Understanding viral hepatitis: Dr Nakul Pathak explains the types, transmission and clinical implications

Hepatitis viruses A to E all cause liver inflammation, but there are certain differences between their transmission and function, shares Dr Pathak.

Viral hepatitis is the inflammation of the liver caused by a viral infection. There are five main viruses that affect the liver, commonly known as hepatitis viruses A, B, C, D and E. While they affect the same organ, the viruses differ in how they spread, how the illness progresses and the long-term risks they carry.

In an interaction with HT Lifestyle, paediatrician Dr Nakul Pathak broke down the differences. They are presented as follows.

Types and transmission of hepatitis viruses

Among the five common hepatitis viruses, hepatitis A and hepatitis E are usually transmitted through food and water that has been contaminated with infected stool, shared Dr Pathak, adding that hepatitis A may also spread through close personal contact.

“Both usually cause acute illness, although severe liver failure can occasionally occur. Hepatitis E deserves particular attention during pregnancy because the risk of acute liver failure, fetal loss and maternal death is considerably higher,” cautioned the paediatrician.

Hepatitis C is mainly blood-borne and may follow unsafe injections, inadequately sterilised equipment, unscreened blood products or shared injecting equipment. It can also pass from an infected mother to her baby.

“Hepatitis D depends on hepatitis B for its survival,” noted Dr Pathak. It may arrive with the hepatitis B virus, or infect someone who already has chronic hepatitis B, where it can accelerate liver scarring, he shared.

How do the hepatitis viruses affect people?

When it comes to liver inflammation, as in the case of hepatitis, the major question is whether the condition clears or becomes chronic, noted Dr Pathak.

In the words of the paediatrician, “Hepatitis A does not become chronic, while hepatitis E usually resolves within weeks. Hepatitis B and C can remain silent for years while liver damage progresses towards fibrosis, cirrhosis, liver failure or cancer. Hepatitis C can now be cured in nearly all treated patients using direct-acting antiviral medicines, while eligible patients with chronic hepatitis B may require antiviral treatment and long-term monitoring.”

What are the symptoms of hepatitis infection?

Fatigue, nausea, and abdominal pain can all be symptoms of viral hepatitis.

Dr Pathak shared that it is not possible to determine the type of hepatitis virus infecting a person based on the observable symptoms alone, and blood tests are absolutely essential. Some of the infected people can also show no symptoms at all.

However, the signs that deserve getting checked out by a medical professional include:

• Fatigue
• Poor appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Pale stools
• Jaundice

How to prevent hepatitis

Like all diseases, prevention is better than cure when it comes to hepatitis.

For hepatitis A and E, Dr Pathak suggested focusing on safe drinking water, sanitation and handwashing.

Vaccination helps prevent hepatitis A and B, and by preventing B, it also protects against hepatitis D, he noted.

For hepatitis B and C, one should be careful to follow safety protocols when getting bloodwork done and ensure that sterile equipment is used.

“In mother-and-child care, there is a crucial window around birth,” noted Dr Pathak. “Every pregnant woman should be screened for hepatitis B, and a newborn whose mother tests positive should receive the hepatitis B vaccine and immunoglobulin within 24 hours, followed by the complete vaccine series.”

“Hepatitis can remain quiet while transmission or liver damage continues, which is why timely vaccination and testing carry far more weight than waiting for jaundice to appear,” he added.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Nakul Pathak is a paediatrician with over 10 years of experience and expertise in managing critically ill infants, children, and adolescents requiring advanced intensive care support. He is associated with Surya Hospitals as a pediatric consultant in the Pediatric Intensive Care and Emergency department.