Overview
Hepatitis is a general term for inflammation of the liver. The word comes from the Greek hepar (liver) and -itis (inflammation).
This inflammation can be acute (short-term) or chronic (long-term) and may result from a variety of causes — the most common being viral infections, but it can also occur due to alcohol use, medications, autoimmune reactions, or metabolic conditions.
The liver plays an important role in cleaning toxins from the body, processing nutrients, and making essential proteins. When it gets damaged or inflamed, it can affect overall health. If not treated on time, hepatitis can lead to scarring (fibrosis), cirrhosis, liver failure, or even liver cancer.
Types of Hepatitis
1. Hepatitis A (HAV)
- Cause: Hepatitis A virus, transmitted via contaminated food or water.
- Nature: Acute infection; it does not lead to chronic liver disease.
- Prevention: Good sanitation and vaccination.
- Recovery: Complete recovery is expected, and lifelong immunity develops afterward.
2. Hepatitis B (HBV)
- Cause: Hepatitis B virus, transmitted through blood, sexual contact, or from mother to child during birth.
- Nature: Can be acute or chronic. Chronic infection may lead to cirrhosis or liver cancer.
- Prevention: A safe and effective vaccine is available.
- Treatment: Antiviral medications can suppress the virus and protect the liver.
3. Hepatitis C (HCV)
- Cause: Spread through contaminated blood, unsterile needles, or transfusions.
- Nature: Often becomes chronic and is a leading cause of liver transplants worldwide.
- Treatment: Curable in most cases with modern direct-acting antiviral (DAA) medications.
- Prevention: No vaccine available yet — but safe injection and hygiene practices reduce risk.
4. Hepatitis D (HDV)
- Cause: A defective virus that only infects those already carrying Hepatitis B.
- Nature: Co-infection can worsen liver damage rapidly.
- Prevention: Controlled indirectly through Hepatitis B vaccination.
5. Hepatitis E (HEV)
- Cause: Spread by contaminated water, often in developing countries.
- Nature: Usually acute and self-limiting but can be severe in pregnant women.
- Prevention: Ensuring clean drinking water and good hygiene.
Other Non-Viral Causes of Hepatitis
Besides viral infections, hepatitis can also result from:
- Alcoholic Hepatitis: Due to prolonged heavy drinking leading to liver inflammation.
- Autoimmune Hepatitis: The immune system mistakenly attacks liver cells.
- Drug-Induced Hepatitis: Caused by certain medications or toxic substances.
- Metabolic Hepatitis: Seen in fatty liver disease or metabolic syndromes.
How Hepatitis Affects the Liver
The liver’s primary role is to filter blood, store energy, and produce bile. When inflamed, its ability to perform these functions declines.
Inflamed liver cells release enzymes into the bloodstream, causing elevated liver function tests (LFTs). Prolonged inflammation may lead to scarring (fibrosis), and continuous damage can progress to cirrhosis, where healthy tissue is replaced with scar tissue, impairing blood flow and detoxification.
Symptoms of Hepatitis
Symptoms vary depending on the type and stage, but may include:
- Fatigue and weakness
- Yellowing of eyes or skin (jaundice)
- Dark urine and pale stools
- Loss of appetite, nausea, vomiting
- Abdominal pain or discomfort in the upper right side
- Low-grade fever
- Joint or muscle pain
Many patients with chronic hepatitis may remain asymptomatic for years until advanced disease develops, which is why regular screening is essential for early detection.
Diagnosis of Hepatitis
Diagnosis involves a combination of clinical assessment and specific tests:
- Blood Tests: Liver enzymes (ALT, AST), bilirubin, and viral markers such as HBsAg, anti-HCV, or HAV IgM.
- Imaging: Ultrasound, FibroScan, or MRI to evaluate liver texture and fibrosis.
- Liver Biopsy: In selected cases, to assess the degree of inflammation or scarring.
These investigations help determine the type of hepatitis, its severity, and the most appropriate treatment plan.
Treatment and Management
Treatment depends on the underlying cause:
- Viral Hepatitis A and E: Usually resolve on their own; supportive care and hydration help recovery.
- Hepatitis B: Antiviral medications (like tenofovir or entecavir) suppress viral replication and prevent disease progression.
- Hepatitis C: Curable with short-term oral antiviral therapy (DAAs) that eliminate the virus completely.
- Autoimmune Hepatitis: Managed with immunosuppressive drugs (steroids or azathioprine).
- Alcoholic Hepatitis: Abstinence from alcohol, nutritional support, and medical therapy are essential.
Along with medical management, lifestyle modifications — such as maintaining a balanced diet, avoiding alcohol, exercising regularly, and preventing reinfection — are crucial.
Prevention of Hepatitis
- Vaccination: Available for Hepatitis A and B (and indirectly prevents D).
- Safe Practices: Avoid sharing needles, razors, or toothbrushes.
- Screening: Pregnant women, healthcare workers, and high-risk individuals should be screened regularly.
- Food and Water Safety: Maintain hygiene and avoid unsafe food or water sources.
Public awareness and vaccination remain the strongest defense against the spread of viral hepatitis.
In Summary
Hepatitis is a major yet preventable global health issue. With timely vaccination, early testing, and effective antiviral treatments, most cases can be managed successfully — and many lives can be saved.
Awareness, prevention, and consistent follow-up are the cornerstones of liver protection.