Inflammation of liver is known as Hepatitis. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Viruses are the most common cause of hepatitis. Types of viral hepatitis There are 5 main hepatitis viruses. While all of them cause hepatitis, they differ in essential ways. Hepatitis A virus (HAV) is present in the feces of infected persons and is transmitted through consumption of contaminated water or food. Infection is mild, with most people making a full recovery and remaining immune from further HAV infections. The outbreak occurs in areas of poor sanitation. Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth. Hepatitis C virus (HCV) is transmitted through exposure to infective blood. The type B and C lead to chronic disease and together, are the most common cause of liver cirrhosis and cancer. Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection. Hepatitis E virus (HEV) is transmitted through consumption of contaminated water or food. Treatment
Some types and cases of hepatitis can heal without intervention, but sometimes it can progress to scarring of the liver, or cirrhosis. HAV & HEV There is no specific treatment for HAV and HEV. The doctor will advise the patient to abstain from alcohol and drugs during the recovery. Most patients will recover without intervention. HBV Anyone who is not vaccinated and exposed to another individual’s potentially infected blood or body fluid can undergo a post-exposure “prophylaxis” protocol. This consists of HBV vaccination and hepatitis B immunoglobulin given after the exposure and before an acute infection develops. This protocol will not cure an infection that has occurred, but it decreases the rate of acute infection. A person with chronic HBV infection needs blood tests and ultrasound of the liver every 6 months to monitor for liver damage and activity of virus. Antiviral drugs like lamivudine (LAM), adefovir dipivoxil (ADV), entecavir (ETV), and telbivudine (TBV) stop the virus from replicating and prevent progression of the disease. These drugs need to be taken long-term to prevent the risk of recurrence. Pegylated interferons (PEG-IFN) modify the patient’s immune response to the virus. HCV A patient with hepatitis C will be prescribed antiviral agents, with or without ribavirin. Some directed antivirals and combination therapies are now available to treat the hepatitis C virus based on its subtype. These treatments target viral replication and prevent the virus from being able to reproduce. These drugs include Ledipasvir-sofosbuvir (Harvoni), Ombitasvir-paritaprevir-dasabuvir-ritonavir (Viekira Pak), Simeprevir (Olysio), and Sofosbuvir (Sovaldi) HDV Hepatitis D has no cure and the treatment involves only supportive measures.