Viral hepatitis refers to liver damage caused by a viral infection. Very different from each other, the viruses causing hepatitis have been labelled A,B,C,D and E. Hepatitis A and E are spread by contaminated food and water, while Hepatitis B and C viruses are spread by coming in contact with infected blood. Hepatitis B, in addition, can also be sexually transmitted or passed on from mother to her child.
Every year, World Hepatitis Day is observed on July 28 in honour of the birth of Baruch Blumberg, who discovered the Hepatitis B virus. This year, the theme is “Hep can’t wait” i.e. people living with hepatitis can’t wait for testing and treatment and the ongoing pandemic should not take the focus off a disease that kills a person every six seconds.
“Hepatitis A and E usually cause acute or short lived Hepatitis (<6 weeks). Here, the body fights off the infection and the liver recovers fully. Hepatitis B,C and viruses may cause chronic or long lasting viral hepatitis where the virus persists in the liver and gradually damages it over years,” said Dr Vivek Shetty, consultant department of gastrointestinal surgery, Jaslok Hospital.
Acute hepatitis is initially characterised by a flu-like illness with symptoms like fatigue, nausea, vomiting, loss of appetite and body aches. After a few weeks, this is followed by jaundice, dark coloured urine and abdominal pain and discomfort caused by a painfully-enlarged liver. At this time the Liver Function Tests (LFT’s) will be abnormal and blood tests can identify the viral infection.
“A patient with chronic hepatitis can be symptom-free for several years but liver damage is ongoing. When extensive liver damage followed by scarring of liver (cirrhosis) occurs the patients develop symptoms of liver failure like jaundice, accumulation of fluid inside the abdomen, and a tendency to bruise and bleed easily. Liver failure can also cause life threatening complications like gastrointestinal bleeding, Hepatic encephalopathy (increased ammonia in blood causing brain dysfunction), damage to the kidneys. Cirrhosis also predisposed the individual to liver cancer,” Dr Shetty told indianexpress.com.
Vaccines are effective in prevention of Hepatitis A, B and D. For those who are already infected, effective drugs are available for treatment of hepatitis B and C infections. When there is already severe damage, a liver transplantation becomes the only hope for survival.
Liver disease and Covid-19
Some patients hospitalised with Covid-19 have shown abnormal liver function tests indicating that the liver may be temporarily damaged due to the infection. As elderly people and those with pre-existing diseases are at higher risk of developing complications, those with liver disease are also more likely to develop severe illness from Covid-19.
“Vaccination for Covid-19 in patients with liver disease has not shown any specific side effects. All the liver disease associations strongly recommend that patients with liver disease should take the Covid-19 vaccine. Even after taking the vaccines continuing precautionary measures like social distancing, practicing hand hygiene and wearing a mask is the best way to keep oneself safe,” said the expert.