Viral Hepatitis: Types, Symptoms, and Global Impact

What is Viral Hepatitis?

Viral hepatitis refers to the inflammation of the liver caused by one of five main hepatitis viruses: A, B, C, D, and E. Each type has unique transmission methods, severity levels, and epidemiological characteristics.

Types of Hepatitis Viruses

• Hepatitis A: This virus is typically spread via the ingestion of contaminated food or water. It usually causes a self-limiting disease without leading to chronic infection.
• Hepatitis B: It is transmitted through contact with infectious body fluids, including blood and sexual fluids, often during sexual activity or from mother to child during childbirth. This virus can lead to chronic infections and significantly increases the risk of cirrhosis and liver cancer.
• Hepatitis C: Primarily spread through blood-to-blood contact, such as sharing needles, it can also be transmitted sexually. Hepatitis C frequently progresses to chronic liver disease.
• Hepatitis D: This virus can only infect individuals already infected with Hepatitis B. Co-infection with Hepatitis D and B can lead to more severe disease outcomes.
• Hepatitis E: Mainly transmitted through contaminated water, it is prevalent in areas with poor sanitation. While it generally results in self-limiting infections, it can be severe for pregnant women.

Symptoms of Viral Hepatitis

Common symptoms include jaundice (yellowing of the skin and eyes), abdominal pain, fatigue, loss of appetite, nausea, vomiting, and fever. However, many individuals, especially those with hepatitis B or C, may remain asymptomatic for years.

Diagnosis and Treatment

Diagnosis: Typically involves blood tests to detect viral antigens or antibodies, alongside assessments of liver function and damage.

Treatment: Depends on the type of hepatitis:

• Hepatitis A and E usually do not require treatment as the infections are self-limiting.
• Hepatitis B is treated with antiviral medications and regular monitoring to prevent liver damage.
• Hepatitis C can often be cured with antiviral drugs administered over several weeks.
• Treatment for Hepatitis D involves medications used for Hepatitis B and may require liver transplantation in severe cases.

Prevention

• Vaccines are available for hepatitis A, B, and E.
• There are no vaccines for hepatitis C and D, but their transmission can be minimized through blood product screening, safe injection practices, and harm reduction services.

Global Impact

• Viral hepatitis remains a significant public health challenge worldwide, particularly hepatitis B and C, which are leading causes of chronic liver disease and liver cancer.
• Greater understanding of viral hepatitis facilitates improved preventive measures, early detection, and effective management, ultimately reducing health burdens.

Viral Hepatitis in India

What is the recent WHO alert on viral hepatitis about?
The World Health Organization (WHO) has issued alerts concerning viral hepatitis due to its considerable global impact and the number of deaths it causes yearly. The recent Global Hepatitis Report 2024 emphasizes viral hepatitis as a leading infectious cause of death, comparable to tuberculosis, necessitating urgent improvements in diagnostics, treatment, and prevention strategies.

Why is India highlighted in the Global Hepatitis Report 2024?
India is noted for its significant share of the global viral hepatitis burden, with 11.6% of total cases. Factors contributing to this high disease load include population density, inadequate screening, and low awareness regarding the disease and its transmission.

What does the report say about the disease load of hepatitis B and C in India?
The report reveals a high prevalence of chronic hepatitis B and C in India, with many cases undiagnosed due to the asymptomatic nature of the infections and insufficient screening programs. This undetected reservoir contributes to ongoing transmission and an increasing disease burden.

Is there an increase in non-viral hepatitis cases in India?
Yes, the report indicates a rise in non-viral hepatitis cases, such as alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). These conditions, driven by lifestyle changes like excessive alcohol consumption and obesity, worsen the overall hepatitis burden, often leading to severe liver diseases.

How can hepatitis B and C be prevented and treated in India?
Prevention of hepatitis B primarily involves vaccination, which is included in the government’s immunization program. Hepatitis C is curable with medication, highlighting the need for accessible treatment options. The government's viral hepatitis control program is critical in offering vaccinations and treatments, especially to high-risk groups and healthcare workers.

What are the key takeaways from the WHO report regarding global efforts?
The report stresses the importance of global and national initiatives to enhance service coverage and access to affordable medications. It reveals that diagnosis and treatment rates for hepatitis are below the WHO's 2030 targets, emphasizing the need for increased efforts in testing, treatment accessibility, and preventive measures to combat the viral hepatitis epidemic effectively. The WHO report serves as an essential guideline for shaping future strategies in the fight against viral hepatitis, urging countries to implement public health approaches that reduce the disease burden significantly by 2030.