Exploring Viral Hepatitis: Types, Diagnosis, and Treatment
Viral hepatitis, a group of infections affecting the liver, has long been a global health concern. As the seventh leading cause of death worldwide it stands out as the only communicable disease with rising mortality. It causes as many or more deaths annually as TB, AIDS, or malaria combined. After decades of innovation in the diagnosis and treatment of viral hepatitis, the 2016 World Health Assembly adopted the resolution that viral hepatitis should be eliminated by 2030. Recently, the World Health Organization (WHO) released its 2024 Global Hepatitis Report, which sheds light on the current state of hepatitis worldwide. Read on to understand the various types of hepatitis, methods of diagnosis, available treatments, and key insights from the WHO report.
|
Type |
Description | Treatment |
| Hepatitis A (HAV) | Transmitted through contaminated food and water, hepatitis A is usually an acute short-term illness that is vaccine-preventable. | Supportive care is the mainstay of treatment until the virus is eliminated in the body, although high-risk individuals may require medical attention. |
| Hepatitis B (HBV) | A potentially serious infection transmitted through bodily fluids, hepatitis B can lead to chronic liver disease and even liver cancer. Vaccination is key to prevention. | Treatment aims to suppress the virus and prevent complications. Antiviral medications are used for chronic infections, while supportive care is used for acute. |
| Hepatitis C (HCV) | Primarily spread through blood contact, hepatitis C can cause chronic liver damage. | With the emergence of direct-acting antiviral medications (DAAs), hepatitis C is now curable. Treatment focuses on achieving sustained absence of the virus in the blood. |
| Hepatitis D (HDV) | Occurring only in individuals with hepatitis B, hepatitis D worsens outcomes of HBV infection. | Management revolves around controlling HBV infection, as specific antiviral medications for HDV are lacking. |
| Hepatitis E (HEV) | Similar to hepatitis A, HEV is transmitted through contaminated food and water. |
Supportive care is typically sufficient for recovery. In high-risk populations, such as pregnant women, specialized management may be necessary. |
Diagnosis
Initially, doctors use blood tests to find out what type of hepatitis virus is present. For types A, C, D, and E a blood test detects if the virus or antibodies are present. For type B however, as described in a recent episode of GLI LIVE a triple panel blood test is required to detect a surface antigen (which indicates active infection), a core antibody total test (which indicates past infection), and a surface antibody test (which can indicate immunity). If hepatitis is found, they may use imaging tests like ultrasound, transient elastography, MRI, or CT scans to look for liver damage or cancer. Transient elastography is a special type of imaging test that measures how stiff or soft the liver tissue is, which can indicate the extent of liver disease. Sometimes, a liver biopsy is needed to check for scarring. During a physical exam, doctors check for signs like yellowing of the skin (jaundice) and liver swelling. If hepatitis A, B, and C are ruled out but symptoms persist, they look for other causes, such as hepatitis E.
2024 WHO Global Hepatitis Report Summary
The 2024 Global Hepatitis Report by the World Health Organization paints a concerning picture of the hepatitis landscape worldwide. Despite progress in prevention efforts, hepatitis-related deaths are on the rise, with approximately 1.3 million deaths annually, equivalent to tuberculosis. The world still bears a substantial burden, since millions of people live with chronic hepatitis B and C globally. Access to diagnosis and treatment remains limited, as of the end of 2022, only 13% of people with chronic hepatitis B were diagnosed, and about 3% received antiviral therapy. From 2015 to 2022, only 36% of those with hepatitis C were diagnosed, and 20% received treatment. Pricing disparities for hepatitis medications persist across regions, further exacerbating the issue. The report emphasizes the urgent need for targeted interventions to address regional disparities, particularly in regions like the WHO African Region, which faces a high burden of new hepatitis B infections with low vaccination rates. Efforts must be made to improve access to testing and treatment, reduce pricing disparities, and strengthen healthcare systems to ensure equitable care for all. Sustained efforts are crucial to eliminate hepatitis by 2030 and alleviate the global burden of this preventable disease.