Chronic viral hepatitis : diagnosis and therapeutics

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In the United States U. It is often mild, and most people make a full recovery, after which they are immune and therefore protected from the virus in the future. However, if it progresses, symptoms can be severe or life-threatening. The liver of a person infected with hepatitis B swells. Severe damage can result. HBV infection can become chronic. This can lead to complications, including scarring of the liver, or cirrhosis. It can also cause a type of cancer known as hepatocellular carcinoma. In , , deaths worldwide were linked to HBV, mostly as a result of complications such as these.

In the U. There is not currently a cure for HBV. However, the incidence rate has dropped in countries where the vaccine is available, and this vaccine is 95 percent effective against the infection. HCV can lead to liver damage and swelling. Around 1 in 4 people with HCV get cirrhosis, and this can lead to liver cancer. Donated blood is now tested for HCV, but people who received organ transplants or blood donations before testing became part of the donation process may be at risk.

Other at-risk groups include healthcare workers who are exposed to sharps, users of intravenous drugs, and infants born to mothers with HCV. The number of cases of HCV in the U. However, the CDC estimate that 33, infections occurred in , including those not reported. Some types and cases of hepatitis can heal without intervention, but sometimes it can progress to scarring of the liver, or cirrhosis.

There is no specific treatment for HAV. The doctor will advise the patient to abstain from alcohol and drugs during the recovery. Most patients with hepatitis A will recover without intervention. A patient with HBV needs to rest and abstain completely from alcohol. The doctor may prescribe an antiviral agent called interferon, or other antiviral suppressive therapies. Some directed antivirals and combination therapies are now available to treat the hepatitis C virus based on its subtype. These treatments target viral replication and prevent the virus from being able to reproduce.

When taken correctly, the cure rate is very high. Many people with hepatitis experience either mild or no symptoms. When symptoms appear, they can do so from 15 to days after infection. This applies to all types of hepatitis. The initial phase of hepatitis is called the acute phase. The symptoms are similar to mild flu , and may include :. The acute phase is not usually dangerous, but in certain people, it can result in acute liver failure and death.

It may also progress to a chronic infection. As the disease progresses, chronic hepatitis can lead to progressive liver failure, resulting in jaundice, swelling of the lower extremities, confusion, and blood in the feces or vomit. The following may occur :. Patient outcomes after the acute phase depend on various factors, especially the type of hepatitis.

Management of Hepatitis C: Evaluating Suitability for Drug Therapy - American Family Physician

Some people will not know they have chronic hepatitis until liver failure occurs. As the symptoms of the different types of hepatitis are similar, the type and severity of hepatitis may only be diagnosed through laboratory tests. A doctor will perform a physical examination and ask for a medical history to assess whether a patient has been exposed to a likely cause of hepatitis. If a patient recently traveled abroad, they may have HAV. If they have had unprotected sex, they may have HBV. Hepatitis A is caused by consuming food or water infected with the hepatitis A virus HAV , often while traveling abroad.

The virus can also be transmitted through anal-oral contact during sex or by injecting drugs. Hepatitis B is caused by the hepatitis B virus HBV and is spread through contact with infected blood, semen, and some other body fluids. It can be a sexually transmitted disease STD. Hepatitis C mostly results from percutaneous infection, occurring when the HCV virus gets under the skin.

Natural History of HCV Infection

It is usually spread through injected narcotics, needle-stick injuries, and a lack of infection control in healthcare settings. HCV cannot be caught from contact with feces, and sexual transmission is less common than in other types. Alcohol, medicines, obesity , and chemical exposure do not cause types A, B, or C, but they may aggravate inflammation and make symptoms worse.

Hepatitis can be dangerous and difficult to treat, so people are advised to take precautions against possible infection. As this is often passed on through the transfer of infected bodily fluids, the following steps can help prevent HCV transmission:. Hepatitis A and C are curable, but hepatitis B is only preventable by vaccine. A cure is still under development. Hepatitis A: This type of hepatitis will normally resolve in 2 months without leaving any long-term effects. A person with HAV will usually be immune to hepatitis A for the rest of their life.

Hepatitis B: Most adults infected with the HBV virus recover within 90 days and achieve lifelong immunity. However, 90 percent of infants , 20 percent of older children, and 5 percent of adults will develop a chronic infection and develop severe health problems, such as liver cancer and cirrhosis. Hepatitis C: This becomes a lifelong infection in 70 to 85 percent of people that have the HCV virus.

Hepatitis C is fatal in between 1 and 5 percent of people. The infection can now be cured, and 15 to 25 percent of people with HCV clear the infection without treatment.


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Diagnosis of Management of Hepatitis C - Steven-Huy Han, MD - UCLA Primary Care Update 2015

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Chronic Viral Hepatitis: Diagnosis and Therapeutics

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Background

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