Question

Describe the five basic types of Hepatitis B virus infections by symptoms, diagnositc markers and disease used to differntiate each.

Answer 1

Ans) Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

Your liver is located in the right upper area of your abdomen. It performs many critical functions that affect metabolism throughout your body, including:

• bile production, which is essential to digestion
filtering of toxins from your body
• excretion of bilirubin (a product of broken-down red blood cells), cholesterol, hormones, and drugs
• breakdown of carbohydrates, fats, and proteins
• activation of enzymes, which are specialized proteins essential to body functions
• storage of glycogen (a form of sugar), minerals, and vitamins (A, D, E, and K)
• synthesis of blood proteins, such as albumin
synthesis of clotting factors

- According to the Centers for Disease Control and Prevention (CDC)Trusted Source, approximately 4.4 million Americans are currently living with chronic hepatitis B and C. Many more people don’t even know that they have hepatitis.

The 5 types of viral hepatitis
Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis.

Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

Hepatitis A
Hepatitis A is caused by an infection with the hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A.

Hepatitis B
Hepatitis B is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus (HBV). Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase your risk of getting hepatitis B.

It’s estimated by the CDCTrusted Source that 1.2 million people in the United States and 350 million people worldwide live with this chronic disease.

Hepatitis C
Hepatitis C comes from the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact. HCV is among the most common bloodborne viral infections in the United States.

Hepatitis D
Also called delta hepatitis, hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through direct contact with infected blood. Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B. It’s very uncommon in the United States.

Hepatitis E
Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply. This disease is uncommon in the United States. However, cases of hepatitis E have been reported in the Middle East, Asia, Central America, and Africa, according to the CDCTrusted Source.

Causes of noninfectious hepatitis
Alcohol and other toxins
Excessive alcohol consumption can cause liver damage and inflammation. This is sometimes referred to as alcoholic hepatitis. The alcohol directly injures the cells of your liver. Over time, it can cause permanent damage and lead to liver failure and cirrhosis, a thickening and scarring of the liver.

Other toxic causes of hepatitis include overuse or overdose of medications and exposure to poisons.

Autoimmune system response
In some cases, the immune system mistakes the liver as a harmful object and begins to attack it. It causes ongoing inflammation that can range from mild to severe, often hindering liver function. It’s three times more common in women than in men.

Common symptoms of hepatitis:
If you have infectious forms of hepatitis that are chronic, like hepatitis B and C, you may not have symptoms in the beginning. Symptoms may not occur until the damage affects liver function.

Signs and symptoms of acute hepatitis appear quickly. They include:

fatigue
flu-like symptoms
dark urine
pale stool
abdominal pain
loss of appetite
unexplained weight loss
yellow skin and eyes, which may be signs of jaundice
Chronic hepatitis develops slowly, so these signs and symptoms may be too subtle to notice.

How hepatitis is diagnosed
History and physical exam
To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or noninfectious hepatitis.

During a physical examination, your doctor may press down gently on your abdomen to see if there’s pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.

Liver function tests
Liver function tests use blood samples to determine how efficiently your liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if you don’t show any signs on a physical exam of liver disease. High liver enzyme levels may indicate that your liver is stressed, damaged, or not functioning properly.

Other blood tests
If your liver function tests are abnormal, your doctor will likely order other bloodtests to detect the source of the problem. These tests can check for the viruses that cause hepatitis. They can also be used to check for antibodies that are common in conditions like autoimmune hepatitis.

Ultrasound
An abdominal ultrasound uses ultrasound waves to create an image of the organs within your abdomen. This test allows your doctor to take a close at your liver and nearby organs. It can reveal:

fluid in your abdomen
liver damage or enlargement
liver tumors
abnormalities of your gallbladder
Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of your abnormal liver function.

Liver biopsy
A liver biopsy is an invasive procedure that involves your doctor taking a sample of tissue from your liver. It can be done through your skin with a needle and doesn’t require surgery. Typically, an ultrasound is used to guide your doctor when taking the biopsy sample.

This test allows your doctor to determine how infection or inflammation has affected your liver. It can also be used to sample any areas in your liver that appear abnormal.

Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic.

Hepatitis A
Hepatitis A usually doesn’t require treatment because it’s a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. If you experience vomiting or diarrhea, follow your doctor’s orders for hydration and nutrition.

The hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between ages 12 and 18 months. It’s a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine.

Hepatitis B
Acute hepatitis B doesn’t require specific treatment.

Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment.

Hepatitis B can be prevented with vaccination. The CDCTrusted Source recommends hepatitis B vaccinations for all newborns. The series of three vaccines is typically completed over the first six months of childhood. The vaccine is also recommended for all healthcare and medical personnel.

Hepatitis C
Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment.

People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant.

Currently, there is no vaccination for hepatitis C.

Hepatitis D
No antiviral medications exist for the treatment of hepatitis D at this time. According to a 2013 studyTrusted Source, a drug called alpha interferon can be used to treat hepatitis D, but it only shows improvement in about 25 to 30 percent of people.

Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop.

Hepatitis E
Currently, no specific medical therapies are available to treat hepatitis E. Because the infection is often acute, it typically resolves on its own. People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol. However, pregnant women who develop this infection require close monitoring and care.