HEPATITIS

Hepatitis means inflammation of the liver. The most common causes of hepatitis are the hepatitis viruses, but it can also occur due to other infections, alcohol consumption, drug abuse, and some forms of autoimmune diseases.

There are about 325 million peoples in the world, who are living with viral hepatitis, yet up to 290 million of these are unaware of their situation, which can lead to liver complications later.

When to suspect Hepatitis?

In many patients there are no symptoms and hepatitis can go undiagnosed. In some people, it can cause the following;

· Yellowing of skin and eyes

·  Fever

·  Fatigue

·  Loss of appetite

·  Nausea and vomiting

·  Abdominal pain

·  Headaches

·  General malaise

·  Diarrhea

Viral Hepatitis: A Matter of Concern

Although hepatitis can occur due to a range of factors, viral hepatitis (liver inflammation caused by a viral infection) is a major health burden. Viral hepatitis can be of five types depending upon which type of virus has caused the disease. Of these, Hepatitis A, Hepatitis B, and Hepatitis C are the common types of viral hepatitis.

HEPATITIS A

Hepatitis A can spread through food or water. Food can be tainted when it is touched by a person with hepatitis and has not washed his hands thoroughly after using the bathroom. Raw and undercooked foods are common culprits in hepatitis A outbreaks.

HEPATITIS B

Hepatitis B can spread through contact with the blood or body fluids of an infected person. It is also possible to get Hepatitis B by unprotected sex, sharing infected needles, razors or toothbrushes. Hepatitis B does not spread by hugging, sharing food, or coughing.

HEPATITIS C

Hepatitis C is spread through contact with blood from an infected person. Sharing needles, getting a tattoo or body piercing with an infected needle can lead to an exposer. Multiple sex partners or HIV too are responsible for the risk and spread of Hepatitis C.

How to Prevent it?

You can easily prevent hepatitis by following these precautions;

• Wash hands thoroughly after using the washroom and before having meal
• Always drink clean water
• During blood transfusions, ensure that blood or any other blood component is being screened for Hepatitis B and C beforehand
• Do not share needles, syringes, razor blades, and other personal items
• Make sure that you are engaging in safe sex
• Get a hepatitis screening profile test

Hepatitis in older people: should you worry?

Hepatitis C is known to be a common cause of acute hepatitis in the elderly; after 20-30 years of being affected about half of them develop chronic hepatitis, and of those a significant number develop cirrhosis (20-60%). Hence, it is wise to watch out for the symptoms and go for regular liver screening tests. Additionally, hepatitis can be diagnosed in the laboratory by the tests; Complete blood count, Liver function test, Hepatitis B & C antigen

Tests Related to Viral Hepatitis

A Hepatitis Test in Kathmandu is generally a blood test that can help in diagnosing which kind of Hepatitis you might be suffering from so that correct treatment can be administered. It is essential to get tested as this is a serious illness that can have life-threatening consequences.

Hepatitis A (HAV) antibody test

This test detects whether you have produced antibodies known as immunoglobulin M and immunoglobulin G against the hepatitis A virus (HAV).

Hepatitis B surface antigen (HBsAg)

This is a test to find out if you have a current infection. HBsAg is the earliest sign of the virus and disappears from your blood as the infection clears. A positive result indicates infection. If the antigen is not found (negative result), this shows that either you have never been exposed to hepatitis B or that you have recovered from infection and cleared the virus. The term ‘surface’ refers to the outer surface of the virus itself.

Antibodies to hepatitis B surface antigen

This is to detect the protective antibody in your blood that reveals whether you have had previous exposure to hepatitis B. The presence of the antibody anti-HBs (positive result) indicates that you are immune to hepatitis B due to vaccination or recovery from past infection, and are no longer infectious to others.

Hepatitis B envelope-antigen (HBeAg)

This test is used to confirm the presence of HBeAg, which only appears in the blood when the virus is present and is a sign that you are actively making the virus (and therefore able to pass it on to others).

What happens after this antigen is found will depend on how quickly your immune system produces antibodies called anti-HBe.

Anti-hepatitis B core antigen (anti-HBc)

The anti-hepatitis B core antigen is an antibody to the ‘core’ part of the hepatitis B virus, the hepatitis B core antigen. However, this antibody does not provide the protection usually associated with antibodies and is found in people with acute infection, in chronic carriers and in people who have cleared the infection. Doctors will use the results of other tests to interpret the presence of anti-HBc in your blood.

HBV RQPCR Assay (Viral Load)

This important test does not look for antigens or antibodies but monitors the amount of virus in your blood, known as your ‘viral load’. The higher your viral load, the more active your infection will be. Active virus replication, where the virus is making lots of copies of itself, is known as positive HBV DNA. Doctors will be looking for a very low amount or no trace of the virus as a marker of your response to antiviral medication.

HCV antibody test (anti-HCV)

An anti-HCV test looks for any trace of antibodies in your blood. If they are found, this shows that you have been exposed to the hepatitis C virus. This test is unable to reveal whether you have active viral infection.

HCV RQPCR Assay (Viral Load)

This test measures the number of viral RNA particles in your blood. Doctors will usually perform these tests over the course of your treatment. Measuring your viral load before and after treatment will show how effectively (or not) the treatment is working.

Tests Related to Noninfectious Hepatitis

Antinuclear Antibody (ANA): Antibodies present in several autoimmune disorders

Smooth Muscle Antibody (SMA): Antibodies present in autoimmune hepatitis

Anti-LKM-1 Antibody: Antibodies present in autoimmune hepatitis

Antimitochondrial Antibody (AMA): Antibodies present in primary biliary cholangitis, a type of liver disease

Medically Reviewed by

• Ramendra Kumar Raman, PhD, Clinical Research

Reference

https://www.who.int/publications/i/item/9789240053779 (Global health sector strategies on, respectively, HIV, viral hepatitis, and sexually transmitted infections for the period 2022-2030)