Hepatitis, a pathophysiological condition causing liver inflammation, is a serious viral disorder. The most common types of hepatitis diagnosed in states are hepatitis A, hepatitis B, and hepatitis C. The less frequent types, hepatitis D and hepatitis E, are also significant health concerns, often caused by unhygienic conditions.

In North America, the incidence of hepatitis is increasing over time; according to a study, the incidence rate of hepatitis A was approximately 0.68/100,000 in 2019. Moreover, according to research published in January 2024, the prevalence of hepatitis B from 2017-2022 was approximately 47/100,000, and the incidence increased among males, people living in resource-deprived areas and older age group people. Another survey related to hepatitis C concluded that in 2021, the incidence of hepatitis C was approximately 19.7/ 100,000, and more males were infected by hepatitis C than females; according to reported data, approximately 62% of males were reported with hepatitis C.

CAUSES OF HEPATITIS

Various factors can cause it, and the following are the causes of hepatitis including:

• Viral infection (HAV, HBV, HCV)
• Unhygienic environment (Hepatitis E and Hepatitis D)
• Excessive use of alcohol
• Unhealthy sexual practices
• Blood transfusion
• Autoimmune disorder
• Drugs side effects

TYPES OF HEPATITIS

Hepatitis A

The HAV virus causes hepatitis A, an RNA virus that is a contagious liver infection that affects the normal physiology of the liver. You can get infected with hepatitis A from contaminated food or water or by close contact with an infected person.

Hepatitis B

The HBV virus, a DNA virus, causes hepatitis B. It is a severe liver infection transmitted through exposure to infectious blood, semen, serum, and other bodily fluids.

Hepatitis C

HCV, an RNA virus, causes hepatitis C; it is a severe liver inflammation causing swelling of the liver, leading to severe liver damage. Hepatitis C can be transmitted through injecting illicit drugs, sharing syringes, and transfusion of bodily fluids, including perinatal transmissions as well.

Hepatitis D

HDV, an RNA virus, causes hepatitis D. It occurs in people who have hepatitis B and can cause serious infection over time, leading to irreversible liver damage and even death. It is transmitted through contact with infectious blood or body fluids. Hepatitis D infection can result in a more severe form of hepatitis and increase the risk of liver failure.

Hepatitis E

HEV, a non-enveloped viral RNA, causes hepatitis E. The primary route of HEV is through the fecal-oral route and consuming contaminated water. It is usually acute and resolves on its own without causing chronic infection, and person-to-person transfer is rare. Hepatitis E is more common in low-middle-income countries.

SYMPTOMS

The symptoms of hepatitis vary from one type to the other, and generally, the following are the symptoms of hepatitis;

• Low-grade fever or episodes of fever
• Feeling tired and weak
• Nausea and vomiting
• Loss of appetite
• Abdominal pain
• Pale skin and dark urine

Hepatitis A symptoms start to appear after a few days to a week of infection by the HAV virus and are similar to gastroenteritis, flu, or respiratory tract infection.

Hepatitis B symptoms include anorexia, hepatomegaly, jaundice, dark color urine, and fever with rashes and periodic flare-ups.

Hepatitis C symptoms start to appear within a few weeks of infection and are similar to acute HBV infection, including anorexia, malaise, and fatigue. In contrast, approximately 80% of patients remain asymptomatic and do not develop conditions like jaundice.

Hepatitis D occurs in patients infected with HBV, and symptoms are similar to that of acute HBV infection, but chronic conditions may cause cirrhosis, fulminant liver failure or chronic hepatitis.

Hepatitis E occurs due to unhygienic conditions; the symptoms are similar to acute HAV infection. HEV is usually cured over time, and chronic conditions like cirrhosis and liver failure are rare. However, the HEV-related mortality rate is higher in pregnant females.

RISK FACTOR ASSOCIATED WITH INCREASE PREVALENCE

The following are the risk factors associated with the increased prevalence of hepatitis in North America;

Improper meal

Having raw meat or partially cooked meat of live stocks and marine animals can also become a cause of transmission of the virus, leading to the development of hepatitis.

Alcohol consumption

Hepatitis is inflammation of the liver, and increased consumption of alcohol is responsible for causing damage to the liver, leading to the development of hepatitis in people.

Unhygienic lifestyle

An unhygienic lifestyle may also contribute as a risk factor for hepatitis E and D. This unhygienic lifestyle includes deprived resources, use of contaminated water, and sharing of things among multiple people.

Unhealthy sexual practice  

Unhealthy sexual practice contributes a lot to the development of hepatitis among people. These practices include unprotected activities, multiple sexual partners, sex with infected persons and the exchange of fluids among people.

Use of illicit drugs

The use of illicit drugs can contribute to liver damage, causing an increased risk of hepatitis development among people. The use of the same syringe while injecting drugs can also cause hepatitis.

MANAGEMENT OF HEPATITIS

For the management of hepatitis and to decrease the rate of prevalence of hepatitis, we need to follow DAP 

Diagnosis, Awareness, and Prevention

DIAGNOSIS

Early diagnosis is a powerful tool in preventing the development of chronic liver inflammation. By maintaining a proper routine follow-up, you can take control of your health. Routine screening is especially crucial for high-risk populations with a history of illicit drug use or those born to hepatitis B or C-positive mothers.

AWARENESS

Spreading awareness about hepatitis is a pivotal strategy in its management. The following are some effective awareness-related strategies that can be implemented in our society;

Educational seminars

The government and healthcare institutions should collaborate to train healthcare practitioners on how to manage disease conditions and what interventions can be used to cure and prevent widespread disease.

In addition to this, seminars can also be organized by the government to spread awareness regarding hepatitis among people.

Counseling sessions

Special counseling sessions should be arranged for addicts and people who are involved in unhealthy sexual practices.

PREVENTION

Safe Injection Practices

Promoting access to sterile needles and syringes helps reduce transmission among people who inject drugs.

Healthcare Practices

Implement standard guidelines in healthcare settings to ensure safe blood and organ donation to prevent hepatitis transmission.

In addition to the above-mentioned preventive measures, lifestyle modifications include eating healthy meals, maintaining personal hygiene, consuming less alcohol, and following standard hygiene conditions in your surroundings.

Effective management of hepatitis involves a combination of prevention strategies, early detection through screening, appropriate medical treatment, and supportive care. Continued efforts in education, and access to healthcare are essential for controlling hepatitis and improving liver health across the continent. By raising awareness and advocating for effective preventive measures, we can work towards a future where hepatitis is no longer a significant public health threat.