World Hepatitis Day 2023: How Acute Hepatitis Can Lead To Liver Cancer

Acute hepatitis refers to the sudden onset of inflammation in the liver, typically caused by a viral infection. It is characterized by symptoms such as fatigue, jaundice (yellowing of the skin and eyes), nausea, vomiting, abdominal pain, and dark-colored urine. Acute hepatitis can be caused by different viruses, with the most common types being hepatitis A, B, and C. In most cases, acute hepatitis resolves on its own with supportive care, but some individuals may develop a chronic infection.

What is  the advanced stage of hepatitis?

Hepatitis, particularly chronic hepatitis is a difficult illness that needs specialized treatment. “Chronic hepatitis is caused at the end of the hepatitis C which means the liver has been severely damaged by the hepatitis C virus. The risk with chronic infection is not only chronic liver disease and cirrhosis, but also the fact that these patients will be at much higher Risk of getting liver cancers (hepato cellular carcinoma),” says Dr Devavrat Arya, Director, Medical Oncologists, MAX Hospital, Saket, New Delhi.

What is the link to liver cancer? 

Acute hepatitis, particularly if caused by hepatitis B or C viruses, can lead to liver cancer over time. “When the immune system fails to clear the viral infection completely, the virus can persist in the liver and cause ongoing inflammation. Chronic inflammation may lead to liver damage and the formation of scar tissue (cirrhosis). Cirrhosis, in turn, increases the risk of liver cancer (hepatocellular carcinoma). It is essential to diagnose and manage acute hepatitis promptly to prevent its progression to chronic infection and the associated risk of liver cancer,” says Dr Tapan Singh Chauhan, Sr. Consultant – Surgical Oncology, Robotics, GI & HPB, Artemis Hospital, Gurgaon.

Continued and persistent viral infection triggers liver inflammation, which, over time, can result in the formation of scar tissue in the liver, known as cirrhosis. If left untreated, this condition may eventually progress to liver cancer.  “Additional factors that may influence the risk of liver cancer in chronic hepatitis patients include older age, male sex, Hispanic ethnicity, diabetes and obesity, smoking, HCV genotype 3, alcohol abuse, and co-infection with HIV or HBV,” adds Dr Arya.

Treatment

Dr Sumol Ratna, Liver specialist from Noida International Institute of Medical Sciences, says, “Depending on the kind and extent of the illness, many hepatitis treatments are available. The standard recommendation for acute patients is supportive treatment and rest. Antiviral drugs may be needed for chronic hepatitis to stop viral replication and lessen liver inflammation. Monitoring liver function and determining the efficacy of therapy need routine medical checkups.”

Medications may be prescribed to manage specific symptoms. For hepatitis A, the infection usually resolves on its own without specific treatment. In the case of hepatitis B and C, antiviral medications may be recommended to prevent chronic infection if administered early in the acute phase.

In patients with chronic viral infection, antiviral therapy and suppression/cure of viral replication is associated with a significant reduction in the risk of HCC development and recurrence. “Also surveillance with a 6 monthly ultrasound is only recommended for selected patients with chronic hepatitis,” adds Dr Arya.

Vaccines act as a powerful defence against hepatitis A and B. Vaccines work by exposing the body to a small dose of the virus, which enables the body to develop immunity to the disease. “The Hepatitis A vaccine is given in 2 doses, 6 months apart, while the Hepatitis B vaccine is administered in 3 doses, with the first dose provided within 24 hours of birth, ideally. Vaccines are recommended for infants, children up to 18 years, and high-risk adults. People with chronic liver disease should also get vaccinated for both hepatitis A and B. Although Hepatitis C isn’t vaccine-preventable, we now have effective treatment for it and remission can be achieved,” says Dr Anup Latne, Consultant Internal Medicine, Surya Mother and Child Super Speciality Hospital, Pune. 

Precautions

To prevent acute hepatitis and its potential complications, Dr Chauhan feels it is crucial to take certain precautions:

1. VaccinationVaccines are available for hepatitis A and B. Getting vaccinated can protect against these viral infections.
2. Safe HygienePracticing good hygiene, such as washing hands thoroughly and avoiding contaminated food and water, can reduce the risk of hepatitis A and E transmission.
3. Safe Sex and Needle UsePracticing safe sex and avoiding the sharing of needles or personal items that may come into contact with infected blood can prevent hepatitis B and C transmission.

Regular health check-ups and screening for hepatitis are essential, especially for individuals with risk factors or potential exposure to the virus. Early detection and timely medical intervention can make a significant difference in preventing the progression of acute hepatitis to chronic infection and reducing the risk of liver cancer.