All About Hepatitis

Broadly speaking, two types of hepatitis can be differentiated, depending on the time of infection. On the one hand, there is acute hepatitis and, on the other, chronic hepatitis.

Hepatitis is an inflammatory disease that affects the liver, the organ responsible for secreting bile, synthesizing proteins, storing vitamins, and detoxifying the body, among other important functions. It’s considered a sexually transmitted disease.

Causes of hepatitis

This disease can be triggered by two factors: by a viral infection or by the action of toxic agents.

Regarding viral infections, there are specific viruses that cause hepatitis, such as A, B, C, D, E, F, and G. However, the most important are A, B, and C, and, to a lesser extent, D and E, with F and G being the least studied.

In addition to these, there are other non-specific viruses that can also cause this disease. This is the case with the Epstein-Barr virus and cytomegalovirus.

On the other hand, as we have said, there are other factors responsible for the development of the infection in the liver . First of all, alcohol and other toxins are very harmful agents for this organ, which is why they become the main toxic agents.

The causes derived from the abusive use or overdose of medications, such as paracetamol, are also frequent. In turn, some hereditary pathologies, including Wilson’s disease, cystic fibrosis, or hemochromatosis, are other factors that affect the appearance of hepatitis.

All about hepatitis: the different types

Broadly speaking, two types of hepatitis can be differentiated, depending on the time of infection. On the one hand, we have acute hepatitis and, on the other, chronic hepatitis.

An acute infection, with proper treatment, can disappear. This isn’t the case with chronic hepatitis, which, as the name suggests, has no cure. This hepatitis can develop into liver failure, liver cancer, or cirrhosis.

They can also be classified according to the virus causing the infection. In this sense, we’ll talk about the following types of hepatitis:

Hepatitis A

This is produced by the hepatitis A virus and is transmitted by contact with the stools of another patient, by lack of hygiene at home, or by consuming contaminated and poorly washed food.

In more developed countries, this disease mainly affects isolated cases of individuals. Although today there are vaccines that can prevent it, environmental sanitation conditions and hygiene standards inside the home are the most effective ways to prevent its development.

It produces a benign and self-limited disease, that is, it only affects the liver . It occurs with diarrhea, stomach pain, loss of appetite, nausea, tiredness, and fever.

Hepatitis B

This is caused by a DNA virus that manages to replicate itself thanks to the DNA polymerase enzyme with reverse transcriptase activity. It’s transmitted through the blood or sexually from a patient with the active disease or a healthy carrier with the HBV virus. It can develop as an acute or chronic infection, with the complications already mentioned in the case of chronic hepatitis.

Unlike the previous one, the B virus multiplies in the liver but can also be present outside it, so hepatitis B is not self-limited. Infected people may feel like they have the flu or have no symptoms.

A blood test can determine the presence of the virus. Currently, there’s already a vaccine for its prevention. However, the practice of safe sex is essential to prevent its transmission.

Regarding treatment, acute hepatitis B virus isn’t treated. Its evolution is only followed to avoid complications and assess its possible chronification.

As for the chronic type, it’s always treated under the supervision of a specialist. This may indicate the administration of antiviral drugs such as:

• Alpha interferon
• Lamivudine
• Adefovir-dipivoxil
• Entecavir
• Combinations of the above

Hepatitis C

This is produced by infection with the C virus. Like the previous one, it’s transmitted through contact with the blood of an infected person, either in the active stage or carrying the virus. Chronic hepatitis C also leads to cirrhosis, liver cancer, liver failure, and ultimately death.

It’s an RNA virus, so, in order to detect it, a laboratory technique called PCR must be carried out. For the diagnosis, as in other types of hepatitis, the doctor relies on the levels of transaminases, which are enzymes that are released into the blood after cell death caused by inflammation of the liver.

This rise in levels can be very serious in acute hepatitis, and is mild or moderate in chronic hepatitis. From there, the diagnosis is completed with other analytical tests that, in addition, will help determine the cause and its prognosis. For the definitive diagnosis, a biopsy of the affected organ must be carried out.

Finally, treatment is based on the administration of antiviral drugs. The treatment of choice is the combination of interferon alfa and ribavirin. Currently, a new formulation of interferon alpha is used: pegylated interferon alpha.

Hepatitis D

The hepatitis D virus is a defective, or viroid, virus that requires the hepatitis B virus to exist. It’s found in all people who are infected with the virus. It’s the only viroid that’s capable of affecting more than just plants. It’s transmitted parenterally.

Two types of infection can occur together with HBV:

• Coinfection: This occurs when the infection is acquired by both viruses at the same time. The chronicity of the disease appears in 5% of cases.
• Superinfection: This occurs when the patient becomes infected with HDV and was already infected with HBV. The infection progresses to chronic in 80% of cases.

Hepatitis E, F, and G

HEV is transmitted in a similar way to hepatitis A and is spread through contaminated water. As for the F and G, they’re the least known; F is even considered as G. The latter is believed to be transmitted through the blood, especially in people who use intravenous drugs.

HGV has a similar homology to the hepatitis C virus. It’s diagnosed by detecting viral RNA in serum. Despite its name, there’s no clear evidence that this virus causes liver disease. It hasn’t been associated with chronic hepatitis, cirrhosis, or liver cancer.

Drug-induced hepatitis

As we have mentioned, this disease can also develop due to the toxicity of certain agents that are harmful to the organ. Some of them are alcohol and certain medications.

A well-known type of poisoning is the hepatic toxicity of paracetamol. When a person overdoses on this drug, they can develop severe hepatitis that has the potential to progress to fatal liver failure.

This intoxication occurs because the drug’s metabolic pathways become saturated and the body is unable to neutralize a compound derived from paracetamol, which is highly toxic to the liver.

The metabolization of a drug consists of a series of chemical reactions that the drug undergoes in the body in order to promote its elimination. Therefore, if they’re saturated, in the case of paracetamol, it can’t be eliminated correctly and this disease can occur.