Hepatitis A B C D and E

Hepatitis virus

Hepatitis is an inflammatory condition caused by tissue destruction which results in various malfunction of liver and lead to sickness.

Hepatitis is a disease that has been known for a long time. It remains a global public health problem, including Thailand where most patients both male and female at all ages encounter acute hepatitis. While a minority had chronic hepatitis which may have subsequent complications, namely cirrhosis and liver cancer.

Hepatitis is commonly found to be caused by the viral infection, followed by alcohol, certain drugs, and etc.

Type of Hepatitis is classified as follows

•          Hepatitis A

•          Hepatitis B

•          Hepatitis C

•          Hepatitis D

•          Hepatitis E

Hepatitis A

Hepatitis A infection is caused by eating contaminated food, fruits, and vegetables, and drinking water.

The incubation period may take about 2-6 weeks (4 weeks in average) after infection. Children tend to have less symptoms while the symptoms of acute hepatitis can be obviously found in adults. This virus will come out in the patient’s stool within 2 weeks before symptoms of the disease appear and until they are onset. This virus can survive in the environment for a long period resulting in an outbreak in the community, groups of people gathered at schools, dormitories, military camps, and etc.

The patient with hepatitis A can recover by themselves without being carrier. They will have immunity after recovery. The mortality rate of this disease is very low.

Hepatitis B

There is around 200 million of the global population found to be a carrier of hepatitis B. In Thailand, 8 – 10% of total population (5 million people in approximate) are carrier of this virus. It is found in the blood vessel, lymphatic vessel, secretion such as semen, vaginal fluid, saliva, tears, milk, allowing the infection to be spread in various ways. For instance, the infection paths are:

1. By sexual intercourse

2. Infants born to carrier mother (may be infected during procreation or care giving)

3. Exposure to the carrier’s blood or lymph via syringe sharing for drug injection, contaminated ear-piercing, blade razor, toothbrush, etc.

4. Through the skin with wound or abrasion.

5. Close contact between carriers and others such as family members, children of school age, etc.

The incubation period may takes around 30 – 180 days (60-90 days in average). 90% of  patient will recover and return to normal while the rest will remain as carrier.

The carrier of hepatitis B often show no symptoms, but the disease is still able to be infected. Some may suffer from chronic hepatitis, cirrhosis, and liver cancer. The possibility risk of getting liver cancer, found in the carriers of this virus are 223-times higher than other people. However, this disease can be prevented by using vaccines.

Hepatitis C

Formerly known as non-A, non-B hepatitis mainly caused by blood transfusion, hepatitis C infection is commonly found in the population (around 1 %). They can be infected via blood and lymph, by sharing syringes among drug addicts and may also be infected through sexual intercourse.

The incubation period of this virus takes around 15 – 160 days (50 days in average), causing acute hepatitis. This virus also causes chronic hepatitis and may lead to liver cancer alike to hepatitis B virus. The problems caused by this virus will continue as long as there it cannot be cured by any vaccines.

Hepatitis D

It’s an imperfect virus that should co-exist with hepatitis B. The infection is found in a group of drug addicts sharing the contaminated syringe or by close-contact as similar as hepatitis B virus.

Hepatitis E

The report states that the outbreak of this virus can be found in some countries e.g. India, Cambodia in which the people can be infected through their dietary as similar as hepatitis A virus.

Acute Hepatitis symptoms

The symptoms are divided into 3 stages as in the following.

1. Initial stage - fatigue, fever, headache, and body aches, muscle pain. Some patients may show symptoms as similar as a cold, influenza, anorexia, nausea, vomiting, abdominal pain in the right ribcage, and diarrhea, abnormal yellowish urine, and etc. This stage may last 4-5 days until 1-2 weeks.

2. Jaundice stage - The patient has got yellow eyes, jaundice, some general symptoms may be recovered but they are still exhausted. The mentioned symptoms may last from 2-4 weeks to 8-12 weeks and will be gradually recovered.

3. Recovery stage – takes 2-24 weeks (8 weeks in average)

Hepatitis diagnosis

            The symptoms as mentioned can be diagnosed as hepatitis infection by physical examination and blood test as in the following

1. Blood test (Liver function test) – SGOT & SGPT enzyme level is higher than normal condition (in case of the patient’s got jaundice)

2. Blood test (Virus detection)

i. IgM Anti HAV

ii.  HBsAg;IgM Anti HBc

iii.  Anti HCV

Hepatitis treatment

There is no direct cure for the disease. It can only be treated by symptoms. For instance, taking a rest helps to decrease in exhaustion in the early stage, refrain from exercise and work-out, abstain from alcoholic drinking, eat easily digestible food, sweetened beverages, fruit juices. Food with rich in fat should be avoided during severe nausea and vomiting period. For severe patients, water may be given intravenously with anti-inflammatories, medicines, vitamins, etc.

Prevention of hepatitis infection

1. Having good personal and public hygiene, such as hands washing thoroughly after excretion, hygiene cooking, eating cooked food, drinking clean water, and etc.

2. Avoid getting contact with the other people's blood, lymph, secretions. Do not share a needle or a sharp object with others

3. Do not do sexually promiscuous and use a condom.

4. Receive hepatitis B vaccine.

4.1 Every newborns especially if the mother is a carrier of the virus

4.2 All children to strengthen their immunity.

4.3 Older children, adolescents, and adults may have been infected who have got experienced with hepatitis B infection should be tested for immunity to B virus (HBc Ab). They must be vaccinated in case of the result is negative to improve the immunity against hepatitis B virus. If the result is positive, the vaccination is no necessary. For more details, please consult a doctor.

5. Preventive vaccination is applied in case of there is an outbreak of hepatitis A in nursing homes, schools, etc. the following