Viral Hepatitis

Posted by Winnie Melda on October 19th, 2018

Introduction

Hepatitis is the inflammation of the liver.  The inflammation may result from various causes both infectious and noninfectious. Viruses are some of the common causes of hepatitis. Viral hepatitis accounts for approximately half of acute hepatitis in the United States. The most common viral hepatitis includes hepatitis A, B and C. HBV and HCV can result in chronic infection. Chronic infections from viral hepatitis may lead to cirrhosis and hepatocellular carcinoma. D virus and E virus are other viruses that cause hepatitis. Infections with hepatitis viruses, particularly A and B have been associated with a range of manifestations. Viral hepatitis often requires treatment to prevent the development of progressive liver damage, liver failure, cirrhosis and liver cancer.

Types of Viral Hepatitis

Hepatitis A

Hepatitis A is a result of hepatitis A virus (HAV). It is a highly contagious liver infection that leads to liver inflammation and reduces the liver's ability to function.  Individuals are more likely to contract hepatitis A from contaminated water or food. The virus may also be contacted from an infected individual.  Mild cases of do not require treatment and the larger part of the population infected have no permanent liver damage.  Good hygiene practices such as regular washing hands frequently are one of the effective ways to protect against hepatitis A.  Hepatitis A signs and symptoms include nausea and vomiting, Fatigue, Loss of appetite, Low-grade fever, Abdominal pain or discomfort, Dark urine, Clay-colored bowel movements, Joint pain and Yellowing of the skin and eyes. Hepatitis A patients may develop a mild illness lasting a few weeks or a chronic illness that may last few months.  The viral disease does not cause signs and symptoms in all patients.

The hepatitis A virus that causes the infection is spread through the ingestion of contaminated fecal matter. Inflammation is a result of infections on liver cells. The inflammation can affect the functioning of the liver and may further bring out other signs and symptoms of the viral infection. There are several ways through which Hepatitis A virus can be transmitted including contamination through food, contaminated water, raw shellfish from polluted water polluted, close contact with an infected person and through sex. The risk of Hepatitis A increases with exposure to certain environments. A person increases the risk of Hepatitis if they work or travel in regions with high rates of hepatitis A or work in a child care center. Other risk factors include oral anal contacts, HIV positive persons, clotting-factor disorders, use of illicit drugs and living with a person who has hepatitis A.

Hepatitis A does not result in long-term liver damage like other types of viral hepatitis. The infection becomes chronic in rare cases. In cases, hepatitis A can lead to sudden loss of liver function that particularly in older adults or individual with chronic liver diseases. Persons experiencing acute liver failure require hospitalization for treatment and monitoring. Acute liver failure may necessitate a liver transplant (El-Serag, 2012).   

Hepatitis B

Hepatitis B is caused by hepatitis B virus (HBV). It is spread through piercing wounds or contact with infectious body fluids including saliva, blood or semen. Having sex with an infected partner, Injection drug use, or sharing razors with infected persons raises the risk of having hepatitis B. For some, the infection may become chronic and take longer than six months. Chronic hepatitis B infection increases the risks of acquiring liver cancer or cirrhosis or liver failure.  Hepatitis B infection is fully recoverable despite its signs and symptoms being severe. Children and infants are more likely to have a chronic infection. Hepatitis B vaccine is used to prevent infections as there is no cure once it is already developed.  Signs and symptoms develop between one to four months after infection for both mild and severe hepatitis. Signs and symptoms include Weakness and fatigue, abdominal pain, Fever, Dark urine, Joint pain, Nausea and Vomiting, Loss of appetite and yellowing of the skin and eyes.

The common ways through which Hepatitis B virus is transmitted include sexual contact, accidental needle sticks, sharing of needles and mother to child. Hepatitis B may either be acute or chronic. Hence, the infections may either be short-lived or long-lasting.  Acute infection does not take longer than six months.  The immune system can clear acute hepatitis B from the body.  However, hepatitis B can cause chronic infections.  A chronic infection can last for a period of six months or longer. Hepatitis B infection may possibly lead to acute infection or serious cirrhosis or liver cancer especially when the immune system cannot fight off the acute infection. The younger an individual is, the higher the risks that the infection may become chronic. The infections may go undetected for long until a person becomes seriously ill from the liver disease. The risk of infection increases with exposure to bodily fluids or travel to regions with high infection rates (Colvin & Mitchell, 2010).

Hepatitis C

Hepatitis C infection is caused by hepatitis C virus (HCV). It is transmitted through direct contact with infected body fluids through sexual contact and injection drug use. The virus is among the most common and serious type of hepatitis in the United States.  A person’s risk of hepatitis C increases with exposure to bodily fluids of infected persons. Health workers who have been exposed to patients’ blood have higher chances of developing the viral infection. Infected needles that pierce a person’s skin may also transmit hepatitis viruses. Individuals with HIV also have a high chance of developing hepatitis infections. Tattoo or piercing using unsterile equipment or in an unclean environment also increases the risks of infection. Individuals who received an organ transplant or a blood transfusion before 1992 are also at risk of developing Hepatitis C infection. Those who received clotting factors before 1987, born to a mother with hepatitis C infections, have received hemodialysis treatments for a long time or have been in prison are also at high risk of developing hepatitis C infections.

