Hepatitis is an inflammation of the liver caused by various infectious viruses and non-infectious agents, leading to a range of health issues, some of which can be fatal.
There are five primary strains of the hepatitis virus, known as types A, B, C, D, and E.
While all these types cause liver disease, they differ significantly in their modes of transmission, severity of illness, geographical distribution, and prevention strategies.
Notably, types B and C are responsible for chronic diseases in hundreds of millions of people and are the leading causes of liver cirrhosis, liver cancer, and viral hepatitis-related deaths.
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An estimated 354 million individuals worldwide are living with hepatitis B or C, and many lack access to testing and treatment.
Certain types of hepatitis can be prevented through vaccination.
A WHO study indicates that approximately 4.5 million premature deaths could be avoided in low- and middle-income countries by 2030 through vaccinations, diagnostic tests, medications, and educational campaigns.
The WHO’s global hepatitis strategy, which has been endorsed by all member states, aims to reduce new hepatitis infections by 90% and related deaths by 65% between 2016 and 2030.
Symptoms
Many individuals with hepatitis A, B, C, D, or E may experience mild symptoms or none at all.
However, each type of the virus can lead to more severe symptoms.
For hepatitis A, B, and C, symptoms can include fever, fatigue, loss of appetite, diarrhea, nausea, abdominal pain, dark urine, and jaundice (yellowing of the skin and eyes).
In some cases, these viruses can cause chronic liver infections, which may progress to cirrhosis (liver scarring) or liver cancer, posing a risk of death.
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Hepatitis D (HDV) occurs exclusively in those already infected with hepatitis B (HBV). Co-infection with HBV and HDV can lead to more severe illness and worse health outcomes, including faster progression to cirrhosis. Chronic hepatitis D is relatively uncommon.
Hepatitis E (HEV) typically begins with mild fever, reduced appetite, nausea, and vomiting lasting a few days.
Some individuals may also experience abdominal pain, itching (without skin lesions), skin rash, or joint pain.
They may present with jaundice, dark urine, pale stools, and a slightly enlarged, tender liver (hepatomegaly), and in rare cases, acute liver failure may occur.
Treatment
Safe and effective vaccines are available to prevent hepatitis B virus (HBV) infections.
This vaccine also protects against the development of hepatitis D virus (HDV) and is administered at birth to significantly reduce the risk of transmission from mother to child.
Chronic hepatitis B infections can be treated with antiviral agents, which can slow the progression of cirrhosis, lower the incidence of liver cancer, and enhance long-term survival.
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However, only a portion of individuals with chronic hepatitis B will require treatment.
A vaccine is also available to prevent hepatitis E virus (HEV) infections, although it is not widely accessible at present.
There are no specific treatments for HBV or HEV, and hospitalization is typically not necessary. It is recommended to avoid unnecessary medications, as these can adversely affect liver function during infections.
Hepatitis C virus (HCV) can lead to both acute and chronic infections.
While some individuals may recover spontaneously, others may develop severe complications, including cirrhosis or liver cancer.
There is currently no vaccine for hepatitis C, but antiviral medications can cure over 95% of those infected, significantly reducing the risk of death from cirrhosis and liver cancer. Nevertheless, access to diagnosis and treatment remains limited.
Hepatitis A virus (HAV) is most prevalent in low- and middle-income countries, primarily due to limited access to clean water and increased risk of contaminated food.
A safe and effective vaccine is available for hepatitis A.
Most HAV infections are mild, with the majority of individuals recovering completely and developing immunity to future infections.
However, in rare cases, these infections can be severe and life-threatening due to the risk of liver failure.
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