3.18 National Liver Care Day | A, B, C, D, E, how did the "five brothers of hepatitis" come about? How can we prevent them?

When it comes to hepatitis, many people's first reaction is infectious disease, which is due to the misunderstanding that "all hepatitis is contagious". In fact, not all hepatitis is contagious. We can divide hepatitis into two categories: infectious hepatitis and non-infectious hepatitis.

What types of hepatitis are contagious?

Usually, hepatitis caused by hepatotropic viruses is considered contagious.

To date, there are five types of hepatitis virus infections that have been identified through clinical research, including hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. These hepatitis can all cause liver problems, and there are significant differences in their transmission routes, prevention and control measures, and disease severity.

It is worth noting that hepatitis B and hepatitis C are the most common, and long-term chronic infection poses the risk of inducing cirrhosis and liver cancer.

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01Hepatitis A

Hepatitis A is generally highly contagious, but the infection is usually short-lived and the most common form of transmission is fecal-oral.

The feces of hepatitis A patients contain hepatitis A virus. If they are not strictly disinfected, the feces will contaminate the surrounding environment, food, and water sources. People who ingest these contaminated foods or raw water are prone to infection. Aquatic crustaceans are susceptible to hepatitis A virus infection. If you accidentally eat uncooked shellfish, such as oysters and clams, you will face the risk of infection with hepatitis A virus.

Key points: Try not to eat raw food or drink raw water, and make sure to fully cook aquatic crustaceans.

Most cases of hepatitis A can be cured, and acute severe hepatitis rarely occurs. Hepatitis A generally does not have a chronic carrier state and is not likely to develop into chronic hepatitis.

02 Hepatitis B

Hepatitis B is the main type of hepatitis in my country. Its transmission routes include blood transmission, mother-to-child transmission, body fluid transmission and sexual transmission. Among them, mother-to-child transmission is the most important transmission route of hepatitis B infection.

Normal interpersonal communication (such as eating, drinking, shaking hands) will not lead to the spread of hepatitis B. (This is the key point, don’t be afraid of hepatitis)

For hepatitis B patients, even if they are just carriers, they should go to the hospital for regular checkups. If they meet the treatment indications, they should receive regular antiviral treatment to prevent cirrhosis and liver cancer, prolong the life span and improve the quality of life. For the family and friends of hepatitis B patients, the best way to block the disease is to get vaccinated until antibodies are produced.

03Hepatitis C

Hepatitis C is also a common chronic hepatitis in my country. The transmission mode of hepatitis C virus is basically the same as that of hepatitis B. Although there is no vaccine for hepatitis C, oral medication for 3 months can achieve a cure rate of more than 95%, which means it can basically be cured.

Patients who are found to be positive for hepatitis C antibodies should go to a medical institution in time for further diagnosis and treatment to avoid worsening of the disease and inducing cirrhosis and liver cancer.

04Hepatitis D

Hepatitis D virus is a "defective" virus, and its source of infection and transmission route are similar to those of hepatitis B virus, but hepatitis D virus usually does not cause disease alone, and is often co-infected with DNA viruses such as hepatitis B virus. Although people are generally more sensitive to hepatitis D virus, it does not cause disease independently.

05Hepatitis E

Hepatitis E is also mainly transmitted through "fecal-oral transmission", and is more common in people with unclean eating habits. It is seasonal and often appears after heavy rains. It is mainly a "water-type epidemic", mainly caused by the feces of hepatitis E patients contaminating water sources. Most hepatitis E patients have a good prognosis, but pregnant women are relatively more susceptible.

It should be noted that daily contact with hepatitis B or hepatitis C patients, such as living, working, or even eating together, sharing toilets, etc., will not cause infection if there is no blood exposure.

If you are married to someone with hepatitis B or C, we recommend that you do a comprehensive hepatitis virus test before marriage. Close follow-up is also required after marriage. Under the full guidance of a specialist, you can successfully complete a series of issues such as childbirth, breastfeeding, and mother-to-child transmission.

Which types of hepatitis are not contagious?

Non-viral hepatitis refers to other liver inflammatory lesions other than viral hepatitis, which is generally not contagious.

01Fatty Hepatitis

Fatty hepatitis is a clinical pathological syndrome characterized by excessive fat accumulation in hepatocytes. That is, the liver is too "fat", leading to liver dysfunction and liver damage.

If liver cells are compared to a "granary", then when too much food (i.e. energy) is stored there and too little is consumed, the accumulated food in the granary may "mold". If you consume too much energy on a daily basis and don't exercise much, it is easy to cause fatty liver problems.

The best way to prevent and treat fatty liver is to maintain a dynamic balance between energy intake and consumption, control your diet, exercise, and ensure an appropriate amount of daily exercise, that is, a combination of diet therapy and exercise therapy. It is worth noting that if fatty liver is not treated for a long time, there is also a risk of cirrhosis and liver cancer.

02Alcoholic Hepatitis

Alcoholic hepatitis is an inflammation of the liver caused by heavy drinking. Long-term, excessive drinking will undoubtedly significantly increase the risk of cirrhosis and liver cancer.

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03Drug-induced hepatitis

Drug-induced hepatitis refers to liver damage caused by various types of drugs, including chemical drugs, biological agents, traditional Chinese medicine, natural medicine, health products, dietary supplements and their metabolites and even drug excipients. Simply put, it is a liver disease caused by excessive use of "drugs".

Many drugs may cause liver damage, such as lipid-lowering drugs (commonly used statins), antipyretics, anti-tuberculosis drugs, chemotherapy drugs, hypoglycemic drugs and some antibiotics.

On the other hand, some people have special physical conditions, and even taking normal doses of non-hepatotoxic drugs can cause liver damage. Therefore, rational use of drugs can minimize and avoid the side effects of drugs on the liver, which is why many drugs need to be taken under the guidance of a doctor.

04Autoimmune hepatitis

Autoimmune hepatitis is caused by a disorder in the immune system, in which the body launches a targeted immune attack on liver cells, leading to liver damage and inflammation.

The liver is still our "granary", and normal immune cells are like security guards, defending against external invasion. However, in certain specific situations, immune cells may accidentally injure normal liver cells, thus destroying the "granary". This type of liver cell damage comes from the body's normal immune cells. The main signs of autoimmune hepatitis are elevated transaminases and immunoglobulins, and autoantibodies will also show positive results. It is necessary to go to a regular hospital for systematic diagnosis and treatment to reduce the incidence of cirrhosis.

Regardless of the type of hepatitis, whether it is contagious or not, hepatitis patients should seek medical treatment promptly and actively cooperate with treatment. Delaying treatment will lead to liver damage and worsening of the disease.

In recent years, the incidence of liver disease has continued to rise and is showing a trend of younger people. Only by doing a good job of prevention can we protect ourselves from the troubles of hepatitis. Whether it is blocking the transmission route or doing a good job of conditioning in life, no aspect can be relaxed in order to better protect liver health.

Source: Editorial Department of Liver Doctor

Author: Yu Zhuo, Department of Hepatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine

Review expert: Li Shiying, Second Affiliated Hospital of Chongqing Medical University

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