Research Paper On Hepatitis
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The paper looks at hepatitis infection, the different viruses and the spread of disease sin U.S. as well as across the world. It discusses how one get infects with hepatitis and the different types of hepatitis. The essay also sheds light on the available treatment options and the precautions to take when dealing with a hepatitis patient. The prime aim is to offer a comprehensive info on hepatitis infections.
The ‘hepatitis’ word comes from the Ancient Greek word ‘hepat’, which means liver and in Latin, it means inflammation. In simpler words, hepatitis means injury to the liver that can cause inflammation of the liver cells. The most common cause behind is a viral infection. There are five kinds of hepatitis viruses - A, B, C, D and E. Hepatitis causes grave concern among the medical community, hospitals and patients as it can cause illness and death and the disease has the potential for epidemic spread. Hepatitis A, B, and C are the most common cause of liver cirrhosis and can lead to chronic disease in millions of people. Common modes of transmission are contaminated blood or blood products and using contaminated equipment for invasive medical procedures. The infections may carry limited or no symptoms Hepatitis. (2015). The Liver
The liver is the largest gland in the body and weighs about 1.36 kg. It is reddish brown to look at and has four lobes of different sizes. The hepatic artery and the portal vein carry blood to the liver. Thousands of lobules make the liver, and each lobule is further made of many hepatic cells that are the elementary metabolic cells of the liver. The liver plays a very important role in the body and is responsible for a wide range of functions such as detoxification of the blood, Protein synthesis, preserves the right levels of glucose, and stores glycogen. It aloes create 80% of the cholesterol in the body and are responsible for the storage of vitamins A, D, K, and B12. It helps in the construction of hormones and synthesis of plasma protein (What is hepatitis, 2014).Thus, any damage or injury to liver or its cells means serious complications for the whole body. Hepatitis can heal on its own, or it can further lead to scarring of the liver tissue. It is projected that about 2 billion carry HBV (Hepatitis B virus) infection, and another 350 million are chronic transporters of HBV 1. About 75% of chronic carriers live in the Western Pacific regions and Asia. It is estimated that 15-40% of HBV patients are likely to develop cirrhosis. More than a million people die of HBV infections every year. Because of the high illness and death related to hepatitis, the burden of HB is substantial at a global level (Hou, Liu & Gu, 2005).The Spread of the disease in the United States vs. worldwide
Hepatitis virus infection can lead to a wide range of liver disease such as cirrhosis, chronic hepatitis hepatocellular carcinoma. Acute infections can be either asymptomatic or symptomatic in case of acute hepatitis. Most infected patients can recover, but 5%–10% are unable to overcome the infection and can get chronically infected. The virus has a distinct ability to persist in infected cells and can replicate through an RNA intermediate. The patients with acute infections can progress to cirrhosis and liver cancer and will require timely therapeutic intervention and careful monitoring (Liang, 2009).
About, 2 billion people, which means 1 out of 3 people are infected with hepatitis, and about 400 million are already chronically infected. More than one million people decease every year from complications infections, and it means that they are not able to get free of the virus, and succumb to its complications. In the U.S., more than 12 million people and it means 1 out of 20 people are infected with hepatitis. About 100,000 new people get hepatitis B infections each year, and about 5,000 people die from these infections (General Information, 2015).
The maximum incidents of Hepatitis are seen in the Western Pacific. African and Asian countries. The most common cause of infections in these countries is infections in early childhood and transmission from the chronically infected mother. When the occurrence of the disease is studied in southern and Eastern Europe, the intermediate infection is found to be due to perinatal transmission, nosocomial transmission as well as tattooing and needle sharing among drug users. In other countries such as America, Australia, and Western Europe, the prime transmission is chiefly through sexual contacts and needle sharing (D’Souza, & Foster, 2004).
The prime challenges related to Hepatitis is the lack of knowledge in predicting the progression of HBV infection. More research needs to be done in the field of molecular, cellular, immunological, and genetic basis of the disease manifestations that are linked to HBV infection.
How does one get infected with hepatitis?
Hepatitis can spread through contact with infected body fluids. Blood is the key vehicle for transmission, and the only natural host is human. However, other body fluids such as semen and saliva have also been implicated. At present, there are three main modes of Hepatitis transmission, and these are parenteral/percutaneous, perinatal and sexual transmission. Till date, there is no evidence that aerial infections can occur and feces are definitely not a source of infection HBV cannot get transmitted by having contaminated food or water (Hou, Liu & Gu, 2005).
