Viral Hepatitis – What You Should Know About HAV, HBV, HCV
Every year we need to monitor our health with the help of different medical tests so we can stay away from unpleasant surprises.
The attention we give to our health has a preventive character and its purpose is early identification of specific diseases correlated to age, season, genetic factors, and so on. Particular attention should be given to liver diseases because liver damage can be in many cases irreversible. Although the liver is the only organ capable of regeneration (diseased cells are replaced with new and healthy ones), can be subjected to constant infectious aggresion (viral hepatitis A, B, C, D, E) or noninfectious (hepatitis caused by alcohol, drugs, obesity) leading to severe liver disease like hepatitis, cirrhosis, gallstones, liver cancer, Wilson’s disease.
They represent a group of diseases characterized by impaired liver function due to the multiplication of viruses in liver cells. Acute liver damage is initially acute (first 6 months of infection), most liver viruses persist in the body and gradually modify the architecture and functionality of the liver leading to irreversible stages. Liver disease that evolves over 6 months is called chronic hepatitis and viruses that can cause these diseases are: hepatitis virus B in combination or not with delta hepatitis virus (hepatitis D virus) and hepatitis C virus.
HAV (hepatitis A virus)
HAV only causes acute hepatitis (heals in 2-3 months). Once we have contacted this type of hepatitis we develop immune protection for life. Acute hepatitis A infection is an overall body infection, but is predominantly affecting the liver. Dirty hands, contaminated food and water are the main sources of infection. It is transmitted through blood, injections, surgery. The virus multiplies in liver cells but does not injure them therefore after virus removal, the liver is left without permanent damage.
HBV and hepatitis D virus
Chronic hepatitis B is caused by hepatitis B virus that persists for more than six months.
The most common ways of transmission for hepatitis B are through infected blood and blood products, unprotected intercourse with an infected person and transmission from mother to child (birth moment is the most infectious stage).
Frequently, infection with hepatitis B virus is associated with hepatitis virus D and sometimes C or even HIV virus. Hepatitis D virus can not determine chronic hepatitis without associated B virus infection. The presence of hepatitis D virus is reveald by the presence of HVD antigen found in the blood.
After an episode of acute hepatitis B, the virus :
- Can remain dormant in the body (will not cause clinical symptoms and transaminases have normal values) but it can be transmitted by the chronic carrier.
- Can multiply in the liver resulting in permanent injuries causing chronic hepatitis.
- One third of those infected with the virus will evolve to stage B cirrhosis and liver cancer. 60% of hepatic carcinomas are grafted on liver that is infected with hepatitis B virus.
Symptoms of chronic hepatitis B are sudden fatigue, drowsiness, pain in the liver area, dyspepsia, enlarged liver (hepatomegaly).
Association of hepatitis D virus with hepatitis B virus can cause severe forms of hepatitis, frequently leading to the development of liver failure. Cirrhotic patients without virus or with hepatitis C virus must be vaccinated against hepatitis B virus, any additional aggression of the liver will result in a accelerated evolution of major complications (gastrointestinal bleeding, cancer).
HCV (hepatitis C virus)
Chronic hepatitis occurs when the virus is present in blood for 6 months after the acute infection, even if transaminases are normal and there is no microscopic liver changes. Hepatitis C virus infection is the most common infection transmitted by injection.
Hepatitis virus C infection has a very high occurrence frequency, causing over 20% of acute hepatitis, 70% of chronic hepatitis, 40% of liver cirrhosis, 60% of liver cancers and 50% of causes of liver transplantation.
Risk factors for infection with this virus are represented by:
- Intravenously-infected contact with a infected syringe needle, infected blood transfusions, intravenous administrated drugs using infected syringe needles.
- Mother-newborn infection transmission.
- Intercourse with an infected person – multiple partners
- Hemodialysis (patients with end-stage renal disease).
Most acute infections with hepatitis C virus progress to chronic hepatitis, cirrhosis and in some cases even to liver cancer, especially if the virus is helped by other damaging factors like alcohol, associated hepatitis B virus infection or weakened immune system caused by other severe diseases.
Chronic hepatitis does not give many symptoms for a long period of time. When liver damage is quite severe, fatigue, discomfort under the lower right ribs, dyspepsia or rash can be present.
Even if a good period of time it does not cause any important symptoms, chronic hepatitis C must be treated with seriousness, due to resistance to treatment and evolution to serious complications (cirrhosis and liver cancer) which are very probable.