Viral Hepatitis present day scenario:
✔️World report:
According to WHO report on viral
hepatitis epidemiology, mainly people, who are living with low and middle income,
comprise 80% of viral hepatitis infection & death.
40 million people are chronically infected
with hepatitis B and 6 to 12 million people are chronically infected with
hepatitis C. HEV is the most important cause of epidemic hepatitis, though HAV
is more common among children. Hepatitis B virus (HBV) is the most common cause of chronic hepatitis and hepatocellular carcinoma in the world. Almost 20,000 new acute infections occur every year.
✔️Situation in India:
India has reported over 2,700 deaths due to Hepatitis B in the last five years. In 2024, as many as 607 deaths were reported. The highest number of deaths (124) were from Maharashtra following Gujarat (95), West Bengal (80), Uttar Pradesh (79), & in Madhya Pradesh (72).
From 2018, National Viral Hepatitis Control Program (NVHCP) was running under the National Health Mission (NHM) to offer diagnostic and treatment services for Hepatitis C, A and E.
Hepatitis B hotspots in India is like Haryana. The young males with rural background are most vulnerable because of unsafe needle & injection practices due to non-availability of proper health care facilities.
👉👉Impact of Hepatitis on Lung
Hepatitis C virus (HCV) is a hepatotropic and lymphotropic virus. Chronic HCV infection can lead to many direct and indirect effects on the lung. This includes interstitial pneumonitis and pulmonary fibrosis, initiation/exacerbation of pre-existing chronic obstructive pulmonary disease (COPD) and asthma. Pattern of infection are mostly asymptomatic and progressive. Indirect effects comprise port pulmonary hypertension, mixed cryoglobulinemia, Emphysema, non-Hodgkin's B-cell lymphomas, autoimmune thyroid disease , and myositis .
Routine screening with pulmonary function tests (PFTs) would be beneficial in these patients.
👉👉 Impact of Hepatitis on Kidney
Hepatitis C virus infection can cause liver issues, like liver fibrosis or cirrhosis ,development of hepatocellular carcinoma and accelerate CKD progression. HCV infection increases the risk of developing diabetes, which is a major cause of CKD. HCV positive among hemodialysis patients can vary from < 5% to as high as 60% from different regions in the world. It enhance the mortality rate of kidney patients 2.2 folds high. Chance of infection is higher in patients who are receiving hemodialysis.
Effects include mixed cryoglobulinemia, membranoproliferative glomerulonephritis (MPGN), membranous nephropathy, focal segmental glomerulosclerosis, tubulointerstitial nephritis, Diabetic nephropathy.
Diagnostic tests for HCV consist of two broad categories:
(1) serologic assays that detect antibodies to HCV and
(2) molecular assays that detect or quantify HCV RN
Direct-acting antiviral agents (DAAs) have revolutionized HCV treatment, also improves CKD outcomes.
HBV infection can lead to different types of chronic kidney diseases (CKD) .It shows significant effects on kidney especially in adult population in past few decades. The most common kidney problems linked to Hepatitis B are -
Glomerulonephritis (GN), a condition that damages the tiny filters in the kidneys, including membranous nephropathy and membranoproliferative glomerulonephritis. These conditions can lead to symptoms such as swelling, protein in the urine, and impaired kidney function.
Polyarteritis nodosa (PAN), it is a rare condition, where the small and medium-sized arteries become inflamed and narrowed.
Membranoproliferative glomerulonephritis (MPGN): A condition where the glomeruli become thicker and more inflamed & vasculitis occur.
It is believed that the virus can trigger an immune response that results in the formation of immune complexes. These complexes can then deposit in the glomeruli, causing inflammation and damage. In some cases, the virus may also directly infect kidney cells, contributing to renal injury.
Therefore, it is crucial for healthcare providers to monitor kidney function in patients with Hepatitis B or C and to consider appropriate management strategies to prevent or treat any associated renal complications.
👉👉Hepatitis & its impact on Heart
Emerging research indicates a potential link between Hepatitis B and various heart problems. Studies have explored the virus's effects on the cardiovascular system, revealing associations with conditions like increased atherosclerosis risk, potential for heart failure and cardiomyopathy, and impacts on ventricular function.
Some research even suggests a link between paternal Hepatitis B infection and congenital heart defects in offspring. Myocarditis, Pericarditis, Palpitation can be the side effects. The mechanisms behind these associations, though not fully understood, may involve inflammation and immune responses triggered by the virus. While more research is needed to establish definitive links, these findings suggest that Hepatitis B's impact may extend beyond the liver, affecting the heart.
👉👉 Hepatitis & its effect on Brain
Hepatitis C can indirectly but significantly affect the brain through a condition called hepatic encephalopathy (HE).When the liver is damaged and unable to filter toxins from the blood effectively, these harmful substances, such as ammonia, can travel to the brain. This buildup of toxins disrupts normal brain function, leading to a spectrum of neurological and psychiatric symptoms.
These can range from subtle changes in mood, concentration, and sleep patterns to more severe issues like confusion, disorientation, personality changes, muscle tremors, and in advanced stages, even coma.Though neurological complications are not common in Hepatitis E virus infection but it is reported that the virus infects brain microvascular endothelial cells, crosses blood- brain barrier & invades central nervous system,
The neurological manifestations linked to Hepatitis E can include:
- Guillain-Barré Syndrome (GBS): An acute inflammatory polyneuropathy causing muscle weakness and sometimes paralysis. This is one of the most frequently reported neurological complications.
- Neurolgic Amyotrophy (Parsonage-Turner Syndrome): Characterized by sudden, severe pain in the shoulder and arm, followed by weakness and muscle wasting.
- Encephalitis and Meningoencephalitis: Inflammation of the brain (encephalitis) or both the brain and the surrounding membranes (meningoencephalitis). Symptoms can include altered mental state, seizures, and headaches.
- Myelitis: Inflammation of the spinal cord, which can lead to weakness, sensory changes, and bowel/bladder dysfunction.
- Bell's Palsy: Sudden weakness or paralysis of one side of the face.
- Peripheral Neuropathy: Damage to the nerves outside the brain and spinal cord, causing pain, numbness, tingling, or weakness, often in the hands and feet.
- Other rare manifestations: These include vestibular neuritis, acute ataxic neuropathy, oculomotor palsy, myositis, seizures, pseudotumor cerebri, and bilateral pyramidal syndrome. In rare cases, reversible lesions in the corpus callosum have also been reported.
The severity of HE often correlates with the degree of liver dysfunction, and episodes can be triggered by factors like infections, gastrointestinal bleeding, or electrolyte imbalances. Prompt recognition and management of HE are crucial to minimize potential long-term neurological consequences.
👉👉Impact of Hepatitis on Reproductive organs
Fertility & Pregnancy outcomes are effected in both in Men & Women respectively by Hepatitis B (HBV). Chronic infection of this virus can affect sperm quality & motility in men & increased tubal infertility & lower implantation rate in females.
