Abstract
The term “Hepatitis” refers to a group of medical conditions characterized by inflammation of the liver cells hepatocytes, the basic units of the liver. Although there are several causes of cell inflammation, a viral infection of the vital organ is the cause of more than 90% of all the cases (Longo, 2012). Currently, hepatitis types A, B, C, D, and E are the most common viral infections of the liver in humans. Infection with these viruses means that the liver plays as the host or one of the host organs that provide the virus with the required environment for replication before translation. The purpose of this paper is to discuss the cause and management of hepatitis A, B, and C. Specifically, the aim is to discuss the control and management of these diseases.
Description of hepatitis A, B, and C
Prevalence
Hepatitis viruses D and E are less important in the medical field because they are rare or depend on other factors for their virology. For instance, the hepatitis D virus co-infects with type B, entirely depending on it is causing the observable medical condition. Thus, this makes hepatitis viruses A, B, and C the most important viruses with medical importance. Hepatitis A causes more than 30,000 cases of infection every year, with more than 1.3 million people living under the condition throughout the world (CDC, 2012).
Transmission of hepatitis A
The virus is oral-fecal in nature, meaning that the mode of transmission takes place in the oral-fecal route. However, research evidence confirms that the virus is also transmitted through fluid-to-fluid contact between an infected and an un-infected individual. For instance, close person-to-person or sexual contact and blood transfusion are other important routes of transmission.
This means that the individuals at risk include people living in conditions where food contamination with fecal matter is possible, especially in cases where sewage and drainage systems are poor. In addition, people traveling to high prevalent areas are at risk because their immune system tends to be novel. Sexual contact with infected individuals, homosexual contacts, caregiving, and living with infected persons are some of the major factors that contribute to infection. Individuals with clotting factor disorders as well as those who use the injection and non-injection drugs are at risk of developing the condition (Dunn, 2011).
Once an individual is infected with the virus, regardless of the route of transmission, the virus takes between 15 and 50 days to incubate. On average, the incubation period for the virus is around 25 to 28 days. During incubation, the virus is rapidly replicating and infecting novel cells in the liver as well as other parts of the body. Replication is rapid because the virus is lysogenic, meaning that the viral DNA is integrated into the host cell genome and controls cellular functions, including programs for self-inflammation (Teufel, 2009).
After incubation, the progeny viruses infect various cells in the liver and other parts of the body. They lead to observable conditions, such as nausea, abdominal pain, loss of appetite, pain in the joints, fatigue, jaundice, fever, brown bowel movements, and vomiting. Evidently, most individuals do not portray some of the conditions. In fact, individuals may have one or a few of these symptoms. It is rare to find a case in which all or a large number of symptoms are presented in a single patient.
Young children, especially those under the age of 6 children, have the lowest probability of developing a symptomatic acute infection. It is evident that the probability of developing symptomatic acute condition increase with age. For instance, children aged between 6 and 15 years have a relatively high probability of developing the acute condition, mostly at around 40% to 50%. However, adults and adolescents aged above 15 years have the highest likelihood of developing the condition, currently amounting to 70% to 80% of the cases. In fact, these cases involve jaundice, which is the most common symptom in acute infections with the virus. However, chronic infection is not common in HVA infection, unlike in Hepatitis B and C groups. This means that condition is rarely fatal, with most people recovering within a few months and without long-lasting harm caused to the liver cells (Masuoka & Chalasani, 2013).
Transmission of hepatitis B
The virus is transmitted through direct contact with infected persons. The main routes of transmission include birth (mother to child), sexual contact, sharing of contaminated syringes, needles, and other items, such as sharp objects.
Hepatitis C
The virus is also transmitted through direct contact with infected body fluids or tissues. The routes of transmission include using the same sharp objects. such as needles, and syringes, sexual contact as well as mother-child transmission.
Test, treatment, and control
Hepatitis A
In the modern context, biomedical tools have developed rapid, effective, and high throughput techniques for the detection of viral infection in suspected individuals. Serological tests provide one of the most effective and inexpensive techniques for detection. For instance, infection with hepatitis A virus triggers the release of antibody IgM that targets human cells infected with the virus. In this case, the human immune system recognizes the infected cells and releases IgM anti-HAV antibodies. These antibodies are the hallmark molecular aspect for serological based diagnostics. Using such techniques as Enzyme-Linked Immunosorbent Assays (ELISA), it is possible to mobilize anti-IgM antibodies in a solid surface or microwells, which targets and binds the target IgM proteins.
Hepatitis B Tests
Like HAV, HBV infection triggers the release of anti-HBV antibodies. In acute infection, detection of IgM is effective in determining the presence of the virus in blood and serum. In both the chronic and the acute infection, HBsAg is the major aspect targeted in serological tests.
