top of page
Writer's pictureMa. Teresita Chica
3 days ago7 min read

The Alphabets of Hepatitis: A to E Types and Their Complications

Did you know that 304 million people worldwide are living with Hepatitis B and C?


But what makes Hepatitis B different from Hepatitis C and the rest? What sets these forms apart?


Hepatitis is a liver inflammation caused by pathogens (i.e., viral and bacterial infections) and other metabolic factors (e.g., related diseases) [1, 2]. Viral Hepatitis is the most common with numerous cases estimated hundreds of millions of affected individuals worldwide. This refers to a group of hepatitis viruses A (HAV), B (HBV), C (HCV), D (HDV), and E (HEV) which primarily infect and replicate within the liver cells. However, although such types share the common host and target cells, they differ in various factors such as their origins, modes of transmission, and complications [3, 4].

Hepatitis A

Hepatitis A is caused by a non-enveloped RNA virus called picornavirus, also known as the Hepatitis A virus (HAV) [5, 6]. HAV Transmission is primarily via the fecal-oral route, where incidences of spreading often occur through physical contact with an infected individual, and in situations where poor sanitation and unhygienic conditions are present [5, 7].


HAV-infected patients suffer from an acute but self-limited infection. They may experience mild to severe symptoms such as fever, headache, jaundice, malaise, dark urine, clay-colored stools, and abdominal discomfort within 14 to 28 days of incubation. Adults with Hepatitis A display such symptoms, whereas infected children are usually asymptomatic [7, 8].


There is no specific treatment for Hepatitis A. Prevention through vaccination and improved sanitation is highly recommended to combat HAV [8, 9].

Hepatitis B

Hepatitis C

Hepatitis D

Hepatitis E

The first hepatitis case was recorded in the 19th century. From then, seven types of viruses were identified until 1995. Among these, the A to E types are of greatest concern due to their rapid progression worldwide. On the other hand, Hepatitis F and G are still under evaluation with their existence not yet been proven. While the existing types have already infiltrated the health status of millions across the world, it is important to understand that their complications also vary depending on the genotypes of each form present in hepatitis cases: HAV has six (6); HBV has nine (9); HCV has six (6); HDV has eight (8); and HEV has four (4) [36, 37, 38].


While hepatitis may seem complex, an in-depth understanding of it is a first step toward effective prevention. Currently, strategic awareness through various campaigns, ongoing research, and clinical trials on hepatitis are continuously carried out. In 2016, the World Health Organization adopted the Global Health Sector Strategy (GHSS) to eliminate viral hepatitis by 2030, which has a goal of a major scale-down on the incidence and mortality rates. Easily accessible vaccines are also introduced worldwide, particularly for Hepatitis B [39, 40].

 

References

  1. Khan, T., Ullah, R., & Zaman, G. (2023). Hepatitis B virus transmission via epidemic model. Advances in Epidemiological Modeling and Control of Viruses. 29-54. doi: 10.1016/B978-0-32-399557-3-00007- 7

  2. Tu, T., Patel, K., & Shackel, N. (2017). Chapter 17 - Viral hepatitis. Genomic and Precision Medicine. 317-340. doi: 10.1016/B978-0-12- 800685-6.00017-5

  3. Syed, G.H., Wyle, D.L., & Siddiqui, A. (2014). Hepatitis viruses. Reference Module in Biomedical Sciences. doi:10.1016/B978-0-12-801238-3.00087-8

  4. Bamdad, T. & Yari, A. (2022). Hepatitis viruses. Encyclopedia of Infection and Immunity. (2), 113-122. doi: 10.1016/B978-0-120818731-9-00078-1

  5. Jafri, S. & Gordon, S. (2018). 35-Hepatitis A. Zakim and Boyer's Hepatology. 512-521.e4. doi: 10.1016/B978-0-323-37591-7.00035-5

  6. Calvert, A., Quenby, M., & Heath, P. (2020). Chapter 9, Vaccination in pregnancy in specific circumstances. Maternal Immunization. 191-210. doi: B978-0-12-814582-1.00010-3

  7. Rachal L. (2023). Immunizations. Encyclopedia of Child and Adolescent Health. 378-397. doi: 10.1016/B978-0-12-818872-9.00165-5

  8. World Health Organization (2023,). Hepatitis A. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a#:~:text=Symptoms%20of%20hepatitis%20A%20range,will%20have%20all%20the%20symptoms

  9. Centers for Disease and Control Prevention (2024). Hepatitis A prevention and control. https://www.cdc.gov/hepatitis-a/prevention/index.html

  10. Neligan, P. (2006). Chapter 12 - Infectious diseases and bioterrorism. Anesthesia and Uncommon Diseases. Fifth Edition, 377-411. doi:10.1016/B978-141602212-1.50015-9

  11. Kwon, S.Y. & Lee, C.H. (2011). Epidemiology and prevention of hepatitis B virus infection. The Korean Journal of Hepatology. 17 (2): 87-95. doi: 10.3350/kjhep.2011.17.2.87

  12. World Health Organization (2024). Hepatitis B. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b

  13. Centers for Disease Control and Prevention (2024). CDC Yellow Book 2024. gov. https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/hepatitis-b.