In its earliest stages, an infected person can experience stomach pains, Yellow discoloration in the skin and eyes, fatigue, nausea, Fever, Muscle and joint pains and Dark-colored urine.  Chronic infections are often detected after years as signs and symptoms of chronic infection typically become evident after long. The long duration results in liver damage. Signs and symptoms of overtime infections may include Bruising easily, bleeding easily, Swelling of legs Itchy skin, Confusion, Weight loss, drowsiness and slurred speech, fluid accumulation in the abdomen and Spider-like blood vessels on the skin. There are various complications that are caused by Hepatitis C infections. Hepatitis C infection that continues over many years can cause serious complications, such as Liver cancer, Scarring of the liver tissue and Liver failure. The complications severely damage the liver.

Other types of viral hepatitis

Hepatitis A, B, and C are the most prevalent types of viral hepatitis. Other types of viral hepatitis include hepatitis D and E. However, others including F and G remain largely unconfirmed. Hepatitis D is also known as delta hepatitis. It is caused by Hepatitis D virus often transmitted through contact with infected blood and puncture wounds. The rare form of Hepatitis D occurs together with hepatitis B infection. Hepatitis D is not common in the United States. Hepatitis E is caused by hepatitis E virus (HEV).  It is a waterborne disease common in areas with poor sanitation. It is contracted through ingestion of fecal matter. While the viral infection is uncommon in the United States, several cases of the virus has been reported in Asia, Africa, Middle East and Central America. Similar to Hepatitis A, Hepatitis E is contracted from consuming contaminated drinking water and food.  Hepatitis B, C, and D are contracted through contaminated blood. These forms of hepatitis can be either acute or chronic. Types B and C usually become chronic (El-Serag, 2012)..

Diagnoses of viral hepatitis

A diagnosis of viral hepatitis is carried out through various ways. The first way to diagnose viral hepatitis is through physical examination. The process of physical examination involves pressing down gently on the abdomen to determine the presence of pain or tenderness. The doctor may also test to determine if the liver is enlarged during the examination. Other activities include determining a change in eyes or skin color. Yellowness of the skin or eyes is a common symptom among individuals infected with viral hepatitis.  The doctor notes any changes identified during the medical examination. The second way to diagnose viral hepatitis is through Liver Biopsy. A liver biopsy is an invasive method that allows the healthcare professional to obtain a sample of tissue from the liver. A closed procedure is conducted to obtain a sample of tissue through the skin but without necessarily requiring surgery. The test allows the practitioner to determine the presence of an inflammation of infection. It may also determine any damages that may have occurred in the liver.

The third test that can be conducted is a liver function Test. A Liver function involves the use of blood samples to determine the functioning of the organ.  The test allows the practitioner to determine if the liver is functioning efficiently. The focus of this test is on how the liver clears protein, blood waste, and enzymes. High liver enzyme levels may signal a stressed or damaged liver.  Ultrasound may also be used to test for Hepatitis infections. The test reveals liver damage, enlarged liver, and fluid in the abdomen. An abdominal ultrasound utilizes ultrasound waves to generate an image of the organs within the abdomen.  Blood tests may also reveal the presence of Hepatitis virus. A blood test detects the presence of antigens and hepatitis virus antibodies in the blood. It may also be used to confirm the type of hepatitis virus is in the blood.   Viral Antibody Testing may be used by practitioners to determine if a particular type of the hepatitis virus is present (Mohd et al., 2013).

Treatment of hepatitis

Treatment options vary with the type of hepatitis determined by tests. It may also vary with the acuteness of the infection.  Often, Hepatitis A does not involve treatment. Bed rest is recommended in the case symptoms cause serious discomfort. In the case an individual experiences vomiting or diarrhea, the practitioner may recommend a special diet to prevent dehydration and malnutrition. Vaccination may also be useful in preventing hepatitis A infections by assisting an individual’s body in producing antibodies to fight the type of infection. Individuals with acute hepatitis B do not require specific treatment. Antiviral medications may be required for patients with chronic hepatitis B. Hepatitis B treatment can be costly particularly because it must be followed for a number of months or years. Chronic hepatitis B also necessitates monitoring and regular medical evaluations to test the progression of the virus. Newborns, healthcare, and medical personnel are given hepatitis B vaccinations due to risk exposure to risk factors. 

