Comparison of Hepatitis Types

There are 5 types of hepatitis virus being: A, B, C, D and E, Hepatitis A is caused by a virus called HAV. Which is transmitted by contact with contaminated water or food, mainly seafood and vegetables they also are transmitted through the faecal-oral route which is when the infected particles of the pathogen’s faeces are ingested through the mouth, which is more common in areas lacking proper sanitation of drinking water.(Louten 2016)

The virus can survive up to four hours on the skin of infected hands. The disease can still be incubated for up to six weeks, however, it is already possible to transmit the disease. Hepatitis A may not show any symptoms, but when there are symptoms, they can be as follows:

• Nausea and vomiting
• Fevers
• Muscle aches
• Tiredness and malaise;
• Jaundice

• Whitish stools and dark urine

The treatment of hepatitis A consists of easing the symptoms and usually disappears spontaneously within two months. Some people, however, can take up to six months to clear the body of the virus, rarely, hepatitis A progresses to a more serious complication, such as fulminant hepatitis, which is when the liver stops working. There are vaccines available for this type of Hepatitis (Saude 2019a)

Hepatitis B on the other hand is Transmitted by contact with blood, saliva, semen or vaginal secretions, hepatitis B is caused by the HBV virus, which attacks liver cells and can result in acute, chronic, or fulminant hepatitis. It is considered a Sexually Transmitted Disease (STD) and can also be transmitted by contact with contaminated objects, from mother to child (in pregnancy, delivery and postpartum) and blood transfusions, although the risk is very low.(Christoph Seeger 2015)

Symptoms of Hepatitis B can include the following:

• Nausea
• fever
• muscle aches
• jaundice
• clear stools
• dark urine

Also, tiredness, most of the time, the infected person does not even notice the disease and the virus is eliminated. However, it can progress to chronic. When this happens, it can take years for the infected person to discover the disease, and when he or she discovers the case is already more severe, resulting in liver cirrhosis or liver cancer.

Treatment of Hepatitis B, as in the case of hepatitis A, is aimed at reducing the discomfort of symptoms, but when it comes to chronic hepatitis B there are remedies to be administered. Hepatitis B also has a vaccine.

Hepatitis E, its more common in Asia and Africa its transmission is via faecal-oral, by contact between individuals or through water or food contaminated by the virus. Like other variations of the disease, there are almost no symptoms. However, the most frequent are:

• fatigue,
• dizziness,
• nausea and / or vomiting,
• fever,
• abdominal pain,
• yellowing of the skin and eyes,
• dark urine and light stools.

 These signs usually appear 15 to 60 days after infection. (Saude 2019b)

Apart from Hepatitis B and C in the majority of the cases the host immune system clears the infections caused by the hepatitis virus, however, hepatitis B and C are the major cause of liver disease and chronic hepatitis that can lead to hepatocellular carcinoma which is a type of liver cancer, the hepatitis B virus is found in the body fluids like blood, semen therefore it can be transmitted sexually, or if the person use drugs that are taken with injections also during pregnancy.(Louten 2016).

Also, there is Hepatitis D virus also known as hepatitis delta virus consist of a small viral particle that causes an infection in the presence of hepatitis B virus only. (Zechariah S. Gardner MD 2013)

 It is estimated that Hepatitis C, affects roughly 3% (170 million) of world population, of which nine million are Europeans, making Hepatitis C a much more common virus than HIV. According to the World Health Organization,  therefore, being more common than the other viral hepatitis also considering the number of people who are unaware of the fact that they have the virus.(Mincis and Mincis 2010)

Hepatitis C It is an inflammation of the liver caused by a virus the hepatitis C virus (HCV), which is an RNA virus belonging to the family Flaviviridae. It is a virus that is capable of at room temperature to survive for about 16 – 72 hours. (Bensenor et al. 2006)

Hepatitis C is transmitted through Blood transfusion, Sharing of material for use with drugs (syringes, needles, etc.), for personal hygiene (razor blades and shaving brushes, toothbrushes, nail pliers or other objects that pierce or cut) or for tattoo making and piercings also: From infected mother to child during pregnancy (less common) and Sex without a condom with an infected person (less common).                                                                                                                The disease usually develops into chronic, in most cases. The development is usually slow, and often the diagnosis is delayed. Symptoms of Hepatitis C are usually the follow;

