response test is imperative to determine the quantity of viral RNA in the blood. Moreover, interferon and ribavirin therapy is frequently in practice along with direct antiviral agents (DAA), but it is expensive.
Hepatitis- A Review of Viral Disease
Introduction
Hepatitis also known as ‘jaundice’ is a chronic disease that potentially affect the liver. Hepatitis has a long history because it is discussed by Hippocrates in the Babylonian Talmud of the fifth century and the Bible with a term ‘yerakon’ (meant greenish) and pallor of people respectively. The term yerakon is analogous to disease presently known as jaundice. Moreover, Pope Zacharias was the first person who declared it communicable disease during the period of 8th century. It has become epidemic with the increase in the populace in the cities of European during the period of 17th to 19th century. This disease was also reported as widespread in many wars like smallpox and influenza among overcrowding troops due to inadequate sanitary conditions (Taylor, 2014).
Hepatitis usually develops an inflammation of the liver due to an increase of particular enzymes. In fact, the infections of the liver are caused by the virus and it appears in many forms such as hepatitis A, B, C, D and E. Among these types, the most frequently known virus is Hepatitis A, B, and C. Moreover, the development of yellowish color of skin and eyes, fatigue, vomiting, and nausea are frequently observed symptoms prevailing in all types of hepatitis. Undeniably, liver is one of the most important organs of the body which perform the functions including filtration of the blood, facilitates in the processing of nutrients as well as help in fighting against different infections (Taylor, 2014). Consequently, the inflamed liver leads to disorder of various functions that are important for good health. Hence, this paper delineates the causes, symptoms and potential treatments of Hepatitis A, B, and C.
Hepatitis A
Hepatitis A is a viral infection which is self-restricting and might last in a couple of weeks or few months. The infection is a picornavirus which belongs to the same family as polio and different enteroviruses.
The symptoms of hepatitis A may appear within two weeks to six months after the onset of infection and include nausea, abdominal pain, fever and anorexia (CDC, 2015). According to Godoy et al., (2016), the visitors traveling to endemic countries are at higher risk due to close contact with local folks. In addition, the major cause of its spreading is associated with oral-fecal transmission. Hepatitis A persisted consistently in the U.S. before the advent of vaccination in 1996. Subsequently, the number of patients suffered from Hepatitis A has reduced extensively and it is no more considered a danger in the U.S and Western Europe. Unlikely, hepatitis A disease still persists frequently in South America, Africa and some regions of Asia. The developed vaccine for Hepatitis A was initially utilized incrementally in 1996 for kids living in densely populated communities with the most astounding rates of infection. There are various distinctive and accessible immunizations including a weakened and dead virus. Despite the fact that hepatitis A will be a picornavirus having a non-enveloped viral structure, a few samples collected from the blood of the patients have a membranous cover around them which might be a mechanism utilized by the virus eluding neutralization by antibodies.
Hepatitis B
Hepatitis B also known as ‘serum hepatitis' in the past was discovered accidently. Dr. Baruch Blumberg, who was honored by the noble prize, collected the sample during his extensive traveling during the period of 1950's and analyzed serum proteins. He discovered an antigen that reacted with antibodies present in patients suffering from leukemia, and it was termed as ‘Australia antigen.' He reported that Australian antigen might be a virus related to serum hepatitis. Later on, it was studied and characterized by many researchers and reported hepatitis B surface antigen abbreviated HBsAg as an indicator. The virus of hepatitis B comprises of circular double-stranded DNA having a single-stranded region of DNA. Moreover, its virus possesses such enzymes having the ability to converts RNA to DNA.
The hepatitis B virus can make its route outside the body for no less than seven days. During this period, the virus can potentially cause infection by entering the body of an individual who is not vaccinated. In exceptionally endemic territories, hepatitis B is most usually spread from the mother during childbirth/perinatal transmission, or by exposing to infected blood. The advancement of infection frequently develops in babies from their infected mothers before the age of 5 years. Hepatitis B is likewise spread by mucosal presentation to infected blood, numerous body fluids, menstrual as well as vaginal fluids and so forth. Sexual transmission of hepatitis B might happen in unvaccinated men who have intercourse with men and hetero persons with numerous sex accomplices or contact with professional sex partners (Koff, 2002). Moreover, the transmission of the infection might likewise happen through the reuse of syringes and needles used by the persons who infuse drugs as well as during dental and surgical treatment, using infected razors and so forth (WHO, 2015a).
The interferon-alpha was the first medicine employed to treat Hepatitis B. A decrease in viral antigen was observed after interferon therapy of six-month with a response rate of about 30%. This therapy is costly and associated with side effects such as nausea, flu-like symptoms, fatigue, and depression. Nevertheless, apart from these side effects, hepatitis B virus is eliminated from the human body and restrict the development of liver cancer. Later on, many effective drugs were developed for the treatment of hepatitis B such as Lamivudine (20, 30-dideoxy-30-thiacytidine) and Hepsera. Beside effectiveness of Hepsera, it is prohibited by FDA due to it toxic effect on the kidney (Taylor, 2014).
