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  • Types of Hepatitis

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    What is Hepatitis?

    "Hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.

    Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. Hepatitis is as much a danger as HIV.


    Other Tests.

    • Obstruction of the bile ducts, from either gallstones or cancer, occasionally can mimic acute viral hepatitis.
    • Ultrasound testing can be used to exclude the possibility of gallstones or cancer.

    Here are a few things you might not know about Hepatitis

    1. Get tested if you have had a blood transfusion: Blood transfusion can transmit hepatitis C. If you have had a blood transfusion before the year 2002, get yourself tested for the condition. This is because, blood banks all over the nation started testing blood for the presence of Hepatitis C only after 2002. That being said, anyone who was transfused before that should get tested immediately.

    2. Pregnant mothers: If you are pregnant or are planning to conceive anytime soon, get tested for hepatitis. This is because the virus that causes Hepatitis B can be transmitted from mother to child. The hepatitis test (HbsAg) is usually a part of the Antenatal Profile of blood tests that is prescribed by gynaecologists.

    3. Don't wait for the symptoms: By the time any symptoms manifest, it is usually too late to do anything. A person must get tested early on, or on a regular basis if they are at risk of contracting the disease. If hepatitis is detected early, it can be treated and managed well. Hepatitis can cause irreparable damage to the liver, leading to liver cirrhosis and cancer.

    4. Be aware of the types: Common forms of viral hepatitis include Hepatitis A, B, and C. There is also Hepatitis D and E.

    5. Get vaccinated: There are vaccines for hepatitis A and B, but not for C, D and E. The hepatitis A vaccine is administered as two injections and the vaccine for Hepatitis B is administered over a period of three injections. The good thing about this type of vaccine is that if there is a gap between consecutive injections, one can start from where they left off. There is no need to restart the immunization process.

    Types of Hepatitis

    Hepatitis A is commonly called jaundice. Caused due to a food borne virus, it leads to excess bile secretion, and malfunctioning of the liver. In most cases patients make a full recovery. Common symptoms include yellowing of eyes and skin, pale coloured stools, fatigue and in some cases vomiting.

    Hepatitis B is a viral infection that is spread through blood or body fluids. Either by having unprotected sex or sharing infected needles etc. It infects the liver, and its symptoms do not manifest in most people. This type can be transmitted from mother to child.

    Hepatitis C is a type that can be spread through blood and rarely through bodily fluids. It infects the liver and in most cases the symptoms do not show up until the liver is beyond repair. Symptoms are usually vague and commonly misdiagnosed.

    Hepatitis is a serious liver disease caused by the Hepatitis D virus (HDV). It occurs among people who are infected with the Hepatitis B virus. The transmission of HDV is similar to how HBV is spread and requires contact with infectious blood. There is no vaccine for Hepatitis D.

    Hepatitis is a serious liver disease caused by the Hepatitis E virus (HEV) that usually results in an acute infection. It does not lead to a chronic infection. It is transmitted through ingestion of fecal matter, even in microscopic amounts and outbreaks are usually associated with contaminated water supply Although hepatitis A virus (HAV) and hepatitis E virus (HEV), both enterically transmitted, are highly endemic in India, HEV has been responsible for most of these epidemics. In India, HEV infection is responsible for 30% - 70% of cases of acute sporadic hepatitis and is the major cause of acute liver failure. There is currently no vaccine for Hepatitis E.

    How is viral hepatitis diagnosed?

    The diagnosis of viral hepatitis is based on symptoms and physical findings as well as blood tests for liver enzymes, viral antibodies, and viral genetic materials.

    Symptoms and physical findings
    Diagnosis of acute viral hepatitis often is easy, but diagnosis of chronic hepatitis can be difficult. When a patient reports symptoms of fatigue, nausea, abdominal pain, darkening of urine, and then develops jaundice, the diagnosis of acute viral hepatitis is likely and can be confirmed by blood tests. On the other hand, patients with chronic hepatitis due to HBV and HCV often have no symptoms or only mild nonspecific symptoms such as chronic fatigue. Typically, these patients do not have jaundice until the liver damage is far advanced. Therefore, these patients can remain undiagnosed for years to decades.

    Blood tests
    There are three types of blood tests for evaluating patients with hepatitis: liver enzymes, antibodies to the hepatitis viruses, and viral proteins or genetic material (viral DNA or RNA).

    Liver enzymes
    Among the most sensitive and widely used blood tests for evaluating patients with hepatitis are the liver enzymes, called aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes normally are contained within liver cells. If the liver is injured (as in viral hepatitis), the liver cells spill the enzymes into the blood, raising the enzyme levels in the blood and signaling that the liver is damaged. Also see Liver Function Tests.

    Viral antibodies
    Antibodies are proteins produced by white blood cells that attack invaders such as bacteria and viruses. Antibodies against the hepatitis A, B, and C viruses usually can be detected in the blood within weeks of infection, and the antibodies remain detectable in the blood for decades thereafter. Blood tests for the antibodies can be helpful in diagnosing both acute and chronic viral hepatitis.

    In acute viral hepatitis, antibodies not only help to eradicate the virus, but they also protect the patient from future infections by the same virus, that is, the patient develops immunity. In chronic hepatitis, however, antibodies and the rest of the immune system are unable to eradicate the virus. The viruses continue to multiply and are released from the liver cells into the blood where their presence can be determined by measuring the viral proteins and genetic material. Therefore in chronic hepatitis, both antibodies to the viruses and viral proteins and genetic material can be detected in the blood.

    Examples of tests for viral antibodies are:

    1. anti-HAV (hepatitis A antibody)
    2. antibody to hepatitis B core, an antibody directed against the inner core (nucleus) of the virus (core antigen) HBcAg
    3. antibody to hepatitis B surface, an antibody directed against the outer surface envelope of the virus (surface antigen) Anti HBs
    4. antibody to hepatitis B e, an antibody directed against the genetic material of the virus (e antigen) Anti HbE
    5. hepatitis C antibody-antibody against the C virus Anti HCV

    Examples of tests for viral proteins and genetic material are:

    1. hepatitis B surface antigen HBsAg
    2. hepatitis B DNA
    3. hepatitis B e antigen HBeAg
    4. hepatitis C RNA

    Reference -
    http://www.cdc.gov/hepatitis/
    http://www.medicinenet.com/viral-hepatitis/page5.htm/how-is-viral-hepatitis-diagnosed/
    http://health.india.com/diseases-conditions/world-hepatitis-day-2013-be-aware-of-hepatitis-get-tested-today/

    For more information, please contact us at +91 22 66949876 / 9833141024 or email us at disha@pathologylabindia.com for any test requirement or any query related to our pathology lab

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