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The term “hepatitis” means an inflammation of the liver. This inflammation may have viral (caused by a virus) or non-viral origins.

Non-viral Hepatitis

UNon-viral hepatitis is the often acute inflammation of the liver. It may be caused by exposure to medications, drugs, toxic substances or by an autoimmune disease.

Other causes are possible, such as contaminated food or water, certain mushrooms and chemical products including metals, solvents or pesticides. Non-viral hepatitis may lead to hepatic insufficiency. ¹

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Viral Hepatitis

Viral hepatitis is the inflammation of the liver caused by a virus. There are five viruses known to cause hepatitis, each one identified by a letter: A, B, C, D, and E. They were named in the order of their discovery. It is important to note that other viruses, such as herpes, can also lead to hepatitis.² The hepatitis viruses are each distinct in their modes of transmission, their risk of becoming chronic conditions, and the medications employed in preventing or treating them.

Viral hepatitis may be acute or chronic.

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Acute or chronic

Hepatitis C is an inflammation caused by the hepatitis C virus (HCV) that attacks liver cells, also called hepatocytes. It is generally asymptomatic and can be acute or chronic, depending on the duration of the infection.

The acute phase of infection manifests within six months of having contracted the virus. For 15-40% of cases, the body eliminates the virus on its own within the first six months after primo-infection (initial infection). This phenomenon is called spontaneous HCV clearance. People who have had acute hepatitis will retain anti-HCV antibodies for life, though they are non-viremic. The RNA of HCV is indetectable, so there is no risk of viral transmission.

Hepatitis C is chronic when the virus stays in the body for longer than six months following primo-infection; 60-85% of cases are chronic. Chronic hepatitis C is generally asymptomatic for many years (10, 20, and even 30 years).

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The liver

The liver functions 24 hours a day and serves more than 500 vital functions in the body such as:

• Cleaning blood: the liver metabolizes alcohol and other drugs and chemical products, neutralizing et destroying toxic substances;
• Regulating the body’s energy intake: the liver produces, stores and provides rapid energy (glucose) and produces, stores and distributes fats;
• Creating essential proteins for transporting substances in the bloodstream, for blood coagulation and for infection resistance;
• Regulating hormones, including sexual hormones and thyroid hormones, cortisone and other adrenal hormones;
• Regulation cholesterol: the liver produces and excretes cholesterol and also transforms cholesterol into other substances essential for the body;
• Regulating vitamins and essential minerals, including iron and copper.
• Producing bile, which eliminates toxic substances from the body and facilitates digestion.³

The liver possesses the ability to regenerate itself. It is for this reason that the illness caused by hepatitis C progresses slowly.

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History of the hepatitis C virus

In the 1970s, people began reporting cases of hepatitis that were associated with blood transfusions. The majority of these infections became chronic, despite being caused neither by the hepatitis A (HAV) or hepatitis B (HBV) viruses, nor any other source. This phenomenon was named hepatitis non-A, non-B (HNANB); it would be years before hepatitis C (HCV) was identified.

In 1989, Doctors Houghton, Choo, Weiner, Kuo, Overby and Granby discovered HCV. Following this discovery, a test was developed for detecting HCV antibodies. Blood testing greatly helped in preventing iatrogenic transmission. Later, polymerase chain reaction (PCR) testing technology made it possible to identify the virus’ RNA in its early stages (during the first acute phase of hepatitis C).

Strains of HCV are classed by six genotypes and numerous subtypes. In Canada, the genotype 1a is the most common.

In 2020, the Nobel prize in Physiology or Medicine was awarded to biochemist Michael Houghton and virologists Harvey J. Alter and Charles M. Rice for their discovery of the hepatitis C virus and other associated work.⁴

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References

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