Perinatal Transmission The transmission of the Hepatitis virus can occur during the perinatal period and is one of the most common factors in spreading the infection. Mothers who are HBsAg-positive but HBeAg-negative were responsible for 10-30% proportion of babies that became HBV carriers. However, when the mother is both HBeAg-positive and HBsAg-positive, the incidence of perinatal infections goes up to 70-90%. The infected mothers can infect their babies via transplacental transmission of HBV in utero or postnatal transmission during care or the natal transmission during delivery or through breast milk. The perinatal transmission is the riskiest as the transmission occurs antenatally, and the hepatitis vaccines cannot block this route (Hou, Liu & Gu, 2005.. The studies on transplacental transmission advocate two probable mechanisms, one is the hemagenous route such as threaten abortion that can lead to the breakage of placental microvascular and the maternal blood can enter into fetus' circulation. The other is cellular transfer where the high-titer of HBV in maternal blood infects the placental tissue. HBV can also reach the fetus' circulation through the villous capillary endothelial cells.
The children who are less than a year old and have acquired hepatitis infection perinatally, run a higher risk of the infection getting chronic. This could be because the neonates and children at this age have an immature immune system. Sexual Transmission Another major source of hepatitis infection is the sexual transmission, especially in the low, widespread areas, such as North America and Western countries. Hepatitis B is looked upon as a sexually transmitted disease (STD). Homosexual men are considered to be at the maximum risk of infection due to sexual activities. Majority of homosexual men are found to get infected after five years of sexual activity. The history of sexual transmitted disease, number of sexual partners, duration of sexual activity, are some of the factors associated with increased risks of the infection. Sexual partners of prostitutes and drug users are at particularly high risk for infection (Hou, Liu & Gu, 2005).
Different types of Hepatitis Viral hepatitis leads to considerable morbidity in the human population, and the infections can get acute and chronic. Hepatocellular carcinoma is one of the most common cancers worldwide and is closely linked to cancers. The different types of hepatitis virus are Hepatitis A virus, Hepatitis B virus, Hepatitis C virus, Hepatitis D virus and Hepatitis E virus (Zuckerman, 1996).
Hepatitis A virus (HAV) - The virus is also referred to as hepatovirus, and the small and symmetrical RNA virus shares many common individualities of the picornavirus family. It leads to epidemic hepatitis that is conveyed by the fecal-oral route (Zuckerman, 1996).
Hepatitis B virus (HBV) – The virus is a member of the hepadnavirus group. The viruses made of double-stranded DNA can replicate by reverse transcription that is considered to be unusual. A number of variants of the virus have been recorded, and it is endemic in the human population across many parts of the world (Zuckerman, 1996).Hepatitis C virus (HCV) - The single-stranded RNA virus is faintly related to flaviviruses and is related with chronic liver illness, as well as cause of primary liver cancer. Infection is common in many countries because of this recently identified virus (Zuckerman, 1996).
Hepatitis D virus (HDV) - The circular RNA virus is single-stranded and carries a number of similarities to plant viroids. This virus is a central cause of chronic liver damage and will need hepadna virus functions to propagate in hepatocytes (Zuckerman, 1996).
Hepatitis E virus (HEV) - The single-stranded RNA virus shares many biochemical and biophysical features with caliciviruses. It is the major cause of epidemics of acute hepatitis in countries like Africa, Central and Southeast Asia, India, the Middle East, etc. (Zuckerman, 1996).
How does one get Hepatitis and its Symptoms
Many people are not able to follow the symptoms of Hepatitis as they can be easily mistaken for the flu. Sometimes, there are no symptoms at all. However, the most common hepatitis symptoms are loss of appetite, mild fever, fatigue, nausea and vomiting, muscle or joint aches, abdominal pain, etc (Hepatitis Health Center, 2015).
Hepatitis A virus infected person can spread the virus about a week before the symptoms appear. Thus, people who are carrying the infection, will show no symptoms and can spread the hepatitis. This usually happens through the exchange of infected blood, semen or vaginal fluids from an infected person to another person's body. When symptoms appear, they comprise of loss of appetite, abdominal pain, diarrhea, nausea, fatigue, fever, jaundice, etc. (Hepatitis Health Center, 2015).
