Understanding 5 Types Of Hepatitis & Their Symptoms

5 Types of Hepatitis and their symptoms

What Is Hepatitis?

Hepatitis is an inflammatory condition of the liver, often resulting from viral infections but can also arise due to other factors such as excessive alcohol consumption, certain medications, and autoimmune diseases. 

The liver, a crucial organ for metabolism, detoxification, and immune system support, becomes compromised in its ability to function effectively when inflamed. This condition manifests through various symptoms including jaundice, fatigue, and abdominal pain, and is categorised into several types, notably Hepatitis A, B, C, D, and E.

Understanding and addressing hepatitis is essential for maintaining liver health and preventing the severe complications associated with chronic forms of the disease, such as liver cirrhosis and liver cancer.

The Prevalence Of Hepatitis

The prevalence of hepatitis, including various types such as hepatitis C virus (HCV) and hepatitis B virus (HBV), varies significantly across Australia and globally.

In Australia alone during the year 2001, it was estimated that there were 210,000 individuals living with HCV antibodies, with an incidence of 16,000 new cases in that year alone. The projections suggested an increase in HCV-related cirrhosis and liver failure, highlighting a significant public health concern.

By 2005, the estimated number of people with HCV antibodies had increased to 264,000, primarily due to injecting drug use.  Additionally, The prevalence of HBV infection in Australia is nearly 1%, with significant underdiagnosis. Improved screening is essential for better detection, management and reduction of liver-related morbidity and mortality associated with HBV.

Globally, the prevalence of chronic HBV infection was estimated at 3.61%, with the highest endemicity in African and Western Pacific regions. As of 2010, about 248 million individuals were HBsAg positive, indicating a widespread challenge in managing and preventing HBV infection.

Types Of Hepatitis & Its Symptoms

Understanding the different types of hepatitis is crucial for several reasons, each related to the unique nature of the viruses involved, their modes of transmission, the diseases they cause, and the implications for treatment and prevention. 

Moreover, each type of hepatitis virus spreads in different ways. For example, hepatitis A and E are primarily transmitted through contaminated food or water, making sanitation and hygiene critical prevention measures. In contrast, hepatitis B, C, and D are spread through blood-to-blood contact, requiring different preventive strategies like safe needle practices and screening blood transfusions.

There are currently 5 types of hepatitis that are known.

Hepatitis A (HAV)

Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). It is primarily transmitted through the ingestion of contaminated food or water, or direct contact with an infectious person.

causes of hepatitis A (HAV)
Causes of hepatitis A (HAV)

The severity of hepatitis A can vary from a mild illness lasting a few weeks to a severe condition lasting several months.

Generally, hepatitis A is considered less dangerous than other viral hepatitis types. HAV does not typically become chronic or lead to long-term liver disease, although in rare cases, hepatitis A can cause fulminant hepatitis (acute liver failure), which is more likely to occur in older individuals or those with pre-existing liver diseases.

However, certain groups are at higher risk of severe illness from hepatitis A. These groups include older adults, people with chronic liver diseases (such as hepatitis B or hepatitis C), and individuals with compromised immune systems. 

Symptoms of hepatitis A can range from mild to severe and usually appear 2-6 weeks after the virus is contracted. Not everyone, especially young children, will exhibit symptoms, but when present, they may include:

  • Jaundice (yellowing of the skin and eyes)
  • Fatigue
  • Abdominal pain, especially on the upper right side beneath the lower ribs (where the liver is located)
  • Loss of appetite
  • Nausea and vomiting
  • Fever
  • Dark urine
  • Clay-coloured stools
  • Joint pain

Hepatitis B (HBV)

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It can develop into both acute and chronic forms, with the chronic condition posing a significant risk of serious complications, such as cirrhosis (scarring of the liver), liver failure, and liver cancer.

