In line with the Sustainable Development Goals
Article Title:
Viral Hepatitis By Dr. Fadel Sahib Al-Sultani
Introduction
Viral hepatitis is considered one of the most significant global health problems, with hundreds of millions of people estimated to be infected with one of its types. This makes it a major contributor to disease and economic burden worldwide. The illness primarily affects the liver, the vital organ responsible for blood detoxification, metabolism regulation, and the production of many essential proteins.
Types of Viruses
There are five major viruses that cause hepatitis, each with unique epidemiological and clinical characteristics:
Hepatitis A Virus (HAV):
Transmitted through the fecal–oral route (consumption of contaminated food or water).
Causes acute infection that usually resolves completely without progressing to chronic disease.
Hepatitis B Virus (HBV):
Transmitted via blood, unsafe sexual practices, or from mother to child during childbirth.
Can be acute or chronic. Chronic infection is linked to cirrhosis and hepatocellular carcinoma.
Hepatitis C Virus (HCV):
Mainly transmitted through blood (such as unscreened transfusions or sharing sharp instruments).
Often progresses to chronic hepatitis and is the leading cause of liver transplantation in many countries.
Hepatitis D Virus (HDV):
Cannot infect on its own; requires HBV to replicate.
Aggravates disease severity and is associated with rapid progression to cirrhosis and liver failure.
Hepatitis E Virus (HEV):
Transmitted through contaminated food and water.
Usually self-limiting, but can be fatal in pregnant women.
Clinical Symptoms
Common clinical manifestations include:
General fatigue and loss of appetite.
Nausea and vomiting.
Pain in the upper right quadrant of the abdomen.
Jaundice (yellowing of the skin and eyes).
Dark urine and pale stools.
Diagnosis
Diagnosis relies on:
Laboratory tests: Liver function tests (ALT, AST, bilirubin) and specific tests for antigens or antibodies.
Molecular techniques: Polymerase Chain Reaction (PCR) to detect viral DNA or RNA.
Medical imaging: Ultrasound to assess liver size and possible complications.
Prevention and Treatment
Prevention:
Vaccination against HAV and HBV.
Improved personal hygiene and sanitation.
Avoiding sharing sharp instruments and ensuring safe blood transfusion practices.
Treatment:
No specific treatment exists for HAV and HEV; management is supportive.
Modern antiviral drugs (such as NS5A and NS5B inhibitors) have achieved high cure rates in HCV treatment.
Long-term antiviral therapy helps control HBV infection and slows disease progression.
Liver transplantation may be the final therapeutic option in cases of cirrhosis or end-stage liver failure.
Conclusion
Viral hepatitis remains a global public health challenge due to its prevalence and potential complications. Prevention—through vaccination and healthy practices—remains the most effective strategy to limit its spread and reduce its burden.
Al-Mustaqbal University – the First University in Iraq