Hepatitis – Causes, Types & Treatment | Science & Technology for UPSC CSE PDF Download

Hepatitis

• Hepatitis is characterized by inflammation in the liver, affecting various metabolic processes such as bile production, fat and protein metabolism, enzyme activation, and protein synthesis.
• While viral infections are a common cause of hepatitis, there are other potential factors behind the condition. These include autoimmune hepatitis, as the body produces antibodies against its liver tissue, as well as drug-induced hepatitis resulting from medications, substances, toxins, or alcohol.
• Autoimmune hepatitis can manifest as either acute, presenting with symptoms like jaundice, fever, and vomiting, or chronic, with inflammation lasting over six months but often remaining asymptomatic.
• World Hepatitis Day, observed on July 28th each year, aims to raise awareness about viral hepatitis.

Causes

• Hepatitis is typically attributed to a set of viruses referred to as "hepatotropic" viruses, which primarily target the liver. These include hepatitis A, B, C, D, and E. Additionally, certain other viruses can lead to hepatitis, such as the varicella virus responsible for chickenpox. Even SARS-CoV-2, the virus responsible for Covid-19, may result in liver damage.
• Other contributing factors encompass drug usage, alcohol abuse, accumulation of fat in the liver (fatty liver hepatitis), or an autoimmune response where a person's immune system produces antibodies that attack the liver (autoimmune hepatitis).

Types of Viral Hepatitis

Various types of viral hepatitis are classified based on the specific virus responsible for the infection. These types include hepatitis A, B, C, D, and E.

Hepatitis A

• Caused by the Hepatitis A virus.
• An acute, short-term disease.
• Symptoms may include vomiting, nausea, fever, severe abdominal pain, jaundice, and weakness.
• Typically transmitted through contaminated food, water, or close contact with an infected person.
• Can be prevented with a Hepatitis A vaccine.

Hepatitis B

• Caused by the Hepatitis B virus.
• Can be acute or chronic.
• Transmission occurs through contact with infected blood, saliva, or bodily fluids.
• Symptoms may include abdominal pain, fatigue, and jaundice.
• Preventable with a Hepatitis B vaccine.

Hepatitis C

• Caused by the Hepatitis C virus.
• Typically becomes chronic.
• Transmitted through infected needles, during birth (from mother to child), or contact with bodily fluids.
• Symptoms may include loss of appetite, fatigue, fever, jaundice, joint pain, and abdominal pain.
• No vaccine is currently available for Hepatitis C.

Hepatitis D

• Caused by the Hepatitis D virus (HDV).
• Occurs in conjunction with Hepatitis B infection.
• Transmission through infected blood or wounds.
• A severe liver disease.

Hepatitis E

• Caused by the hepatitis E virus (HEV).
• Typically spread through contaminated food, water, or blood.
• More common in areas with poor sanitation.
• Can be either acute or chronic.

Complications of hepatitis

Chronic hepatitis B or C infections can lead to various complications, primarily affecting the liver. These complications may include:

• Chronic Liver Disease: Persistent inflammation of the liver due to the viral infection can lead to chronic liver disease.
• Cirrhosis: Over time, chronic hepatitis B or C can cause liver tissue to be replaced by scar tissue (fibrosis), eventually leading to cirrhosis, which is advanced scarring of the liver. Cirrhosis can severely impair liver function.
• Liver Cancer: People with chronic hepatitis B or C are at an increased risk of developing liver cancer, known as hepatocellular carcinoma.

Liver failure can result from these complications, leading to additional health problems:

• Bleeding Disorders: Liver dysfunction can lead to impaired blood clotting, causing bleeding disorders.
• Ascites: Cirrhosis can lead to the accumulation of fluid in the abdomen, a condition called ascites.
• Portal Hypertension: Increased pressure in the portal veins entering the liver, known as portal hypertension, can result from cirrhosis.
• Kidney Failure: Liver failure can lead to kidney dysfunction and failure.
• Hepatic Encephalopathy: The buildup of toxins, such as ammonia, due to impaired liver function can affect brain function, causing symptoms like fatigue, memory loss, and diminished mental abilities.
• Hepatocellular Carcinoma: This is a form of liver cancer that can develop in individuals with chronic hepatitis B or C.
• Death: Severe complications of chronic hepatitis, including liver failure and liver cancer, can be life-threatening.

Global Scenario

• Hepatitis B and C together are the most common cause of deaths, with 1.3 million lives lost each year.
• In 2016, 194 governments across the globe adopted WHO’s global strategy which aims at eliminating viral hepatitis by 2030.

Indian Scenario

• 40 million people are chronically infected with Hepatitis B virus and 6 to 12 million with Hepatitis C virus.
• In 2018, the government launched the National Viral Hepatitis Program. The program is the largest program for Hepatitis B and C diagnosis and treatment in the world.
  • Hepatitis B is included under India’s Universal Immunization Programme (UIP) which provides free of cost vaccination against eleven (excluding Hepatitis B) vaccine-preventable diseases i.e. Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Pneumonia, and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhea.