Pathophysiology, transmission, and treatment of viral hepatitis A, B, and C

¶ … hepatitis of the liver and how they are transmitted to how we can find a remedy to slow down the deterioration process if not cure it completely.

Hepatitis

Hepatitis A

Hepatitis B

Causes of hepatitis B

Transmission of hepatitis B

Symptoms

Tests for hepatitis B

Self-protection

Hepatitis C

Risk Factors for HCV Infection

Consequences of HCV Infection

Diagnosis

Hepatitis is the disease connected with the inflammation of the liver. This disease was not discovered too long ago, however doctors and researchers have been able to find out the causes of hepatitis. There are several causes such as, viral, parasitic, infiltrative, drug or alcohol induced, or non-specific. Before a person is even diagnosed with this disease some of the prominent indications of the acute phase can be ranging from a symptomatic, where we may not even be able to notice we have hepatitis to feeling extremely tired, jaundice- where our skin or our eyes become yellow, nausea, vomiting, or even diarrhea.

When the concerned patients undergo proper laboratory tests and they are monitored, one of the first things the doctor will tell you is that there is definitely an increase in the level of the liver enzymes.

Before dive into what hepatitis is all about it is important to understand that this paper is contains information about the pathophysiology, its causes and also the various treatments available commercially or if they are under clinical trials for viral hepatitis A, B, and C, and drug/alcohol induced hepatitis.

Hepatitis A

Hepatitis A also abbreviated as 'HAV' is transmitted mainly through oral-fecal contact. This form of acute HAV persists for a shorter time period anywhere from 4-6 weeks and this could be with or without the basic symptoms of jaundice, fatigue and hepatomeglia. However, this can have extreme affects on those individuals who are suffering from this acute phase and also infected with human deficiency syndrome (HIV). The overall affect is to lower the number of T-cell counts that will recover in 6 to12 weeks after being diagnosed with the acute infection. With proper care and medication, the body can recover from HAV within 6 weeks but it can take up to several months to recover from acute HAV. [Hepatitis A-B-C]

Doctors advise that the best form of treatment for HAV is through ample bed-rest, good intake of water coupled with a good diet for quick and speedy recovery so that it doesn't relapse. Also patients are advised to discontinue drug therapy until the acute phase is completed, once it is completed therapies can be restarted. [Hepatitis A-B-C]

Recently, a new vaccination for HAV was distributed in pharmacies for those who are affected with the disease. This is a form of measure that is considered as preventive therapy for those patients suffering with chronic terminal infections, such as, HIV infection. Research shows that this vaccination can also shield patients from potential infections who may be suffering from HIV. In the West, some insurance companies, health care facilities or studies are offering the vaccination free of cost to patients. [Hepatitis A-B-C]

Hepatitis A has a worldwide distribution occurring in both epidemic and sporadic fashions. About 22,700 cases of hepatitis A representing 38% of all hepatitis cases (5-year average from all routes of transmission) are reported annually in the U.S. In 1988 an estimated 7.3% cases were food borne or waterborne. HAV is primarily transmitted by person-to-person contact through fecal contamination, but common-source epidemics from contaminated food and water also occur. Poor sanitation and crowding facilitate transmission. Outbreaks of HA are common in institutions, crowded house projects, and prisons and in military forces in adverse situations. In developing countries, the incidence of disease in adults is relatively low because of exposure to the virus in childhood. Most individuals 18 and older demonstrate an immunity that provides lifelong protection against reinfection. In the U.S., the percentage of adults with immunity increases with age (10% for those 18-19 years of age to 65% for those over 50). The increased number of susceptible individuals allows common source epidemics to evolve rapidly. [FDA/CFSAN Bad Bug Book Hepatitis A Virus]

[FDA/CFSAN Bad Bug Book Hepatitis A Virus]

Hepatitis B

Hepatitis B is also a liver disease, which causes the liver to inflammation just like hepatitis and this prevents the liver from functioning correctly. There are different cures that are being discovered and researched on everyday because it is mandatory for the liver to perform its functions accurately since a healthy liver does many things to keep a person alive. The liver has many functions but some of the most important are that it fights infections and stops bleeding, it also excretes drugs and other poisons from our blood. The liver also helps retain stored energy to make it available for our body when it needs it.

Causes of hepatitis B

The main cause of the disease hepatitis B is by a virus. A virus is defined as a germ that causes an illness. One example of an illness caused by a virus is the flu. Flue spreads between people through the virus, which is transmitted in the air. The virus that causes Hepatitis B is called the hepatitis B

Tests for hepatitis B

When a person is suspicious about having this type of hepatitis it is best to consult the doctor for the disease through a sample of your blood test. By analyzing the blood sample, the doctor can test for the presence of the disease and if it is present then to what degree is the seriousness of the disease. The other test is through a liver biopsy, whereby the doctor takes a sample of the liver through a needle and examines the piece taken for any indications and also to see if the liver has been damaged.

One of the ways of curing this disease is through regular shots of a drug called inferno. This treatment can cure people within four months. Another drug is called lamivudine; this drug is taken orally once in a day. The treatment is for almost a year. A drug called adefovir dipivoxil, is also taken orally once a day with the treatment lasting usually for one year.

If the condition worsens to such an extent where the liver stops working, the only solution then becomes surgery. The surgery is called a liver transplant, whereby the liver is transplanted by removing the old damaged one and replacing it with a new healthy liver taken from another person called a donor.

Self-protection

The best way to protect oneself is through the hepatitis B vaccination. This vaccine is a drug that keeps a person away from contracting this illness by keeping our immune system active towards this disease. This vaccination is given to a person in three installments of one shot each in a period of six months. Infants are given this shot 12 hours after their birth, the second shot is given at an age of one and two months, while the third shot is given between the ages of 6 and 18 months. [What I need to know about Hepatitis B]

Hepatitis C

HCV was discovered in 1989 by researchers at Chiron, Inc. They took parts of the HCV genome and secluded that portion by screening cDNA expression libraries made from RNA and DNA in chimpanzees infected with serum from a patient with post-transfusion non-A, non-B hepatitis. They called the new virus hepatitis C virus.

HCV is a positive, single-stranded RNA virus in the Flaviviridae family. The genome is approximately 10,000 nucleotides and encodes a single polyprotein of about 3,000 amino acids. Host cell and viral proteases into three major structural proteins and several non-structural proteins necessary for viral replication process the polyprotein. Several different genotypes of HCV with slightly different genomic sequences have since been identified that correlate with differences in response to treatment with interferon alpha. [Hepatitis C by Howard J. Worman, M.D.]

The productions of drugs for curing HCV have not been produced however, using excellent diagnostic methods we can examine this type.

Risk Factors for HCV Infection

Approximately 170,000,000 people worldwide and 4,000,000 in the United States are infected with HCV. Primarily blood and blood products transmit the virus. The majorities of infected individuals have either received blood transfusions prior to 1990 (when screening of the blood supply for HCV was implemented) or have used intravenous drugs. Sexual transmission between monogamous couples is rare but HCV infection is more common in sexually promiscuous individuals. Perinatal transmission from mother to fetus or infant is also relatively low but possible (less than 10%). Many individuals infected with HCV have no obvious risk factors. Most of these persons have probably been inadvertently exposed to contaminated blood or blood products. [Hepatitis C by Howard J. Worman, M.D.]

Consequences of HCV Infection

Studies indicate that nearly 85% of individuals who are acutely infected with HCV end up as chronically infected patients. HCV is the main cause of chronic hepatitis. The drawback of this phase is that once a person is chronically infected, the virus is in the person till the person dies. This is because in many cases, HCV infection causes clinically acute disease that leads to the malfunctioning of the liver; the problem lies in the fact that the acute infection is undetectable in the early phases.

The history of chronic HCV infections in individuals varies between individuals, since some show hardly any signs of the disease to very low liver disease so they never get into the complicated stage at all. However, in some other cases there are signs of chronic hepatitis. They develop all the signs of the disease and end up developing cirrhosis. Nearly 20% of individuals with hepatitis C who develop cirrhosis end up with the last-stage of the liver disease. Cirrhosis caused by hepatitis C is currently the man cause for orthotopic liver transplantation in the United States. People who develop with cirrhosis from hepatitis C have higher chances of developing hepatocelluar carcinoma, this is type of liver cancer.

Of the major problems doctors' face in discussing diagnosis in patients with chronic hepatitis C is the difficulty in finding those who have a benign course and who have the chances of developing cirrhosis or cancer. It is observed that persistent alcohol abuse can lead to cirrhosis.

Diagnosis

History, serological testing and liver biopsy can diagnose chronic hepatitis C Examinations indicate that most patients with chronic hepatitis C will be a symptomatic or show signs such as, fatigue. In some cases, the diagnosis will be done from the results of blood tests.

Individuals suspected of having chronic hepatitis C include:

Those with symptoms of chronic liver disease

Those with risk factors such as past or current intravenous drug use or blood transfusions prior to 1990

Those with abnormal laboratory tests suggesting liver disease [Source: Hepatitis C by Howard J. Worman, M.D.]

Those hose blood samples show the signs of chronic hepatitis should be immediately tested for the presence of serum antibodies against HCV. Chronic hepatitis is seen by the presence of anti-HCV antibodies in a person who has chances of developing the liver disease. If the test does not find anti-HCV antibodies, this means that no further diagnosis is needed. Tests for HCV RNA in blood is done in those people who contain anti-HCV antibodies to validate the diagnosis and in the patient who does not have anti-HCV antibodies but the diagnosis is still done out of suspicion. After the diagnosis, a liver biopsy is done to examine the degree of liver inflammation and fibrosis and also for the presence or absence of cirrhosis.

Treatment

It is important for patients with chronic hepatitis C to be assessed by a specialist who can predict if there is any room for possible treatment with the remedies available. Doctors say that adults under the age of 70 years, who indicate active inflammation on liver biopsy and without advanced cirrhosis, are good treatment patients. Also, patients with advanced cirrhosis should undergo liver transplantation. [Hepatitis C by Howard J. Worman, M.D.]

Conclusion

Hepatitis is a disease that affects our liver and can also be caused by taking drugs that are taken to treat other illnesses. One of the best ways to evaluate any signs of the disease is through testing an increase in liver enzymes. Once the person has been diagnosed, and undergone for in-depth evaluation, the drugs that were being taken should be discontinued and a regular checkup is to be done.

Prevention is still the best medicine for this illness. It is recommended that condom be used during sexual intercourse since it will decrease the risk of hepatitis B and the usage has shown to be effective. Also, proper washing of hands is important for the prevention and protection from the transmission of most viruses. Even today, we don't have much information available about other causes of hepatitis but there are numerous studies being conducted to evaluate effective treatment for those infected with this chronic disease. [Hepatitis A-B-C]