Hepatitis C requires Antiviral medications for treatment. The medication is used for both acute and chronic forms of hepatitis C. Individuals, who develop chronic hepatitis C are usually treated with a range of antiviral medication therapies. They may also require further testing to establish the best form of treatment option.  Given that chronic hepatitis, C may lead to cirrhosis or liver disease, and a liver transplant may be carried out in Hepatitis C patients. Alpha interferon is a medication used for the treatment of Hepatitis D. Recurrence of Hepatitis D is common among patients even after undergoing treatment. Hepatitis E is generally acute in nature. There are no specific treatments used by individuals infected with Type E hepatitis.  Since the infection is often acute, it usually resolves on its own. Individuals with this type of infection are advised to drink plenty of fluids, get adequate rest, avoid alcohol and get enough nutrients (Lai & Yuen, 2013).

Prevention and control of viral hepatitis

Immune globulins are effective tools in the prevention of infection and illness before and after exposure to hepatitis viruses. Immune globulins are used as sterile solutions for human plasma.  Plasma is fundamentally obtained from paid donors. Cold ethanol fractionation contains a degree of protein and is the single plasma tested to be free of antibody to HIV and hepatitis B surface antigen virus used to prepare immune globulins. Immune globulin produced in the United States has antibodies useful in the prevention of hepatitis A virus. Hepatitis B immune globulin is a form of is an Immune globulins prepared from plasma that has high of anti-HBs. Hepatitis is highly contagious and requires various prevention mechanisms. Given that it is usually transmitted through person-to-person contact, fecal-oral route or consumption of contaminated food and water, other prevention techniques focus on the mode of transmission. Vaccines produce Antibodies in response to Hepatitis infections. These antibodies may for long protect against re-infection. Vaccination has been regarded as the best way to prevent Hepatitis virus. Hepatitis B is also vaccine preventable. There is a safe and effective vaccine to protect infants, children and adults from hepatitis B. Billions of doses have been given worldwide. All close household members, family and sex partners of a chronically infected individual should be tested and vaccinated. It is also important to reassure patients that hepatitis B cannot be casually transmitted except through the blood and bodily fluids. Additional Prevention Measures include:

  • Washing hands thoroughly after any possible exposure
  • Avoiding direct contact with bodily fluids such as blood
  • Covering wounds and all cuts
  • Avoid sharing of cutting and piercing materials such razors, toothbrushes, nail clippers, and earrings or body rings
  • Discarding sanitary materials into plastic bags
  • Avoiding donated blood or body organs where necessary.
  • Making sure that only new, sterile needles are used for tattoos, ear or body piercing and acupuncture
  • Practicing safe sex with partners
  • Cleaning up blood spills with a concentrated solution
  • Avoiding drug use (Davis et al., 2010).

Conclusion

Hepatitis is the inflammation of the liver that results from various causes both infectious and noninfectious. The most common viral hepatitis includes hepatitis A, B and C. Hepatitis A, B and C are the most prevalent types of viral hepatitis. Other types of viral hepatitis include hepatitis D and E. However, others including F and G remain largely unconfirmed. Hepatitis A signs and symptoms include nausea and vomiting, Fatigue, Loss of appetite, Low grade fever, Abdominal pain or discomfort, Dark urine, Clay-colored bowel movements, Joint pain and Yellowing of the skin and eyes. Hepatitis A patients may develop a mild illness lasting a few weeks or a chronic illness that may last few months.  The viral disease does not cause signs and symptoms in all patients. The hepatitis virus that causes the infection is spread through the ingestion of contaminated fecal matter. Inflammation is a result of infections on liver cells. The inflammation can affect the functioning of the liver and may further bring out other signs and symptoms of the viral infection. There are various complications that are caused by Hepatitis infections. Hepatitis infection that continues over many years can cause serious complications, such as Liver cancer, Scarring of the liver tissue and Liver failure. The complications severely damage the liver. Immune globulins are effective tools in the prevention of infection and illness before and after exposure to hepatitis viruses.

References

Colvin, H. M., & Mitchell, A. E. (2010). Hepatitis and liver cancer: a national strategy for prevention and control of hepatitis B and C. National Academies Press.

Davis, G. L., Alter, M. J., El–Serag, H., Poynard, T., & Jennings, L. W. (2010). Hepatitis C virus in the United States: a multiple cohort models of HCV prevalence and disease progression. Gastroenterology, 138(2), 513-521.

El-Serag, H. B. (2012). Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology, 142(6), 1264-1273.

El-Serag, H. B. (2012). Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology, 142(6), 1264-1273.

Lai, C. L., & Yuen, M. F. (2013). Prevention of hepatitis B virus–related hepatocellular carcinoma with antiviral therapy. Hepatology, 57(1), 399-408.

Mohd Hanafiah, K., Groeger, J., Flaxman, A. D., & Wiersma, S. T. (2013). Global epidemiology of hepatitis C virus infection: New estimates of age‐specific antibody to HCV seroprevalence. Hepatology, 57(4), 1333-1342.

Sherry Roberts is the author of this paper. A senior editor at Melda Research in nursing writing services if you need a similar paper you can place your order for Customized Research Papers.

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Winnie Melda

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Winnie Melda
Joined: December 7th, 2017
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