Hepatitis C
Unlike HAV and HBV, HCV has no serological marker for acute infection. However, screening assays, such as EIA and CIA, are effective for anti-HCV. In addition, more specific assays, such as Nucleic Acid Testing, are effective.
Molecular tests for HAV, HBV, and HCV
In addition, research has developed molecular techniques that target the specific viral DNA using such techniques as the polymerized Chain Reaction (PCR) that specifically amplifies the viral DNA for easy identification. Such methods are not only effective but also precise. Nevertheless, they are expensive and laborious because they involve molecular techniques, such as DNA isolation and polymerization.
Since both serology and molecular diagnosis are highly effective and specific, treatment and management intervention procedures tend to rely on information obtained from the tests. If these tests indicate that the individual is infected with the virus, treatment is necessary.
Management Strategies for Hepatitis A, B and C viruses
Medical interventions
Both hepatitis viruses A and B do not have pharmaceutical intervention protocols because there are no antiviral drugs targeting the virus, its proteins, or infected cells. However, HBV is best treated through regular management and monitoring of liver diseases associated with the virus. On the contrary, HCV is treated with antiviral drugs (an acute stage) and regular monitoring of liver pathologies in chronic cases.
Social support
However, there is no specific medical treatment available for managing the condition because it is mostly self-limiting and has no long-term impact on the hepatocytes. As such, the best management intervention is to provide social and psychological support. Patients should be provided with adequate material and immaterial support to ensure that they cope with the condition and enhance healing. People with other conditions, such as cancer, HIV/AIDS, and diabetes, tend to take long before the virus is cleared from their system due to immune compression. In such cases, intervention protocols should focus mainly on the disease rather than on the virus.
Lifestyle and behavior change and adaptation
It is advisable to control the disease through awareness programs. These programs aim at reducing the number of infections, which means that they are control protocols. In such cases, people are encouraged to avoid behaviors that are likely to predispose them to the virus. For instance, sexual infection is managed controlled by encouraging people to avoid unprotected sex, change sexual behavior, and reduce the number of partners.
Frequent testing is important to determine whether individuals have the virus. In addition, people should be encouraged to be careful when sharing sharp objects and needles and avoid contact with human fluids, such as semen, blood, and others (Kumar, Fausto & Abbas, 2003). People living with or caring for patients suffering from pepatitis should avoid direct contact with these fluids. Disinfection of clothes, wastes, utensils, and other objects should be done frequently.
Vaccination
One of the best ways of reducing infection rates and cases of hepatitis infections is through vaccination. Hepatitis vaccinations are developed through attenuation of the virus, conferring memory cells in the vaccinated individuals. The aim is to ensure that a novel infection or re-infection triggers anti-IgM, making it impossible for the virus to infect and replicate in the host cells (Inaba & Cohen, 2004).
Vaccinations are recommended for the groups that are at high risk of infection. For instance, children aged one year and individuals traveling from regions of low to high or intermediate prevalence should be immunized. Moreover, other individuals such as people who live or work with infected individuals, have unprotected sex with suspected partners as well as those with disorders of the clotting factor are also at high risk and should be immunized. Noteworthy, people who work with animals such as primates are prone to infection because primates harbor hepatitis in nature and easily pass them to humans due to contact.
Conclusion
This analysis provides adequate information vital for the development of effective and sustainable techniques for managing hepatitis infection. A comparison with other viruses of the same Hepatitis group is important in order to determine the condition affecting an individual before proceeding with management.
It is evident that infections with these viruses have no direct cure, although they are self-limiting in most cases. This means that healthy lifestyles, behavior change, vaccination, and mass awareness programs are the best methods for controlling the spread of these viruses.
References
Centers for Disease Control and Prevention, CDC. (2012). The ABCs of hepatitis. Web.
Dunn, M. A. (2011). Parasitic Disease. Oxford, UK: Wiley-Blackwell.
Inaba, D., & Cohen, W. B. (2004). Uppers, downers, all arounders: physical and mental effects of psychoactive drugs. Ashland, Or: CNS Publications.
Kumar, V., Fausto, N., & Abbas, A. (2003). Robbins & Cotran Pathologic Basis of Disease. New York: Saunders.
Longo, D. L. (2012). Chronic Hepatitis. New York: McGraw-Hill.
Masuoka, H. C., & Chalasani, N. (2013). Nonalcoholic fatty liver disease: an emerging threat to obese and diabetic individuals. Annals of the New York Academy of Sciences 1281(1), 106–122.
Teufel, A. (2009). Update on autoimmune hepatitis. World Journal of Gastroenterology 15 (9): 1035–4.