Hepatitis C
The virus of Hepatitis C belongs to flavivirus family and disease may progress into an acute and chronic infection. It develops slowly and continue to remain unrecognized for a prolonged period before the growth of apparent symptoms. It is also associated with increased liver enzymes that make hepatitis C as one of the prominent causes for cirrhosis of the liver as well as liver cancer (Lazarus et al., 2014; Taylor, 2014). According to Taylor (2014), WHO reported that about 15–45% of infected people may recover without treatment within a period of 6 months. On another hand, 55–85% of the infected people may experience chronic HCV infection and resulted in liver cirrhosis within a period of 20 years. Although hepatitis C is persisting globally, many regions of Asia and Africa are more prone to be infected with its virus. WHO reported that there are about 170 million people infected with chronic hepatitis C on the globe and approximately 350 thousands of the people die in each year (Mehta et al., 2013).
The development of yellowish color skin and eyes may also appear among the infected persons that is common symptoms in all kinds of hepatitis as aforementioned. The appeared symptoms at chronic phase may include fatigue, joint pain, dark colored urine, muscular pains as well as swelling of legs, feet and belly and so forth. In addition, chronic infection may result in bleeding from veins of the digestive tract that is known as variceal bleeding. Furthermore, nervous system and brain may be damaged (encephalopathy) that develop symptoms like the issue of memory and confusion or lack in the concentration of mind (CDC, 2015).
The virus of hepatitis C mostly transmitted by injecting drug using shared injecting equipment, reuse or non-sterilized medical equipment such as needles and syringes and transfusion of unscreened blood. Moreover, hepatitis C virus can be transmitted from mothers to their babies and sexual activities, but the frequency of these modes of transmission is low. It is imperative to consider that it is not transmitted through food, water, breast milk and casual contacts like kissing or hugging (CDC, 2015; WHO, 2015b).
There are many steps involved in examination and identification of this virus. Introductory testing for the vicinity of antibodies in the blood demonstrates whether an individual has been retaining the infection. A second test is polymerase chain response abbreviated as PCR that measures the quantity of duplicates of viral RNA in the blood. During this phase of infection, the virus may exceed to109 particles for each ml of blood. A third test is done to investigate the strain of hepatitis C in order to anticipate treatment reaction (CDC, 2015; WHO, 2015b).
According to CDC (2015), the methodology and standards set for recovery from hepatitis C are kept on changing depending on circumstances. Interferon and ribavirin therapy is most commonly in practice involved weekly injections that need to be continued for 48 weeks. Presently, many drugs have been developed that are safe and need short period for treatment. Among these drugs, direct antiviral agents (DAA) is very effective and period of therapy is generally 12 weeks. Unlikely, DDAs is very costly and not available in most of the countries.
Conclusion
In conclusion, hepatitis A, B and C are the frequently known types of this viral disease and development of yellowish color of skin and eyes, fatigue, vomiting, and nausea are few common symptoms in all types of infections. Many treatment methods and vaccines such as interferon-alpha as well as interferon and ribavirin therapy have been developed to treat hepatitis B and C respectively. The transmission of the virus of hepatitis B and C mostly occur by injecting drug using shared injecting equipment, reuse or non-sterilized medical equipment such as needles and syringes and transfusion of unscreened blood. Moreover, unprotected sexual activities of unvaccinated people is one leading causes of transmission particularly in the case of hepatitis B. Hence, there is a need to create awareness as well as a change in social behaviors and health care settings to avoid ill effects of hepatitis.
References
CDC. (2015). Viral Hepatitis-Division of Viral Hepatitis. Cdc.gov. Retrieved 8 March 2016, from http://www.cdc.gov/hepatitis/
Godoy, P., Broner, S., Manzanares-Laya, S., Martínez, A., Parrón, I., & Planas, C. et al. (2016). Outbreaks of hepatitis A associated with immigrants travelling to visit friends and relatives. Journal of Infection, 72(1), 112-115.
Koff, R. (2002). Review: Hepatitis A, Hepatitis B, and Combination Hepatitis Vaccines for Immunoprophylaxis: An Update. Digestive Diseases and Sciences, 47(6), 1183-1194.
Lazarus, J., Sperle, I., Maticic, M., & Wiessing, L. (2014). A systematic review of Hepatitis C virus treatment uptake among people who inject drugs in the European Region. BMC Infect Dis, 14(Suppl 6), S16.
Mehta, B., Dharma, V., Chawla, S., Jindal, H., & Bhatt, B. (2013). Hepatitis C. Human Vaccines & Immunotherapeutics, 10(2), 417-419.
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WHO. (2015a). Hepatitis B. World Health Organization. Retrieved 7 March 2016, from http://www.who.int/mediacentre/factsheets/fs204/en/
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