Chronic Hepatitis B and C

The hepatitis B and C viruses cause chronic hepatitis B (HBV) and C (HCV), both of which are liver diseases. Both conditions are a global health concern as they cause a number of liver diseases, such as cirrhosis, liver failure, and liver cancer. According to estimates from the World Health Organization (WHO), there are about 350 million persons with chronic hepatitis B and 71 million with chronic hepatitis C globally.

Chronic hepatitis B and C are persistent liver illnesses induced by viral hepatitis. Although both viruses induce hepatic injury, they possess unique modes of transmission, risk factors, and treatment options.

Hepatitis B virus (HBV) infiltrates the liver and produces chronic hepatitis B. A chronic infection occurs when the virus remains in the body for more than six months, resulting in continuous inflammation of the liver and possibly liver damage. Chronic HBV infection can result in cirrhosis, liver failure, or liver cancer (hepatocellular carcinoma).

Chronic Hepatitis C is caused by the hepatitis C virus (HCV). Like hepatitis B, the infection is classified as chronic when it lasts more than six months. The most common outcomes of a chronic HCV infection, particularly in those with a longer infection duration, are cirrhosis and liver cancer.

Symptoms

One of the most difficult aspects of chronic hepatitis B and C is that they are frequently asymptomatic, particularly in the early phases of infection. Many individuals may not even be aware that they are infected until they have sustained substantial liver injury. Nevertheless, symptoms may manifest as:

• Fatigue: Persistent tiredness or lack of energy is a common symptom for both HBV and HCV infections.
• Jaundice: A yellowing of the skin or sclera, resulting from hepatic impairment.
• Abdominal Pain: Discomfort or pain in the upper right quadrant of the abdomen, where the liver is situated.
• Nausea and vomiting: Nausea and vomiting frequently accompany hepatic disorders.
• Loss of Appetite: A decrease in appetite and unintended weight loss can occur.
• Dark Urine and Pale Stool: Dark urine and pale feces are indicators of liver failure and are frequently accompanied with jaundice.
• Joint Pain: People with chronic hepatitis C may develop joint pain or inflammation.

Diagnosis

The first step in diagnosing chronic hepatitis B or C is through blood tests. These tests are used to determine the presence of the hepatitis virus and quantify the severity of liver injury. The primary diagnostic investigations include:

• Hepatitis B: HBV DNA test: Determines the virus's concentration in the bloodstream.
• Liver function tests: Evaluate the liver's functionality.
• HBeAg and anti-HBe antibodies: Assist in the evaluation of viral replication and infectivity.
• Liver biopsy or imaging: A liver biopsy or imaging may be performed to evaluate the extent of liver damage in specific circumstances.
• Hepatitis C: HCV RNA test: Identifies the virus in the bloodstream and quantifies the viral load.
• HCV genotype test: This test identifies the virus strain, which can be used to inform treatment decisions.
• Liver imaging and liver function tests: Assess the extent of liver damage.

Treatment

Though curable, both chronic hepatitis B and C need long-term treatment to avoid complications:

• Chronic Hepatitis B Treatment: Commonly used to fight the hepatitis B virus and stop liver damage are drugs such as tenofovir and entecavir. In some cases, interferon injections may be used to boost the immune system and control the virus.
• Chronic Hepatitis C Treatment: The treatment of hepatitis C has been completely transformed by direct-acting antivirals (DAAs), which provide a very successful, brief course of treatment with cure rates that are above 90%. By targeting specific phases of the virus lifecycle, these medications reduce the virus to undetectable levels in the majority of patients. Combinations of these drugs were previously used to treat hepatitis C. However, these treatments are now used less because their efficacy has decreased and side effects are harmful, which has become a problem since the introduction of DAAs.

Prevention

Both chronic hepatitis B and C are preventable:

• Hepatitis B Prevention: The vaccine is both safe and efficient at avoiding infection. It is advised for newborns, healthcare personnel, and those at high risk. Avoid sharing needles or other drug-related equipment, and wear protective gear during sexual activity.
• Hepatitis C Prevention: This is the most important measure to reduce the risk of HCV infection. Blood donations and organ transplants should be screened for hepatitis C to prevent transmission. Using condoms reduces the risk of sexual transmission of hepatitis C, though it is less common than blood transmission.

Conclusion

Chronic hepatitis B and C are serious, frequently silent infections that can cause extensive liver damage, liver cancer, and even death. Understanding the causes, symptoms, risk factors, and available therapies is critical to managing and preventing these diseases. Antiviral medicines have advanced to the point where both hepatitis B and C can be adequately treated, and in the case of hepatitis C, cured. Early detection through regular screening, particularly for those at risk, is critical to minimizing the worldwide burden of these silent epidemics.