• Nausea

• Jaundice (skin and the whites of the eye to turn yellow)
• weight loss
• tiredness
• muscle aches
• ascites (belly of water)

Hepatitis C has no cure in about 85% of cases, but there is treatment based on medication, there’s no vaccine available for hepatitis C.(Melissa G. Collier 2018)

when chronic can lead to cirrhosis, liver failure and cancer. For several years it was known as non-A and non-B hepatitis until the infectious agent that causes it was identified in 1989 has then gained special relevance among the causes of chronic liver diseases in the world. Hepatitis C is mainly transmitted through the blood. It is known as the “silent” epidemic because of the increasing number of people with chronic infection worldwide and because those infected may not have any symptoms for ten or 20 years and feel perfectly healthy.(Saude 2010)

Individuals considered to be at risk are those who received blood transfusions and / or blood products before 1992, intravenous drug users, people with with tattoos and piercings, alcoholics, people with HIV, transplanted, haemodialyzed, haemophiliacs, prisoners, sexually promiscuous individuals and even those who share toothbrushes, cuticle pliers, razors and shavers etc…(Ferreira 2004)

Hepatitis C becoming very known to the Irish population in 1994 as a result of a scandal called the “anti-D scandal” which in short was the contamination of Irish Mothers with Anti-D immunoglobulin, which was given to mothers that had Rhesus Negative blood type but gave birth to babies that had Rhesus Positive, this could result into serious damage or kill the foetus as some of the Rhesus Positive could pass through the placenta into the mother’s bloodstream generating antibodies against it. In the 60’s around 40 babies died every year as a result of this, therefore, the use of the Anti-D immunoglobulin was considered a breakthrough becoming widely used in maternity hospitals in the 1970’s.(O’Doherty 2014)

Hepatitis C is one of the few chronic diseases that can be cured by treatment with oral medications. The FDA (Food and Drugs Administration), has authorized the marketing of two drugs for the treatment of the disease – Sofosbuvir and Simeprevir. Therefore, one of the two drugs may be incorporated into the currently used treatment with pegylated interferon and ribavirin, with a greater chance of cure and reduced treatment time, but there will still be restriction to patients intolerant or contraindicated to interferon or ribavirin. The bad news, however, is the cost of these drugs.(Saude 2019)

• Ferreira, C.T. (2004). epidemio_hepC-Brasil. , 7(4), pp.473–487. Available from: http://www.scielo.br/pdf/rbepid/v7n4/10.pdf.
• Louten, J. (2016). Essential Human Virology [online]. , pp.213–233. Available from: https://www.sciencedirect.com/book/9780128009475/essential-human-virology [accessed 18 February 2019].
• Melissa G. Collier, … Scott D. Holmberg. (2018). Hepatitis C virus. Available from: https://www.sciencedirect.com/topics/immunology-and-microbiology/hepatitis-c-virus.
• Mincis, M. and Mincis, R. (2010). Hepatite C. Revista Brasileira de Medicina, 67(6), pp.172–178. Available from: http://www.scielo.br/pdf/rsbmt/v34n1/4321.pdf.
• O’Doherty, C. (2014). anti-d-scandal-was-a-bloody-disgrace-259488 @ www.irishexaminer.com. www.irishexaminer.com, 2014. Available from: https://www.irishexaminer.com/viewpoints/analysis/anti-d-scandal-was-a-bloody-disgrace-259488.html.
• Saude, M. da. (2019). Hepatite E. Available from: http://www.aids.gov.br/pt-br/publico-geral/o-que-sao-hepatites/hepatite-e.
• Saude, M. da. (2010). Terapêuticas para Hepatite Viral C e Coinfecções. Ministerio da Saúde, 2010, p.144. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/protocolos_diretrizes_hepatite_viral_c_coinfeccoes.pdf.
• Bensenor, Isabela M. Tibério, Iolanda de Fátima Calvo. Bernik, M.M.S. (2006) Medicina em ambulatório diagnóstico e tratamento.1st.ed. São Paulo: Sarvier, 2006.