This collection of hepatitis varieties is named by letters of the alphabet: hepatitis A, hepatitis B, and so on through hepatitis E. Often, patients will also hear doctors refer to their hepatitis as being acute, chronic, or fulminant. These categories refer to the length of time the liver is inflamed; acute hepatitis refers to inflammation that lasts six months or less, regardless of the cause, while lengthier inflammation is chronic hepatitis. It is possible for a patient to advance from acute to chronic hepatitis. Fulminant hepatitis is the most severe form of acute hepatitis, and its symptoms include jaundice, coagulopathy (the inability to clot blood), and encephalopathy (confusion or decreased consciousness) that occurs in only a few days. For these patients, liver failure and subsequent death can come within weeks, and a liver transplant may be the only solution.
How the viruses that cause hepatitis are transmitted is specific to various forms of the disease. Some strains can enter the body through the digestive system, while others are transmitted during sexual contact or through contaminated blood.
To determine which form of viral hepatitis a person might have contracted, a physician will order a series of blood tests called a hepatitis serology. In these tests results, doctors look for antigens (Ag), the viral invaders, and antibodies (Ab), the immune system’s way of fighting antigens. Testing for the specific antigens and antibodies that are linked to the various forms of hepatitis reveal whether a patient has been exposed to those viruses.
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Before hepatitis A virus was identified in the early 1970s, the disease was referred to as infectious hepatitis because it was so easily transmitted from one person to another. Fortunately, the HA virus causes only short-lived acute hepatitis; after six months, any inflammation, symptoms, and abnormal LFT (liver function test) levels are resolved, and the liver suffers no long-term damage.
Few people are aware that HAV is widespread. It is estimated that about 135,000 individuals in the United States contract HAV every year, and that nearly half of American adults over the age of 50 have been infected.
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Because HAV does not cause chronic liver disease, and there is no possibility that cirrhosis or liver cancer will develop as a consequence of HAV, it is considered the least serious of the hepatitis viruses. Moreover, HAV is totally preventable with a vaccine.
While it lasts, however, HAV causes people to be seriously ill, and if they have been diagnosed with another liver disease, HAV can be a serious, even fatal, complication.
HAV is usually transmitted by oral-fecal transmission, otherwise known as the enteric route. The virus enters the mouth, then travels to the digestive system, and eventually enters the liver. The infected person is most contagious during the two weeks before any symptoms develop and for one week after, though many patients experience no symptoms at all. Not surprisingly, HAV is commonly seen in day-care centers, where toddlers are bound to be careless about bathroom hygiene. Long-term-care facilities for the mentally disabled also see frequent cases of HAV. Direct person-to- person contact isn’t necessary; the virus can be passed along in food touched by a person whose hands carry the virus.
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