Hepatitis is a public health problem worldwide. Viral hepatitis is caused by any of at least five hepatotrophic viruses namely hepatitis A, B, C, D, E viruses. Hepatitis caused due to other viruses is cytomegalovirus, Epstein-Barr virus, rubella virus, and enteroviruses.
The infection leads to necrosis of single or group of parenchyma cells, starting in the centre of the lobules and followed by infiltration of the parenchyma and portal areas with lymphocytes, macrophages, plasma cells, eosinophils and neutrophils. Cells or cluster of cells containing mitotic figures evidences regeneration of parenchyma cells. The liver morphology becomes normal after 3 months of the onset of clinical illness.
The changes are similar in HAV and HBV viral infection but the changes in non-A non-B, are seen mainly in the portal triad. There may be sub clinical infection.Hepatitis A, E tends to be acute, hepatitis B, C are insidious. Hepatitis D often presents as fulminant hepatitis, although most cases are indistinguishable from hepatitis B. Hepatitis E is rare in children below 15 years of age.
Hepatitis C may be associated with autoimmune diseases such as Sjögren’s syndrome and sialadenitis, idiopathic pulmonary fibrosis, polyarteritis nodosa, porphyria cutanea tarda, and a variant of autoimmune hepatitis associated with the presence of anti-kidney and liver microsomal autoantibodies.
Difference between hepatitis A and hepatitis C viruses:
Despite the fact that they both infect the liver, the hepatitis A and hepatitis C viruses actually have very little in common. The two are far apart genetically, are transmitted differently, and produce very different diseases. Hepatitis A spreads through the consumption of fecal particles from an infected person (in pollution-contaminated food or water, for example), but hepatitis C is generally transmitted only by direct contact with infected blood. Hepatitis A produces fever, nausea and abdominal pain that can last for weeks, but rarely lead to death; hepatitis C, by contrast, often spends decades quietly damaging the liver, until a victim's only hope for survival is an organ transplant.
Hepatitis C is caused by the hepatitis C virus. The virus is spread mainly through contact with infected blood. Sometimes it is spread through sexual contact. Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months or years. Infection with the hepatitis C virus increases your risk for liver cancer.
Getting a tattoo could be a key infection route for hepatitis C, the most common chronic viral infection affecting almost 2 percent of the United States population, according to a study.Organ transplantation can transmit hepatitis C. This raises serious questions about the continued acceptance of organs from donors positive for anti-HCV.Mortality among kidney-transplant recipients positive for HCV antibody was frequently related to liver diseases, such as cirrhosis and hepatocellular carcinoma.
The hepatitis C virus (HCV) spreads within its host by replicating its RNA and using it to build proteins that form new viruses and by inhibiting various antiviral proteins inside host cells. By understanding both mechanisms, scientists hope to prevent the virus from replicating, thus stopping the infection.
Rarely, HCV infection can be associated with skin and kidney problems. The hepatitis C virus is linked to an increased risk of porphyria cutanea tarda, a condition that may cause a blistering rash, and to cryoglobulinemia, which can cause a purplish rash (purpura) on your lower extremities and may lead to kidney damage.
Adults infected with hepatitis C virus (HCV) are at increased risk for developing end-stage kidney disease, a serious disease that requires lifelong dialysis or kidney transplantation, investigators report in the Archives of Internal Medicine.
Research has shown that the liver is not the only organ affected by HCV, Dr. Judith I. Tsui and her associates note. Still, the impact that this virus has on kidney disease has not been well-defined.
In the new study, Tsui, from the Veterans Affairs Medical Center in San Francisco, and her team linked data from Medicare, the Department of Veterans Affairs, and the United States Renal Data System. Their goal was to see if HCV infection was associated with end-stage kidney disease.
The study group included 474,000 veterans who were tested for HCV within 1 year of a having blood levels of creatinine measured, a simple test of kidney function. Of these subjects, 53,000 tested positive for HCV.
HCV infection nearly tripled the risk of end-stage kidney disease, the results indicate. However, this finding was only apparent in subjects younger than 70 years of age and was most pronounced in those with normal or near-normal kidney function when the study began.
"Patients with HCV are more likely to experience rapid decline in (kidney) function," the authors conclude.
Antiviral therapies commonly employ inhibitors, compounds that block enzymes from reproducing the virus. The infection eventually subsides as a result. However, a defense mechanism previously identified in HIV works when the virus enzyme “excises” inhibitors, removing them and allowing the virus to continue multiplying.
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