The hepatitis B virus can get into the body through the breaking or rupture of the lining of the vagina, rectum, urethra or mouth. Sharing infected needles and other equipment used for injecting illegal drugs can spread the infections. Health care workers handling blood or instruments or working in the labs too run a risk of getting infected if they get stuck accidentally with a used needle or another sharp instrument. Infection also can spread through cuts in the skin or eyes and the mouth. Body piercings and tattoos are a common causes of the infections when needles used are not sterilized properly. Grooming items such as toothbrushes and razors can spread the virus if they carry blood from an infected person. Organ transplants and blood transfusions could also spread the disease. This is the reason all donated blood and organs get screened for the virus (Hepatitis Health Center, 2015).
Symptoms can appear after two to three moments of getting the virus. Once the symptoms start, the semen, blood, and vaginal fluids are highly contagious during this period.
Hepatitis C can lead to liver cancer, liver failure and cirrhosis. Most patients are not aware that they have hepatitis C until they experience some kind of liver damage, and sometimes, this could take years. Sometimes, people who get Hepatitis C can recover for a short time and even get better. But most individuals who are sick with hepatitis C virus go on to develop hepatitis C, in the long run. Although the infection is very serious, it can be managed, and people can lead active lives (Hepatitis Health Center, 2015).
One can get hepatitis C by sharing infected needles and other equipment commonly used for injecting drugs. This is the most common way of getting the virus. You can also get the infection because of blood transfusion, tattoo or piercing, etc.
People exposed to the hepatitis C virus risks are people who have multiple sex partners, are injection drug users, health care workers, hemodialysis patients and infants born to infected women. As there is no vaccine for hepatitis C, the only way to control it and minims the risk are to reduce the risk of exposure by avoiding behaviors such as having multiple sex partners or sharing drug needles, razors, toothbrushes, nail clippers, etc. Peginterferon and the antiviral drug ribavirin is used as the treatment for Hepatitis C (Viral Hepatitis: A through E and Beyond, 2015).
Hepatitis D can spread through any contact with infected blood and Injection drug users carry the highest risks, as well as those living with a person infected with hepatitis D. Chronic hepatitis D, is treated with pegylated interferon and research is still going on (Viral Hepatitis: A through E and Beyond, 2015).
Hepatitis E can spread through contaminated food or water due to feces from an infected. However, the infection is uncommon in the United States. People who are most exposed to the hepatitis E virus risks are international travelers or those living in areas with common hepatitis E outbreaks or having sexual relation with an infected person. There is still no approved vaccine for hepatitis E and the only way to control the disease and lower the risks are by lowering the risk of exposure to the virus, as well as practice good hygiene and sanitation when traveling internationally (Viral Hepatitis: A through E and Beyond, 2015).
Precautions to take when dealing with a hepatitis patient
Hepatitis virus infections can be prevented by following safety measures. The public should be educated about infection control practices and given risk-reduction counseling. The donated blood, plasma, organ tissue and semen should be screened for any virus infections. However, the most effective prevention measure is the routine immunization for infants. The high-risk individuals such as health care workers, intravenous drug users, persons with several sex partners, patients with chronic diseases should also get immunization. Administration of hepatitis B immunoglobulin and HBV vaccine can prevent the infection from getting in the babies born to HBsAg carrier mothers (D’Souza, & Foster, 2004).
In order to prevent and control Hepatitis infection, one has to pay special attention to the hygiene. There are several strategies that can prevent the spread of the infections. For example, washing your hands regularly is the most effective strategy for reducing transmission, as the virus can active for a couple of hours on the fingers. Hands should be washed with an effective antimicrobial soap and rubbed for at least half a minute. One should pay special attention to the fingernails, and the rinsing should be done thoroughly. Single use towels should be used for drying the hands. Alcohol-based hand rubs can be effective against hepatitis, especially when there are no sinks (Cheney, 2015).
One should also take precautions when preparing foods to reduce the risks of catching the infection or spreading it. The fruits and vegetables should be washed thoroughly before eating, and one should not drink unpasteurized milk. The raw foods like meat, fish, and poultry should be kept separately from other foods and cooked thoroughly before eating. Cooked foods should not be left outside, uncovered and at room temperature. It should be refrigerated promptly. People who are traveling to areas with Hepatic infection or dealing with such a patient should that these precautions as discussed to avoid becoming ill or spreading the infections (Cheney, 2015).
