Hepatitis is a disease that affects more than 300 million individuals worldwide. A characteristic feature of hepatitis is an inflammation of the liver, which, in most cases, is caused by a viral infection with one of the hepatovirus family variants (hepatitis A, B, C, D, and E). Symptoms range from fatigue, jaundice, and abdominal pain to loss of appetite and are typical for all hepatitis subtypes. However, each of the variants possesses individual characteristics, especially different routes of transmission, courses of the disease, available options for treatment, and possible preventive measures.
Hepatitis A virus (HAV), for example, is typically transmitted through contaminated food or water. Fortunately, most individuals recover fully without the need for any specific treatment. To prevent infection in the long term, individuals can get vaccinated with a series of two shots. As biomedical research advances, efforts have been made to create new vaccines. By applying genetic engineering techniques, modern vaccines contain the recombinantly produced surface antigen of the Hepatitis virus, which will train the immune system to handle the virus after receiving the vaccine. Recent vaccines combined the recombinant surface antigen of the Hepatitis B virus (HBV) along with inactivated HA viruses, resulting in a vaccine that can be applied to immunize against both of those two variants.
Unlike HAV, Hepatitis B virus (HBV) spreads through infected blood, sexual contact, or from mother to child during delivery. It can result in acute or chronic infections when the virus remains in the body for more than 6 months. Chronic HBV infections may lead to severe liver complications, including cirrhosis and liver cancer.
The Hepatitis C virus (HCV) variant is primarily transmitted through blood-to-blood contact, often along with blood transfusions or shared needles used for drug injections. Chronic HCV infections will result in liver complications similar to those mentioned above for HBV.
Hepatitis D virus (HDV) is considered a "satellite" virus because it can only infect individuals that had been infected by the HBV variant. HDV co-infection worsens the outcome, leading to more severe liver damage compared to HBV infection alone.
The last variant, the Hepatitis E virus (HEV), is transmitted predominantly through the consumption of contaminated water or food. In most cases, an HEV infection will be cured without further ado, but pregnant women and individuals with pre-existing liver disease are at a higher risk of facing severe complications.
Biomedical research has made significant progress in the treatment of hepatitis, particularly Hepatitis C. The introduction of direct-acting antiviral (DAA) treatments now offers high cure rates with minimal side effects. These medications target specific viral proteins, inhibit viral replication, and lead to a sustained virologic response (SVR). Recent studies have made efforts to develop more effective therapies for HBV in order to achieve complete viral suppression and functional cure. However, challenges such as the persistence of covalently closed circular DNA (cccDNA) and the development of viral drug resistance are an issue and need to be addressed by further research studies.
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https://centralbiohub.de/blogs/over-300-million-people-in-the-world-live-with-viral-hepatitis
Citations:
1. World Health Organization (WHO). Hepatitis. Retrieved from: https://www.who.int/health-topics/hepatitis
2. Asselah, T., & Marcellin, P. (2017). Direct-acting antivirals for the treatment of chronic hepatitis C: one pill a day for tomorrow. Liver International, 37(s1), 60-68.
3. Locarnini, S., & Yuen, L. (2010). Molecular genesis of drug-resistant and vaccine-escape HBV mutants. Antiviral therapy, 15(3), 451-461.