  14. Paula, R. (2013). 42-Liver disorders. Emergency Medicine. Second Edition, 347-355. doi: 10.1016/B978-1-4377-3548-2.00042-2

  15. Fabre, T. & Shoukry, N. (2016). Immunology of the liver. Encyclopedia of Immunobiology. 5: 13-22. doi: 10.1016/B978-0-12-374279-7.19005-8

  16. Moghoofei, M., Mostafei, S., Ganjouei, A., Kavosi, H. & Mahmoudi, M. (2018). HBV reactivation in rheumatic diseases patients under therapy: A meta-analysis. Microbial Pathogenesis. 114: 436-443. doi: 10.1016/j.micpath.2017.12.014

  17. King, T. (2007). 9 - Gastrointestinal pathology. Elsevier's Integrated Pathology. 217-246. doi: 10.1016/B978-0-04328-1.50015-2

  18. Eickhoff, J. & Collamer, A. (2018). Autoimmunity mimics: Infection and malignancy. Primary Care: Clinics in Office Practice. 45 (2): 343-360. doi: 10.1016/j.pop.2018.02.012

  19. Centers for Disease Control and Prevention (2024). Viral hepatitis surveillance and case management. https://www.cdc.gov/hepatitis/statistics/surveillanceguidance/HepatitisC.htm

  20. Prasidthrathsint, K. & Stapleton, J. (2019). Laboratory diagnosis and monitoring of viral hepatitis. Gastroenterology Clinics of North America. doi: 10.1016/j.gtc.2019.02.007

  21. Basit, H., Tyagi, I. & Koraila, J. (2023). Hepatitis C. Statpearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430897/

  22. World Health Organization (2024). Hepatitis C. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c

  23. Martinello, M., Solomon, S., Terrault, N. & Dore, G. (2023). Hepatitis C. The Lancet. 1085-1096. doi: 10.1016/S0140-6736(23)01320-X

  24. Dodd, R. (2007). Chapter 43 - Hepatitis A, B, and non-A, non-B, non-C viruses. Blood Banking and Transfusion Medicine. Second Edition. 584-591. doi:10.1016/B978-0-443-06981-9.50048-X

  25. Soriano, V., Alvarez, C., Edagwa, B., Mendoza, C., Montoya, N., Trevino, A., Gendelman, H. (2022). Ultra-long acting (XLA) antivirals for chronic viral hepatitis. International Journal of Infectious Diseases. 114: 45-50. doi: 10.1016/j.ijid.2021.10.052

  26. Stockdale, A. (2023). Chapter 11 - Hepatitis D. Comprehensive Guide to Hepatitis Advances. 281-307. doi:10.1016/B978-0-323-98368-6.00027-6

  27. Tulchinsky, T. & Varavikova, E. (2014). Chapter 4 - Communicable diseases. The New Public Health. Third Edition. 149-236. doi: 10.1016/B978-0-12-415766-8-00004-5

  28. World Health Organization (2023). Hepatitis D. https://www.who.int/news-room/fact-sheets/detail/hepatitis-d

  29. Abbas, Z., Memon, M.S., Mithani, H., Jafri, W. & Hamid, S. (2014). Treatment of chronic hepatitis D patients with pegylated interferon: A real-world experience. 19(5): 463-468. doi: 10.3851/IMP2728

  30. Sherman, K. & Sterling, R. (2018). 37 - HIV and the liver. Zakim and Boyer's Hepatology. Seventh Edition. 536-555. doi: 10.1016/B978-0-323-37591-7.00037-9

  31. Misdraji, J. (2010). Liver and bile duct infections. Diagnostic Pathology of Infectious Disease. ISBN: 978-1-4160-3429-2

  32. Lawrence, R. (2011). Transmission of infectious diseases through breast milk and breastfeeding. Breastfeeding. Seventh Edition. 406-473. doi:10.1016/C2009-0-47458-0

  33. Panda, S. & Varma, S. (2013). Hepatitis E: Molecular virology and pathogenesis. Journal of Clinical and Experimental Hepatology. 114-124. doi:10.1016/j.jceh.2013.05.001

  34. Debing, Y., Jochmans, D. & Neyts, J. (2013). Intervention strategies for emerging viruses: use of antivirals. Current Opinion in Virology. 3:217-224. doi:10.1016/j.coviro.2013.03.001.

  35. World Health Organization (2023). Hepatitis E. https://www.who.int/news-room/fact-sheets/detail/hepatitis-e

  36. Robotis, J. F. & Vassilaki, N. (2014). Viral hepatitis. Reference Module in Biomedical Sciences. doi: 10.1016/B978-0-12-801238-3.05401-5

  37. Office of NIH History and Stetten Museum (n.d.). Hepatitis. https://history.nih.gov/display/history/Hepatitis

  38. Feinstone S.M. (2019). History of the discovery of Hepatitis A virus. Cold Spring Harb Perspect Med. 9(5):a031740. doi: 10.1101/cshperspect.a031740

  39. Waheed, Y., Siddiq, M., Jamil, Z., & Najmi, M. H. (2018). Hepatitis elimination by 2030: Progress and challenges. World Journal of Gastroenterology, 24(44), 4959–4961. https://doi.org/10.3748/wjg.v24.i44.4959

  40. World Health Organization (2020). Hepatitis. https://www.who.int/health-topics/hepatitis/elimination-of-hepatitis-by-2030#tab=tab_1 Assessed and Endorsed by the MedReport Medical Review Board

bottom of page