Brazil reported 718,651 confirmed cases of viral hepatitis between 2000 and 2021, according to the Ministry of Health. Inflammation that occurs in the liver can be caused by viruses, alcohol abuse, or other toxic substances, such as drug-induced hepatitis.

Hepatitis can have many causes; learn about the most common ones and learn how to avoid them. Photo: Arquivo/Marco Verch Professional Photographer/Flickr/Disclosure/ND

Gastroenterologist Maira Marzinotto says that there are currently vaccines for viral hepatitis A and B. These vaccines stimulate the body’s response to viruses and are included in the vaccination schedule for children.

For hepatitis A, two doses of the vaccine are offered. According to SBIM (Brazilian Society of Immunization), the immunizer is on the public network for children aged 15 months to 4 years, 11 months and 29 days. Above this age group, the vaccine can only be used in a private network and on the advice of a doctor.

For hepatitis B, its immunizers are administered in three doses, with the first dose being given in the first 12 to 24 hours of life and the remainder at two and six months of age. It can be found both on SUS (Single Health System) and on the private web.

Hepatitis can cause acute cases

The disease can generate intense, short-term or chronic cases. In the most severe cases, hepatitis involves severe damage to the liver, which can cause the organ to stop working.

In this case, fulminant hepatitis can occur with the need for transplants, which, according to Marzinotto, is extremely rare.

On the other hand, chronic hepatitis can progress to cirrhosis, which increases the risk of liver cancer.

Learn about the types of hepatitis

According to the Ministry of Health, viral hepatitis can be divided into types A, B, C, D and E. In addition, there are autoimmune, alcoholic and drug-induced hepatitis.

Hepatitis A

It can be caused by the HAV virus and is usually benign, but with symptoms and mortality that increase with age.

Its mode of transmission is the fecal-oral route, which is closely associated with a lack of proper eating hygiene, inadequate basic sanitation, close personal contact, and unprotected intercourse.

Symptoms include fatigue, malaise, fever, muscle pain followed by nausea, vomiting, abdominal pain, constipation, or diarrhea. There may be dark urine before the yellow skin phase. Symptoms usually appear 15–50 days after infection and usually last for two months.

Its form of diagnosis is through blood tests that detect the presence of IgM antibodies to HAV (initial infection) noticeable for six months, or an IgG antibody test that confirms past infection or then an immune response to the vaccine.

Treatments for hepatitis are nonspecific, so they vary from patient to patient, but are aimed at relieving symptoms.

The most effective ways to prevent hepatitis A are vaccination, hand hygiene, proper sanitization, condom use, and proper food preparation.

Hepatitis B

Hepatitis B is caused by the HBV virus. According to the Ministry of Health, this typing was responsible for 32.8% of hepatitis cases reported in Brazil in 2018.

The disease can develop in acute (short-term) or chronic (more than six months) forms.

For the most part, hepatitis B is asymptomatic and is not diagnosed until decades after infection. To do this, conduct a study on the HBV antigen (HBsAg) using rapid tests or laboratory tests. The diagnosis must be confirmed by additional tests that detect the presence of viral DNA (HBV-DNA).

Although there is no cure, treatment for hepatitis B is available at the SUS, helping to reduce the risk of complications (cirrhosis, liver cancer, and death).

Prevention is through vaccines, the use of condoms, and not sharing personal belongings.

Hepatitis C

The inflammatory and infectious process is caused by the HCV virus and can be acute or chronic. The second type of infection is the most common (60% to 85%), progressing to cirrhosis in 20% of cases.

The virus is transmitted through contact with infected blood. That is, sharing needles, nail supplies or reusing tattoo materials, medical and dental equipment, inability to sterilize nail supplies, surgeries without a biosafety protocol, unprotected sexual intercourse, and vertical mother-to-baby during pregnancy.

This type usually does not show symptoms, so the disease is only identified using rapid tests or serological tests that indicate the presence of antibodies to HCV.

SUS offers free treatment with antiviral drugs that can cure and prevent the progression of the disease.

There is no vaccine to prevent hepatitis C. However, some measures can stop its transmission. The main ones are: do not share materials that can come into contact with blood and use condoms.

Doctors say those who test positive must ask their family members and sexual partners to be tested for the disease, in addition, they must cover up open skin wounds, clean blood splashes with a chlorine solution, and cannot donate blood or semen.

Hepatitis D

This type of inflammation is usually associated with hepatitis B. It can be infected by the HDV virus in two ways.

In cases, it may be co-infected with HBV or with HBV superinfection in people with chronic HBV infection. However, it can be associated with hepatitis B and is transmitted in the same way.

Hepatitis D usually has no symptoms, and when they do, they include nausea, fatigue, dark urine, pale stools, and yellowing of the eyes and skin. The diagnosis is established serologically by checking the amount of anti-HDV antibodies.

After confirmation, the doctor will prescribe treatment in accordance with the Clinical Protocol and Therapeutic Guidelines for Hepatitis B and coinfections. The proposed treatments aim to control liver damage and do not cause a cure. SUS provides medication. Such patients are advised not to drink alcoholic beverages.

Prevention of this type, in addition to hepatitis B vaccination, includes the use of condoms for all sexual intercourse and the non-sharing of personal belongings.

Hepatitis E

HEV infection is of short duration and self-limiting, usually benign.

It is transmitted by the fecal-oral route, so the main forms of spread are drinking contaminated water, poor sanitation, eating undercooked meat, transfusing infected blood, and vertically from mother to child during pregnancy.

Symptoms last two to six weeks and include fatigue, malaise, fever, muscle pain, nausea, diarrhea, dark urine, and jaundice. As with hepatitis A, treatment is non-specific and aims to relieve symptoms.

alcoholic hepatitis

According to Maira Marzinotto, alcoholic hepatitis occurs after drinking a large amount of alcoholic beverages. The MSD guidelines state that the condition can range from mild and reversible to severe, life-threatening illness.

Signs include emaciated patients, fatigue, jaundice, fever, liver pain, organ enlargement, and liver murmur. The condition may also include manifestations similar to those of cirrhosis of the liver.

The gastroenterologist states that the diagnosis is based on the patient’s history of drinking, and the treatment is by stopping the intake of alcoholic beverages.

drug-induced hepatitis

Caused by the use of drugs that can cause inflammation in the liver. The diagnosis is made on the basis of the history of treatment carried out by the patient. His treatment is based on the abolition of drugs that cause the disease.

autoimmune hepatitis

According to the doctor, this type occurs when the body’s own cells attack the liver, causing the organ to become inflamed.

Diagnosis is based on a blood test for autoantibodies that can cause hepatitis. Treatment is specific and individualized, usually with the use of corticoids and immunosuppressants to reduce cellular attacks on the liver.

*According to the portal R7.