Causes of hepatitis B (HBV)
Causes of hepatitis B (HBV)

The virus is transmitted through contact with infected bodily fluids, such as blood, semen, and vaginal secretions, or from mother to child during childbirth. It’s also possible to contract hepatitis B through needlestick injuries, sharing needles or other drug-injection equipment, and, less commonly, from sharing personal items like razors or toothbrushes with an infected person. 

The prevalence of HBV infection is notably higher among non-Hispanic Asians, reflecting patterns of endemicity and vaccination coverage in their countries of origin or ancestry. This highlights the need for targeted public health interventions to address these disparities

The morbidity of HBV is highlighted by a few factors: 

  • Chronic Infection: Between 5-10% of adults infected with HBV will develop chronic hepatitis B, which can lead to liver cirrhosis and liver cancer.
  • Liver Cancer: Chronic hepatitis B is a leading risk factor for hepatocellular carcinoma, a common form of liver cancer.
  • Cirrhosis: Ongoing infection can lead to liver scarring, impairing liver function and potentially resulting in liver failure.

Many individuals with hepatitis B, particularly in the early stages, may not experience any symptoms. When symptoms do appear, they can be mild or severe and include:

  • Jaundice (yellowing of the skin and eyes)
  • Fatigue that persists for weeks or even months
  • Dark urine
  • Light-coloured stools
  • Pain in the abdomen, particularly on the right side beneath the lower ribs
  • Loss of appetite
  • Nausea and vomiting
  • Fever
  • Joint pain

It’s crucial to note that chronic hepatitis B might not present any symptoms until complications develop, highlighting the importance of screening and early diagnosis, especially in people at high risk of infection. For those diagnosed with hepatitis B, monitoring and treatment can significantly reduce the risk of liver disease and prevent transmission to others.

Hepatitis C (HCV)

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). It can manifest in two forms: acute and chronic. The acute phase refers to the initial few months after infection and is often asymptomatic, meaning many people are unaware they have been infected. In some cases, acute hepatitis C can spontaneously clear without treatment. However, in approximately 75% to 85% of individuals, the virus remains in the body, leading to chronic hepatitis C, which can persist for a lifetime.

Hepatitis C is primarily transmitted through exposure to infected blood. This can occur through sharing needles or other equipment to inject drugs, receiving contaminated blood transfusions or organ transplants (mostly before 1992 in the United States), needlestick injuries in healthcare settings, or being born to a mother who has hepatitis C.

Causes of hepatitis C (HCV)
Causes of Hepatitis C (HCV)

The risk of sexual transmission is considered low but can be higher among certain groups, such as men who have sex with men, individuals with multiple sexual partners, or those who have other sexually transmitted infections.

Additionally, HCV can be considerably dangerous due to its potential to cause chronic liver disease, cirrhosis, and liver cancer. The chronic nature of the disease means that many individuals are unaware of their infection until liver damage becomes apparent, which can take several decades. Chronic hepatitis C is one of the leading causes of liver transplantation and a significant cause of liver cancer worldwide. 

In its acute phase, hepatitis C rarely causes symptoms. When symptoms do occur, they may be mild and flu-like, including:

  • Fatigue
  • Fever
  • Muscle or joint pain
  • Abdominal pain
  • Poor appetite
  • Nausea
  • Jaundice (yellow discoloration of the skin and eyes)
  • Dark urine
  • Clay-coloured stools

Most individuals do not experience symptoms during the early stages of chronic hepatitis C, and when symptoms do present, they often indicate advanced liver disease. Therefore, screening for hepatitis C is crucial, particularly for those at increased risk of infection.

Hepatitis D (HDV)

Hepatitis D, also known as delta hepatitis, is a unique form of liver inflammation caused by the hepatitis D virus (HDV). This virus is unusual because it can only infect individuals who are also infected with the hepatitis B virus (HBV). Infection with both HBV and HDV can occur simultaneously (co-infection) or HDV can infect someone already chronically infected with HBV (superinfection). Hepatitis D is considered the most severe form of viral hepatitis due to its potential to rapidly lead to liver-related complications.