Diagnosis and Control
Hepatitis B is a life-threatening disease of the liver and the principle causes of several liver disorders. Baruch Blumberg accidently discovered it in 1963, and the HBV is the smallest known DNA virus. The infectious virus particle is responsible for 600 000 deaths and infect millions of people around the world. Tremendous efforts are being made by many scientists for the control of the viral infection, and there are many successful vaccination strategies to control viral spread. There is a higher need to educate the masses and spread awareness regarding the Hepatitis infection and how to control the infections (Saeed, Waheed & Ashraf, 2014).
Routine liver function tests and serological assays help in the diagnosis of chronic Hepatitis infection. In order to evaluate the stage of chronic hepatitis, the HBV antigens and antibodies should be detected. DNA hybridization with signal amplification can help monitor HBV DNA, as well as measure the disease activity and the response to treatment. It is very essential to perform Liver biopsy to confirm the diagnosis.
The prime aim of treatment of hepatitis is to control the replication of the virus and induce reduction of liver disease before it gets to even a more acute stage and turns cancerous. Recombinant subcutaneous interferon-α and oral lamivudine are uses in many countries and have bene approved for use. The American Association for the Study of Liver Disease advocates that patients who carry moderate or severe chronic hepatitis should be offered the treatment (D’Souza, & Foster, 2004).
Hepatitis of any kind and especially B is dangerous. These infections are thought to be more serious as the virus can enter people without them knowing and spread the silent infections. Most people are unaware of the Hepatitis virus they are carrying and can pass the infection to others unknowingly through their infected bodily fluids or blood. Those who develop chronical infections show an increased risk of developing serious liver diseases and problems later on. As the virus can spread quietly and attacks the liver continuously over the coming years without being detected or the patient getting aware.
As there is no fool proof treatment or vaccine developed, one relies on supportive measures and preventive action to restrain the spread of the infection. There are several drugs available that can reduce potential liver damage and slow their replications There are cases where the virus has been got rid of completely.
There are certain steps to take and follow precautions to avoid the spread of sexually. For example, avoiding unprotected sex with an infected pattern, maintaining good hygiene and avoid using illicit drugs are some of the essential steps to take when dealing with hepatitis. Be very careful when using needles or getting body piercing, and tattooing done. . If you're moving to a country that is riddled with these infections, it is best to consult your doctor about what further precautions to take and learn about hepatitis vaccine in advance, and if you need them.
Cheney, C. (2015). HEPATITIS A OVERVIEW. Retrieved from http://www.uptodate.com/contents/hepatitis-a-beyond-the-basics
D’Souza, R., & Foster, G. R. (2004). Diagnosis and treatment of chronic hepatitis B. Journal of the Royal Society of Medicine, 97(7), 318–321.
General Information: FAQ. (2015). Retrieved from http://www.hepb.org/patients/general_information.htm
Hepatitis. (2015). Retrieved from http://who.int/topics/hepatitis/en/
Hepatitis Health Center. (2015). Retrieved from http://www.webmd.com/hepatitis/
Hou, J., Liu, Z., & Gu, F. (2005). Epidemiology and Prevention of Hepatitis B Virus Infection. International Journal of Medical Sciences, 2(1), 50–57.
Liang, T. J. (2009). Hepatitis B: The Virus and Disease. Hepatology (Baltimore, Md.), 49(5 Suppl), S13–S21. doi:10.1002/hep.22881
Saeed, U., Waheed, Y., & Ashraf, M. (2014). Hepatitis B and hepatitis C viruses: a review of viral genomes, viral induced host immune responses, genotypic distributions and worldwide epidemiology. Asian Pacific Journal of Tropical Disease, 4(2), 88–96. doi:10.1016/S2222- 1808(14)60322-4.
Viral Hepatitis: A through E and Beyond. (2015). Retrieved from http://www.niddk.nih.gov/health-information/health-topics/liver-disease/viral-hepatitis-a- through-e/pages/facts.aspxWhat is hepatitis? Symptoms, causes and treatments. (2014). Retrieved from http://www.medicalnewstoday.com/articles/145869.php
Zuckerman, A. (1996). Chapter 70Hepatitis Viruses. Medical Microbiology, 4(1).
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