What is hepatitis?
Hepatitis is a disease that affects your liver.
This vital organ regulates metabolism, produces proteins, stores vitamins and iron, removes toxins, and more. If the liver fails to function, serious illness and death can result.
There are a number of causes of hepatitis, including viruses, alcohol and immune disorders. Five main viruses have been identified as causing hepatitis: hepatitis A, B, C, D and E. Though they produce similar symptoms, the viruses vary in terms of transmission, impact, treatment and prevention. The most common types of viral hepatitis in Australia are A, B and C.
These viruses cause the liver to become inflamed, so that it doesn’t function properly.
Hepatitis is usually described as acute or chronic. An acute illness affects a person for a short period, with recovery possible within a few weeks; a chronic one lasts for a long time, and can be incurable.
Symptoms of hepatitis
Not everyone with hepatitis has symptoms. When they do occur, they may include:
- Abdominal discomfort
- Dark urine
- Jaundice (yellow skin and eyes)
- Lethargy (tiredness)
- Oedema (swelling)
- Painful joints
Causes of hepatitis
Anyone can be infected if they come into direct contact with the hepatitis A virus through food, drink or objects contaminated by the faeces of an infected person. Symptoms may last several weeks, but a full recovery is usually made.
The hepatitis B virus is found in blood and, to a lesser degree, bodily fluids such as semen and vaginal secretions. You can contract hepatitis B through unsafe sex, sharing needles, and other activities where the body fluid of an infected person enters your bloodstream.
Mothers who have chronic hepatitis B sometimes pass the virus to their children, either through the womb, at the time of birth or shortly after birth. People who become infected with hepatitis B may develop a chronic infection, with babies and children who become infected at a greater risk.
Hepatitis C is contracted when blood from an infected person enters another person’s bloodstream. In Australia, it is most commonly transmitted through sharing injecting drug equipment.
20 to 30 per cent of people who have been infected with hepatitis C may clear the virus from their blood with no treatment; these people no longer have hepatitis C and are not infectious.
70 to 80 per cent of people infected with hepatitis C, if untreated, may continue to have the virus in their blood and become chronically infected. Of these, 10 to 20 per cent will develop cirrhosis or scarring of the liver. A small number of this group may, in turn, develop liver cancer.
Uncommon in Australia, hepatitis D is prevalent in countries that have a high incidence of hepatitis B. Hepatitis D can either be acquired as a co-infection of hepatitis B or super infection in people who are already infected with hepatitis B. Hepatitis D is contracted through unsafe sex, sharing injecting drug equipment, and other activities where the blood of an infected person enters the bloodstream.
Hepatitis E is most common in developing countries, and is severe among pregnant women, particularly in the third trimester. The virus is found in the faeces of infected people and animals, and is spread by eating or drinking contaminated food or water. Pregnant women are strongly advised not to travel to areas where hepatitis E is rife.
Diagnosis and treatment of hepatitis
Tests used to diagnose hepatitis may include blood tests and a liver biopsy – where a small piece of liver tissue is taken for laboratory examination.
Treatment depends on the type of hepatitis.
There is no specific treatment for hepatitis A. In most cases, the immune system will clear the infection and the liver will completely heal. Treatment is aimed at easing symptoms and reducing the risk of complications, and may include rest, eating small meals more often, and avoiding intake of alcohol so as to protect the liver.
Immunisation is the best protection against hepatitis A infection, and is recommended for people in high-risk groups. Immunisation includes a course of injections over a six to 12-month period.
Current treatments include antiviral medications, some of which are covered by the Pharmaceutical Benefits Scheme (PBS). It is also a good idea to limit alcohol intake and eat a well-balanced, low-fat diet.
A hepatitis B vaccine is included in the standard immunisation schedule, beginning in infancy. Screening mothers before birth can prevent infection of newborn infants – if a mother tests positive, hepatitis B immunoglobulin is given to the baby when they are born along with the vaccination.
The current treatment for Hepatitis C – combining the medicines pegylated interferon and ribavirin – has greatly improved the outcomes for people with this form of the virus. It can help decrease inflammation in the liver, and clear the virus in 30 to 65 per cent of people, though there are some side effects. There is currently no vaccine available to prevent hepatitis C infection.
There is no specific treatment for hepatitis D; research indicates the medication used to treat hepatitis B has a limited effect on hepatitis D. Co-infection with hepatitis D can, however, be treated through hepatitis B vaccination.
There is currently no treatment for hepatitis E, just bed rest and fluid replacement. Prevention against the virus is the most effective approach – with no vaccination available, this involves drinking clean water and good personal hygiene.
Further information and sources