Root cause of hepatitis D (HDV)
Cause of Hepatitis D (HDV)

Hepatitis D is less common than other forms of viral hepatitis. Its prevalence varies significantly across different parts of the world, being more common in regions such as the Mediterranean, the Middle East, Central Asia, and parts of Africa. The global incidence of hepatitis D has decreased (specifically in Asia-Pacific region), partly due to the widespread use of the hepatitis B vaccine. However, it remains a significant health concern in areas with high rates of HBV infection and among certain high-risk groups.

The severity of hepatitis D: 

  • Individuals co-infected with HBV and HDV are more likely to develop acute liver failure compared to those infected with HBV alone.
  • For those who develop chronic hepatitis D, the disease tends to progress more rapidly towards liver cirrhosis and liver cancer than chronic hepatitis B alone.

The symptoms of hepatitis D do not differ significantly from those of other types of viral hepatitis and might include fatigue, abdominal pain, jaundice, and dark urine. However, many individuals may not show symptoms until significant liver damage has occurred.

Given the severity and challenges in treating hepatitis D, prevention — primarily through hepatitis B vaccination, which effectively prevents hepatitis D coinfection — is crucial.

Hepatitis E (HEV)

Hepatitis E is a liver disease caused by the hepatitis E virus (HEV). This virus is primarily transmitted through the faecal-oral route, usually via contaminated water. It’s more prevalent in areas with poor sanitation and is especially common in parts of Asia, Africa, and Central America.

Causes of Hepatitis E (HEV)
Causes of Hepatitis E (HEV)

Certain occupations, such as those involving close contact with animals or blood products, may have a higher risk of hepatitis E virus (HEV) infection. For instance, a study found a higher prevalence of HEV infection among individuals with occupational exposure to swine, suggesting potential zoonotic transmission routes

The prevalence of hepatitis E varies significantly around the world. It’s highly endemic in parts of Asia, Africa, and Central America, where outbreaks are often linked to contaminated water supplies. In developed countries, sporadic cases of hepatitis E have been increasing, attributed to zoonotic transmission through the consumption of undercooked or raw animal products. 

Overall, the global burden of hepatitis E is substantial, with the World Health Organization (WHO) estimating about 20 million HEV infections worldwide annually, leading to approximately 3.3 million symptomatic cases.

For most individuals, hepatitis E is a self-limiting illness that resolves within weeks without leading to chronic infection. However, certain groups are more at risk of developing severe complications:

  • Pregnant Women
    The virus can be particularly dangerous for pregnant women, especially during the third trimester, with a significantly higher risk of acute liver failure, which can be fatal.
  • Individuals with Pre-existing Liver Disease
    Those with existing liver conditions may experience exacerbations of their liver disease if infected with HEV.
  • Immunocompromised Individuals
    People with weakened immune systems, such as those receiving organ transplants and on immunosuppressive therapy, may be at risk of developing chronic hepatitis E, although this is rare.

The symptoms of hepatitis E are similar to those of other types of viral hepatitis and can include:

  • Fatigue
  • Jaundice (yellowing of the skin and eyes)
  • Dark urine
  • Pale stools
  • Fever
  • Nausea and vomiting
  • Abdominal pain

The Cruciality Of Understanding Hepatitis

In summary, delving into the complexities of hepatitis and its various types illuminates the intricate interplay between viral infections and liver health, underscoring the necessity for comprehensive understanding and proactive management. 

From the relatively mild, self-limiting hepatitis A and E to the more daunting prospects of chronic conditions associated with hepatitis B, C, and D, the spectrum of this disease necessitates a multifaceted approach to prevention, diagnosis, and treatment. 

Notably, advancements in medical science have brought forth promising treatments, particularly for hepatitis C, transforming once grim prognosis into stories of hope and recovery. However, the battle against hepatitis remains a global endeavour, requiring sustained efforts in vaccination, public awareness, and access to healthcare services.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

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